June 4, 2007

To Manila for Bone Marrow Transplant


September 13, 2006


Yam, with her parents and Ate Cathy, flew from Davao to Manila on September 9. She was to meet with her physicians at the Asian Hospital and Medical Center on Monday, September 11. Upon arrival in Manila, the group proceeded to Ayala Alabang where Yam will stay prior to, and after, hospitalization.


At her home, Helen Macasaet, an ICT executive and company owner, was waiting with a sumptuous lunch ready. She expected the party to arrive for late lunch. She had a room ready and amenities prepared. Helen and her children, Ray James (RJ) and Aileen, will host the family in need. Yam enjoyed milling around the house, watched a DVD, played with Ate Aileen’s numerous teddy bears and found the mother of her own favorite bear, Ashlee. She named her Mama Lily Bear.


On Monday, September11, Yam and her parents consulted with Dr Francis Lopez and Dr Allan Racho. Both doctors are known in their fields: Dr Lopez for internal medicine, hematology and medical oncology which includes bone marrow transplantation, and Dr Racho for pediatric hematology and oncology. Both very good-looking, the doctors were very good-mannered, good-humored and really good as persons. They made their patient very comfortable and so with the parents.


On Tuesday, September 12, Yam met with Dr Rodolfo Tuazon, a pediatric-surgeon who is to put a vascular access device for Yam’s blood and medicine infusion and transfusion upon admission. The parents realized that Yam had an international medical team (no pun and fun intended): Dr Lopez is “Tisoy”, Dr Tuazon is “Chinoy” and Dr Racho a 100% Bol-anon.


On Wednesday, September 13, Yam and her parents, Aunt Puring and Uncle Niko, met with the top guns at the Philippine Charity Sweepstakes Office to receive a guarantee letter for her hospitalization. She met with Chairman Sergio Valencia and Director Tess Gonzales and had pictures taken with other PCSO directors.


September 15, 2006


Yam was admitted to the Asian Hospital and Medical Center at 11 am on September 14, 2006. After the routine check up, she underwent a minor surgical procedure in the afternoon to insert a femoral central line, a device for blood transfusion and extraction, including medicine infusion. What was expected to get done in 30 minutes extended to an hour and a half.


Before admission, Yam had a hearty breakfast and some pictures taken with her gracious hosts: Helen and Aileen Macasaet. At the hospital lobby, Yam had a talk with Nina Surban, a mother of three, who had a successful bone marrow transplant (BMT) in April this year. Nina was so kind to give Yam a hug and pep talk. In the evening, Helen and Aileen visited Yam at her room (713) and brought her a cute koala bear.


Yam is the 23th BMT patient at the Asian Hospital. Her case is very similar to that of Nicole Figueroa, the first BMT patient in December 2002, who is back to school and reaping academic honors.


Yam started her chemotherapy today up to September 23. The transplant is on the 25th.


September 20, 2006



September 15. Yam’s second day at the hospital was made significant by visit from friends. In the morning, Kenneth Sy came with Father Dominic and two others. May Ferreros dropped by and had a peep at Yam. In the afternoon, Dax and Cesar Maligalig visited and volunteered some members of their family as blood donors. Ferdie Figueroa, father of Asian Hospital’s first BMT patient, dropped by to say hello.


Meanwhile, Yam continued taking dilantin to prevent seizures. She started chemotherapy with busulfan to begin wiping out her bone marrow to make room for the new set of stem cells that will be infused to her.


In the evening of the same day in Mati, Davao Oriental where Yam’s Dad works, a benefit show was staged by students. Several student groups prepared a variety of presentations and heightened the community’s awareness on the deadly disease of leukemia. In addition to the students was a cross-section of the community which came for Yam’s cause.


September 16. This day passed quietly with regular medications.


