It never rains but pours

Just as I thought I could lead at least a more a normal life again with the medication, waking up early, doing stretching exercise and even a brief jog around the neighbourhood, just when I am eating quite ok, I had a gastric attack. A long time since I last had one.

What exactly did I not do or have I done wrong? I exercised, I eat regular meals, I avoid spicy and oily food, I started to take Yakult...

Upon recollection, then I realised what I had done. I had missed tea-break cos the bread I bought was kinda spoilt. So I ate CNY goodies instead to fill the hunger pangs. At home, it was dinner as usual and I took just a teeny weeny bit of archar that my neighbour had made for us. The next morning, I woke up early, did my warm up exercise, then a short jog and it was then that the gastric attack began after the jog. So I took a few mouthfuls of bread before going to the polyclinic for the medication.

Ended up queuing for 2.5hrs to see the doctor to confirm that I can still take the TB medication. According to her, the medication is not supposed to cause gastric pain. To play safe, I took the medication after my porridge lunch. It came again...and I had no choice but to take the syrup that the doctor gave to ease the gastric discomfort.

I should not have exercised without breakfast thou that was my usual routine. I should have taken a proper tea-break instead of the CNY goodies which probably have caused the discomfort. I shouldn't have taken the archar...gosh...why am I so weak?

One of my colleagues said I had too many inhibitions and am like a protected flower that can't weather harsh conditions. Indeed. If I could turn back the clock, I would never never take cold drinks every morning. I would never ever finish a can of coke when I was young. I would not take ice-cream or cold drinks during recess. With my current weak constitution, I have no choice but to be extra careful.

So if you have young children, as far as possible, keep them away from cold drinks until they are much older.

Sometimes I do wish that I would never wake up from my sleep. Of course life isn't that bad if compared to those who are struggling, but it's still a long, weary and in fact, torturous process for me. Imagine having to struggle to eat despite feeling nauseous. I envy those who can eat despite feeling unwell, those who binge whenever they are stress. To put on 1kg for me is like asking someone to reduce 10kg; and to lost 1 kg all it takes is eating a few mouthfuls of breakfast and lunch.

I'm tired. I tried so hard to put on weight but somehow some thing will happen and I'd be back to square 1. If I'm really fated to be of this weight so be it. But don't make it so torturous for me to lose appetite and make each day a drag to go on.

Anyone can share any miracle recipe to cure the gastritis and improve my appetite? Or at least get my appetite back?

I don't swallow

The new nurse was intrigued by this little useful tool I've brought along with me since the day I've started medication at the polyclinic.

Bought from Guardian a few years back, it has been a very useful tool for people who can't master the skill of pill swallowing.

It has 3 functions - it grinds (pic 1), cuts (pic 2) and stores pills (pic 3). It's amazing how a simple action of twisting this little tool, a pill can turn into the powder form quite easily. And I'm very grateful to the person who has invented this little useful tool. Otherwise, I'd be carrying a mortar everyday to the treatment room.

Because of the numbness of my right leg, I was given additional pills to counteract the side effect. Fortunately it was the tiny vit B pills and not the yucky white pills.

2 months......I wish it could be over with a blink of an eye.
Would be going for a review this Thurs at this little TB Centre located near Novena...still holding on to that liiiiiitle glimpse of hope that it could be a wrong diagnosis......

一路的思绪

我， 病了。
世界还 在旋转，而我的步伐
放 慢 了。

想了很多， 听了很多，
反思了很多， 也体会了许多。

害怕，恐惧，焦虑，担忧
失望，感伤，无奈，接受

过程中有许多感触。
看到了家人的爱与关怀， 是无私， 无条件的。
明白了朋友的鼓励与慰问，不是理所当然的。

无声的责怪，厌烦，懊恼,恐惧...
我了解.
我还在学习如何放得下，看得开。

走着，走着，
复杂的思绪随着慢慢的脚步逐渐清晰了。
原来自己其实也可以安慰自己。
回家的路，虽然自己走, 但还是开心的。

Medication time...

It’s been 3 days since the diagnosis. The news is still taking time to sink in. I do feel depress occasionally and having mixed emotions. And I’m still holding on to the slimmest chance of a wrong diagnosis.

Maybe I’d receive the good news 2 weeks later from the doctor that it is actually not TB. The skin test result isn’t a 100% indication as a person with low immunity would also have a skin reaction. The doctors may have made a mistake in observing the x-ray film and that the little spots are actually scars which could be an indication that my antibodies have won a TB war much earlier. My sputum test is negative so far.

