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You may not believe that this is actually the title of a book, I Don't Know What To Say ... ... with sub-title of How To Help And Support Someone Who Is Dying. Written by Dr. Robert Buckman, a medical oncologist involved his life with terminally ill people, with contributions by Ms Ruth Gallop, a registered nurse and psychotherapist, and Rev. John Martin who is a hospital chaplain at a cancer center. This book is first published in 1988.
The book is structured into three main sections.
The First Section titled Talking and Listening, with three chapters: 1. Why Talk? Why Listen? 2. Sensitive Listening 3. Why You Need to Know What's Going On
The Second Section titled The Process of Dying, with 6 chapters: 4. The Transition 5. Facing the Threat 6. Being Ill 7. The Last Stage 8. Saying Good-bye: The Function of Grief 9. Spiritual Aspects
The Third Section titled Pacticalities, with 4 chapters: 10 Things Every Caregiver Should Do 11. Individual Relationships 12. AIDS and Dementing Diseases 13. Talking with Health Professionals
The first section is really the foundation of preparing ourselves to deal with the dying process. To start with, we need to be a good listener, a sensitive listener. It is also suggested that we shall get prepare ourselves, to learn what's really going on before we start the communication process. Ignorance sometime can hurt other people, especially those that you actually would like to help.
Then, the second section, it discussed some issues that arose from Elisabeth Kubler-Ross' Dying Process. It specially draw our attention to the fact that "all human beings are capable of experiencing several different emotions at the same time". It also discussed the feelings of the patients: shock and disbelief, fear and anxiety, anger and disappointment, guilt and blame, despair and depression, etc. What's important is how to manage the "the last stage", especially the feelings of the patients and the person who is trying to offer their help. No matter you are the dying one or the living ones but trying to taking care of the dying one, we need to address our own feelings carefully. The struggle of the feelings are not easy, and sometime it's just can go ups and downs, even a few times a day. Trying to take control of one's feeling is important but then it can also create tension both inside and outside. The key is on one's self awareness, i.e. knowing how much you can take and manage, and knowing how to release/relax yourself.
The third section is more on some supplementary topics and offered some practical advise.
There is no guarantee that you know what to say after reading this book, but it at least offered some good food for thoughts. It's indeed not easy to communicate with cancer patients, especially those who is very sensitive and surely difficult to handle. More, it's usually best if they themselves can help themselves in this process, as it's the most effective way of addressing this "end stage of life", or like the scholars suggested "the end stage of growth"!
It's a long awaited Saturday because the SUCCESS Chinese Help Lines staff and volunteers planned for a BBQ outing. Originally, the weather forecast was saying "cloudy with 40% chance rain", but starting the noon time, the rain, though soft and small, was kind of non-stop and make the front car window quite wet. It's very thoughtful that the organizer has planned a few tent for the location, and when I arrive there, they have started enjoying the hot-dogs, and I also see some deserts coming along way. It's only a pity that I did not wear appropriately for the location and I was feeling chilling inside. Therefore, I did not really stay for long. I chatted with only a few of the volunteers, took a few photos and have to apologize and left.
I hope you all understand that although the encounter was short, I felt very warm inside me as I haven't met you guys for long. It's good to shake hands and hug with you guys in order to feel my existence and also to show you physically that I am progressing well (except that my spine still hurt me even under pain control). No doubt that I shall continue to try my best to progress and yes please continue to provide me with all the prayers and best wishes! Thank you!
In the evening, after 6 months hard practices, Olivia's performance with Vancouver Academy of Dance (VAD) took place in Gateway Theater in Richmond. It's actually the second day of performance. The whole evening is packed with great performance, starting from a dance paying tribune to Michael Jackson (or simply put MJ), and then hip-hop, ballet, Jazz and Modern dance, Chinese dance, ball room dance and even acrobatic. The performers age from 2 and above and it's really an enjoyment to see them perform. It's also quite incredible that how Ms Annabel Ho has built VAD up and now in it's 15th anniversary. Great job!
The show wouldn't finish until the clock passed 11pm. This also means that I have been sitting for 4 hours and it's a kind of long record for me. I was feeling a little uncomfortable at the beginning, but then slowly I altered my position every now and then. This uncomfortable feeling can easily be off-set by the nice feeling of meeting up with old friends at the location. When I lied down at my bed finally by mid-night, I can almost hear my spine saying "thank you for relaxing me as I needed it badly"! All I can say to my spine, "Sorry about this, but you have brought me such a wonderful evening and thank you for that!" Hahahah!
There have been a few other things happened also yesterday. For example, the Blackhawks won the Flyers of 6 to 5 in the first game of Stanley Cup final. It was actually a very nice game to watch as both sides played very well and very close! Then, LA Lakers also won Phoenix Suns by 111 versus 103 in Game 6 of the Western Conference. The final now is set for LA Lakers versus Boston Celtics. Being the Canadian is not too happy as both the final teams for the Stanley Cup are from the US, while Steve Nash, who is the icon of Canadian basketball in US now lost and will not join the final. In sport, I guess it's more important to enjoy the game itself. Just like life, it may not go the way we want, but at least we can find our way to enjoy it (or merely to reduce our sufferings)!
It's such a wonderful day! Thank you everyone and wishing you all the best, and good health!
Using the local library searching engine, I exhausted it to find books with titles of "life" and it found a book called The Joy of LIFE - From growing up to growing old, a celebration of life's fun and wonder. It's a book filled with photographs and was edited and written by Philip B. Kunhardt Jr. and published in 1989.
In the opening, the editor said "Joy is contagious. It can spread like a forest fire, whipped by a high, hot wind. Joy can be shared in a crowd. Or it can be savored all alone. Joy can bellow. Or it can fall soft as a kitten's tread. Joy can excite. Or it can comfort. Joy can be sensuous. Or it can spring from the intellect. Joy can bewitch. Joy can be sweet. Or it can be zesty, euphoric, giddy. It can teach. It can heal. It can lay to rest old pain. In a world so darkened by suffering and uncertainty, joy can brighten our heavens and make life worth living all over again."
The book segregated in different chapters, and the first chapter, The Beginnings, it said "In the beginning there is darkness. Then, rising over the bleak lip of the moon comes Earth, aswirl with the water and the air that make life possible on our great blue planet. Rising too, out of the darkness of the womb, comes a new life. And with it comes new joy, new pain, new hopes and dreams, new mystery."
There are two photos attracted my attention.
It's description as: At the winter quarters of Ringling Brothers Barnum & Bailey Circus in Venice, Florida, student clowns are put through a yoga exercise called the "lion" to rid them of their inhibitions.
During World War II, in the summer of 1944, a 25-year old US tank gunner befriended a weeping 10-year old on the streets of te crumbling old Italian village of Passiano. He visited her home and met her family. Something about her haunted him and when he had to move on, George Fortin told little Nina Farano, "When you grow up, I'll come back and marry you and take you to America." At the end of the war George went back to work in a textile mill in New Bedford, Massachusetts, but he kept in touch with the Farano family and the little daughter with the "dark, lovely eyes" that he remembered from her Communion picture. After wooing the budding beauty by letter, George finally proposed and, now 31, he returned to Passiano and married his Nina, one day before her 17th birthday.