September 17. A pot luck lunch was held at Tita Helen’s house to welcome Yam. Tita Helen and the guests feasted on carbonara, fried chicken, frozen durian, pomelo, cake and a variety of goodies. Bitty Palines came all the way from Batangas, Aubert Escio who works in Arizona Dad’s Manila-based batchmates were around: Bitcha Letargo, Linda Broch (with daughter Isabella), President Galo, Joel Morata (with family) and Mon Perdon. Dad’s college classmate and brod, Atty Rene Espano (and family) also came. Mon Tayag called in from Toronto and got almost everyone on the phone. When Atty Pol Poblador, who lives some blocks away didn’t show up, the group drove to his house and had coffee, strawberry shake and a tour around his newly-constructed abode. arrived.


September 18-19. Yam continued with her medications. She started ATG on the 19th, a drug that prevents tissue rejection and prepares her body for new cells. Expected side effects include fever and chills. Both side effects manifested moderately on this day but Yam’s mood almost immediately fouled up. She slept through the afternoon and didn’t take in anything. Meanwhile, blood donors from the Philippine Marines (arranged by Ate Aileen’s friend Triska and her dad, Retired Admiral Art Garrido) and from nearby community arrived for screening at the hospital’s blood center.


September 20. This day is the most eventful so far. Minutes after the second dose of ATG was infused, Yam chilled.The chilling became so intense that she pleaded that the infusion be stopped. It was a struggle for 30 minutes even as several blankets were placed on top of her. Kuya John massaged her feet, Mom took care of every thing she says and the nurse made sure clinical signs were at tolerable levels. After this episode and as Yam stablilized, Dad was at the blood center and met Mr. Montegrande, an elderly patient who had BMT in April 2005. He related his own ordeal with ATG. His narrative gave relieving assurance that the anguish is but a temporary and a necessary step along the path to wellness.



September 24, 2006



September 21. Yam is on the third day of ATG, an immuno-suppressant. On the previous day, this drug sent Yam to unbearable chills. So when Yam showed signs of chills and began to complain, Dad put on part of his weight on her thinking that it might help suppress the shivers. It didn’t. So Dad prayed that, if possible, the discomfort be conducted to him. True to her being courageous in spite of the pain, Yam overcame.


Soon after the chills were over, her blood pressure and temperature shut up. The ATG was stopped, resumed after an hour, stopped again and resumed another time until finally consumed.


Blood counts also went down which required red blood cell infusion. Platelet count likewise plummeted to 59k from 313k two days ago. Thankfully, a donor (Butch Caneda, a nurse working in Saudi and on vacation) came and patiently waited for the apheresis procedure. A second donor was also screened and bled.


September 22-23. The ATG days are over!!! Yam was administered with cytoxan, a chemo drug meant to wipe out the remaining bone marrow. She was very stable except that she didn’t like to take in anything. Dr Racho visited in the evening after he was called in.


At the hospital’s blood bank was a long line of prospective donors. Yam’s own donors had to wait for a long time before being attended to. We were informed that the dengue outbreak increased the demand for blood and platelet. While donors for Yam were more than sufficient in number, the special procedure needed for her led to the disqualification of some. The daily long line of donors and the concerned comments we heard from patients’ relatives has taught us the value of blood donation. Such agencies like the Red Cross and many other organizations that maintain a blood donor database should indeed be helped in any way we can. Lives are saved through the simple act of many.


September 24. This was a rest day for Yam. No drugs today, only prophylactics. Dr Racho visited in the afternoon.

June 3, 2007

September 25: Transplant Day




September 25, 2006
Bone Marrow Transplant Day

On the preceding day, John (the donor) was admitted at Yam’s adjacent room (714). He was given the Granulocyte Colony Stimulating Factor (GCSF) for the fourth day. Even after admission, John attended to Yam’s blood donors who waited patiently in the long queue. In effect, he was the only patient in the hospital who was doing errands. In the evening, John downed four pieces of oranges and six pieces of bananas in preparation for the harvest.

