A January Valentine's Celebration
(Stephanie's words) Just got back from Bangkok - it was a great trip, Mark looked really good, though it is still obvious he is very sick and is in pain much of the time. We relaxed on the island while there, and Mark and I got to relive some of our childhood memories; it was interesting to see how two different viewpoints of memory can still both be correct. We checked our views with mom and she had a third viewpoint! The picture is of Mark and me having fun on the beach with an English elementary teacher from Japan who had his hair done in an interesting style for the holidays. He had to cut the hair off before returning to "normalcy" in Japan.

Mom has a great new idea: she's been working hard to keep Mark healthy and shops for his fresh food daily, preparing meals at home and trying to get him to eat a small amount every 4-5 hours. We know that Mark does better when he can eat (he suffers from nausea frequently, though) and we also know he loves adventures and even the spark of a thought of going somewhere perks him up. Mom's thought: we're going to ask everyone we know to send a Valentine's card to Mark, NOW through Feb. 14. Just before Valentine's day will mark the anniversary of his diagnosis (see archives of blog for Feb. 05 postings) so Valentine's cards now will cheer him up and help him work towards that next month and big anniversary. Many people have sent him cards of encouragement, and he truly does appreciate them- he has the cards displayed nicely on the bookcase in his living room. It is wonderful to see how many people have him in their thoughts. So, friends- please take a moment to send a Valentine's card or note or even postcard. Anyone who has happened onto this blog and is interested in doing this, no problem - send my mom an email (see link in profile) and she can tell you the address. We welcome new friends.

A Happy New Year to all of you.

Christmas On the Island of Koh Tao
Mark's sister, Stephanie, came to Bangkok, to join our family trip to the island of Koh Tao for Christmas. Koh Tao and Koh Nang Yuan are where Mark wants his ashes spred when he dies and we wanted to bring him here at least one more time alive and hopefully many more times if he can hold this cancer in check. Koh Tao means turtle island as it is shaped like a turtle.

On Dec. 21st We flew to Koh Samui on Bangkok Airlines. This airline gives you free food and drink in the airport lounge and free internet, not for VIPs only but for all passengers. When we arrived in Koh Samui, we bought tickets to go on the High Speed boat to Koh Tao and were taken by van to the waiting area near the boat dock, where we sat in the sand in plastic chairs under a canopy in the rain with an international group of people waiting to go scuba diving or just vacationing on Kah Tao. I spent 30 minutes talking in Spanish to a woman from France and we exchanged e-mail addresses. For an extra dollar or so we rode in the VIP lounge on the high speed boat to Koh Tao. Almost everyone barfed except Mark and me, and I was very close to barfing most of the trip. It was the roughest crossing I have ever made. It has rained so much and the seas are so rough that some days the boats have been unable to ferry people from Koh Samui and at one point the Navy took some people off Koh Tao so they could fly back home as they had been stranded. The weather has cleared up today and there is promise of great weather for the rest of our trip.

When we arrived in Koh Tao, Mark was energized and laughing and talking and excited. Instead of needing a wheelchair like he usually does in airports, he outpaced the rest of us and arranged a truck to take us to our bungalos on the beach. We all jumped in the bed of the truck with the luggage.

This is a low budget trip to places Mark stayed when he was here before. Stephanie and I are in a bungalo without hot water but we have TV and airconditioning for about 35 dollars a night. Mark was in one of these until he got extremely cold and we moved him to a nicer room with heat and hot water as well as air conditioning. He lets us come down for daily showers so Steph and I are back to hot showers.

There are many wonderful places to eat here and food is extremely cheap, though Mark has been on a pizza kick, so we've eaten twice already at "Gringos", perhaps the best pizza in Thailand. The beach is beautiful and each morning Steph and I get up early and eat our soup-breakfast at a hut-style restaurant on the water; we take our reading materials and just relax leisurely.

Christmas eve dinner was on the beach. Mark had been sick all day but recovered by evening. We went to the place where all the young divers were gathering to celebrate. We had a buffet with lots of different foods including turkey and gravy (Mark loved it) at Ban's Dive Restarant. Our table was on the beach and we saw fireworks as we ate.

It will be a different Christmas but experiencing Mark laughing and smiling makes it a very good one for Stephanie and me. This is like "Make a Wish" time. Stephanie and I are fullfilling Mark's wish before he dies, instead of a foundation fullfilling it. We are the make a wish team in Thailand although it is actually less expensive being here than being in Bangkok, but don't tell anyone because the more Americans and Europeans that come here, the higher the real estate and tourist prices will soar.

We will be thinking of you where ever you are and wishing you a very Merry Christmas.

Another day at the hospital. Dr. Theera Umsawadee said that Mark was the bright spot in his day as Mark is his patient who is doing the best. Mark looked great as usual with a tan sport shirt, dress black slacks, belt, and new black shoes from Austin trip. Best dressed and healthiest looking patient in the waiting room. Although he looked great, Mark complained of feeling VERY bad today and he was eager to get back home. Today there were patients of all ages and nationalities in the waiting room There were several little kids in the waiting room who have cancer. The kids come from all over the world.
Dr. Theera is waiting for results of tests for folate and intrinsic factor, but reported Mark's CBC is good today. His CAT scan report indicated all abdominal systems are functioning well and the tumors are no worse..maybe slightly improved but certainly no bigger and no evidence of further metastasis. His endoscopy showed improvement in the GE tumor and the walls of the esophagus. Chemo on the 28th again.
Our Sunday school class has collected the money for Mark's chemotherapy this month. Dr. Larry Lake our teacher is collecting funds for Mark and you can contact Dr. Lake about how and where to send a contribution that is tax deductible.
Mark is worried he will be too sick to go to the islands of Koh Samui and Koh Tao on Wednesday. He wants his ashes spread there when he dies. Stephanie and I are determined to get him there one more time while he is alive and hopefully many more times.

December 16, 2005 The Sights and Sounds of Bangkok

I wish I could share the sights and sounds of Bangkok with you in person. Some things here are beautiful beyond belief. The flowers are arranged so beautifully and there are flowers everywhere.The Thai people are very artistic and creative. On the other hand, the sidewalks and roads are treacherous. You must watch your step every minute.

There is food to buy everywhere. There are huge markets all over the city where you can go to purchase fruits, vegetables, curries, eggs, dried foods, seafood and meats of every kind cut before your eyes. There are fruits and vegetables that I have seen no where else but in Thailand. I am now going to one of these markets just one subway stop from the condo. Jin and I buy all we can carry and it costs about 200 Baht or less (about 5 dollars), unless I buy huge shrimp and then it would be about 400 Baht.I get a cooking lesson from Jin who takes good care of Mark and me too.

There are also street carts with food being prepared on them everywhere all over Bangkok. You select ingredients from the cart and buy food cooked before your eyes. No one ever seems to get sick from either food carts or restaurants. The people are very clean and remember they don't shake hands...They do what is called Wai (pronounced like the letter Y) and that is to put the palms together and bow the head slightly. It is much more sanitary than coughing and sneezing on your hands and then shaking someone's hand. They are also very good about hand washing.

Yesterday I sat and watched a woman preparing food on one of the street carts. Every afternoon people go on the street to get soups, salads, and fruits, from street carts, to take home.The Thai people eat very healthy diets. Many never cook, but just buy food from the street carts. Some homes do not even have a stove because it is not needed. No matter how hot it gets, people eat soup. Some I can eat, but not the one that is made from chicken entrails.The entrails are sold in a plastic bag along with several egg yolks. The woman chops the entrails up and puts them in a hot broth and cooks them along with green vegetables and possibly some mushrooms to go into the soup and of course lots of small red peppers that are hand ground before your eyes. Every ingredient is fresh. Mexicans and Texans cannot hold a candle to the Thais when it comes to eating spicy hot foods. They eat hot red peppers every day, virtually every meal, and in nearly every dish. If you were here, maybe you would like some fried bugs? There is also the bug cart where you can buy fried bugs of every kind to eat. There is also food prepared on the Soi (pronounced Soy which means street) that we Westerners can eat. Check the blog later and I will tell you more about Mark and about Thailand.

Things Get Moving When Miss Betty The Mom Goes to Bangkok - Endoscopy and Cat Scan ..the works and we didn't even have an appointment.

It's been a whirlwind last four days and even before that. I worked a few days at the drug study clinic then stayed up all night on Sat. wrapping presents for kids and grandkids who will be in Austin Texas for holidays with James, cleaning bedrooms, and finishing packing for the trip to Bangkok and tying up loose ends..then it was off to the airport where I learned that American Airlines now has a limit of 50 pounds per bag...less than United or N. W. Airlines so when the agent weighed the first suitcase and it was 35 pounds, james took off for the x-ray machine that then loads it on the conveyor belt...The agent weighed the second bag and it was 55 pounds. I had to yell like crazy accross the airport to get james to stop as he was at the x-ray machine ready to put the bag on...I stopped him at the last minute and made him bring the bag back and on the floor in front of the agent I repacked...This saved 25 dollars in over weight charges as it is a hard and fast rule of 50 per bag and not 100 total for two bags. One bag could weigh 5 pounds and if the other is 55 then it is an extra charge.