Wow! The Joy Of Life! Let's enjoy the joy of life ... and allow it to spread.
A good friend of mine, Eric, sent me this beautiful poem written by John Hall. Read it slowly and you will find some of the sentences/questions provoking, and it even sounds like a morning a prayer. And certainly, as the title of the poem suggested, you may also think deeply into it at the end of the day.
Did you win the day or lose it? Was it well or sorely spent? Did you leave a trail of kindness? Or a scar of discontent? ... ...
... And God will say "You have earned one more tomorrow, by the good you did today!"
+++++ +++++ ++++++ At A Day's End (By John Hall)
Is anybody happier
because you passed their way?
Does anyone remember
that you spoke to them today?
The day is almost over,
and its toiling time is through,
Is there anyone that will utter
a kind word about you?
Can you say tonight in parting,
with the day that's slipping fast,
that you helped a single person
of the many that you passed?
Is a single heart rejoicing
over what you did or said?
Does the one whose hopes were fading
now with courage look ahead?
Did you win the day or lose it?
Was it well or sorely spent?
Did you leave a trail of kindness,
or a scar of discontent?
As you close your eyes in slumber,
do you think that God will say,
"you have earned one more tomorrow
by the good you did today?"
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There is another one very similar text, listed inside a book of "Living Sparks of life" by Major Ernest N. Reeves printed in 1938 (in Page 82).
The Day's Work (By Anonymous)
Is anyone happier because you passed their way? Does anyone remember, that you spoke to him today? This day is almost over and it's tolling time is through, Is there anyone to utter, a kindly word to you?
Did you give a friend a greeting who come along? Or a cheerful sort of howdy, and vanished in the throng? Well you selfish, pure and simple as you rush along the way? Or did someone mighty grateful for a deed today?
Can you say in parting with the day that's slipping past, That you have helped a single person of the many you past? Is there a single heart rejoicing over what you said? Did a man whose hopes fading with courage look ahead?
[I went to Olivia's dancing rehearsal on Victoria Day (24/May) and I saw this leaf lying on the ground. The other fallen leaves appear more like rubbish, while this one gives me strong feeling of it's strength and will to live-on. Though I guess it also knows it's destiny, it's trying hard!]
The Richmond Review is a free of charge publication to every household in Richmond City. Usually, it's delivered to your door front. It comes with a lot of advertisement, sale and discount coupons. This morning at about 9:00am, when I opened the door and to pick up today's issue, I am so delighted to find the covering article "Facing Death, Matthew finds peace!" and the photo next to it, two thumbs up with the blue colored "Life-O-Life" T-shirt. (*I used to wear XL size, and now even with a M size I find it roomy! Hahahah!) Considering that the interview was only done this Tuesday, i.e. two days ago, with all the writing, editing and publishing tasks, having this article in my hands 9:00am this morning is like an impossible task, and yet made possible! Unbelievable efficiency!
Mr Matthew Hoekstra has done an excellent job in summarizing our dialogue and the key messages are carried very well. Ms Jennifer Gauthier's photos (the one on front page and another one on Page 3) are so beautiful. Thank you Matthew! Thank you Jennifer! And thank you for all the beautiful people/staff in Richmond Review to make this happen!
The objectives of this Blogger remains the same: To encourage open discussion on the end-of-life stage, and even better to enjoy the death and dying process. And to make friend with Cancer, to understand him/her, to live with him/her and to treat him/her well!
Being the readers of this Blogger, please participate in help promoting these ideas to those you may think appropriate and may be benefited from it. No matter how little step we take, it's done for the betterment of the community!
Again, thank you for providing me with all these positive energies and make my new voyage such an enjoyment! Thank you and let's continuous to work in this direction and make this community a better place to live in.
This book, titled "Living Time - Faith and Facts to Transform Your Cancer Journey" is an easy and straight forward read and I find most of the content very practical and useful. What make this book special is it's author, Dr. Bernadine Healy, is not only a pioneer and leading medical doctors in the field of cancer, she herself is a cancer survivor.
May be it's God's plan, may be it's just co-incidental, it's so dramatic that it was on the Valentine's Day in 1999 that Dr Healy was informed that she has a rare case of brain tumor. Like what she wrote in the book "Here I was in the prime of life, and fairly diligent about all the healthy habits I had preached so reverently for decades. Though a cardiologist by training, I had also earned my stripes in the war on cancer: I was then the dean of the College of Medicine and Public Health at Ohio State University, where I had been expanding the school's cancer genetics program. Years before, I had headed the Research Institute of the Cleveland Clinic Foundation, where I built it's first cancer biology department. And as director of the National Institute of Health in the early 1990s, I oversaw the National Cancer Institute and participated in its 1991 celebration of twenty years of the National Cancer Act, which brought us the war on cancer. ..." She further elaborated her feeling for the moment: "At that long moment of discovery, looking up into the sad, drawn face of my husband, I knew that all of our medical expertise combined would not help us cope with this numbing news. No matter who we are, from whatever background, we all feel the same chill upon hearing the C word. It's a universal fact: when serious illness strikes, we are the same vulnerable souls." The sarcastic face of the reality is a practical joke in reality, and it's a dark humor! A medical expert spending her whole life fighting cancer is now pronounced a death penalty of brain tumor.(*Hahahah! I am in tears!)
What I like about Dr Healy is that she promotes the idea that doctors are the servant of the patients and not "the Lord" of patients. Like the wisdom of Sir William Osler, one of the founding doctors of John Hopkins Hospital, said "From the standpoint of medicine as an art for the prevention and cure of disease, the man who translates the hieroglyphics of science into the plain language of healing is certainly more useful." And this surely will be a better world if all medical doctors can keep this in mind when they are talking to their patients.
Dr Healy provided also some useful tips in "Finding Your Way". She illustrated that "Cancer's path can be rocky, and each of us needs to find our own way in what is an intensely personal experience." and this includes: - Catch your breath - Control what you can - Stay constructive - Avoid the anger trap - Look for the humor - Insist on respect - Nourish your spirit
Like any other advises, some is easier said than done. Meantime, I do encourage us to start trying as without trying, it's doomed to fail (and will have the chance of success)!
After the long weekend, there is a little rain this morning just enough to wet the floor. A 6-feet tall handsome man arrived at my Home Care Unit sharp on time at 10:30am. He is Mr Matthew Hoekstra of Richmond Review. The whole dialogue took about 45 minutes and we have covered most subjects from my Blogger to the little known story of my elder sister, Angela, who passed away 22 years ago after a full year struggle with colon cancer. She died at the age of 25.
A little later, Richmond Review's photographer, Ms Jennifer Gauthier, with her full Nikon gear came at 11:30am and we took quite a few shots inside the house, and later on outside the house using the sky as the background, and as a tradition now, I am putting my two thumbs up, and the big smile!
