Thursday, 29 October 2009

The Day Has Finally Arrived

Will be admitted to Royal Hallamshire Hospital today for the ultimate high dose chemotherapy and stem cell transplant. Expecting to be warded for at least 3-4 weeks, insya Allah.

Thank you everyone who has dropped by to provide your support and prayers. I have nothing but my sincerest gratitude and du'a. Jazakumullahu khayran katheera.

Allahumma yassir wa la tu'assir.

Friday, 23 October 2009

It's finally coming...

Assalamualaikum wbt

A date for my high dose chemotherapy and stem cell transplant has finally been decided. It will be on next Thursday, the 29th October 2009. Speaking to my consultant this morning about the treatment, I am already feeling a bit nervous.

BEAM chemotherapy is the regiment I'll be having this time around, before they end up with transfusing my stem cells back into my body. BEAM consists of:

* Carmustine (BiCNU®)
* Etoposide
* Cytarabine (Arabinoside)
* Melphalan

In short, the treatment will be given over a period of 8 days, which includes the stem cell transplant on the final day. The daunting bit will be how I respond to the treatment and stem cell transplant straight after, and for that reason I'll probably be kept in hospital for another 2-3 weeks. Altogether, it is expected that I'll be in hospital for at least a month this time around.

I've mentioned how the 2 ESHAP chemotherapy I've had in the past were stronger than the initial ABVD chemotherapy, and I ended up with worse side effects and longer recovery period than normal. But having learned the likely side effects of this BEAM chemotherapy, I seriously need to prepare myself both physically and mentally for what is to come.

Nausea, vomiting and extreme tiredness are probably side effects I'm quite used to, and hopefully ones that I can cope with even with the BEAM chemotherapy.

Obviously I'm always slightly apprehensive with the possibility of infection, being anaemic and risk of bleeding with this high dose chemotherapy. But what I am not really looking forward to is the other likely side effect I've never had in the past, in particular the mouth ulcer (mucositis).

As warned by my Consultant, often the mucositis gets really bad that patients need to be given morphine to ease the pain and can hardly swallow food and therefore had to be given nutrients via a nasogastric tube.

NG tube is inserted via the nasal cavity, goes all the way down into the stomach.

I must admit I already feel this is one task too daunting to bear, but I am not going to turn back now having made this far. I need to persevere.

I have Allah. I believe in Allah's plannings. I must.

At least I get an initial impression of what lies ahead of me from this video, showing Emma Hargreaves, a teenager with cancer who shared her experience of going through the BEAM chemotherapy and stem cell transplant. I'm not sure how she is at the moment, but she certainly has one strong character given her young age, and I wish her all the best in life.

Her video is one of the many videos that can be watched via the website, a creative initiative by the Teenage Cancer Trust to share experiences of teenagers living with cancer. Spend some time watching a few of the videos, and you'll be amazed how strong and positive these young people are towards their condition. I have nothing but my utmost respect to each and every one of them.

6 days to go. O Allah, you are sufficient for me and a Great disposer of affairs are You. Make my path easy if that is Your Will.

Plenty of dua's please...

Monday, 19 October 2009

About trials and tribulations...

"So this is our famous Dr Mas Masarudin. Ever since you were interviewed by ITV last month, a lot of the hospital staff have been talking about you. Nice to meet you finally."

Those were the welcoming greet of the stem cell transplant nurse the moment I entered into the stem cell transplant room in Royal Hallamshire Hospital last Monday. Yup, my face did appear on national television last month when a group of representatives from ITV Calendar for the South Yorkshire region came to ward P3, where I was treated. They were interviewing me to find out how young patients with cancer cope in a ward where majority of the patients are elderly people.

The stem cell harvest machine, connected to the veins in the arm or the Hickman line.

The fluid bag with the brick-like color is the stem cells filtered out from the bloods.

I just love sharing views and opinions, especially when I know they are of benefit to other people. Even when I am in the hospital, the consultants would usually suggest my name to the medical students for them to take history from. I guess that is my way of helping people, and I always find joy and pleasure out of it.

And last weekend, I had the opportunity to share my experience living with Hodgkin's Lymphoma to the new group of students from Malaysia to embrace the United Kingdom for their studies. Even though I'm quite used to talking in front of people, the topics I've talked about in the past were never anything to do about myself. This was the first time ever that I've opened up about my disease in a public speech to mostly unfamiliar faces.