The trip took about 28 hours and was fairly uneventful except for not getting aisle seats. One leg of trip I sat next to a young man from Brazil who was going to soccer matches in Japan. I was second in from the aisle. When he fell sound asleep I crawled over 5 people to go to the bathroom. On the last leg of the trip I sat next to a very very old couple who coughed and sneezed their way from Tokyo to Bangkok. I had the window seat so had to crawl over both of them to go to the bathroom and not only over them but the woman had a suitcase on the floor...not under the seat but on the floor with her feet on it, so I did an imitation of a Russian Ballerina doing a cross between a lateral arabesque and a pirroette to sail accross two people and a suitcase.

When I got thru the long passport check and visa lines and down to baggage, it was past midnight in Bangkok. I was wondering around looking dazed when a Japanese Airlines Agent chased me down and asked me what flight i was on and said my luggage was not put on the plane. I filled out paper work for an hour and just as I finished, someone found my suitcase. It was good since I had two HEB cooked briskets in one suitcase. If lost for a week they might smell bad.

The taxi line was long as usual even though it was after midnight...(most flights get in at 11:30 pm.) I got to Mark's condo at 2:30 am. Word had been left at the outside security desk that the Farang (Foreigner) Madame (not Madam..it is all in the pronunciation) was to be expected and helped with luggage.

By 10 am Mark had decided he was feeling bad and wanted to see Dr. Theera but Dr T's was not in the clinic today and there were no patients there..I think it was a government holiday. The staff told him on the phone that the doctor had no clinic today, but Mark held in there and Dr. T. said he would see Mark if he came right away. Dr. Theera was very kind and acted as if he would give us all day if we needed it...He examined Mark and after a chat it was decided Mark would have endoscopy and a CAT scan. The doctor arranged the endoscopy to occur nearly immediately. At 2:30 PM Mark was having an endoscopy after an evaluation by the endoscopy doc...He was out of recovery at 6 pm and we headed home after taking a couple of pictures by one of the many decorated trees at the hospital.

Tomorrow at 8 am Mark has an appointment for a CAT scan and then he will see Dr. Theera again. I think Mark has been scared to schedule this endoscopy and CAT SCAN earlier and has been putting it off. He was a tad nervous before the endoscopy, but it happened so fast and was over fast so he had little opportunity to delay it.

By midnight today which is less than 24 hours after my arrival, Mark has had a visit to the doctor, seen a specialist, had endoscopy, eaten supper, arranged a dinner party, instructed me in various tasks, and is on his second load of clothes that he is personally washing. We will be at the hospital tomorrow at 8 am prompt.

The saga will continue and you will learn about the results of the CAT scan and the endoscopy.
Tune in again.

Mom and I are on the way to Bangkok for Christmas. (Stephanie's words) Mom left yesterday (Sunday am Austin time) and makes about 3 stops before landing in Bankok a day or so later. My vacation starts in a week, so I will follow then. Mark called a few days ago and was very excited that we might get to spend a few days on one of the islands in Thailand... that's been the goal since he moved there for treatment, but something else has always come up. Mom's packed brisket again and I stocked up on Mark's favorite snack foods that he can't get there... the number one request was for Pizza Rolls (they have some in BKK, but it's $30 a bag!) so I am working on how to keep them from melting on the plane. We plan to have a nice holiday, wherever we are, and Mom has packed our childhood stockings, and I have bought a Texas cowgirl-boot stocking for Mom. Santa, if you're reading this - we'll be leaving some yummy Thai goodies out for you!

Jin
Mr. Mark's Alien Baby Hat Knited by Friend Jin In an earlier blog, Mr. Mark shared that his friend Jin was knitting a neon green ski type hat that Mark claimed looked like it was suited for an alien baby and he told Jin to keep it in case they saw some aliens. Mark has chills at times and wears a ski hat and wraps up in a blanket on the balcony in the hot Bangkok sun to counteract the chills. He has taken to wearing the Alien Baby Hat and decided he likes it. He has suggested that Stephanie and I get one too in the same color and if we ever get to go skiing again like we used to that we will be able to spot each other easier on the slopes. The visability distance of this hat, according to Mark, is in the 100 yard range. He claims that if you are caught in an avalanche, the hat might stick up out of the snow and be visable by a passing helicopter. This hat is a potential life-saver. Mr Mark's days are tough most of the time. He says he can take it if he has a good meal once in awhile and cards and letters. Mr. Mark claims to have made the perfect Caesar Salad this week, making the dressing from fresh ingredients. He also fixed one of the briskets I took him in my suitcase this last trip over and claims this helps his quality of life too . He will have another round of chemotherapy on Monday.

Mark spent a whirlwind two weeks in Austin, Texas before heading back on Tuesday to Thailand and Bumrungrad Hospital to continue his chemotherapy there. He almost delayed his leaving to stay over Thanksgiving, but in the end did not want to be too long off chemotherapy. He gained about twelve pounds and learned more about how to control his pain (Thanks to Dr. Brown and Eloise, a hospice nurse in our Sunday School Class), and from the internet he learned about foods high in iron and what to eat to elevate his low hemoglobin and hematocrit. It was interesting to learn that clams are very high in iron: much higher than spinach, grits, and steak and other things I am used to thinking are the best sources of iron. We made a huge pot of Manhattan clam chowder, ate steak, and cooked lots of shrimp (fairly high in iron) and this may have accounted for a rise in his hemoglobin and hematocrit on his last Complete Blood Count (CBC). Mark relearned that he still has some friends and other folks in Austin who care about him. He could count these things among his blessings along with the fact that he is still alive after being told in Feb. this year that he would be dead in three months.
On Being Positive
Mark, his sister, and I continue to strive to be as positive as we can be. That does not mean that we don't have times we worry about running out of money or running out of time and Mark dying way too young. He reads the obituaries and checks to see if anyone younger than he has died. One man had died at 47 and Mark said: "Maybe I can make it to 47. " I held him four mornings in a row while he cried and I cried too. It was good to cry, but then we had to move on and do what we could to deal with the problems and enjoy the day.
Return to Bangkok with gifts
Yes, he is back in Bangkok with two suitcases full of brisket, eight pounds of canned hominy for his friend John, hot sauces, a small vacuum swiffer for Jin and other gifts for friends there. He came with a very small carry on and a small check bag with only clothes. I went to the attic and got two big suitcases for him to take things back in. Alex, a good friend of Mark's from Saipan arrived in Bangkok shortly after Mark arrived and is visiting with him now. This brightens his day and is another blessing to count. We are very blessed.

On Wednesday Mark was evaluated for cyberknife and it was a positive experience in many ways. I am very grateful to Dr. Wilson and nurse Catherine for their kind treatment, positive attitudes, and professional manner and the time they each spent with Mark and I. It was one of the best medical experiences I have had in my life time and yet Mark is not to have cyberknife, at least not yet. I'll let you read what Mark wrote about it.

Thursday November 17, 2005
Dear friends, Just to let you know I was evaluated for the cyberknife yesterday and was expecting bad news like the cancer is too advanced or something like that to indicate I was not a candidate for cyberknife, but no...not at all. Mom and I were in the waiting room waiting to see Dr. Wilson. I was filing out the forms for the cyberknife evaluation and talking with a fine gentleman, who is in the process of cyberknife treatments, and his wife. He is over 65 and has battled several sites of cancer and continues to battle cancer and other health problems. He has Medicare and even Blue Cross that pays for cyberknife. I sat there across from him in the waiting room, happy he can have cyberknife. He tells me it is wonderful. It doesn't hurt. It has reduced his pain a lot and he is happy. He highly recomends the cyberknife. I am worried the doctor will say I am too far gone for this treatment. Mom is worried too. In the evaluation, Dr Wilson spent a lot of time with us and was very encouraging. He went over my CAT scans of February and September and showed me that the liver cancer had shrank considerably through chemotherapy. He told me I could have cyberknife and it would reduce my pain and diminish my liver tumors further and cut off blood suppy to the tumors, but it would not cure...I would have to continue chemotherapy...So I was all encouraged thinking maybe I could get my pain at a bearable level and the tumors to a point the chemo might finish them off. Then the bad news came out. Cyberknife would cost me 50,000 dollars. Mom was going to give me $15,000 if that were the cost, but it turns out that the cyberknife costs around $15,000 only if medicare pays because the hospital, and probably the doctors too, take medicare assignment and that is all medicare will pay. If you are on private pay, cash out of your pocket the cost is around $50,000. That is a lot of money. You know I am too young for medicare, but I don't have to wait until I am 65. I have to wait two years after applying for SSDI to get on Medicare. I can have Medicare and get cyberknife in Spring 2007, about 16 months from now.I don't know if cancer will let me wait. If I had kidney dialysis or Lou Gherigs Disease, I could have medicare immediately without waiting as these are the two exceptions to the two year wait for Medicare. If I were over 65, I could have Medicare at the next enrollment period which is January. I can's help but ask: "What kind of system is this in which young people with cancer, who are in their working prime have to wait two years for government help to kill the cancer and go back to work? Most will probably be dead from the cancer before the system kicks in. I guess I should be thankful that if I can keep myself alive for 16 months or so by keeping my cancer under control through paying out of pocket for ongoing chemotherapy and dealing with feeling awful from the chemo and endure the pain , I can hopefully have Medicare and cyberknife.
People in the states keep asking me why I don't get treatment in the United States instead of in Bangkok. The answer to this question is simple: I can't afford treatment in the states. I head back to Bangkok on Tuesday to be treated there. Cancer is a full time job and I am working overtime. Mark

Latest Adventure - Mark flies from Bangkok to Austin for "Last trip home."