Matthew said the article will probably be out this week. Keep in mind the Richmond Review is out usually Thursday and Saturday, so watch out for the article this week then. As of today, it's the fifteen thumbs up! And this number shall continue to grow.
Thank you Matthew, Jennifer and everyone supporting this Blogger. We certainly hope the community can be more open and receptive to "death and dying", as well as easier to "make friend with cancer". It's certainly an enjoyable to share all these wonderful thoughts with the Loved Ones, family and friends, and even friends of friends! Enjoy everyday!
China is one of the four ancient civilization and it's filled with wonderful publications which passed onto today! Among them is Tao Te Ching (also known as Dao De Jing) written by Lao Tzu (also known as Lao Zi) at about 500 B.C., or 2,500 years ago. As there are many different translation, today I used the Tarcher Cornerstones Editions translated by Jonathon Star.
Verse 22
"Surrender brings perfection"
The crooked become straight
The empty become full
The worn become new
Have little and gain much
Have much and be confused
So the Sage embraces the One
and becomes a model for the world
Without showing himself, he shines forth
Without promoting himself, he is distinguished
Without claiming reward, he gains endless merit
Without seeking glory, his glory endures
The Sage knows how to follow
so he comes to command
He does not compete
so no one under Heaven can compete with him
The anceint saying.
"Surrender brings perfection,"
is not just empty words
Truly, surrender brings perfection
and perfection brings the whole universe.
+++++ +++++ +++++
You may also interpret "surrender" as "let go" and in life, it's important that we know how to "let it go", "let things go", and "let life go" ... etc. Once we know how to surrender and let go, we will feel the internal peace, we will feel the unity between us and the universe, we will feel how insignificant we are and this unimportance will bring us a lot of relief and peace in mind!
The sunset picture above was taken by David C. a couple of years ago in Hawaii. Important is the words "Remember the moments of the past, look forwrd to the promise of the future, but most of all, celebrate the present for iti s precious ...". Thank you David C.!
A lot of things happened these two days and I am making good progress towards normalization of daily life. There are quite a few things that I have not done in the past three months, and quite a few things for the first time in the past three months, i.e. since the time when I was hospitalized and diagnosed with my cancer. It's both memorable as well as an indication of the improvement that I have made.
Last evening (22nd May, 2010) was Esther's Chinese Dance performance in Michael J. Fox Theater in Burnaby. It's organized by the Chen Ling's Dancing Academy, and standing in the middle is her teacher, Ms Zhang Jun. The show overall is a success and it's my first time to attend a public performance show, where I set for 3 hours. A record of my continuous sitting time. I also took a lot of photos and HD movies.
This morning, with the plan to normalize my daily life, Sunday breakfast gathering is set in a local restaurant and three other families joined to chit chat on various things. Although the gathering was short (about an hour as usual), the feeling was very nice and especially a step towards normalization. I zipped the "milk tea" (Hong Kong style) and it's nice although I have not tasted it for over three months!
Then, Esther, Leo, Olivia and myself attended the 12:00 noon Mass at our Parish. The 12:00 noon Mass usually are filled with not so many people and the atmosphere is quite relax. We met with a few friends and Parish goers, and both Father and Sister recognized me almost instantly and congratulated me on the progress I made, or at least I am able to attend church myself after 3 month's time. Thank you for all the prayers by our Parish families, I am so glad that at least today I am able to attend the church by myself and I shall continuous to work in this direction. Leo later collected the Parish photo album and it's really a joy reading those family photos inside the album. They are all very nice and well taken. It's an album and a record for the Parish, and it's filled with smiles, happiness and joy.
The Black Hawks (Chicago) won the Game 4 against the Sharks (San Jose) and entered the final of Stanley Cup. They are likely to meet with the Flyers (Philadelphia) unless miracles happens to the Canadiens (Montreal). Then later today will be the NBA Western Conference to watch how Lakers (Los Angeles) are going to perform today. Last but not least, the TV series LOST, being the Season Six and having the Finale (2.5 hours) this evening, it's going to be very enjoyable to watch and a certain kind of "lost" feeling afterward. Consider it's been six years that Leo and I have been watching this TV series, we developed a certain kind of feeling with them (the characters). Six years is a long time! Or at least six years is NOT a short period of time!
Life is so good and so enjoyable! Let's all live an enjoyable life!
My neighbour, the mother of a girl (7) and a boy (4) sent me below email. She has been fighting with cancer in the past 18 months and is still fighting. Her feeling is so true and touching that I am in tears every time I read this email, especially the treatment she got from her friend and family relatives, and the hard fate of her mother died when she was only six years old. In comparison to the challenges that she is facing and those I am facing, no doubt I need to appreciate that everything is relative and I am always more gifted than someone. Important is I am aware of this fact and see the positive side of all these life challenges.
Indeed, my neighbour, like you said, it's God's Will that we are living opposite to one another and being engaged now with the same friend Cancer. Your email is very encouraging to me and let's live strong my neighbour! With our prayers and God's blessing, no matter what tomorrow may hold for us, tomorrow will ONLY be a better day! Look at the Orchids that you have given us, they are so strong and so beautiful! The pleasure is really ours to have you and please drop by more often.
+++++ +++++ +++++
Dearest Matthew and Esther,
Thank you for sharing your blog Matthew, I cannot say that it didn’t’ bring tears to my eyes, as did the article of Matthew in the Metro News (on 27th April, 2010).
Your positive attitude and zest for life is inspirational. I battle daily the sadness and fatigue I feel from my cancer. I don’t’ like to be “sick” and I don’t’ like to look “sick”. For me it’s been an 18 month journey that has changed my life in ways I cannot measure, I have made friends that will remain life friends, I know who are my true friends, but I have also lost friendships and family relations due to my cancer. Perhaps they just can’t “handle” it and have chosen to separate their lives from their own fears of death and dying.
My husband and children have been the reason I don’t’ lie in bed all day long and feel sorry for myself. Although my children are young, their understanding of my disease has shaped them into empathetic and compassionate individuals although only 4 and 7 years old, something I don’t’ think that I could have taught them but has come from living with their mommy that once did almost everything for them, then being in sick in hospital a couple of times, it was especially hard on my son since he couldn’t sleep without me. My children have learned to nurture me, and understand that I am still there Mommy and I can’t carry my son around and sometimes last year I did not have the energy to read them a bedtime story. My son even at 3 years old would sing to me “hush little baby” song, and rub my back soothing me and in his own way trying to comfort me. My daughter who understands all too much, of death and dying, knows that I have lost my own mother, her grandmother when I was only 6 years old. When I was diagnosed and she was 5 years old, asking if I was going to die when she turned 6 like my mother (her grandmother) had died when I was just 6 years old.