I did so not because I wanted them to sympathize with my predicament, rather I wanted to show to them that as mere mortals, we can't run away from being tested in life. But trials and tribulations are not meant to break us, as Allah has promised that He will never impose upon us a burden for we can't bear.

Just when we think that there can't be anyone more unlucky than us, just think about those people who have lost their parents before they can even see their faces.

Just when we think that God has given us the biggest test one can ever bear, just think about those innocent children living with cancer whose life revolves only around the hospital.

Just when we think that no one is going through a life as difficult as what we are facing, just think about the people in Gaza or Africa.

So do not despair and whine when we are tested, for it will bring us nowhere.

Face it. Stand up to it.

That was the message I hope I've managed to get across to these youthful students, full with exuberance. But come to think of it again now, that was actually a message I hope will remain ingrained in myself especially for the next few months, as the high dose chemotherapy looms closer.

Allah does not burden any human being with a responsibility heavier than he can bear. Everyone will enjoy the fruit of the good that one has earned and shall suffer for the evil that one has committed.(O Believers, pray like this to Allah: ) "Our Lord, take us not to task if we forget and lapse into error inadvertently. Lord! lay not on us the kind of burdens that You had lain on the people before us. Lord, lay not on us the kind of burden that we have not the strength to bear. Be kind to us, forgive us and show mercy to us. You are our Protector : help us against the disbelievers." [2:286]

p/s: Talking about stem cell harvest, I remembered adik Siti Nurain who a few years ago had her stem cells harvested just like me. But not for herself, but this young girl did it for her brother. The processes involved during and prior to the harvest are tedious and can be draining, as I've experienced myself, so it touches my heart to read this article and witness the sacrifice she made for her brother.

Friday, 9 October 2009

Am I ready???

"As-alul laahal azeem Rabbal arshil azeem An yashfiyak..."
I beg Allah the Almighty, the Owner of the Majestic Throne, that He should cure you.

"Antash shaafie. Laa shifaa-a illaa shifaa-uk. Shifaa-al laa yughaadiru saqamaa."
You are the only One who cures. There is no cure but Yours. Grant such (complete) cure that leaves no trace of illness.

That was roughly some part of the du'a I could remember from the one recited by the Imam on me after our Friday prayers today. He saw me sitting at a spot within the main prayer hall, walked towards me to greet me, sat down and instantly recited a du'a for me. He knew all along about the news regarding my condition and it had certainly brought a smile to his face to see me again after I've been missing for 3 weeks from the masjid.

Yup. Alhamdulillah, I've finally made my way again to the Muslim Welfare House of Sheffield today after what I personally regard as a long time away from my second home. Due to treatment and its recovery period, I've not visited the masjid for almost 3 weeks and I can only thank Allah for allowing me to garner enough energy to make the walk up the hill today.

The ESHAP chemotherapy is certainly a different opposition altogether compared to the previous ABVD treatment. It certainly affects me stronger than the latter, almost to points where I must admit that sometimes I almost lost the plot.

But let's not talk about how I felt those last few days. Let them be buried as past. I certainly have more daunting things to expect not long from now.

Since Wednesday and for the next 3 days, I have been injecting myself with Granulocyte colony-stimulating factor (G-CSF). The G-CSF, in plain term, is meant to boost my bone marrow to produce more stem cells, that will then circulate through my blood and be collected later this Monday as a preparation for my high dose chemotherapy. Those extra keen to know reasons for harvesting the stem cells prior to my high dose chemotherapy can refer to my previous entry entitled "Here we go again...".

Harvesting the stem cells are just part of the several tests I need to undergo prior to the commencement of the high dose chemotherapy. I've had an Echochardiogram done 2 days ago to assess the function of my heart and whether it has been affected by previous treatments. I am also scheduled to have a Respiratory Function Test to assess my lungs, a dental check-up to rule out possibilities of catching infections from any dental problems and a CT scan to evaluate the progress of my disease.

Plenty of things happening soon huh? Well, that is part and parcel of medical plannings when expecting something they regard as a 'critical and crucial period'.

To make sure that they have made all the preparations necessary.