When I last posted I (The Mom) was in Bangkok with Mark. I left Bangkok at 6 am on the 27th of Oct to come back to Austin, Texas. Mark had been saying that he was too sick to make the trip to Austin, but on the day before I left, he suddenly insisted that I get him a ticket to Austin after his next chemotherapy in two weeks. He had not walked more than a couple of blocks at any time, but he insisted on walking 12 blocks to the travel agent to pick up the ticket. He had to climb a lot of stairs to an overpass, rest at the top, then cross and go down stairs on the other side. I was urging him to take a taxi but he decided to build up his strength for upcoming trip to Austin. He also walked the 12 blocks back to the condo. I was certainly amazed. He passed the next two weeks getting ready to come home, getting copies of his records and images and packing enough medicine, etc. He went to get chemo and spiked a temp of 103 during chemo. The infection control doc hospitalized him and wanted to keep him for observation for days...After a couple of days of no fever, I called the doc in Bangkok and asked him to turn Mark loose since he was only getting his temp checked every three hours and it was normal...but in the end he had to sign out AMA.

Mark arrived in Austin on the 8th of Nov. after a long long trip of about 22 hours. He looked great but reminded me he is sick on the inside. He had 3 plus pitting edema of his legs and feet. His eyesight is now fine after surgeries and procedures by specialist in Bangkok so he immediately borrowed my car after not having driven for 10 months. He still has a current drivers license from the Northern Marianas Islands. He immediately started visiting friends he used to work with at the local hospitals and elsewhere. He has gotten together with Bruce and Frank and Steve. He has talked on the phone or gotten calls from Randy and Dave and Paul and others.

He is only home two weeks unless he extends his stay so he has had a terrible sense of urgency about getting things done and people seen. Some of the guys facilitated him getting to see a pain specialist here. My workplace (Dr. Brown's CCRI) got his CBC done.

He has an appointment next wednesday to be evaluated for cyberknife. He realizes his cancer may be too advanced for cyberknife to help. It is not a cure for liver cancer but could give him some more time and less pain if he is a candidate. Cyberknife is more expensive than the plastic surgery I was thinking of getting to make me look better on the outside....I could have my whole body redone for what we will have to pay out of pocket for cyberknife...but guess what they say is true...It is what is on the inside that counts. Mark's insides are more important than my outsides.

Medicare does pay for cyberknife, but ironically Mark has to wait two years after being disabled with cancer to get Medicare. If he had kidney dialysis or Lou Gherig's Disease the two year wait would be waived...says a lot for the renal dialysis and Lou Gherig's Disease lobbies..but it somehow feels like discrimination in health care coverage by the government. I am writing a letter to Lance Armstrong asking him to work on this and put a word in for cancer patients when he sees Pres. Bush later this month. When I taught nursing one of my male students took a week off from school to help take care of Lance Armstrong early on in his treatment for cancer. Most students could not do this and still pass but this guy was very bright and motivated so it worked out ok.

I will keep you posted about Mark's adventures in the states before he returns to Bangkok. He thinks about moving back to Austin...but access to health care is a challenge and it is very costly compared to Thailand. Public transportation on a scale from very poor to very great, finds Austin at the very poor end and Bangkok Thailand at the very great end. Many people in Bangkok don't have a car even if they can afford one. You can get where you are going easier and quicker and cheaper by the sky train and/or subway or in nonpeak hours by taxi. Sometimes when I am on one of Austin's major roadways (like MoPac) and it is like a parking lot with traffic moving at 5 miles an hour or slower, I long for the skytrain or subway of Bangkok. Austin will never have great public transportation as our decision makers prefer to have tollroads which are the answer for the affluent and people who make money on toll roads rather than the answer for the homeless, the poor, the sick, and those who don't drive or can't drive.
Tune in for the continuing adventures of Mark Richardson and his mom's soap box discourses.

October 16, 2005
It has been a busy past week. There were visits to the Horizon Cancer Treatment Center of Bumrungrad Hosp. for lab tests and neupogen injections to bring up low neutrophils (immature white blood cells). There were lots of highs and lows for Mark this week.
The lows have included feeling awful at times and fighting nausea and thinking about the cost of the nausea pills which are $10 each one (cash out of pocket), but I am told that these pills cost much more in the states.
The highs include a party we threw at his friend John's place, for friends and some ex patriots especially some with Texas ties. I had brought a suitcase full of smoked brisket which John had professionally sliced. Mark's friend Jin and I made a mountain of cole slaw with a vinegrette dressing. John baked home made bread and made home frys. We served over 60 people...started out to be 35 or 40. Mark was so happy and profusely thanked me for the brisket and for making this possible. At first he wanted his cole slaw with mayo...and was bad mouthing the idea of vinegrette dressing but then all of a sudden he decided it was great. It is made with an old recipe from a restaurant in Calhoun County Illinois. It keeps for days but we did not have to worry about that as it was eaten before before the night passed.
Thanks to those 10 dollar nausea pills, Mark has been eating brisket every day. His other favorite right now is a thin hamburger patty cooked well done with some pickles and tomatoes. I brought the pickles from Austin since you really can not buy good pickles in Thailand . My back pack had a gallon of pickles in it. Two checked suitcases and two carry ons and none contained much in the way of clothes....mostly food and books.
Mark and I have had some serious talks as he is dealing with many important decisions about life and death and how to get what he needs from the medical profession which is not easy and could be termed "the impossible dream" . Most of us deal with that on a small scale. People with cancer are playing for higher stakes.
Each day becomes more important. Mark's world is so small in some ways right now: the cancer center and his balcony and the condo and a rare trip elsewhere. But it is big in other ways. He reads a lot and is curious about the world and tries to figure so many things out and shares with me those he has figured out. Some we are not quite so sure about like could we really fry an egg on the hot Bangkok sidewalk, but it is fun to think about such things. We are both more and more interested in the history and present day happenings in the countries around Thailand as well as Thailand itself. Mark is also interested in the happenings around him. From his balcony before dawn each day he watches the Hindus gathering accross the street and listens to their chants and music. Sometimes he thinks he recognizes an old late 60's or 70's tune in what is really some Indian music. He watched two storm fronts come together two days ago. He saw the lightening strike the Sheraton Hotel lightening rod and some other ones as well and yelled at me to come join him to see it. It was a fantastic show of nature. There was a beautiful rainbow after the storm. Mark seems so finely tuned in to so many nuances of nature but then again he always has been.
We are going to try to go this week to a village near the mountains. On the way we will stop at a large "farm" with a dairy herd and cowboys. I saw it on Thai TV. There are Thai cowboys there complete with outfit, hat, guns that they twirl just like on old cowboy movies and they rope the steers. Visitors can milk a cow and have lunch of T-bone steak. We will also stop at a Thai winnery. Sounds just like what tourists in Austin might do....go out to a ranch and a hill country winnery. One difference, we will be near a jungle full of orchids, mushrooms, and other wild things when we are in the village. Mark was resistent to going at first but now he is getting real excited about this excursion. This is going to be our big adventure this week if all goes well. Mark , his sister, and I send hugs to you. Miss Betty the mom

October 11, 2005
I arrrived in bangkok on Oct 3 one week ago at 11:30 pm which is the most usual time for flights from USA via Tokyo to arrive. The trip was long and I spent the long leg of it caring for a woman who fainted and vomited all over everything (including herself) in the rear galley of the plane. What a challenge. No end of adventures to be had. Mark was overnighting in the hospital for chemotherapy. I made my way to his condo in a taxi. It is all familiar to me. I slept a few hours and went to the hospital. where I found Mr Maark as they call him here (he calls himself "Chemo Man") , looking great; the best I have seen him in the past six months after the cancer diagnosis. Mark has a tan from lying on his balcony and he has been eating a lot. Do you have to worry about getting cancer from sun exposure when you already have cancer? My guess is "no" and anyway Mark enjoys this sun bathing.