It has been a long journey for me and in so many ways still a journey. Although the doctors cannot guarantee me to be cancer free, and I myself have a hard time calling myself a survivor, I know that I have many blessings to count. The chemo and hard part in finished for me, and I am starting to look “normal” again, yet feeling “normal” again will be a challenge.
I believe that it is God Will that we crossed the street to be “nosy” neighbours the other day. Something in my heart has not been feeling right for many weeks now, before we even saw the ambulance at your house that night.
We will pray for you Matthew and Esther that God will continue to grant you peace in your hearts, and perhaps a selfish prayer of a longer time on this earth.
Looking forward to having tea with you one day soon!
I am a big fan of Rabindranath Tagore and his works appeared in this Blogger two times already. The other day, when I was reserving my books with the local library, I decided to make a complete search for Tagore and a book titled "This World Is Beautiful!" came up and actually it's a (rare) collection of Tagore's works.
Inside this book, there is a poem I read the first time, and was written by Tagore in 1886 (age 26).
LIFE
This world is beautiful. I do not want to die.
I wish to live in the life of man,
and have a place in his living heart,
as in a sunbright flowerful garden.
Oh, the ceaseless ripple of life on earth,
the meetings and partings so happy and sad
With human joys and griefs I shall wreathe my song,
and live for ever in the deathless life of man.
If I fail, then may I have
a little place in your midst, my friends,
and make new songs at morn and eve,
like flowers that bloom to be culled by you.
Pick my flowers with a smile on your face,
and throw them away when they fade.
My friends, pick my flowers with a smile on your face, and throw them away when they fade!
The Canadian Cancer Statistic is a publication made possible by the Steering Committee which includes individuals from Canadian Cancer Society, the Public Health Agency of Canada (PHAC), Statistic Canada, the Canadian Council of Cancer Registries, as well as researchers in related organizations across the country. It has been an annual activity since 1987.
Being a Cancer Fellow myself, I find this report quite informative and it may provide us with some different perspective in looking at Cancer. Using this year's report, allow me to share some of my thoughts with you.
1) An estimated 173,800 new cases of cancer and 76,200 deaths in cancer will occur in Canada in 2010: In other words, if your doctor, like me, told you that you got cancer this year, you are ONLY one out of the 173,800 new cases of cancer. Some people like to describe having a cancer is like winning a lottery (say 6-49), by reading this number, you would immediately awake that this is overly exaggerated as there can't be 173,800 person winning a lottery in 2010! You may even start to see having a cancer is an ordinary thing. Then, on the 76,200 death in cancer, this is about 30% of total death (29% to be precise) in Canada. In other words, 3 out of 10 people will die of cancer in 2010. If anything to make you think you are unique, no doubt about that! If anything to make you think your death are unique, you may need to re-think again as if you are going to die because of cancer, in 2010, there are at least 76,200 other people will die of same reason, i.e. cancer. So, why bother about the uniqueness of your way of death. Rather, I would spend more time in improving my quality of life before my death! Keep in mind, I am still as unique as I am thinking about myself!
2) Different kind of cancer: In Page 13 & 14 of the report, you would see the classification of different type of cancers, for new cases as well as for death. It shows 24 different types. Lung, Colorectal, prostate and breast are among the highest, and they together accounted for >50% of cancer cases. Lung cancer remains the one with highest death rate. (*I am lung cancer Stage IV.) We need to pay special attention that all these 24 types of cancer are different, and their treatment methods and behavior are also different, some actually very different. For the general public who has not encountered cancer before, they thought cancer is cancer, but for those like myself, we would notice that even for Lung Cancer, there are sub-types, and the cancer cell types are different, some very different. Once again, the important point here is due their differences, the treatment approaches/methods are also different. We cannot see cancer as one cancer, and we need to deal with it as individual cases! For same reason, the sharing of one cancer patient with a different type of cancer may not be that useful as another cancer patient with a different type of cancer would have very different reaction to similar treatment, and sometime the information can be contradicting and even frustrating.
3) The End-Of-Life Services: It is good that this year's topic is on End-Of-Life services and it is rather clear that "services are inadequate to allow individuals to die at home when that is their preference, palliative care services are being used insufficiently and families bear substantial psychological and financial burdens". This shall provide our politicians, community policy makers, managers in related organizations, cancer patients and their families and friends, if all added up into a significant number as well as a big group of service users, to start working in this direction. Not only to provide appropriate services to those who needed most, but to expand and to educate the general public regarding death & dying and how to deal and manage the process of their End-Of-Life, to make it more meaningful and enjoyable, or at least less stressful. If any researchers who are interested in this subject, they may even be able to convert the above into a quantitative research and should not be difficult to find out that if we can transform this End-Of-Life process from destructive to constructive, from a suffering to a enjoyable process, then the community as a whole will benefit from it. It's a win-win-win scenario!
We are all going to die (one day sooner or later) and if we know how to make this End-Of-Life process enjoyable, we are not only helping ourselves, but helping EVERYONE!
You left a comment in yesterday's posting, and as you didn't provide me with your personal email address, allow me to reply you using today's posting, which other readers may also benefit from same.
First of all, may I seek your understanding that I am not in a position to provide you with any "medical advise". Although I am a semi-profession (with knowledge in the pharmaceutical side), I am not a medical professional and therefore should not provide any medical advise. In additional to this, without having assess to the complete file of your mother, I personally fear that any "medical advise" is irresponsible and should not be provided. Meantime, by reading your elaboration of the situation, I can sense the difficult dilemma that you are in. Please do take note that you are not alone, the dilemma that your mother and you are in are very similar to a lot of other cancer fellows, desperately seeking the best treatment approach for themselves. If I may offer my 2 cents worth of advise, and assuming if I were in your position, the following would be what I will do IF I were in your situation:
1) Communicate with your mom, respect her "gut feeling". Ask her whether she would prefer the western route of treatment, or if she is more comfortable with the Chinese way of treatment. What is important is that she would need to understand the "possible outcome" of each approach, i.e. in the case of Western approach, what would be the side effects and possible outcome of the chemotherapy, and in the case of Chinese approach, then it may take longer time and unproven track records of recovery, etc. In Canada, one more consideration is that if Chinese way of treatment is chosen, there is a financial burden attached to it, which can be higher than the western approach. The good thing is if the treatment approach is being chosen by your mom, then she shall laid confidence in the treatment approach and can possibly avoid her "blame or regret" in future.
2) If for whatever reason that your mom is too weak, too emotional unstable to choose among the two approaches, then you, possibly in consultation with your family members, e.g. your brothers and sisters, to jointly make a decision. Important is once the decision is made, try to go with either one of them. Betting on both of them can be a torture to the patient. I was told that there are Chinese Medicine Practitioners who are willing to work with patients undergoing western treatment. In this case, basically the Chinese treatment would become the "complementary" treatment approach, i.e. to support the western treatment approach, and focus mainly in reduction of side effects of western treatment.
3) Quality of Life: This is really something we need to focus on. As a cancer patient, everyday we have a lot of different challenges, especially on management of our pain and the side effects of the drug. But this really becomes our prime duty everyday.
