Mr.Mark is out of the hospital and we leave for Chang Mai today. Two days ago Mark got up and made himself a ham and cheese sandwich just like he likes it (Japanese mayo on one slice of bread and dijon mustard on the other) and prepared himself a sack lunch, headed for chemotherapy at Bumrungrad expecting to come home that night (Saturday), but Dr. Theera decided to keep him overnight. Mark had been sick, not eating anything without it coming up and/or out for a week, and was somewhat dehydrated.

The medication regimen has changed: Metochlorpramide 10 mg IV(Plasil), Paraplatin 450 (Carboplatin), Leucovorin two doses one of 100 mg and one of 50 mg., Mag sulfate, Manitol, Emend, Nausea, Benadryl, KCL, and one 1 mg tablet of Ativan (4 baht about 12 cents). Mark tries to refuse the ativan even though it is cheap, but says the Emend for nausea is worth every penny it costs (1 dose =1,615 baht= 46 dollars) as it stops nausea really well. The Leucovorin serves many purposes. It helps in folic acid deficency, potentiates 5FU (not sure if Mark is on 5FU or not), lowers levels of circulating estrogen, and is used in treating breast cancer in post menopausal women. Remember that men can get breast cancer. Men have breast tissue and circulating levels of estrogen as well as testosterone. Women have both hormones also but they don't get prostate cancer as that part is missing.

Without hospitalization the prior week, a weekly round of chemo was about 200 dollars, but with hospitalization, extra medication, extra IV set ups, out patient charge and inpatient charge, and the nursing fees, etc. the bill this week was 44,257 Baht. The exchange rate at the hospital into dollars is 35.3356 so one weekly round of chemo with hospitalization was approx. 1,320 dollars. nothing on the bill is as expensive as in the USA but everything adds up. This bill is in addition to two or three office visits to see Mark's two doctors (Sunantha for radiation and Theera Umsawadee for chemo). Mark is very happy with his doctors and his treatment in Thailand and wishes he could stay here but we must head for the VA in Houston soon to cut our expenses, get some additional evaluation, a treatment plan, and get it going. For those friends and family who have asked, there is a tax-deductible fund for Mark's care - see the link on the right side of this page. We have now spent over $200,000 out of pocket on this, and I am thrilled at the extra time it has given us with Mark. (From Mark's sister, Stephanie: for those who don't know, my mom has been retired but has also been working several jobs where she can to help pay for Mark's treatment. Even if you're just sending a dollar, it helps her to see that people care. Same for visiting the blog - she loves seeing the numbers go up, and for leaving comments here on the blog... it all just lets us know we are not alone in this difficult time. Mom doesn't know I am adding this, from the bolded sentence on, to the blog.)

We are taking our suitcases to the hospital today as Mark has an appointment with Dr. Sunantha. We're cutting it close as usual and must make a flying taxi trip to the new airport as Mark has changed our time of departure for Chang Mai and we are cutting it close. He is excited about the trip and it has really perked him up. We got cheap tickets of $108 each including hotel transportation. We have rooms at 25 dollars each including a full breakfast buffet. The international flower show is our big objective. More on that in next blog.

Mark Continues Radiation and Now Weekly Chemo
Mark is in Bangkok until November 14th working on closing out his lease to get his deposit back and saying Good-bye to friends, his treatment team, and the city he loves. If he were wealthy, he would stay in Bangkok longer. His doctors there have kept him alive 21 months when he was given three months or less to live at the time he was first diagnosed on the island of Saipan. He is so thankful to have good doctors.

Dr. Theera now has Mark on weekly chemotherapy of smaller doses instead of monthly larger doses and radiation is daily until he has received 15 treatments. This is of course expensive even though the price at Bumrungrad is far less than it would be in the states. Mark's sister called Mom from Japan, yesterday and caught her coming back from a high school reunion (another interesting story). Mark had not been able to reach mom and he couldn't access a small account he has to pay for treatment (His card would not work) and what to do to pay for his treatment on Thursday? Luckily mom has a small account in Bangkok too so she gave Mark the card but not the password before he left Texas for Bangkok. A sharing of the password gets this week's treatment paid for and then the thinking cap is on about paying next week.

Mark's sister is traveling in Japan this week. Mom just got back from high school reunion and heads to Miami Sunday before going to Bangkok on the 24th. We all keep in touch about every day with very low cost phone calls using our computers to call cell phones. What a wonderful technology-friendly time we live in!

Up and Down the Cancer Roller Coaster Some More...

(From Stephanie:)Today Mark had radiation again; he's feeling a lot of pain and says he's hot but also is covered by a blanket and trying to rest. He is getting 2-4 hours a day of activity and the rest of the time he sticks close to home and sleeps or wanders the apartment. He looks so good that people (myself included) forget how hard it is for him to get through the days.

As the photo shows, we packed up most of Mark's belongings and I took them to the Enbassy to mail home. He had to get rid of about everything to move here in the first place, so I was more than happy to be able to help him keep some things that mean something to him. The folks there at the post office were very nice and helpful; it wasn't entirely easy to lug 7 boxes around, but we got it done! I am hoping that this will help Mom and Mark have an easy move back to Texas in a month. Ideally, Mark would be able to mail more and could just step onto the plane with a carry on and not worry about anything else, but the Thai mail is crazy expensive... I think the hardest part of this is just that he loves Bangkok and hates to leave - he knows he has to, but he's not sure he will be back. It's been a great place for him to receive such good care. Anyway, we're all feeling good that we got the boxes mailed, but also melancholy at the thought of a move where there are so many unknowns; another adventure, perhaps?

A funny story from today: We'd stopped at the hospital and while Mark was in radiation, I stopped by to chat with Dr. Theera and thank him for the great care. I made sure he had this blog address. Then, a little while later, Mark met up with me and said he'd stoped to say hi to Dr T and ask him how he (Mark) was doing, and Dr T answered "I don't know, I haven't had a chance to check your blog for the latest"! Funny, but now Mark has a great idea to have patients blog their symptoms and progress and have docs check it before visits so patients don't have to repeat things to docs so often. Hmmm....

Click that little green "comments" link below here to leave us a note- I would LOVE to see who is checking the blog out! Stephanie