I went to Mark's eye doc appointment with him and he got a thumbs up on his eye that had received the surgeries. On the way to the eye appointment, he walked the last two blocks after our taxi got stalled in heavy traffic and then we climbed two flights of stairs at the hospital on our way to the Laser Eye Department. This was remarkable . Mark was in the very best shape I have seen him in for months. The roller coaster was climbing high. We began planning a trip to the mountain village of our friend Jin and yesterday the driver was coming for us when we learned Marks WBCs were very low and he began vomiting so he was side-lined by the doc...got neupogen and to return for repeat CBC wed...The roller coaster has taken a low dip after going up high. Our driver was cancelled and our trip postponed.

Today I am up at at 4:30 am working on Mark's computer. Mark is up at 5 am to listen to the city and watch it from his balcony. Below on the street the garbage men sort through all the sacks of garbage from the condo and take out cans and glass. This is the way we recycle here...We toss it all in and men sort it out. Accross the street the vegetable and fruit and meat and fish market stalls are dark...the Buddist retreat center is a bee hive of activity as eating and singing goes on at dawn and then the many many Buddists in white turbans and robes...leave in their cars and busses..Behind the Buddist retreat is the Baptist Retreat...dark at this hour and beyond that the Westin Hotel and we can see a number of tall buildings including Times Square Building which Mark loves...he tells me he loves the colors of it as sun reflects off it. We can see the sky train start up the day...It has been dark but it comes to life and begins to run...I love to watch the sky train. We can see the river...so much to hear and see from the balcony where mark has chairs and his recliner and his plants which he tends until they are perfect. What a place to be. i love Bangkok almost as much as Mark.

So much to see and do in Bangkok. I have spent a fair amount of time this week while Mark slept, at Pontip Plaza a huge techological building with many stores and booths within it. I have a young technician i trust and he lets me sit on a stool for hours watching him work on Mark's computer which is now perfect after correcting various problems which the computer had. I have met some of the customers who are international and multilingual..and helped sell a separate fan for laptops to some young Italians.

Mark is reading again. He is reading Bangkok Tatoo which is a detective story and mentions the corner where we live...I am reading the Thai Amulet which tells of many places I have visited. We saw the movie about Stephen Hocking who discovered the big bang therory..and Mark is fascinated by Hocking and wants to read the book. We have played with a game that Clift and Sue Price Sent. It is a lot of fun. Mark has counted his money you all sent and has counted his Kool-aide packages and enjoyed the book tapes and the candy and pudding and other things that people sent These are all reminders to him that people do care. and have made his low points in the roller coaster ride bearable. Mark has made a list of everyone who sent anything and wants me to thank each and every one. He is greatly touched by your kind words and your reaching out to him in hopes of pulling him back to health or easing his time of dying. Cancer is a terrible companion... uncertainty and unpredictability the only things that seem predictable, certain, and constant about it. My thanks and Mark's thanks and love to all of you. Miss Betty the Mom in Bangkok, Thailand

9/26/05 Mark goes into Surgery tonight USA time...It is morning 9/27 in Bangkok and evening in Austin Texas. This is for a biopsy of the kidney because a suspicious spot seen on CT scan. As soon as I hear the results, I will post them. Mark was down a bit because of this. Friends, relatives, strangers have been blitzing him with letters of encouragement and enclosing five, ten, or twenty dollars or a few euros to help with his latest expenses and keep him opening mail when he won't e-mail. He says his treatment is a full time job with overtime and he can't fit that e-mailing in...and he does not feel up to doing it. He keeps all his letters and cards and has his favorites that he reads over and over like one from Tom Zimmerman, a therapist colleague of mine. Mark told me that Tom said: "My hand is on your back, buddy" and some other things that lifted his spirits and gave him hope. He has other favorites...some posted on his refrigerator like one from a student of his sister Stephanie...and probably one you sent. It does not have to be a purchased card...just draw him a picture or write a note. It does not have to be money. It could be koolaide or a small package of taco seasoning. Postage is 80 cents if you don't exceed the letter weight. E-mail me for the address if you want to send him a postcard from somewhere in the world or a note of encouragement. Hugs to you all. Miss betty the mom

Stephanie's Update- It's now 9pm Japan time on the 27th, 7 pm Bangkok time. I just got off the phone with Mark - he goes in for the biopsy in about 12 hours. He was upbeat on the phone, but he also said he worries about the pain it will involve; Mark tolerates pain fairly well, but he said the eye procedure was excruciating and he knows what to expect from this biopsy, so he's thinking about that.

Markie's always been a slow waker- he just doesn't get up and out of bed in a happy mood - it takes him a while. Tonight was no different - he grumbled and growled and said he couldn't hear the phone. But it only took a few minutes and he was talking away about how the weather is, what friends had called recently, new neighbors he had met upstairs, 400 years' of war between Burma and Thailand, etc. Mark had been on my mind heavily for days and so I told him I had been thinking of him and he seemed happy to hear that. He also told me to be sure to say hi to Jessica. the student who wrote the poem that is on his fridge. Mark's really happy to know Mom's coming for a visit soon - he was obviously happy at the thought of going to the beach (2 hours from Bangkok) and soaking up some sun and solitude.

Having cancer or a relative with cancer is like being on a roller coaster ride. Some days there is good news and some days there is bad news.

Today I got a call at 8:00 and it was Sarah asking if I could come work at Dr. David Brown's office this morning. I stopped on the way briefly to have coffee with my wonderful and understanding friend Olga whose father was a pathologist and who lost one brother to cancer and has a twin brother, a psychiatrist who is fighting cancer and other health problems now. Olga and I talked about how cancer is like a roller coaster ride. I had just told her about how upbeat and hopeful Mark was yesterday when I got a call from home telling me Mark had called and his mood was down because his cat scan results were given to him today and he has something odd on one kidney that has to be biopsied. Olga gave me a big hug. Later I listened to the message on the recorder and Mark was concerned this might shorten his "time on earth, " and he said: "It's good you are coming to Bangkok now." I will double my efforts to try to get friends and family and strangers to send him notes of encouragement and I will do my best to encourage him too. He is not ready to give up the fight.

It is odd but off and on all day I have thought not of the trips described in previous blogs but of the MEDICO trips that Mark and I took together and our scuba experiences on the island of Roatan after MEDICO trips. MEDICO stands for MEDICAL EYE DENTAL INTERNATIONAL CARE ORGANIZATION. MEDICO takes volunteers to Honduras and Nicaragua to give care to people in remote and underserved areas. I made 14 or 15 trips with MEDICO and was so fortunate to have Mark on some of the same trips. Mark still wears his MEDICO shirt and heads off in the taxi to chemo wearing it. You will see in the picture of above, he lost a good bit of hair and looked a bit pale but still proud of his MEDICO experience.

One of our more remarkable trips was to the Moskito Coast of Honduras. Our team was flown into the Moskito Coast by the Honduranean Army (arranged by a Rotary International Rotaract group). When we went to board the two planes, Mark and I split up and each went into a different plane. The planes were ancient. One had a large fuel tank in the middle and it was leaking and puddling down the middle of the plane. The other had metal seats down both sides and the exit door said "In case of emergency, use axe" and I didn't see an axe. I yelled at Mark as I boarded the plane: "Spend your inheritence well."

Luck was with us and both planes arrived in the Moskito Coast where our team spent sun up to sun down seeing patients all day long. We could not carry in enough water for a team so we drank river water with chlorine drops in it. Large rats lived in the rafters of the rooms we slept in so no fruit could be left out by the bed or you would awake to the chomping of the fruit by the big rats.

The day we were to leave, we found out our departure was delayed a day because one of the two planes had broken down. We had an unhappy crew. The military base not too many miles from from our clinic put us up and cooked a good supper for us to keep our group happy. The next day our planes came. They landed, but we did not board immediately. The army cooks prepared breakfast for the pilots and served it under the wing of one plane. At the same time, some soldiers unloaded the supplies from the plane: lots of cartoons of eggs and boxes of food and supplies and a coffin of a local woman who had been in difficult labor and flown to the city where she died in labor and was returned via coffin. It was quite a scene, the pilots sitting at a table with table cloth and silver coffee service and formal service by waiters and the cartoons of eggs piled high near them along with a coffin. A station wagon came and loaded the coffin while the pilots ate. The coffin stuck out the back door of the station wagon and when the wagon started to drive away, the coffin fell out.

Finally our team loaded up and took off, our crew not too happy going home a day late. Unlike the rest of our group, Mark and I were headed to Roatan to scuba dive. Mark was diving with one dive master and I was taking a scuba course with a different scuba master. I arrived a day late and had to catch up...immediately demonstrating all skills the rest of the class had taken. The class was three men and myself. The men were all young, muscular, and over six feet tall. On the third day of the course, I was exhausted after 12 days of hot sun working sun up to sun down in the Moskito Coast and two days of heavy duty scuba with jocks. I awoke late and had no breakfast. This day for some reason Mark went with us out on the scuba dive along with his dive master not our dive master (who may have been under the weather and the other students). The water was extremely choppy. I was the first to go in going over backwards off the boat. I had to hang onto a buoy line to keep from being washed away waiting for the others. We went down and were moving along pretty good when all of a sudden I lost all my energy: a result of exhaustion catching up with me and no breakfast...I could not get myself off the bottom with any BC adjustment.