For Pain Management: Good that your mom is now under morphine, and what's important is not to allow her to suffer from any pain. Repeat, the key objective of pain management is try NOT to have any pain. And once the pain is under control, and the dose of morphine (and time for taking the dose) becomes routine, than the quality of life would improve a lot (as the pain is no longer a threat to daily life). Some patients think bad about morphine, which is wrong, they should be allowed to take as much morphine as they feel like, and I am sure you are aware about the term "breakthrough" which allows the patient to take as much morphine whenever needed.
For the side effects of the drug, nowadays, it's good that most of these side effects are known, and I would assume the doctors or the nurses would have informed you regarding how to manage the side effects. What's important is those information provided is really general information and being a cancer patient ourselves, we should try to work on it and work out the best approach for our individual needs. Using constipation as an example, after using morphine, constipation is almost ascertained, but the important question is how should we manage this issue using the drugs (laxatives) available to us. Usually you would be prescribed with Sennosides, Lactulose and Docusate, they are there for different reasons. Sennosides is commonly use as laxatives, Lactulose is to allow more water in the poo-poo, while Docusate is to breakdown the poo-poo into small pieces. Depends on your mom's situation, usually taking Sennosides once in the morning and once in the evening, together with Lactulose once a day would be sufficient, but some people may need one more dose a day. However, some people may react better to Docusate but not reacting so well to Lactulose. Thus, some trial and error is required here. Don't get easily frustrated if the trial failed the very first time, be patient and work out the best approach, with the objective to improve the quality of life for yourself. Yes, it's for yourself. Imagine once you achieve the best balance, you would then back to your "good quality of life". For constipation, some exercises, e.g. contraction for the anus muscle, some leg movements and simply walking (to allow the abdominal cavity to move) are very useful. Of course, it would be good if it can be assisted by diet input, e.g. eating food with higher fibre content.
Likewise, for sleeping problem and lack of appetite, all these issues can be worked out, closely with your mom. If she can take the lead, it would be the best. She is incharge of her life and she should continue doing so. Having a positive attitude is really the first step of a good recovery!
I will try to address some other issues in my future posting, but John, your mom's emotional state is the most important part, once she is strong emotionally, the other issues would be easier to deal with.
Yours, Matthew
[This picture is sent by David C. Per David, this photo was taken 38,000 feet and it was a sun rise. The words were added by David's friend.]
There's an article in the recent issue of Canadian Business (Volume 83, Issue 8, 11-24 May, 2010) titled Dead Set Against It? "Death Bonds" are a macabre business. But is sound moral judgment or a bad rapy keeping them out of Canada? written by Greg Hudson.
As the article suggested: "Death Bond" might sound like the title of a Charles Bronson moive, but in fact, it's the name of a legitimate financial product in the U.S. and pockets of Canada, other referred to more euphemistically as a "life settlement." Depending on who you ask, the idea of a secondary life insurance market is either a godsend in troubled times or another example of the grotesque depths to which people will stoop to make a buck.
The idea is to allow life insurance policy owner to sell forward (i.e. to sell the policy to someone before his/her own death) so that he/she can have the cash (again before his/her own death) for whatever reason. Of course, everything comes with a cost and sometime can make things more complicated as the beneficiary in this case will clearly be different than the one originally assigned. On the other hand, I personally see a clear advantage of this "selling forward" is that the policy owner can actually enjoy his/her own policy, be it for a stressful financial reason, be it for a selfish life enjoyment expenditure item.
I would actually urge the government to work with the insurance industry to make this "Death Bonds" or "Life Settlement" policy more transparent and more favorable/fair to the consumers. The situation is like death today, the general public and community members are reluctant to openly discuss these topic, as a result, this "business" is kept within a small group of people. You can imagine that the less people know, the less knowledge they acquired and therefore the worse position they are in to protect/achieve for themselves. Imagine that if a consumer can gain 10-20% more cash value in selling their life insurance policy forward, assuming for a U$500,000 policy, it is like a positive gain of U$50,000 to U$100,000. Wow! A lot of things can be done with this amount of money.
I was a very naughty boy. I never sit still, always running around and have a lot of different activities. I love playing soccer, basketball, badminton, table tennis, and you name it. When I was older and at my teenage, I started to enjoy learning photography, model making (mainly the Japanese pre-fabricated plastic models but they are very expensive stuff), and I also enjoyed Chinese Calligraphy. And possibly due to my interests in Chinese Calligraphy, I also enjoyed reading a lot of Chinese history as well as reading a lot of Chinese literature and old poems. (We even entered into competition in who could memorize the most old poems from Tang Dynasty.) It's all fun!
Having a hobby or more than one hobby, in my opinion, is very important! Hobby is a mental regulator and more effective than any medication can achieve for you. I still remember there were time when I was working under very high pressure. I often went home after work, very focused and very concentrated, practicing my Chinese Calligraphy for about 15-20 minutes, possibly with some light music on, and at the end, I would feel very relaxed and almost like refreshed. Most of my work pressure would be released and seldom I would have sleeping issue. A lot of people liked my Chinese Calligraphy, yet a few of them criticize me quite seriously. But for me, to tell the truth, I don't really care how the others are viewing my works. To me, Chinese Calligraphy is my hobby, a very personalized hobby that I can enjoy it on my own. Some people try to compare my works with the established houses of great works, for me, it's my own enjoyment and I am more interested in feeling my own feeling, i.e. when I was doing my works, how would I feel. I try to keep my mind focus and clear and usually I would also feel great inside, the peacefulness, and especially the feeling of me, the brush, the paper, the ink and the works being all together in one place at the same time, which I call it "the unity of the moment"!
No matter who you are, I encourage you to develop a hobby for yourself. It really doesn't matter what you do, be it art and craft, or anything else that you enjoy doing. Something that can allow you to focus and concentrate, and again, not something that you are good at and not something that you would like to enter competition with others.
Although I don't have much spare time these days, as I need a lot of time resting and relaxing. I still keep some of my hobbies alive and I really enjoy doing them. Enjoy and have fun!
Almost on a daily basis, I would like to work on some improvements. No matter how small is the improvements, I would just dream up something (from no where) and then trying to get it done, or better worded as "achieved" or "achievement", which really sounds great!
The improvement (or achievement) can really be anything else. For example, walk 10 more minutes, get out of the house, or merely go to the library or supermarket, etc. All simple and doable tasks, but once it's done can make you feel good.
Esther has been cooking all the meals in the past three months since I fall sick. Even the best cook on earth can run out of ideas about what to cook, especially when I am at very strict diet control. Olivia had her dancing practice until 8:00pm. So instead of eating at home, which the logistic can be clumsy, we decided to dine out. The very first dinner outside of the house in the past three months. By the time we arrived at the restaurant, it's already 8:30pm and not many people there. But for those that were there, they spotted me immediately as my face does not look normal. One of the young boys, around 6 years old, was looking at me and then asked his mom "What happened to his (my) face?" I actually would very much like to answer his question, especially I don't think his mother knew the correct answer for my case.