Though non life-threatening (provided I obediently and conscientiously take the medication), having to go through a 6-month treatment sounds a long time to me. I’ve to report to the polyclinic daily to take my medication under the supervision of a nurse for the next 2 months daily. For Sun and PH, medication will be packed for me to take from home. It’s tedious, especially to a non-pill swallower like me, it’s tough having to take 7 pills everyday. I don’t blame such a system as I know there will be people out there who will ‘default’ taking their medication which would cause the bacteria to become resistant to the medication and new medicines have to be taken for a longer period of time with more side effects with a lower chance of cure. Worse, the person might also spread the drug-resistant TB to others.

Fortunately, the nurses at the polyclinic have been helpful and patient. My first medication took place at the TB Centre. The social medical worker helped me pound all the medicine into powder form which I estimated it to amount to 3 tablespoonfuls. You can imagine the taste of the concoction. If only someone would try to make all medicines taste better, then patients at least would be more willing to take them.

Day 2, I took about half an hour to finish. The nurse helped to cut the pills up whilst I cut them smaller with my pill cutter. Still it took 2 glasses of water and several attempts to get those smaller pieces of pills down. The bitter aftertaste lingers…

Today, I strategized by grinding them into powder one at a time instead of mixing all up. It sped up the process a little with less aftertaste. I’d feel a little lethargy after medication and am experiencing numbness on my left leg which I’ll have to alert the doc of this side effect if it continues. No alcohol and TCM for me now as the medication might affect the liver. Well to lighten things up, my pj now is like Fanta Orange, due to one of the pills I’m taking.

Looking forward to the end of 2 weeks so I can be back at work, and looking forward to 14 Mar – the end of the daily torture. After which, I would only be required to go for medication on a thrice a week basis for the next 4 mths and hopefully, with fewer medication.

I suppose when I get back to office, probably some colleagues might feel uncomfortable of my presence. Can’t really blame them for I too had the stigma when I visited the TB centre. Face mask, no using of hp in the premise, went back to bathe to sanitize myself right after the visit and even disinfecting my bag with dettol disinfectant spray.

The social medical nurse explained to me that the TB bacteria can stay inactive in a person and become active later especially when one’s immunity level is low. It’s airborne and it’s hard to tell who, where and when you catch it from such as my case. I can only presume that I may have caught it at crowded shopping malls in town as these are the last few places I’ve been before I was down with the flu. But then again, I could have caught it earlier- in the lift, in the trains, in the taxis… Well one word that probably says it plainly -- “Suay”……

A healthy person who is infected has a 10% chance of developing TB disease in his/her lifetime. The chance is higher if one:

1. suffers from diseases such as diabetes or HIV infection
2. is a drug addict
3. is on steroids
4. have poor nutrition

And well, it’s obvious I belong to the last category. For now, I just have to avoid crowded places to reduce the chance of me catching some other bugs esp a flu or a cough bug which might distress my lungs further.

Apparently, TB seems to be back here and has seen a rising trend according to reports, probably partly due to the increase of foreign workers. With almost 5 mil people living on this small island, it's really tough to find places without the crowd and the noise...

Unforgettable 2010

The results are out - I have contracted TB.

Before you get freaked out, the doc said there aren't cavities and from the first sputum test result which indicated that I was not contagious. She also said my colleagues need not go for screening when I asked if it's required. Surprisingly, the medical social worker told me that I don't need to separate utensils from Uncle Tan, even thou I had been doing that since I caught the flu last Dec which is a usual practice for us whenever either of us are unwell.

How does one get TB?
Based on the article from MedicineNet.com, a person can become infected with tuberculosis bacteria when he or she inhales minute particles of infected sputum from the air. The bacteria gets into the air when someone who has a tuberculosis lung infection coughs, sneezes, shouts, or spits. People who are nearby can then possibly breathe the bacteria into their lungs. You don't get TB by just touching the clothes or shaking the hands of someone who is infected. Tuberculosis is spread primarily from person to person by breathing infected air during close contact.

So next time I see people spitting illegally, they are sure gonna get it from me.

Treatment is a long process and a tedious one as it requires daily visits to the nearest polyclinics to take medication (fortunately only once a day and unfortunately 7 pills in all) for the next 2 months followed by a visit to the TB centre for another xray and sputum test. Thereafter, treatment will reduce to 3X a week for the next 4 mths.

So goodbyes to my Switzerland holidays in May...I won't be able to travel until I have completed my course of medication which will take 6 mths if I'm doing well, if not 9-12 mths. Am hoping I'll have no side effects from taking the medication and perferably it will make me eat more :)

Ah Kin initially was scared especially when told she had TB by the doc, she could not believe her ears. But I guess at least there's a closure now. At least I know why I'm still not completely recovered from my cough.