I had not panicked yet but was close to it as I was wondering what I would do as the others had left me behind. While Mark was not buddied to me, he missed me and signaled to the dive master who deputized Mark to stay with the students while the dive master came back for me...When I hit the top I was in bad shape, coughing struggling to breathe, gasping for air and this continued for two or three hours after getting back to the dive shack. It was our last dive of the course. I took the test that night, passed it and passed the course, but the most important thing was that I was still alive. I credit Mark with saving my life. I owe him and it is pay back time.

Sometime I will tell you about our MEDICO trip to the Nicaraguan Moskito Coast where we were accompanied by guards with big guns and slept in a tree house built especially for our team and woke up in the middle of the night in a sideways rain. OOPs I told you a lot of it, but there is more....

Mark called this morning at 5:30 am. I was already up and eating breakfast as I am working today at 7 am to make some money to help Mark out with his expenses. He had a cat scan yesterday and is awaiting the results. He had some kind of contrast dye put into a vein in his hand and the vein was blown, infiltrated, and he has been uncomfortable with it and it wakes him sometimes from sleep.
Mark was in a mood to talk business today and we went over his finances on the phone. He wants to stay in Bangkok as long as he can as he has great confidence in his doctors, nurses, and the hospital. He will come back to the USA when he runs out of money and his fear is that he will not be able to access care as easily as he can in Bangkok.
We were discussing his hospital bills. I noted that there was an early x-ray that cost 230 baht which is under 6 dollars. The radiologist fee for reading this x-ray was 115 baht or just over $2.50. The radiation was about 300 dollars a treatment which he had daily for awhile. The neuclear medicine radiologists fee was just under 50 dollars a visit. The chemo doctor's fee is about 25 dollars a visit. Ultra sound was about 125 dollars. An overnight stay was $275 for the room. Three days of chemotherapy seem to cost about a thousand dollars because everything is billed and that includes bills for nursing service, doctor's fees, the room, IV's, chemo drugs, antinausea drugs, various pills and lab work. Drinking a pepsi out of the stocked refrigerator in the patient room costs less than 50 cents. While many things are cheaper than the USA, some things like pain medication are extremely expensive compared to the USA. The nurses and doctors are extremely respectful to and kind to the patients. Every staff member is professionally dressed. The nurses wear caps and answer the client's light within seconds. One of Mark's bills was for about 400 dollars for the radiation doc. Mark explained this was for several visits and it was worth it in his mind as the radiation doc knew her business and early on shrank his tumor and made it possible for him to eat solid food after being on liquids due to the size of the tumor compressing his esophagus. Mark also said: "And after all Mom you can't even hardly buy a set of tires for $400. "

2004 picture of Mark and Mom (me) on Koh Nangyuan off the coast of Thailand; this island is like three little islands joined together. We snorkled down below in the clear waters and saw a lot of beautiful fish. We had a lovely lunch outdoors at the hotel on the island. This is Mark in Spring 2004 before he got a diagnosis of Cancer and before chemotherapy. This is not the best picture of me, so just look at Mark.
Hallalujah! Good news! Mark's last eye surgery has enabled him to see clearly and to read again. Mark had at least 4 eye surgeries. He was ready to quit after the first surgery, but somehow hung in there. Mark is still not cleared to fly anywhere due to the condition of his eye, but he can see and read. I have a reservation to fly to Bangkok on Oct. 3rd . Mark asked me why I was coming that he did not need me to come and that he is managing ok. I told him I was coming anyway and then he said: Oh great. The timing is perfect and he got real excited about my visit. He so wants to be independent and to not be a worry to me.
Michael St. John, whose blog Stephanie came across one day, is sending Mark some audio books. Isn't that great?I think that the letters, notes, prayers, and gifts from the heart from all of you are giving Mark the courage to fight his cancer. I talked to Mark on the phone today and he tells me that Dr. Theera says that he (mark) is his best patient and that he is responding best to the treatment (chemotherapy). Mark cautioned me not to expect too much from him when I come to visit as to quote him: I do not have that much energy and I mostly just go to the hospital, sometimes twice a day in a taxi" and "My cognitive level of functioning is not all that great."I had to laugh at that statement. On Mark's worst day he is sharper than some of the rest of us. Mark tells me that some of the hair that fell out from chemo has grown back in and he has combed it over his forehead so he looks like one of the Beetles in the early days of that group.He likes detective stories and he has bought DVDs of one season of CSI and is watching CSI for entertainment. He finds the forensics interesting. This is one of my favorite tv shows too. Mark is enjoying life in spite of all the physical problems he has had: old BPI injury, Cancer, broken arm, eye surgeries, and maybe more. His adventures continue. If you need Mark's address contact me bkrich@sbcglobal.net

September 08, 2005
Mark is facing one more laser surgery on his eye. The eye still has a fluid leak and he is not cleared by the eye doctor to fly, so no visit to Texas just yet. His cancer center doctor is pleased with Mark's response to chemotherapy and the chemotherapy continues. Mark has caught a cold. His broken arm is healing and hurts him less. He does not talk about his brachial plexus pain anymore. I figure that he is too busy with all his other problems and efforts to resolve them that he just ignores the BP injury problems.
I am planning to go visit Mark in Bangkok in 3 or 4 weeks to check on his health state and the state of his bank account. Thinking of banks, I just had a strange mental synapse to a memory of when Mark was a baby and came home from the hospital. His first trip outside the home was to the bank with mom. It was cheaper in those days to have a baby. I think my hospital and doctor bill was about 150 dollars total. But then again I had excellent insurance. When Mark was born I was a nurse working on the obstetrical unit of Memorial Hospital in Springfield, Illinois and the doctor (Dr. Zelle) may have given me a discount since I often helped him deliver babies in the labor rooms or took care of his moms and/or their babies after delivery. If any of you reading this were born in Memorial Hospital Springfield Illinois between 1959 and 1965, I may have helped deliver you or have changed your diaper.
Back to the visit to Mark. He made me promise to go lightly on him when I come back to Bangkok or I couldn't come. A cold, chemo, cancer, a broken arm, an old brachial plexus problem, and financial worries seem to have worn him down so he does not want to be questioned, pushed, prodded, or told when or what to do. I think I kind of know how he feels. I think it is like when I am really tired and have given about all I can and just want to be "babied."

Waiting to hear if the eye doctor will let him fly...
to Austin from Bangkok for a visit here soon, and if he is feeling well enough to fly and if he or I can find enough air miles for him to get a ticket so he can reserve his cash for treatment. He is a little worried he will run out of money for treatment. About a month after he started treatment for cancer with an initial prognosis from doctors on Saipan of only 3 months to live, someone asked Mark if he had enough money to live on and get treatment and he said: "If I die in two months I have too much money and if I live much longer I don't have enough." Of course he is headed into his 7th month after diagnosis.

Early this year, generous co-workers on Saipan donated him their sick time. Recently my workplace, Community Clinical Research, wired money which covered a three day chemotherapy treatment and sent him a care package too. Very early on friends on Saipan gave him money for treatment, and three of my former co-workers at ACC sent money and of course I have given him funds, and some of you reading this have sent him gifts, money, Koolaide, candy and prayers. Every one of these gift from the heart have greatly helped his spirits and his ability to stay in chemotherapy and to keep his hope up. Thank-you all.

Today I looked at the pictures (see above) I took of Mark and I sailing in the San Juan Islands in March of 2003 and pictures of him in March 2005 and I can see the toll that chemo and cancer have taken....the loss of hair...the loss of color in his skin...the loss of energy. Sometimes he looks really sick and sometimes he still looks great even today without his handsome head of wavy hair. He still has his sense of humor and can make us laugh. He still dresses up when he goes somewhere and looks as much like a G.Q. model as he can muster.

Mark is at a crossroads in which his doing radiation and continuing to do chemotherapy and all the prayers could help him get better or he could die way too young at 45. Mark yearns to have more adventures and I think that is why he continues to go for chemotherapy when it makes him so sick for days and drains him financially. I have reminded him that he has had more adventures than most people have in a lifetime and he has a lot of great memories of trips we took to various parts of Honduras and to the Moskito Coast of Nicaragua and Honduras volunteering with MEDICO, our trips to sailing schools and chartering a sailboat to go watch whales in the San Juan Islands, fishing in Cabo San Lucas and Cabo San Jose, trips to Cambodia, adventures in Thailand, Scuba diving off Roatan, and years ago when we lived in the country: riding motorcycles and camping out and shooting muzzleloading guns and throwing tomahawks at a number of National Muzzle Loading Competitions in Friendship, Indiana.

Yes, we have had a lot of adventures together and then too, he has had a lot of adventures without me; perhaps adventures with some of you who are reading this.

I hope Mark has many more adventures and I am ready to help him plan another adventure soon. One of his expressions when we get into a tight spot or a strange situation when we are off the beaten path is: "and the adventure continues." And so it does.