Three of us shared three dishes. The strategy of dining out is always order those dishes that you are unable to make at home. So here we are, enjoying our dinner which of three dishes that we don't cook at home.
It's the companion, the atmosphere, the content of the dialogues and certainly the foods as well that make this dinner memorable. Although the spine was having some stretched feeling (due to long time sitting), overall the feeling is fine and I think I can manage sitting for longer.
When did you invite your Love Ones out for dinner last time? Consider to invite them, or him/her to go out for a dinner with you. There are no need for a specific purpose, but just a time to enjoy being together.
The weather this week is so so beautiful which I don't think anyone would have the slightest complaint. It's only that due to skin rash, I am advised not to go out during mid day to avoid the exposure to UV lights which I am more than happy to adhere to. The air in the morning is very fresh. It's so fresh that as soon as you inhale, you actually feel the oxygen inside your lung was transferring to your other body parts through the blood stream. I am not exaggerating and you have to go out and try it for yourself. Yes, go out and try it for yourself!
Today is Saturday (weekend) and I am not sure if it's a good idea to talk about this serious topic. I borrowed a book from the local library called "A Better Way of Dying" and subtitled as "How to make the best choices at the end of the life". This book is written by two sisters, one is a lawyer (Eileen Fitzpatrick) and the other one is a medical doctor (Jeanne Fitzpatrick).
The book's subject is about the Contract of Compassionate Care. It lets you choose what medical treatment you want or don't want at the end of your life. It gives you the option to choose a natural death. The authors placed high emphasis on the communication process and believes that Compassion Protocol opens a dialogue between you and your family, friends and health care professionals regarding your end-of-life care. Keep in mind, this dialogue is usually absent in our society, or more accurately rephrased that it is purposely avoided.
"The option to choose a natural death" is a controversial topic. It involves debate of various legal, social, ethical and religious issues. In early March, when I showed the MRI report of my spine and skeletal bones to an Oncologist, seeking his second opinion. He came back with a short email "Your report is not good and I suggest you immediately prepare your personal matters, e.g. your will." Hahahah! I was expecting a second opinion in how to go forward, and rather than dealing with medical issues, it seems to me he believes legal issues are more important and this leads me to believe that my (biological) situation must be pretty bad! Then, I find an appropriate time to talk to Esther (and later with Leo) regarding my will. I told them if at any point of time (in future) that I am so sick that I am unconscious and need to rely on medical instruments to prolong my existence but gain no quality of life, they would have to allow me to leave and instruct the medical professionals to stop using all those medical instruments. I also make them understand that it is MY decision, and not their decision, and they should have no emotional burden as they simply follow my instruction to act accordingly. I also informed them regarding the donation of my body organs.
Indeed I have seen a few struggles by families when their Loved ones were dying and fell unconscious. The picture is so sad that you see tubes and medical instruments are attached everywhere to an unconscious human body which lacks the ability to provide you with a normal feedback, e.g. a blink of the eye. Often, a simple cough, or a bad facial expression, brings anxiety and gives their family and friends the wrong impression that he/she must be suffering in their dying bed. A lot of scientific journals would argue that although a person fall unconscious, their six senses actually still working! Anyway, I am more looking at "quality of life" and if the prolonged period of stay is a torture to my family and friends, and especially to my Loved Ones, then I prefer to cut this suffering short and keep it a pretty process. As you all would agree, it's not the length that it matters, it's the quality that matters!
Since yesterday's posting regarding the side effect "skin rash", I am touched by some of the readers courtesy and care and it seems that they would like to know more about the side effects (especially if I am suppressing some of the side effects purposely using my positive attitude) and how I am working with the side effects so other fellows can also draw reference to it.
First, I will not suppress myself in mentioning any of the side effects using my positive attitude. In fact, the side effects were not mentioned because simply it doesn't really bother me. Now that you have asked, may be I should elaborate a little more, especially in the sharing of how I deal with these side effects.
The skin rash is really the main side effects that you may expect after taking the Tarceva. In my case, the skin rash didn't start until the 6th day mark. But when it comes, it comes really fast. This I mean, in the morning, you only see a few round flat brownish spot around your neck, in the middle of the day, the numbers of spots grow fast and at the evening, you face, neck and upper body has been filled with all these spots. Then, the second morning when you get up, you see a lot of tiny bubbles surrounding your nose, mouth, and even underneath your hair (back of the skull) and they are all itchy. The appearance of the skin rash certainly is not good, but for me, I don't really need to meet with people. All I need to do is to keep the hygiene of it. Carefully and gently wash my face and neck with clean water and try not to rub and hurt the bubbles which will cause bleeding easily. In case you may need it, you can consider to apply some mild lotion, or some moisturizer. On the itchy feeling, I tend to use "mind control". It may sound hard for some people. Basically, I try not to allow my brain to have the itchy feeling of my face. I try to focus my mind in other, usually more important, stuff. If it's so difficult that you cannot stand the itchy feeling, then I will consider to use some cold water to wash my face, or simply use my hand to press on my face, rather than scratching it, I just laid my hand on the face and allow the feeling between the hand and the face to overcome the itchy feeling.
There are surely some other approaches that can also help reducing side effects. Important is it works for you. I shall try to touch on this subject again in future postings! If you have something to share with us, please also feel free to do so. We all learn from each other!
Be warned that today's photograph (at the bottom) may not be suitable for all viewers, as it shows my skin rash this morning. Rather than using hundreds of words in describing something, I often find a photograph can do a lot better job and you would immediately have a feel what it is like. Case-In-Point, the skin rash is an good example!
Everything has a side effect! Side effect(s) also come with how much quantity you take for a short period of time. It's only common sense that the higher quantity is taken within a short period of time, the side effect will usually be more. Drug safety is of prime importance, and authority, such as FDA in US, they treat drug safety issue much higher than the effectiveness of the drug. In the history of drug approvals, it's very easy to find that a lot of disapproved drugs were due to some unexplained side effects and ceased to proceed with their clinical trials (or approval process). Of course, if the side effects can be explained and are known to researchers, then the drug will be allowed to proceed with their approval process and usually to be approved together with it's known side effects. Also for same reason, you may read in the Drug Information Sheet (also known as Packing Insert) a long list of side effects, even those side effects which rarely take place.
If it's the first time you read about the long list of side effects, some time it can be scary. Yesterday, I was talking to a cancer fellow, she was very concerned regarding the side effects that she is going to get from her chemotherapy. She is concerned about the vomiting, the constipation and the dizziness. She said she can survive the surgery, but she doesn't think she can survive the side effects of the chemotherapy in the next 6 months. She developed some anxiety and requested the doctor to prescribe her the anti-anxiety drug, which is going to give her another side effect! What can I tell her to ease her mind?
