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.