Contact MissBettythemom at bkrich@sbcglobal.net if you want to send Mark a postcard from somewhere in the world or you want to send him some sour candy or send a small contribution to help with chemo or to buy ice cream.

Mark has had laser surgery on his eye.

He is no longer sick from the last round of chemotherapy. I am waiting to hear the latest news on his vision and on the eye that has had a problem. He is eating again and has gained weight. He is cooking again and reading again. He tries to get the books with print that is not so small. Those of you who are, lets not say older but just more mature, will understand the problem. Some novels have very tiny print and some have larger print.

Treatment for cancer is a roller coster. Sometimes Mark is sick for days and eats very little if anything and is not capable of doing anything. He suffers from extreme coldness and chills at times and sits out in the hot Bangkok sun with a wool hat and a blanket. Other times he is extremely hot and can't stand heat. As he gets further away from a chemo round, he is much more lively and attending to things like getting the drapes cleaned or cooking a gourmet meal, and eating to put on weight for the next round. Why not stop all the chemo? The doctor found him in very bad shape when he first saw him in Feb. He could not swallow solid food. His tumors were large, his liver swollen and after about three months of treatment a CAT scan showed his primary tumor reduced in size, his liver much improved and he was able to eat solid food. He is a guy who was given three months to live and has now passed six months. My hat is off to Mark for going through treatment. He has a lot of grit.

Mark has called me about several problems he has.

When you hear you have terminal cancer, you know the months ahead will be precious, but difficult. We're now encountering difficulties we never saw coming.

He fell on his slick hardwood floors dashing to answer a phone and he broke his arm. He is nearly blind in one eye and can not read now. He had to have an emergency surgery on his eye. He is feeling bad from chemotherapy and can not keep any food down.

Mark calls me from the hospital groggy with pre-operative medication and as they are wheeling him to surgery he dictates his last will and testiment to me just in case he dies today. He has been in pain from his eye surgery. The doctor did a biopsy (mark did this under local anasthesia to save money), thinking it might be occular metastasis. This biopsy was sent to N.Y., and while we are waiting for results, Mark tells me that he will just have his eye taken out and get a glass one with a smiley face on it. He has not lost his sense of humor. He has a bubble in his eye of some sort and has to sleep sitting up. He is not allowed to lie down.

He desperately wants to come to Texas to visit for 10 or 12 days between chemotherapy but the eye doctor will not let him fly until his eye problem is corrected due to the pressure on the eye when flying.The doctor wants to do a laser surgery on the eye but Mark says he can not afford it. He has a different type of surgery on his eye...a second surgery and then finally decides he will go ahead and have the laser surgery. It will be a week or so after the surgery before he knows if this will help his eye problem.

Through all of this I am trying to get some records from Mark to use in filling out his tax forms for 2004. He is too sick to deal with this and when he feels better and does deal with it, the records keep getting lost in the mail and those sent by fax are illegible. I finally get his signed request for an extention in the mail. This has been a fair amount of worry and work as I have to send any paper forms to him in Bangkok then bug him to find whatever I need or sign whatever needs signing and mail it it back.

On Aug. 15th I pay an H and R block tax preparer, who is expert in dealing with foreign income, to do Mark's taxes based on a lot of research I have done to get information about how these taxes need to be handled and the documentation needed and many many calls and letters back and forth to Saipan and Bangkok and bugging my Austin, Tx CPA friend, who is retired, for suggestions and verification. On August 15, I also go to IRS and wait in line forever to get a request for an additional extention of time because I don't yet have a copy of a W-2 that I need.I mistakenly had thought that this extension request could be postmarked by 15th...it has to be received by IRS and get a stamp on it and the local IRS then sends it to Philadelphia where all filings with foreign income must go. It is a great people watching experience to wait in line in the IRS Taxpayer help facility on a deadline day. I know lots of people will sigh in relief when they learn these tax forms were finally filed.

Stephanie's words: Mark just amazes me at times. I know he is in a lot of pain and doesn't feel like doing anything, doesn't feel "well", but then he also has a desire or need to go out and do everything. He's in need of a trip longer than just to the grocery store today, so we've gone to the travel agency in the Honey Hotel and reserved a car and driver to take us to the "Ancient Capitol" of Ayuttaya.

The drive to Ayuttaya is about an hour with very little traffic. We sleep off and on in the car, and it's hot today. Ayuttaya is really beautiful... we rent a golf cart at the summer palace and drive around, trying to avoid running over any other tourists. Mark seems to enjoy being behind the wheel of a vehicle again, even if it is just a cart. The palace grounds are amazing and we find a little pond stocked with fish, which we feed bread bought from a vendor. Eventually we see a small nose repeatedly poking up out of the water, then a bigger nose of "something" we think might be a turtle, but if it's a turtle the corresponding body would be HUGE. Mark feeds the nose which does eventually come up to us, and which must be the size of a kid's wagon. NO, this photo is NOT of THE turtle, but of his little friend (1/10th the size!)

From the summer palace we drive over to some ruins. They are humbling. The heads from the temple statues were chopped off and taken centuries ago, and only a few remain, imprisoned in the roots of trees. By mid-afternoon the heat is taking the wind out of all of us, but Mark is really worn out and we head home. In the end it takes him a full day to recover from the trip and he suffers chills and fever half the night, but the day is a memory I will cherish and I appreciate him sharing this part of Thailand with me.

Summertime in Bangkok - July
Stephanie's words:
My third trip to Bangkok was surprising. It's July and I had expected it to be hotter than before, but the evening and morning showers kept things tolerable. I've grown to really enjoy the Sky Train- it's cheap, amazingly clean, air conditioned, and going so many fun places.

That's Mark and me in Florida on a summer vacation, probably about 1969. I'm the one that got the chubby genes, on the left. I think that's the summer Mark played with Jellyfish and came out unscathed (same with the time he caught a mink barehanded!); we walked the beach and swam every day - swimming's always been important to the family.

Mark's always been a healthy eater- he loves GOOD food in particular, and he can cook like no one I know. Mom and I worry that he's lost weight; he's always been thin but now we'd like to see him put weight on since it seems he can fight the cancer and associated illnesses better with a good, healthy weight. While I was in Bangkok, he was on a "pressed sandwich" kick. Since it's tough for him to swallow breads, he makes a warm sandwich in the oven, then he uses a board and some weights to press the sandwich flat. It's awesome! He's also been on a sour candy kick, and since you can't find them anywhere in Bangkok, I brought 6 or 8 packages... they went quick! Mark's also introduced Bangkok to the wonders of a good brownie - we like the easy-to-make Betty Crocker mixes, and then he adds his own touch with chocolate chips or nuts, etc. I made a meatloaf while I was there, but not knowing exactly how much a "kilo" is in actual size-amount, I wound up with a HUGE plastic bag of hamburger, which we used for the meatloaf, froze, made burgers with... they are possibly still thinking of what to do with all that hamburger.

While I was in Bangkok, Mark and I both read a lot. It's fairly easy to get books in English; he'd pick some up from a friend or we'd get them at the JJ Weekend Market. Mark loves CIA novels with all the government mystery and intrigue. I was impressed and amazed at his reading speed- one of the days I was there he read THREE NOVELS in about 12 hours, and was able to tell me all about them... one was a history of pirates in Southeast Asia.

Mark loves to read in the sun on the apartment patio, which overlooks the Asoke Sky Train station and the local market. If you're at the station or Soi Cowboy, walk an extra 20 yards past the soi, look up, and you'll probably see him... wave!

Thusday, 12 May 2005-Last day in Amsterdam

Today is the first warm sunny day in Amsterdam and it
is the last day for Mark and me to be here.We head for
Bangkok tonight.

Mark and I went to Groningen on the
train yesterday and had to switch trains in Amfoort.
My friends from Emden picked us up and drove us to
Emden and proceded to train us in the Ostfriesland tea
ritual. For lunch we had huge white asparagus, boiled
potatoes, ham and tomatoes..it was lovely. Next we
went into the countryside to Ockenhausen. This area is
so beautiful and there were so many flowers. The homes
are all of brick and lovely. Pastures with beautifully
groomed horses. We had a nice visit with a cousin and
his family. They too are interested in genealogy.
I think May is probably a nicer time than April to be
in Amsterdam. Good luck to all of you.

Amsterdam, the adventures continue.

Mark and I may go to Germany tomorrow for one day to see an 84 year old cousin. Last night Mark was not feeling well and stayed in. I got a tour of the red light district. There was window after window with pretty girls in bikinis and some of the bikinis were flurescent or luminescent...and the windows were with red light. We also went to an old fortification like a castle for coffee..it had been aplace where women were weighed in the past to determine if they were witches.