My approach is rather straight forward: In the education session, the nurse will provide us with various information before the chemotherapy treatment. It is very detailed and including all the drugs and their side effects. They also provide you with suggestions on how to deal with the side effects. Using vomiting as an example, it's very common that chemotherapy drug will cause vomiting, then Ondansetron (Zofran) will be prescribed as an anti-vomiting agent for you to take before and after the chemotherapy. However, the side effects of this anti-vomiting drug is constipation, which is actually very annoying especially for elderly people who is already suffering from daily constipation. In this case, I will try to find the balance. First, I will be very sensitive on how I am doing on my vomiting, if it's not too bad, I stop taking Ondansetron. If the vomiting continue and I cannot stand, or it's better off to have the Ondansetron, then I will try to work on the constipation through careful trial of various laxatives, i.e. using Sennosides, Lactulose and Docusate, plus diet intake and anus muscle exercise and find out the best and workable approach for me. (*Please take special note that there are various kinds of laxatives and they all work differently and exist for a different purpose.) Most important of all, you must try to keep an "easy mind" as if you are upset by your own situation, your mood tend to go down and this will not help you one way or another. Right the reverse, if you have a positive mindset, you see the issue positively and try to work for the solution, at the end, ONLY YOU are going to be benefit from it, isn't it? Talking to someone with experience also help, i.e. join the support group and see what other cancer fellows can offer you.
One common side effects of Tarceva is skin rash and I am very well informed and prepared for it. In fact, when the skin rash didn't come in the first few days, I was concerned that my body did not respond well to the drug. Hahahah! (*See ... side effects can also be an indicator of the response rate of your body!) Now that I have the skin rash, it's important that I have to take care of it.
It's okay to have side effects. They are expected and it also showed that your body is reacting normally!
This second picture was taken yesterday (15th April,, 2010), and you may observe that the skin is peeling off.
Last evening, it was Game 6 of Second Play-Off between Vancouver Canucks and Chicago Blackhawks. The first 20 minutes were going fine, but then starting the second period, like they said, the game was unbearable to watch! I even felt Luongo's heart aching when Versteeg scored only 36 seconds after Brouwer's first score of the evening. History seems to repeat itself, as vividly remembered in last year, Canucks exactly lost to Blackhawks also in the Play-Off. There must be something that we can learn and there must be something we can improve. This season is now done for Canucks, if the management of Canucks is serious about making improvement in the team's performance, they really need to think critically how to assign their resources. They have some of the highest paid players in NHL but yet everyone (including the CEO of Canucks) has difficulty in finding values in them, while there are quite a few younger players which were not provided of opportunity to grow and mature. At the end, the name of the game is about allocation of limited resources and maximization of efficiency and effectiveness!
Just like the weeds in your garden. They are very clever plants. They grow well on the surface of the soil. They grow very fast and usually can reproduce themselves within a very short span of time. They grow in any space that they can find and they can rely on very limited water and sunshine. On the other hand, the traditional plants were not as efficient as they are and rely heavily on you, the gardener, to help protect them, as it is clear that the weeds compete consuming the same nutrients as your plants, the plants that you would like to see them grow and prosper.
The weeds in my garden grow so well and strong, the stems are 2-3cm in diameter (no kidding as you can see from the photo) and about 2 to 2.5 feet tall. After the walk this morning, without a second thought, I decided to take out those big and strong weeds (and there are a lot of smaller weeds still in existence).
We need to seek improvement everyday and we shall not hesitate in making changes, as well decision shall come naturally and promptly. Risks (and costs) are always there attached to a decision, but some of the decisions are so obvious that you will never regret making them! Like taking out the weeds from your life ... just take them out and you will be fine! Hahahah!
The weather this morning, like in past three days, is so charming and blissful. It's a day good for anything. No matter what you are planning to do will only be enjoyable one way or another. For me, having an interview at home is a good idea. By 10:30am, Ms Maggie Li of Fairchild Radio FM96.1 (Mandarin) is with me at the Home Care Unit, together with Esther.
The interview started without us notice it. Maggie is very well prepared. We talk about everything in free style and then towards the end, the questions are more structured, like Q & A. The whole interview took about an hour to accomplish. It was a very relax and enjoyable process. It's more like talking to a good friend.
Maggie will need to do some editing that this interview will likely be aired next Tuesday (18th May, 2010) at 10:20pm. And it will last for about half an hour. If you are living in Vancouver, you may simply turn on the radio and listen. However, if you are living outside of Vancouver, you may consider to log on to the www.fm961.com and listen to it's LIVE broadcast.
Today, we have twelve thumbs up, and let's continue in this avenue and slowly we are going to get more and more thumbs up! Thank you Maggie, thank you colleagues and friends, thank you for everyone who supported this Blogger! Again, please also help spread the ideas!
Vancouver Canucks is entering Game 6 of Second Play-Off tomorrow. After yesterday's 4 - 1 result which, like they say, kind of expected and kind of of unexpected. Chicago Blackhawks were playing not too bad but something just didn't happen as in Game 3 & 4. Anyway, now of Chicago Blackhawks leading 3 - 2 games, Canucks can only win tomorrow to stay in the game. It will take place in Vancouver GM Place. Luongo must remember to shave again! (*As he joked about himself in Game 5 that "If he didn't shave yesterday, he doesn't know if he would have been able to pull it off out there!") Repeat, he said "shave" and not "save"! Hahahah!
My sweats at night has improved as it doesn't really bother me when the sky shines again. What I am saying is there are sweats, but it's not that much and it's well tolerated. However, the sweats still come when I did not really expected them. For example, when I just sitting, or when I was trying to eat. First there are some uncomfortable signals sending usually from my back (middle to lower back) and pre-warning me that my back is not feeling good, and then usually a few minutes later, if I don't do anything on the signal, then the sweats will come, and some time the sweats can come faster, i.e. the uncomfortable feelings come and followed immediately by the sweats. I still don't have very solid evidence for it, my observation is that the sweats have something to do with the "pain" that I am having, especially my back pain. Keep in mind that I continue to research in the internet as well as talking to professional medical people and fellow cancer survivors. Some of the cancer fellows shared that as soon as their cancer is in recovery, their sweats situation also improved.
To combine the above two situations together: I don't feel comfortable of where Canucks is in now, neither am I feel comfortable with the sweats situation. Meantime, important is if we have tried our best and if there are anything else we are able to do (or able to try). I choose to continue to listen to my body and pay very detailed attention to his signals. Meantime, I now have a positive attitude towards sweats. The thinking goes like this: The body fighting, generated some activities and may even generated some pain in the process, thus, the sweats come out. The sweats come out in order to give the owner of the body, i.e. me, an important signal that he is fighting (and sweats), and it is also obvious that I, as the bigger body, need to support him more. So, now, whenever I got the message from the body regarding the sweats, I will make a decision of how to proceed to the next activities, or simply just lie down and let the body just relax and take care of itself. Either way, the sweats will slow down and finally stop (after a while). It's not a new trick, it's still "listen to your body" and "make the right decision on what to do next"!
"Go Canucks Go!" "Go Matthew Go!"
