May 2, 2006

Brods,

Yam was admitted to the hospital on April 9 for pallor (pale condition) and intermittent fever. Her red and white blood counts were both low, her platelet count was okay and her lymphocyte count was high. She was subjected to a series of tests to eliminate common suspected illness like dengue, malaria, flu and even lupus. All were ruled out.

On a daily basis, her blood counts were monitored and showed constant drop in both red and white cells (parehong di maganda). Her platelet count was ample and steady (ok) and her lymphocyte slowly rose (hindi ok).

On the fourth day she underwent a bone marrow aspiration to extract sufficient bone marrow sample using to 4-inch needle to rule out leukemia. The results showed hypocellular condition (kulang ang cells), and 12% lymphoblasts (immature lymphocytes). The leukemia threshold is 25% but the normal level should be up to 5%.

I brought the medical record to the Philippine Children's Medical Center in Quezon City on April 19 while the blood smears were sent through LBC courier. The doctor's analysis is being sought yet. We brought her back to the hematologist on May 1 and she showed improved red and white blood cell count, steady platelet count but still elevated lymphocyte (elevated lymphocyte count indicates something wrong). She still has intermittent fever and will be back to the doctor on May 8. She lost about 2 lbs and might have a second bone marrow aspiration for biopsy and a more sophisticated test called immunophenotyping. The latter is done to rule out leukemia conclusively. This will be done at St Luke's, Philippine General Hospital or National Kidney Institute. St Luke's was highly recommended.

Yam is now at home resting and takes in food supplements, and a couple of medicines. Her appetite is normal, is in high spirits but is affected by the intermittent fever.

Brods, we need your continued prayers forYyam's quick and complete recovery. Thanks for your encouragement and prayers.

May 11 2006

11 May 2006
Update on Yam's Condition

Thank you all for your encouraging text messages and posts on the egroup. We indeed take comfort from you at all times.

Yam underwent a second bone marrow aspiration from which she had her biopsy and immuno-phenotyping last Tuesday. Her blood smears were analyzed by two doctors in Davao and by two others at St Luke's Hospital. The St Luke's analysis was just phoned in this morning.

Just yesterday, Emma and I had a conference with Yam's physician. She told us of their findings here in Davao and gave us management advise. The diagnosis is acute lymphoblastic (lymphocytic) leukemia. Tthis is what the blood analysis say. We were assured that the prognosis for this type of leukemia for Yam's age is good - i.e. up to 80% survival or complete remission. She was given steroids to arrest the growth of bad cells and to enhance the production of good cells.

We were briefed on the possible chemotherapy management which can commence next week and will last for 6 months active chemotherapy and 2 years management. We were adviced not to have her enrolled because of here susceptibility to infection. We were also adviced to wear mouth masks at home to minimize air-borne microorganisms that can trigger infection.

Just this morning while i was at Yam's school to inquire about the possibility of home study, Emma sent me a text message saying the doctor called up to update us of the lab results from St Luke's Hospital. The test done is called immunophenotyping, an objective and accurate method. The results indicate another type of leukemia. It is AML or acute myelogenous leukemia which normally occurs in older persons. The bad news is that this type has poor prognosis and requires a more aggressive treatment.

Tomorrow, we will have another conference with the physician at the San PedroHospital, Davao City to discuss what can be done.

We are appreciative of Yam's doctor, Dr. Jeannie Ong, a young, diligent and expressive doctor. In her clinic hangs specialization diploma obtained at UST, Univ of HongKong and 1 or 2 prominent others. On another side of her clinic hangs a cardboard filled with cards and letters of thanks and endearment from her patients.

It's a hard time for us, brods. We appreciate your prayers.

May 13, 2006

13 May 2006

Yesterday, I posted an update on yam's condition. Just at noon time today, we had a more lengthy conference with Yam's physician, Dr. Jeannie Ong, to discuss the results of yam's biopsy and immuno-phenotyping from St Luke's Medical Center.

Without getting to the medical profession's jargon and technicalities, the results showed that Yam has Acute myeloid leukemia (AML) which occurs more in both adults than children. This second diagnosis is more accurate than the first as this underwent a more specific and objective process. This type of leukemia also requires a more focused and aggressive treatment than the earlier diagnosis (ALL).

The experience of listening to the doctor's revelation was harrowing even as we also discussed the treatment protocol, the possible side effects, the patient's possible reaction to the treatment, the treatment duration and the comparatively poorer prognosis.