Today was Mother's Day.
I rousted Mark's butt out of bed for early breakfast and he complained of his legs hurting, but I wanted him to see Amsterdam and I had figured out the tram and made him go to Central Station area to catch a boat...intending to ride the canal boat half a day which should not make his legs worse, since we would be sitting down... but we ended up getting off at the Van Gough museum since Mark wanted to see it, having lunch at a nearby restaurant and then seeing all the paintings in the Van Gough. Mark knew a good bit about a number of the paintings and seemed to greatly enjoy the museum although he was not feeling top notch. We came back on the canal boat which stops very close to the museum and we got off at a place close to hotel and had a beer and he went home and I rode boats some more. After he rested we took a late night supper at an Italian restaurant.

Planning trip to Amsterdam
I have purchased plane tickets for Amsterdam for Mark and me, and I worked hard to get seats with more leg room so he will be comfortable.

His mood had been down and he looks very sick, so I asked him what he was thinking about. He said he was thinking that he would never go on another trip again. I asked him where he wanted to go and he said "Amsterdam." He has lost a lot of weight from nausea and vomiting while on chemo.and was pretty sick, but I decided to take the bull by the horns and order up some tickets. Then I found out that we were going during the Queens silver anniversary on the throne and over a holiday weekend. I had to get help to find a room. Here are some e- mails to my daughter Stephanie and to James who are scouring the internet for rooms for Mark and I.

Steph, We have not found rooms yet in Amsterdam...James found the Nicolaas Witsen and he had our dates of arrival departure off by one day and had 8 days down and it was available until I changed the dates to make reservation

Steph and James, my shipbuilding geneology friend Hinrich in Emden has a cousin in Amsterdam checking on rooms for us It turns out the 5th is a holiday and people flock to Amsterdam...so we had best get something soon or be out in the cold..Maybe the cousin will come up with something.. ..We are scheduled to arrive on 5th and leave on 12th..it is probably the 5-7th that is the problem.

I have a contact with a young man in Amsterdam thru couchsurfing.com - I have his phone number and he has invited us to a free trip of National Park with a group.
more later of continuing adventure.

A rough day today...

Lots of decisions- with hosptial and treatment and whether to do this or that or drop out and do traditional medicine.. Everyone has advice and "a friend who tried...", but what to do?

I went to cooking school..hot time in market learning veggies, meats, curries, etc...I got to cook several dishes and a dessert and my cooking group sat down to eat what we had cooked. I did not get to finish as Mark called me from hosp, desperately needing help before school was over. It was a long hot trip back to the hospital, by boat, then sky train, then walking several blocks. I am tired ...it was a long day

Day after Mark's 45 birthday.
We had a grand four days ...maybe five days here in Bangkok. Mark has been feeling better although he has napped many times during the day and night and does not have the energy to walk more than a block. I know he felt better even though he says when he feels good, he feels bad...I know it because he was not grouchy and he was playing jokes on me. He came into my office center I sat up in my bedroom and had me touch his hand which was very cold. He said his heart had stopped while he was sleeping. To my wide eyed reply of "REalLy?", he said: "No, my room airconditioner is really working and it is sooo cold and I had my hands outside the covers...It reminded me of one time years ago when he was a little kid about the 6th grade and he caught a mink and caged it. That animal had some teeth. He came to me one time with his fingers bent back so it looked like he was missing some of his fingers. He said the mink had ate them...I almost believed him as I saw that mink eat a frog in seconds and reduce it to chewing gum...bones and all.
Yesterday was Mark's birthday. We began it by watching southpark season 5 DVDs that I got him for his birthday. He rested most of the day and we never left the condo until late in the evening. We went to a restaurant called Neil's Restaurant and Bakery at 9:20. It is a block away on Asoke. We had Caviar and Oysters Rockefeller and salmon appetizers and then rock lobsters with salad and potato and corn...Mark wanted some dessert but the bakery had closed. This is an excellent restaurant...very fine decor and wait service. Mark was able to eat because he is as far out from chemo as he ever is...the further out he gets from chemo days, the better he can hold food down and the better he feels.
It was a great birthday then this am it was off to the hosptial for chemo...we were there from 10:45 until 6 pm. Mark is now not feeling well and has a fever. He gets chemo three days in a row....then our plans are to take a short trip if he isn't too sick from chemo. I will tell you about if we pull it off. The doctor is working with us to get Mark in shape and provide some medicines I can give IM if necessary. I think that his being able to plan a trip and having something to look forward to is what is keeping him going. Periodically he also tells me an interesting story from his experiences and we both enjoy it. I think that is my role at times to listen and encourage him to tell his story.
This next three days may be rough. Mark is very sick during chemotherapy and for a period of time after chemo he is very sick and can keep nothing down. I have Mark's friend Jin staying with him in the morning as I head for the Thai cooking school on the Chao Phraya River. I will be back in the hospital in the afternoon.
My best to all of you and more stories later....PS my diamond fell out of my ring...i thought it was lost down the drain...the cleaning girl found it and gave it to me...couldn't do the drain for three days cause of holiday..and the last day of holiday, she found it on the floor under something...My PDA plug- in is fried due to my stupidity and I have a new one that takes 220 or 110 but the addresses I had on it are gone. My watch battery stopped. ...all small potatoes compared to how Mark is doing...and all will wait for fixing until I get back to Austin. Hopefully my computer will hold up...I may have to get an abbacus

Stephanie's Words: Happy Thai New Year!
Since I've been coming to see Mark in Thailand he's been talking about New Years and how fun it is here. I didn't understand it at first, just that it involved a lot of water and water guns... but it was at least as much fun as he had said it would be! I'm staying at a hotel near his place and I took the tuk-tuk over to the soi where the action is set to take place. At noon it's just getting started, but as I get a block from my hotel I get some squirts of water coming through the tuk-tuk. I make it to the soi without too much more water and then I see The Fun: a whole 5 or 6 block street, people everywhere carrying buckets, squirt guns, water cannons, hoses, anything that will carry or toss water. Some folks have large plastic trash bins filled with water and ice! And it's all being tossed out at everyone else.

No one can explain to me exactly why - why water for New Year's, why a water parade (as people file up and down the street tossing water and being tossed at, and why after you've been "wetted" you get a dose of talc on your face, too. About 10 minutes into it I realize it doesn't matter why - it's just a blast. I look at Mark and see this man who really fought to get himself up and goingt oday, who is in great pain, and he has now the most wonderful and sincere smile on his face as he enjoys watching the parade go by. He shoots water occasionally at friends or farang. He's transformed into a little boy, teasing and shooting water and watching the other kids play all around him.

I worry about him this day. He's been feeling feverish lately and there are so many potential germs and viruses all around us. He's having a blast, but he decides he needs to go lay down an hour or so later. In a way I am relieved because he's been thoroughly doused by friends going by (those who don't realize he's hanging back a little because he needs to not be jostled today). He's gone through a round of chemo since I last saw him in March, and he's starting to lose some hair; what's still there has gone from a beautiful chestnut brown to gray. But we all laugh at my mom, who is wearing a shower cap under her hat, in a lame attempt to keep the water at bay.

It was a great New Years.

March 28, 2005 James and I are both in Bangkok with Mark.

Saturday morning Mark had a CBC drawn at the hospital and in the late afternoon, Dr. Theera called to tell him to come to the emergency department. We jumped in a cab and dashed over to the hospital to learn that Mark's platelets and WBCs were very low. He got a unit of blood and two injections of Neupogen which is an expensive medication to stimulate the bone marrow to produce neutrophils a type of WBC. We were at the hospital until 10 pm or so getting this done. On Sunday I gave him two injections of Neupogen at home. On Monday he went back to the hospital for another CBC and to get his radiation. His platelets and WBCs were so low that the docs would not give him radiation and it took a lot of convincing to be able to stave off hospital admission. The docs wanted to admit Mark but instead gave him some more Neupogen and told him to stay inside, wear a mask, and be very careful to avoid any infectious sources.

Mark is very energetic at times and it is hard for him to stay in the condo and rest. He is making pickles for entertainment. He packs his pickles with garlic pods, fresh dill, dill seeds, carrots, onions, and chives.Last evening when he was to be resting and avoiding germs, he decided we had to go to the condo pool and gym. The pool is on the second floor and is indoor-outdoor and very beautiful. One of our condo balcony' is above and overlooks this pool with its plants and palm trees. After a little time at the pool, Mark wanted to use the dry sauna and the wet sauna (steam room). There is one in the men's locker area and another in the women's...Mark was afraid to go by himself as his blood pressure is low and he was afraid he would pass out. James doesn't like saunas and would not go with him..so I went into the mens rooms with him and fortunately, or unfortunately depending on how you look at it, no men came in naked to use the steam room. The reception lady in the gym brought some special scents to put in the steam and our bucket for the dry sauna also had some oils and natural scents in it.. We spent a good bit of time in the saunas and felt real healthy afterwards...The docs probably would not approve of it.. but this gym and pool is exceptionally clean...the floors are marble and everything else is a high quality polished wood. The lockers are not metal but high quality well designed and of a fine wood. We have on the 9th floor Squash courts. you would really have to see this building to get a real picture of the quality but it is exactly what Mark needs....extremely clean and comfortable in the midst of a city that has great contrasts in the extremely clean and the extremely dirty and often in very close proximity to each other.

