I was alone. Mum was downstairs in the food court, Bro was in school stuck with lessons. Hubby was in another school stuck with lessons too. Dad was lying on a hospital bed in front of me. He was hospitalised last night. His eyes were closed, his mouth couldn't close with the cervical collar ordered by the dr. I don't know if he was awake and listening or he was sleeping. Talking has been a problem for him since Tues morning.
While waiting to talk to Dad's dr who has been delayed for more than 2 hrs, I started to browse through the blue patient's file in front of me. The staff nurse has just left it behind for the dr to explain it to me. Keen to know more about dad's condition, I started to browse the notes and investigations. When I saw the biochemistry report, my eyes immediately picked up on CEA. I was familiar with CEA cos when I was still working at CGH's Biz devt dept, I was in charge of marketing CGH's health screening packages. CEA is a cancer marker mainly for colon cancer.
His CEA readings were 15000ug/L (normal 0-5), CA19-9 is 1798U/ml (normal 0-30). CA19-9 is a cancer marker for pancreatic cancer. This I knew only after googling. I was still calm when Bro told me about the growth last night. I did speculate if it can be cancer but I thought maybe it's a benign growth caused by the fall. Nobody knows for sure, nothing is confirmed, I told myself.
But reality sank in as I read and reread the blood test report. Dad has C-A-N-C-E-R. There is no other reason to explain for the high readings. I suddenly choked with tears, overwhelmed by emotions. Why him? Why must this happen when he is already so old? Why didn't we send him to hospital earlier despite mum's nagging? His legs have always been weak due to his long standing problem with varicose veins and venous ulcer, problems that were triggered in his younger days when he was a hawker as he needs to stand for long hours. Is it our fault for taking things for granted? I thought cancer happens to middle aged or the young, how come it can affect someone who is already 83 yrs old? Why must he suffer now? I suddenly understood why doctors usually call for a family meeting when breaking bad news so that at least there is family support. I was so unprepared that I didn't even make sure that anyone else is with me before asking to meet the dr.
Flashback to 17 Feb 2012. Dad had a fall at home in the kitchen while trying to remove his kitchen slippers. The fall left him with a laceration on his forehead. Bro sent him to hosp at night after referred by the GP. The A&E dr stitched up the wound and ordered a CT scan to the brain in case of any bleeding but results were negative so he was discharged him in the morning, much to our relief. But after he got home, he started a steep decline, from being able to walk slowly with his walker, he complained that his arms are numb and painful and cannot lift the walker, soon he was unable to stand.
On 15 Mar, one day after I returned from Phuket, hubby and I drove Dad to see 毛医师 Mum's trusted Tuina physician at Toa Payoh. Dad had just been reviewed at Bedok Polyclinic 2 days ago and x ray showed that there was a possible slipped disc that was affecting his mobility. Specialist appt with ortho dr at CGH was in May, more than 2 months away and too long for us to wait. Mum was getting worried cos Dad has started to just lie on the bed whole day. She wanted us to send Dad to hosp straight but we were concerned that with no acute symptoms, the A&E dr will just observe him and send him back. So, the interim decision was to bring him for Tuina first and see if that will help him to regain the strength of his legs.
Dad could not walk or stand since 11 Mar but when he was lying down on Mao yi shi's examination bed, he could still move his right leg left to right vigorously but his movement for his left leg was minimal. As Mao yi shi massaged his neck and back, he told us that he needed Dad's MRI to understand the condition of his spine so that he can manage his condition more effectively. The x-ray report from Bedok Polyclinic was not good enough. Since I couldn't contact my bro, couldn't make a decision regarding the MRI because first of all, it has to be private rates and secondly it cannot be paid using medisave. Also,it was only the first tuina session so don't know if my dad/bro will decide to have long term treatment at Mao yi shi. Called CGH radiology dept but they will not do any MRI unless referred by dr (at least a GP). And even if we pay private rates (about $900+), the earliest MRI appt is in June.
So, bro and I discussed and decided that to do as Mao yi shi suggested so that we don't waste time. He has just stopped walking for 4 days plus and we wanted to keep the momentum of the tuina sessions, hopefully he can walk again. We paid $1712 for MRI of neck and spine & collected referral letter from Mao yi shi last Sunday 18 Mar, then brought him for MRI at Radlink, Paragon on Tues, Mao yi shi is supposed to review the film on Wed and tailor treatment accordingly.
Yesterday evening, I received a call from Bro, saying that he is waiting for GP clinic to open (Dr Chai) cos the MRI report said Dad's spine has a growth and Mao yi shi advised us to bring Dad to see western drs cos there is nothing he can do for him at present. After getting a referral letter from Dr Chai, Bro sent Dad to CGH A&E at 7+pm. I went over to CGH at 8+pm to relieve Bro cos he needs to attend to some matters. Bro came back at 11pm and we left the hosp at midnight after handling the admission procedures. I received the call from hosp at 130am that Dad has finally gotten a bed. After sending RA to school in the morning, I called the hospital and the nurse asked for the MRI films so after picking mum up at home, we went down to the hospital at 930am. I asked the nurse if I can speak to the dr in charge and I can wait for her.