Uncomfortable feelings can also be described as "Crabs in boiling water!" and the recent uncomfortable sweats (and also the situation now Canucks is in) reminded me the Alaskan Crabs. You simply need to put them inside boiling water until it's cooked, and dip them with any kind of sauce that you prefer, or sometime simply some ordinary salt or soya sauce, and it's already one of the best dish that you can taste in life!
It took three months' organization work. All initiated by the young ladies (the daughters) of the 6 families and supportive work by their parents. Life-O-Life Team 2010 joined the Mini Sun Run 2.5K today, which is affiliated to the Vancouver Sun Run annual event. They have their own uniform. In the front it is the Team's name Life-O-Life, and in the back of the T-shirt it says "I'm ready for my journey!" The idea is to promote health and life!
The weather and temperature is perfect today for Team Life-O-Life's first outdoor activity. Though Sunday, and despite what was the sleeping hours last evening, everyone needed to get up by 6am this morning in order to leave home by 6:45am - 7:00am, arriving at the Concord Place by 7:30am ready to get started by 8:00am, i.e. the official starting time. And before anything happen, a photographic section is important to bookmark such a memorable and important first event of Team Life-O-Life.
A few thousands people gathered at the Starting Line and the Mini Sun Run started. You see parents with the kids, young adults with their elderly, you also see couples walking in pair hand-in-hand, and disabled in wheelchairs and different groups of people and individuals in different and interesting fittings.
You can see people run, you can see people walking, but you can also see people pretending running (i.e. their upper body with hands in running motion, while their lower body in walking motion). But it's more important to participate as no one really pay attention to the time. The whole journey would take about 30 minutes, before you recognized, you are already in the finished line.
Three gentlemen, David Gan, Ron Kwan and Leo Chan have registered for the Vancouver Sun Run and therefore, they would need to walk from where they just finished to the starting line of Vancouver Sun Run in Georgie Street. All the three gentlemen managed the race quite well. They all said the journey was very enjoyable though there were really a lot of people surrounding them.
Well done Team Life-O-Life, keep up the good work! Health and life are indeed both important and we must try our best effort to preserve and enjoy both!
N.B. A few friends and readers asked about the purchase of the Team Life-O-Life T-shirt. Regret to let you know that this is only a limited and once in supply for those participated this time (and was not opened to public). However, if there are future events that may require additional T-shirts to be printed, then the young ladies said they will consider to open for others to place order. Until then, Team Life-O-Life T-shirt will remain an "invaluable" item!
There are quite a few good reasons for immigration to Canada. Most of the families that I know of, they put their children education on the highest. Then, living quality, such as a 800 square feet 3-rooms apartment in Hong Kong in exchange of a 2,500 square feet 5 bedrooms house (and with a good size lawn) in Richmond usually would come second. Then, it will be quality time together with the family members, air and environmental super quality versus Hong Kong's continuous struggle for a blue sky and clean air. Often, I also heard people saying although workload is high in Vancouver, it is good that they do respect their holidays and long weekends and make work and your private life very easy to segregate.
The downside, usually in the difficulties of getting a job for the man and it's a luxury item to have a maid/helper at home in Vancouver, unlike everyone gets one in Hong Kong, while the children grew up actually talking in Philippino-English. It is also clear that you cannot be rich if you rely on a local job and local income as the living standards are actually high in Vancouver, especially assuming you have two growing up kids still in their studies.
There are always good and bad in life and everything is up to us to define, as it is our own life that we are living through. I personally see a lot of interesting events around in Vancouver, especially these events have a clear connection with the Mother Nature. One of the events, tomorrow, is once a year event of Vancouver Sun Run, and it's quite an experience. It's actually one of the most attended 10K run in North America, certainly in western Canada. You will experience 55,000 people running together, all the way from Georgia Street downtown, touching Stanley Park and continue into Beach Avenue, through Burrard Bridge and entering into the other side of Vancouver until you take the Cambie Bridge again and finished off at GM Place (yes, where Canucks play). If you take it leisurely, it's about an hour to an hour and a half to finish. There are so many activities going on that morning and you won't feel anything before you finished. The whole 10K is almost filled with drinks, music and cheering people along two sides of the road, and surrounding you will be those half running or walking individuals trying to catch up their breath and enjoy the rest of the run.
It's quite an experience in life and I strongly recommend that you should try it, more for fun than for health in this case. You will not regret this decision!
[This picture was taken back in April 2008. Leo joined me as it's my birthday present, since then, he and I did not stop running, except this year that he will continue to run but I will take a rest. But I shall return ... at least I will try to return!]
[This is my number in 2010 together with it's T-shirt.]
Today is my fourth day on the new drug Tarceva. Yesterday I felt some stress on my right kidney and also the left chest (attached to the skeletal ribs and muscles). Then, in different times of the day, when I was resting in bed, sitting, and especially when I was eating, I had a lot of sweats. The sweats just come out without any pre-warning. Like what I described yesterday, the sweats were more like dripping of water and made everything it passed soaking wet. The blood pressure was checked during those times and they were usually okay (low 70-80 to high 105-115 range), while the heart beat rate usually on the slightly high side, i.e. >90 or even >100. Body temperature would be normal 36.3'C to 37.8'C. Then, 5:30am this morning, I woke up with whole body wet, from head to toe, from front to back! Everything was wet ... wet with sweats!
As I got this "sweating" issue for almost two months now, which I also reported to the doctors in BCCA, so far, all can be said is "You situation is unusual! The sweats are probably cancer related, and it may not be a bad thing!" Do you understand this comment? Or if this comment bring you any "useful information"? I also checked through the internet and through various professional websites, the National Cancer Research Institute in US and similar one in UK provided some good food for thoughts, but mostly it's pointing to the direction of hormonal related, especially in breast cancer and prostate cancer. In my case, I am lung cancer and migrated to spine and other organs (unless it is a signal that my cancer migrated to some hormonal organs).
No matter how advance our medical sciences are today! There are always something that we cannot comprehend (and thus no firm conclusion to be drawn). We must also understand that each individual is indeed different, their body system as a whole is similar to one another, but yet they are different as an individual and obviously, different individual reacts differently to both inside and outside factors.
What's important (or even critical some time) is that we need to take good care of our body. We need to respect our body, listen carefully to him/her. A few days ago, in my Facebook wall, I wrote: "Your body has been working for you all these years, when did you thank him/her?" More often than not, we take it for granted that our body is part of us and we did not even want to pay attention to her/him. Or usually until it's too late then a more drastic signal to be sent, e.g. cancer, stroke, heart failure, etc. Then, like they say, it will be "a little too late"!
Everyday, take a moment to communicate with your body and try to listen to your body, especially if there are anything that you may need to do for your body. Serious problem usually starts and comes from simple and minor indications. Like a lot of disasters in human history, if we are careful enough and pay sufficient attention to the little signals that we were provided, disasters can be avoided and many lives and Mother Nature can be saved!