James continues to cook for Mark and he is definately eating better. He has gone from eating nothing and only drinking about one ensure a day to actually eating a meal. He still has some difficulty eating but has figured out what and when he can eat. Breakfast is his big meal. He awakes about 5 am and leaves a note for James about what to cook. This morning it was french toast and bacon. He sits on one of the balconies and falls asleep again in a chair like a tweety bird asleep on a perch...waiting for James to cook breakfast.There is a fresh vegetable and fruit market and fish market just a block from us so we are able to get lots of fresh things and very cheaply.Hopefully Mark will have an increase in platelets and his white cells will be in the normal range soon.

March 24, 2005
Today is my birthday and we celebrate by taking friends to the Marriott for dinner. Mark is successful in eating some of his steak. This is a big improvement over not being able to swallow anything but liquids when he arrived in Bangkok and presented himself to the Horizon Cancer Center at Bumrungrad Hospital. Mark has begun chemotherapy but he still has his handsome head of hair.

Bumrungrad Hospital and its Horizon Cancer Center
When I arrived in Thailand March 7, 2005 Mark's sister, Stephanie, had been with Mark about a week and our visits overlapped a few days. Mark has had radiation most days since I arrived. We have spent a good bit of time in the hospital's Horizon Cancer Center. The hospital is impressive. This is a world class hospital accredited by the Joint Commision International. People come to this hospital from all over the world. The hospital is extremely modern and beautifully decorated. Complementary hot and cold tea and bottled water is provided in the waiting areas for visitors and patients. There are beautiful flower arrangements in many locations throughout the hospital. The nurses answer the call bell promptly, are polite, professional, competent, and wear nurse's caps.
There are restaurants in the hospital - Starbucks, a nice Italian restaurant, a Japanese restaurant, Au Bon Pain, and many Asian places. Not only are there banks of elevators but escalators as well. At the international help desk, there are usually about 10 translators to help you in a variety of languages.
Each day Mark pays for services before he leaves, and the costs are usually 1/10th - 1/2 what the costof the same procedures in the US would be; medicines are still very expensive here and Mark's medicines can run itno the thousands of dollars a month, depending on what he needs- the pain medicines and nausea meds are some of the more expensive. We found a nausea medicine that is $15 a pill, and mark is hesitant to take it, but it works when nothing else will, so I feel it is worth it, though still expensive.

There are cashiers' desks throughout the hospital and much effort goes into making sure patients pay before leaving. Sometimes a deposit is required before services are given. After service, patients receive a numbered card, and monitors throughout the hospital tell you when the cashier has your charges processed. After paying, you go to the on-site pharmacy where they fill any prescritions the doctor may have ordered. When you have x-rays taken, they are available at the doctor's computer screen within a matter of minutes.

February 28, 2005 The first report or update on Mark:
Mark's decision to go to Thailand is turning out to be a good decision. Even though it is private pay, it is turning out to be true that he will get the very best of care, at 1/5th the cost. He made an appointment with an oncologist for the day after he arrived in Thailand. He was at the hospital from 9 am until 8pm. seeing not only the oncologist but a radio-oncologist, an orthopedist and an infectious medicine specialist as he had developed an abscess on his elbow in some mysterious way. He had a battery of scans and tests: bone scans, heart scan with radioactive tag, blood tests, renal tests...and an IV with IV Rocefin. He is to get radiology every day for awhile as an outpatient, beginning right away, to shrink his esophageal cancer. There is the option of some laser cutting also. There is no talk of a magic cure though as some suspicious areas on his spine also.

More metastasis? One of his docs just arrived after 15 yrs at MD Anderson and is familiar with the experimental studies and drugs and treatments, as well as latest non-experimental treatments. He was greeted and treated like a king, escorted everywhere in the hospital which is apparently huge with a mall and restaurants. I have only viewed it from the outside and looked the lobby windows in the past and been impressed by how clean and how modern it is.
Mark's goal is to increase his quality of life and extend it as far as he can. I am less worried about him than I was. He accepts that he does not have long to live and I accept it too..however if he can have time to put his affairs in order, perhaps have a few more adventures while under good medical care, and to say goodbye it will be wonderful. I will be in Thailand March 7 to 21 unless I need to stay longer. If I come home, I will make a return trip perhaps 6 weeks later. Thanks for all your prayers and caring, betty

It is 10 days after I received word from Mark that he was diagnosed with cancer. He has been hoping and believing that his health insurance would send him to a hospital in Hawaii or the Philapines for evaluation and some treatment, but he finally came to believe that they were not going to send him as they believe he only had three months to live. But then again, shouldn't he be evaluated by specialists in the field of oncology, of which there are none on Saipan? He has given away all his belongings except for a camera, a computer, and just a few clothes. When I visited him this past fall, he had closets full of clothes and 15 or so plastic crates of belongings and clothes that the hospital had paid to ship to Saipan, a television, an answering machine I had sent and lots of household items he and i had bought and cupboards full of canned goods and housewares : virtually everything he had collected over the years. He gave it all away except for a camera, a computer, and about 5 pair of pants and 5 shirts and bought a ticket for Bangkok.
Mark sends me an e-mail:
Well, I made it here. It was a rough trip, my back hurt, and then my elbow and my ankles got very swollen.. I am headed to the hospital now, but it is a holiday here so I don't know how much I can get done. My friend, the Thai doctor in Saipan, wrote me a note and referral to an oncologist at Bumrungrad Hospital, but in the same note he said that in my case he wouldn't reccomend radiation or chemo, because I might not survive it, or it might make me sicker. He is reccomending traditional Thai medicine, and said his family would help me with it.
It seems every person that I have talked to also knows of some doctor or cure that worked on someone they know. People are almost offended if I don't show the proper awe and gratitude at their sugestions for my care.
Talk to you soon, Love Mark.

e-mail to sister Stephanie: I just called mark at 6:45 a.m. my time. Mark was just preparing to go to sleep...I think it is 4 pm..maybe he is working nights...I am not sure if he is or not but he said he is trying to stay on schedule as long as possible to extend some benefits out..
Today looks like the insurance company will authorize him go to Hawii and will pay for the first round of radiation if the doc in Hawaii says he needs it..
I will call MD Anderson today and talk to lots of people but it looks like he needs to get first round in Hawaii and when that will happen is still not settled...maybe he will go tomorrow or weekend or mon....island behavior...Thank you for looking stuff up: a lot of links and sorting thru misc stuff of little value could be overwhelming to mark ..so sift thru it and just send him the gems if you can...kind of like us panning for gold in Japan..lots of panning for tiny gems.
Love you mom

E-mail to sister, Stephanie.
"Mark is waiting to see if he is to go to Hawaii...They have decided he is not to see Dr. Pang but Dr. Sterns and they can't get ahold of Dr. Sterns to get an apt for Mark yet..but they are trying to get an apt...then he will go to Hawaii..he thinks he will be there a couple of days, come back to Saipan, pack and head for Thailand. He has his friend John there looking for an apt for him.
He is willing to think about M.D. Anderson if they can do anything for him...I will call tomorrow.
I have encouraged him to talk with the social worker at hospital in Hawaii regarding his Medicaid and SSDI questions and continue to tell him I will provide some money and even sign if need be saying I will pay...eventually. He does not want to be on Saipan any longer than necessary since they can do nothing for him. I told him we would meet him there after Hawaii and he said...come to Thailand."

It's frustrating. You don't expect this to happen, and you can't be prepared for it. When insurance backs out on you, it feels like your choices become severely limited. Add to it that the choices you have keep being taken away, and you have what we have- no control.

Stephanie has talked to Mark and she writes in an e-mail:
OK, talked to Mark for a while... he answered and sounded tired- I guess he was asleep, but it was a real good talk. He's gotten news from somewhere that they won't pay for much care because it's "not curative", meaning it's just to keep him comfortable but not to save his life. He agreed that he should do some of it anyway - said he'd be in Hawaii in a day or two, to discuss with doc, then back to Saipan then on to Thailand for treatment b/c he likes the hospitals and people there.

A Thai doc from his hospital said he'd send his family to pick Mark up and care for him and then I guess he also knows someone who does some alternative treatment. I asked about clinical trials and he said he doesn't qualify but to feel free to send out his contact info and he'll talk to anyone. Said he will sell or give away most of his stuff but that he hates it b/c he's gotten it down to stuff he really really likes. I told him that photos are really important to you and me and he understood that and he said that was the plan... he seems to be hanging onto having a plan and that's understandable.

I told him I wanted to see him and to contact me as soon as he lights somewhere that he has a doctor so I can do that. We joked about going to Tahiti for alternative treatment... that was nice. Then (note: morbid thoughts ahead... proceed with caution) he asked would we take his ashes and what would we do with them and so I said "that's up to you- mom and i will do what you want us to do, but come up with something fun, creative" and he says "Okay, I want you to skydive and..." and I said "be careful with this, cuz you know Mom will do it if you ask" and we laughed again.