To my family members, friends and colleagues who have showered me with their concerns, Thank You :) I really appreciate your prayers, well-wishes, support, encouragement and advice.

I still have 2 crownings and one potential filling to be done...I wonder when it will end......

Indeed, health is very important. Can't stress more on that and thou Ah Kin has been eating healthy food and avoiding unhealthy ones, healthy lifestyle is one habit I haven't quite picked up yet.

Unforgetable 2009

Eve of New Year's eve -- I was waiting at the A&E at TTSH. Waiting for my turn to be examined by the doctor to confirm if I had contracted TB.

I caught a flu about 3 weeks ago, followed a cough. It didn't occur to me that I had been coughing for quite some time as it did not disturb my sleep. The only inconvenience was the inability to converse without being punctuated by the intermittent coughs.

My colleagues and boss suggested I should go for an x-ray just to elimate the possibility of other diseases. The x-ray showed some unknown patchy stuff, indicating "suspected pulmonary tubercolosis" on the report and advised further clinical assessment and followup. I wasn't that anxious yet as previously my mum also experienced similar case but was cleared when a 2nd x-ray was done. All was calm until when I see my GP.

"I think this can be quite serious." How would he know when he only listened to my description and hadn't even looked at my x-ray ? "I don't think we can handle this....I think you should go to TTSH now for a thorough check...I'll write a referral letter and you can go to the A&E at TTSH and they will refer you to the TB dept".

Now I partly understand why A&E is such a busy dept. And I also feel strongly that doctors should also be trained in having EQ or to be specific, "The Art of Communicating With Your Patients".

Doctors' words can really freak you out and scare the hell out of you.

At this moment, you'll realise suddenly that the support from your family, your friends & even colleagues make a difference. I can now imagine the fear and anxiety faced by people who have been told they had contracted an incurable disease. the fear I felt was probably 1/100 of their fear.

I was texting my thoughts and feelings into my mobile phone - to distract myself and to remind myself of the fear and the importance of health. My heart was probably beating fast as I was texting. What if I really were to contract the disease? Though curable, the thought of the long treatment and even the thought of the diagnostic tests I may have to go through already worries me. Gosh and those people who have been in contact with me...

A song in Alice In Wonderland that goes like this:

"I give myself very good advice but I very seldom follow it. That explains, the trouble that I'm always in..."

Indeed. I should have listened to my own advice and sleep early. I should have exercised more, avoid last minute shopping at crowded places. I should have stuck to one trusted doctor instead of conveniently going to whichever doctor that was near and still opened. I should have looked after myself better......

"Will I ever learn to do the things I should?"

One hour had passed...the wait was killing me. I didn't want to be admitted. Better still, I hope it was a false alarm and that my GP was just overly anxious and wanted to play it safe.

Finally my name was called. I was examined by a nurse. Afterwhich I was told to sit and wait for the doctor.

Security was quite strict. Only one person was allowed to accompany the patient. The rest of the family had to wait outside the tentage. And only the patient is allowed into the waiting zone. I thought that was a good way to prevent the spread of diseases. Unfortunately, there were some who keep testing the boundary, not wearing the mask they were given and tried to enter the area whilst the security was not around. I was also wondering how a sexily-dressed lady who could still take cold drinks be one of the patients waiting at the A&E.

When I finally saw the doctor, she was busy typing whatever I was describing to her into her pc as she asked the questions. She examined my throat, x-ray and somehow gave me the feeling that it wasn't as bad as it seems. She told me to wait at the waiting zone whilst she sought clearance from her boss. This should sound familiar to those in the civil service.

I signalled to my family that I had to wait and told my poor brother who hasn't had his dinner to go and look for food as it'd be a long wait. Indeed, it took about 3 hours - from about 8.30pm to 11.30pm for the whole process which includes medicine collection, to end.

The doctor said they did not think that it is TB but suggested me to visit the TB dept just to make sure as the doctors there are more specialised in that field. So I was given a week's MC, and strangely, they called me later to fix the appointment date on 7 Jan.

So from now to 7 Jan, I'm home, trying to take whatever stuff to strenghten my lungs and TRY to stick to a healthier routine. Am trying to get to bed by 10.30pm which is pretty tough...

Humans...the moment they know they are not in that critical moment, they somehow will lax into the unhealthy habits again......

To my family and friends, which also includes my colleagues whom I already consider them as friends, thank you for your concern, your assurance and your encouragement. Ah Kin is really grateful and will try to look after myself better =)