When I finally saw the dr at 130pm, she confirmed that it is highly likely to be cancer. And explained the other pending blood tests and CT that they will doing to find the source. The physiotherapist came to assess his breathing and she ordered oxygen and a abdominal binder to help him breathe better. Another dr asked if she can meet up separately with us. When we went away to a corner, I heard her asking me about DNR instructions. I was still in a daze so I was surprised by how composed I am as I hear myself telling her that it is too early for us to decide when we don't have a clear picture. He has a steep decline for the past 1 month, so we want to make sure we have done our best to try and reverse the situation. Whatever decision I make has to be a joint decision with Bro and Mum. Let's arrange a meeting with the consultant dr after all the results/reports are back.
Born in China, my dad had a hard life. When he was just 13 yrs old, he had already lost both his father and his mother. He was an orphan at an young age and he and his younger sister was brought up by relatives. He came to Singapore when he was a young adult while his younger sis remained in China. His first job was at a goldsmith shop but he quit some years later and started to run his own biz. Though he was a tall tanned handsome young chap who runs a biz at pasar malams and loved swimming at Chinese Swimming Club, he didn't want to get married. He once told me he didn't want to marry because if he marries and have kids, the kids suffer when he pass away because they become orphans like himself.
But a close friend who was from his hometown managed to convince him to consider marriage because he ended up being matchmaded with Mum. He told me their first date was a steamboat dinner and even back then, Mum refused to let him crack an egg into the soup because the soup will be cloudy with an eggy 臭腥味. Mum's family rear pigs so she will not eat pork but she is ok to cook pork. Dad is a beef lover but Mum will never cook beef because she is a Buddhist. I guess Dad must have agreed to follow Mum's dietiary habits and accept her religion for the rest of his life because they decided to get married. Mum was the eldest daughter in a farmer's family of 8 kids and was already considered an old spinster in her 30s when she married my dad. Dad was 9 years her senior. They tried for many years and sought medical treatment before they finally had kids. When I was born, Mum was already 38 yrs old and Dad was already 47 years old. They have always been conscious of being old parents and were embarrassed when customers and acquintances asked them 是你的孙还是你的孩子?
As a typical Teochew man, Dad has always been concerned with 面子. When he had to wear slippers due to his venous ulcer, he will refuse to attend wedding dinner because he cannot wear proper shoes. He felt it was a loss of face and will only attend if we are representing the hosts or the 男方. When he turned 80 yrs old 4 yrs ago when I was expecting RaeAnne, I suggested having a 80大寿 dinner celebration. He only agreed to a family dinner and strictly said no birthday cake. Later on, Mum told me he refused to have a cake because he thinks other people will 'laugh' at him for having only 2 children and 1 son in law at the age of 80, with not even 1 grandchild when most people of this age are already 子孙满堂. I comforted him that he does have a grandchild just that she is still in my tummy. :P
Dad has always been the strong, silent type. Typical Asian father with no hugs nor kisses. Although my dad is not the demonstrative type, sometimes I find him quite stubborn, I know he loves us and the grandkids in his own ways. One of my favourite childhood memories was discovering that he had bought a yellow toy guitar from the market. I found it before he even had the chance to personally give it to me. Another one was when he opened a brand new can of glucolin for me when I was having severe food poisoning. I only took the glucolin once or twice. Once I got well, I didn't like the articial sweet taste. We were not rich and Dad was a canned food hawker. He could have sold the glucolin for a profit instead of wasting it on me, I was very touched then. When I was a primary school student, my grades were good and Dad will reward me with things that I want if I came in first in class. He gave me $200 in cash (big sum of $ in those days), bought me my first pair of binoculars (he got my uncle to help me buy cos he didn't know where to buy it), my first set of 毛笔 and practice books. But unfortunately, his investment did not pay off as I never learnt to write calligraphy cos never had proper lessons.
And in all these years, Dad has been a good husband and father. Because he takes care of the family, gives my mum and grandma a regular allowance, drive us from Alexandra to Tampines visit my maternal grandma every Sunday without fail. He sends $ to his sister's family in China regularly until they were more comfortable financially. Dad has no vices, he doesn't 吃,喝,嫖,赌. He spends his time n $ only on his family.
He has never travelled and does not even own a passport. When he was younger, in his 60s, we were still in uni or just graduated with little resources to sponsor his travelling with his hometown friends who went back to visit Swatow, China. By the time, we got older and wanted to bring him, he doesn't want to go anymore cos his legs are weaker and he does not know many pp in his hometown anymore n has no one to go with. He said he has no urge to travel and is happy in Sg. His only interests is sinful foods esp fatty meats, n parson's nose, reading the newspaper and watching tv and most recently his biggest love is Starhub's Phoenix Channel cos it is Mainland Chinese programmes. I only get to talk to him during Sunday dinners cos that's the only time when Mum will watch over the gals and I get in eat in peace instead of feeding or bathing the gals. To him, I feel more guilt than my mum because he really has not had much luxuries in life.
I wrote this post to gather my thoughts and as an outlet for my mixed emotions to help me think better. I really don't know what is the road that lies ahead for Dad. I don't know how much he knows of his condition, and if we should be frank with him and let him choose his treatment options. After all, he can hear whatever is going on and he is mentally alert. Should we opt for aggressive treatment? Should we treat conservatively in view of his old age? Which decision will I be able to live with the least guilt? What decision is best to him? I don't know. Right now, all I know is this. As much that I am hoping for a miracle for the drs to treat him, if one day, treatment causes him more suffering than the disease itself, I dread having to ask myself this question: Am I ready to let him go?