As for myself, have I prepared myself enough? And I don't mean just physical wise for this upcoming heavyweight battle, but spiritually. Am I ready to expect what might come out of all of this?


As people say, you can never understand something until you experience it yourself. When I was a medical student, trying to understand the emotions running through a person's mind prior to his/her life-or-death operation is a difficult thing to grapple with. But now, as I draw closer to my high dose chemotherapy, that emotion is all clear in me. It's a feeling you don't wish people to have, believe me.

Be strong, o heart.

Thursday, 1 October 2009

Living with Cancer : Living With Uncertainty?

Assalamualaikum wbt

As I meet and talk to people in the hospital afflicted by cancer, be it a cancer similar to mine or not, we all often agreed on one thing. That it is one of the most uncertain disease one can ever have.

Which is why patients who are successfully treated of their cancer are called 'in remission', and not terms such as 'completely cured' or 'declared cancer-free'. By saying someone is 'in remission' implies the possibility, be it small or big, of a 'relapse' in the future, ie the cancer coming back to haunt you.

However, it's not the term used that I intend to dwell on, but rather how this 'uncertainty' can affect our emotions in the cruelest of manner, if not dealt properly.

"I've just made plans to start work again after such a long break due to treatment. Time to play my part in helping out my family after all the sacrifices they have made."

Unfortunately the cancer relapses and all your plans go out of the window.

"I'm now 55-years old and it's probably the best time to take my family out to live in the countryside and enjoy our life again after what had been a torrid few months battling against cancer."

Unfortunately the cancer relapses and all your plans go out of the window.

"Finally I can now start to think about my marriage plans and starting a family. How exciting will this be."

Unfortunately the cancer relapses and all your plans go out of the window.

Those stated above are certainly not just made up blindly. These are all real-life examples of the people I have came across during my stay in the hospital. The uncertainty. Uncertain whether you can actually start a new chapter in life after being declared in remission from cancer without having to go through a hiccup.

"Well Mas, in your case, 5 years is what we call the magic number. It is unlikely that you will get a relapse after being 5 years in remission from the disease," a specialist nurse reassured me yesterday during our conversation.

Yes, 5 years is the prediction of clinicians based on their study and experience of dealing with the disease. But it is called prediction for a reason. Because all of us are mere mortals and we don't possess the power to say that things will happen for certain, thus we can only resort to predicting.

This shortcoming of not being able to be 100% certain of what lies ahead of you is part of Allah's beautiful plan for human beings.

Not sure when will death come to us.

Or when the Day of Judgement will be.

So that we don't wait until we reach 50-years old before learning to visit the mosque for our prayers.

So that it send shivers down our spine to have the gut to say, "Muda-muda kita enjoy, bila dah tua kita bertaubatla!" [Enjoy while we're still young, and repent when we get old].

There really shouldn't be a saying like, "Abah dah umur 70-tahun, eloklah banyakkan duduk di masjid dan sembahyang." [Dad, you are now already 70-years old, it's better that you now spend more time in the mosque and pray].

What if death comes to you before your dad?!

As for myself, I sometimes am left wondering about how exactly should I deal with this uncertainty filling inside myself. It's very difficult now picturing myself in 10 years time when in the past, I can see clearly where I want to be in the future. That's a feeling I guess myself and people with cancer share in life.

At least one thing is certain. I know I have Allah, and I just have to keep on praying and believing in His plans for me.

وَللَّهِ غَيْبُ السَّمَـوَتِ وَالاٌّرْضِ وَإِلَيْهِ يُرْجَعُ الاٌّمْرُ كُلُّهُ فَاعْبُدْهُ وَتَوَكَّلْ عَلَيْهِ وَمَا رَبُّكَ بِغَـفِلٍ عَمَّا تَعْمَلُونَ

And to Allah belongs the Ghayb (everything that is unseen) of the heavens and the earth, and to Him return all affairs (for decision). So worship Him and put your trust in Him. And your Lord is not unaware of what you (people) do. [Hud:123]

Ward P4, Royal Hallamshire Hospital.
1st October 2009.

p/s: I am currently in Day 4 of my ESHAP chemotherapy, battling hard against nausea and tiredness. If everything goes as plan, God willing, I should be able to go home by this Saturday. Keep the prayers coming everyone.