On BMT Day, a precision-timed series of events unfolded. John woke up early, prepared himself and finished breakfast by 7am. A few minutes after, surgeon Dr. Salvador Abad Santos with an assistant, came into the room to insert the central line for John’s blood extraction. He bantered and pep-talked. Then Med Tech Aura Posada came in with the apheresis machine just when John was ready for it. The contraptions were prepared and at 7:30am, the machine began its job. By 1:30pm, 160 ml of stem cells was harvested and brought to the laboratory for analysis and counting.

Meanwhile, Yam was being prepared at the other room. Mixtures of medicines were administered while she was emotionally being revved up. Yam’s physicians, Drs. Francis Lopez and Allan Racho and the team of nurses were all in the room. Dr Lopez explained the BMT process and as soon as the stem cells arrived from the lab, transfusion to Yam started in no time at all.

While the stem cells were being received by Yam, the well-mannered physicians spent time to narrate stories about their BMT patients. Dad and Mom were inquisitive and the physicians patiently fielded and answered all queries, trivial or not. Yam is the 23rd BMT patient since the first was done in December 2002 and is the 9th pediatric case. She is the third patient this year after Nina Surban and a certain Mr Wang. A fourth, whose case is very similar to Yam’s, was just admitted. Two others are waiting and may undergo the process before the year ends.

June 2, 2007

The First Two Post Transplant Weeks


September 30, 2006
The First Five Days After

Yam’s first five days after transplant were uneventful compared to Typhoon Milenyo which overshadowed Yam’s mundane world, at least for a day. Medicines were administered on the basis of doctors’ observations. The five days passed with doctors neither sighing of worry nor expressing much concern. Thank God, Yam had no mouth sore, no chills, no irritations, no fever (until the 5th day) – all expected side effects that would have manifested at any of the five days.

As if the transplant was as ordinary as her regular treatment (she has seen harder days), Yam fielded phone calls from her sister Janice (in Davao City) and brother Joseph (in Cebu City). She giggled, smiled and chuckled as she gamely answered her siblings’ queries on her BMT and other treatment procedures. She also had her first chance to browse through her mailbox. (Yam’s email address is: yama_moto_shita@yahoo.com).

Typhoon Milenyo blew its power and fury on the 28th and downed billboards and trees. Civic Road, where Asian Hospital is located, was impassable due to uprooted trees and torn branches waylaid on the road. On this day, Drs Racho, Lopez and Tuazon came in one after the other. Dr Tuazon, who inserted a second femoral line, was worried at Yam’s low platelet count which compromises blood clotting. Finding slight bleeding on the wound, he dressed it and applied pressure until the blood sufficiently coagulated. The available platelets taken from two donors were also infused so that there was a frantic search for the next donor. Thankfully, and as God willed it, kind-hearted people are on stand-by….


October 5, 2006
The Second Five Days After

Yam’s second five post-transplant days were like a roller-coaster ride: boring and exciting, unsettling and soothing, disturbing and assuring, distressing and serene. Boring due to the long days of waiting; exciting when her white blood cells registered the first increase on the 8th post-transplant day – an early sign of engraftment. Unsettling and disturbing with the onset of fever, cough, sudden weight gain and abdominal pain; but soothing and assuring as the fever and cough were “normal”, and as the gain was gone and the pain was eased soon after Yam purged the cause. Distressing because of the varied manifestations in Yam’s delicate body and her undulating emotional state, but we are profoundly serene knowing that we have countless friends, relatives and many people we have not met, who are firmly behind her. Most importantly, God is undoubtedly on our side.

The best news is in Dr Allan Racho’s (Yam’s pediatrician) text message on Thursday, October 5, morning: “Good news. Yam Bayogan has engrafted today. She is tolerating the transplant and barring hitches, (she may be) discharged (sooner than expected).

Dr Jeannie Ong, Yam’s pediatrician in Davao City immediately sent this message: “Congratulations to Yam. Praise God!!!)