At home afterwards, I can't stand my loving daughter's reaction when we slowly divulged the nature of her illness. She already understands life and was clearly devastated at the eerie possibilities. I had to get out of our room holding on to my tears as her Mom held on to her. (Mothers truly are full of wisdom when talking to a child)

We accept this condition and hold on to the hope of life and the mercy of the Almighty. With your continued encouragement, we will get by.

June 2 and 4, 2006

2 Jun 2006

Thanks for your gentle, compassionate heart. I have always known you to be one.

After 6 days of chemotherapy, Yam was brought home. She seems ok but begins to feel the expected side effects. Will update you later.

(Pare, Please be strong and keep faith. We will be praying for Yam's recovery and victory. I'd like to help. If you have a PNB account, let me know the account details as I would like to send help.—MT)

4 Jun 2006

Thanks for your encouragement and compassion. I'm in Manila right now, just back from Hyderabad. I will have a meeting at CHED on Tuesday and will go right back to Davao the next day.

Anytime is a good time to visit Davao and a visit to Yam is best on weekends since we are at home at that time. Yesterday, Yam was back to San Pedro Hospital, Davao City, for blood transfusion. This is her 4th trip to the hospital since April. Her hair began to fall, on the 4th day now, since she had her 1st course of chemotherapy more than a week ago.

I called her up this morning and she is drinking her milk and eating cookies. OK naman ang kain nya and is in high spirits.

June 7 and 14, 2006

7 Jun 2006
Subject: update on yam (8 June)

again thank you for your concern and generosity. I believe it proper to update you of yam's condition. She was brought back to san Pedro hospital last Friday, June 2, for platelet and hemoglobin transfusion.

As is common to chemo patients, her hair began to fall. She had been saving her fallen hair in a plastic bag and joked that the hair can be woven for my wig. Of course, her hair will regrow, but I can't say the same for mine.

The platelet transfusion was done through a stand-by donor whose blood was extracted, passed on to a machine so the platelets are separated, then the blood put back to the donor. The process is costly but just one donor reduces risks compared to multiple donors.

I arrived Davao June 7, visited her at about noon and she seems in high spirits. She weaker than normal and lies down most of the time. We hope she gets discharged tomorrow if she has no fever. In 2-3 weeks, she will undergo the second course of chemotherapy. We learned that the chemo period seems "easier", the recovery period when the side effects manifest is difficult.

Today, I went to the blood bank to donate my blood. I was earlier routine-checked but when the nurse obtained a sample for final test, she told me my blood didn't reach the "donor level". Malabnaw daw ang dugo ko.

the family is ok. Emma was so touched with streams of encouraging messages and the kindness of the brods. it seems that adversity has its unique purposes and we are thankful of your support.

attached are 3 of yam's pictures. image2747 was taken may18 and image2267 taken in march, when we weren't even aware she's going have leukemia. thanks brods for everything.
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14 Jun 2006
Subject: About Yam

thanks for your quick reply. I tried to ring your mobile phone but you were out of coverage area. so you are in the Philippines?

adversity indeed has its multitude of purposes. In the harrowing two months when we quickly transitioned through a state of uncertainty, shock, disbelief, denial and acceptance, the family closed ranks. friends stood by as we stared dumbfounded to know that such a fine, bubbly, bright, sweet and healthy girl could have such a condition.

well-meaning friends hang around and eased the pain of knowing the vicious illness plagued our daughter. they hastened our acceptance of her condition.

Janice, our 14 year-old daughter, matured in so short a time, taking on humbling chores she never did before and went through scant sleeps at night to attend to her younger sibling's occasional whims.

we were on our knees as funds dipped low in so short a time and realized our great vulnerability. we realized our inevitable need of others - not just to salve our pained hearts and assist us in the occasional brisk pace of attending to yam's needs but to chip in to the piling hospital bills.

we hopped from doctor to doctor whom we knew could give us sound advice only to fully realize that only God could heal surely and completely. through it all, we are hanging in there quite well, thanks to friends, whom we certainly need as we provide personal care and medical attention to yam.

we continue to beseech God for a miracle and be spared of the usual effects and side effects of medical treatment. we also set aside our hesitance in seeking friends' help as needed. that's why we appreciate your initiative. we will keep you posted and thank you very much for everything.