Monthly Archives: June 2011

Diagnosis – The Inconvenient Truth

Here’s a very good video explaining what leukaemia is:

A simple full blood count (FBC) detected unusual low haemoglobin and platelets level, and high concentration of white blood cells and blast cells in my blood, which are characteristics of leukaemia.

However, FBC alone does not differentiate the type of leukaemia I have. Hence, cytogenetic analysis on my bone marrow cells was necessary to determine the diagnosis, prognosis, management and treatment of my leukaemia. Karyotyping of my bone marrow cells shows chromosomal abnormality – translocation between chromosome 8 and 21.

I am thankful that it’s only leukaemia (with good prognosis) and the diagnosis is simple and straight forward. I had seen and heard many patients directed to different specialists and went through lots of procedures (e.g. scans & scopes) to identify where the problem lies. My advice for all – commit to regular health checkups and visit a doctor if you feel unwell. Most important of all, maintain a healthy and active lifestyle!

Preparing for Chemotherapy

With the problem defined, effective solutions can be recommended. Dr Aloysius arranged for a family conference in the hospital to tell us about the treatment and other relevant information. Dad, my siblings and I sat in the conference room and listened to Dr Aloysius’s treatment plan. It was good that we came prepared with questions of concern about the upcoming treatment.

Some of the key things Dr Aloysius mentioned:

1. Survival rate for young Acute Myeloid Leukaemia (AML) patient with treatment is quite high. However, it depends on the bone marrow biopsy results which will determine the type of AML and whether the prognosis is a ‘good risk’ or ‘bad risk’.

2. Chemotherapy should begin immediately. The prescribed chemotherapy drugs are Idarubicin and Cytarabine which would be administered 3 days and 7 days respectively. The need for bone marrow transplant would be determined after the bone marrow biopsy results are out.

3. Sperm banking should be considered if the patient plans to have a family in future. This is because the entire course of treatment may cause temporary or permanent fertility problem.

Questions and what concerned us:

1. My cancer is in which stage now?

- There are no stages to acute leukaemia. It happens rapidly and requires immediate treatment.

2. What are the side effects of chemotherapy?

- The common side effects include nausea, vomiting, loss of appetite, hair loss and mouth ulcers. These are temporary only.

3. What is each treatment cycle like?

- Each treatment requires patient to be hospitalized for about a month. A week of chemotherapy, followed by rest and recovery of blood counts which could take another 2-4 weeks. The recovery period usually shortens on subsequent chemotherapy cycles.

4. Are there any food that I shouldn’t be eating?

- Raw and under-cooked food (e.g. sashimi, sushi, salad), sliced and thin-skinned fruits (e.g. grapes, strawberries), unpasteurized dairies products (e.g. milk, cheese). Patient should consult the doctor before taking any traditional chinese medicine (TCM).

5. What is the estimated total cost for the treatment?

- About S$10,000 – S$30,000.

There were probably thousand of questions in my head at that time, but I decided to take things a step at a time. No point overloading myself with so much information or creating fears through wild thoughts and imaginations. It’s easier (and more enjoyable) to eat a steak by cutting it up into bite size than to swallow the whole steak. On top of that, every leukaemia patient may have a different set of treatment and experience. I learned to always listen and read with a pinch of salt, and prepare myself physically and mentally for the upcoming challenges.

Health Screening Saved Me

I have never thought about doing a health screening, much less at the age of 27 when I was still young and active. It was a series of events that prompted me to have my health checked. I experienced many unusual signs and symptoms which brought about some inconvenience to my lifestyle. Among the symptoms are fatigue, mild fever after evening jogs, breathlessness and palpitation.

The cheapest way to find out what could possibly be wrong with me was through the information-rich Internet. So I searched Google and shortlisted a few possibilities – chronic fatigue syndrome, heat injury and lack of rest. For fear of a wrong self-diagnosis, I visited the GP. The GP associated my symptoms with the hot weather, insufficient hydration, stress and individual stamina or fitness level, and suggested that I monitor these symptoms for the next few days.

Coincidentally, as it seemed, I received a ‘birthday treat’ of a comprehensive health screening package at a special rate of SGD$188. I applied for annual leave and went for the ‘treat’. With an appointment, there was not too much waiting time and the healthcare services were professional. As my electrocardiogram looked abnormal, the doctor suspected either a cardiac or thyroid problem. I was told to expect the doctor’s call in the afternoon once the other test results are out.

At 1.30pm, the doctor called to say: “Hi Mr Sai, your haemoglobin level is very low at the moment. Please take a cab down to either NUH or SGH A & E immediately! Don’t even consider taking the public transport like bus or MRT.” It was only at SGH A & E, that I found out I have leukaemia. I am thankful for the health screening that I had done in time to have my leukaemia treated early.

The take home message:

  1. Listen to your body signals and any health warning signs.
  2. Never attempt to self-diagnose, always seek a professional.
  3. Have your health checked annually regardless of your age. (If you are young and healthy, a health screening will serve as a reference for your future check ups.)