Also, allow us to share some of the messages we received which gave us the steadying strength and encouragement in caring for our daughter:

"You are welcome. It’s really because God is on your side." (UP President Emer Roman, in response to our thanking her for clinching a generous assistance from the Philippine Charity Sweepstakes Office)

“COURAGE!!! This, plus a never-wavering faith in Him who draws the grand plan for all of us, is what I constantly pray for you and your family. Please tell Yam we all love her like our very own and that we always think and pray for her.” (Baby Rimando & Family, family friends, Baguio City)
"I'm one of Yam's biggest fan. Kasi ganun din ako, 'against all odds.' Hope to see her in person when I get there." (Uly Marquez, Dad’s high school batchmate, New Jersey, USA)
"From us, hug Yam close to your heart, let her feel your heartbeat.
The warmth and the heartbeat she feels are also coming from us.
Tell her we love her. Her smile brightens our day…
Tell Yam that there is so much that we need to do for the UP and for our people.
That Yam is needed in doing these tasks. She has to be very, very strong.
And we know she is. Especially during these times… Yam, smile.
Blow us a kiss across cyberspace. "
(Cesar Torres, UP alumnus and former UP Professor, California, USA)


October 10, 2006
The Exciting Days

October 5 was expected to be an average day. But while preparing for the day, Dad received a text message, FOR THE FIRST TIME IN WEEKS from Yam!!! The message said, “Hello Daddy-doo. Si Moto ito (we also call her Yama-Moto). Laro kami ng cards ni Mimz (she calls her Mom, Mimz). I love you Daddy-doo… Yam”. After a quick response assuring her that Dad will arrive in the hospital soon, she texted back, “Okey, ingat Daddy-doo.” Yam is slowly getting BACK to her elements!!!

Later on the same day, Mom received this text message: “Good news! (Yam) Bayogan has engrafted today. She is tolerating the (bone marrow) transplant and barring hitches, (she may be) discharged next week.” This message was from Dr. Allan Racho, Yam’s pediatrician at Asian Hospital, which he sent to Dr. Jeannie Ong, Yam’s pediatrician in Davao. Exhilarated, Dr. Ong appended this text: “Congratulations to Yam. Praise God!” and sent the message to Mom. It was the 10th post-transplant day and engraftment is usually observed on the 12th. On this day, Yam struggled to drink and eat (she was on intravenous feeding for days).

On October 6, Butch Caneda arrived at the hospital for his second platelet donation. It was the 19th donation since Yam was at Asian Hospital. Dad told him, “You are a kadugo twice over.” Meanwhile, Yam’s blood counts registered encouraging increases and on the following day, October 7, she was declared technically engrafted. Nurses assigned on round-the-clock duty gladly returned back to normal schedule. Zet and Judy, Dr. Lopez’s nurses, made sure they had their tour of duty on the last shift.

On his daily visits, Dr. Lopez kept telling Yam to slowly adjust towards normal routine: eat, drink, sit down, stand and move around. She assured Yam that every step forward will result in an IV bottle off the rack. In one visit, Dr. Lopez gamely tickled Yam- to get her going for the day.

On October 9, Yam's red blood cells reached normal level, her white blood count increased to 3.1 with the minimum normal at 4, while her platelet count increased from 22 to 66, still below normal. She has been sitting on her chair since morning, lied down on bed after lunch and consumed a bowl-full of oatmeal. Discussions on post-hospitalization procedures and what to expect started, including her weekly visits to Asian Hospital and weekly laboratory tests that will be done at the National Kidney Institute.

Meanwhile, Dad is back to his work site and was met by colleagues eager to know the latest about Yam. He also received a call from a friend requesting if he could get in touch with a mother in General Santos City whose 15-year old son needs bone marrow transplant - soon! With this, it seems that a new cycle of “friends helping friends” has began…