Hospice Austin. Mr.Mark is hopeful but he tries to be prepared. He had me call Hospice Austin to get information about care and we learned thatthrough this non-profit organization,Mark could receive care at no cost with a statement from an Austin Doctor that he has six months or less to live and is not on any curative path. He could be on chemo, not for cure, but for reducing tumors to decrease pain or distention, and/or make him more comfortable. While not ready for end of life care because he still has that fighting spirit and a little hope left, he has the information in case he reaches that point.
Story of a Hospice Client
When I used to take nursing students to a nursing home/convalescent center,I would assign one of them to Johnny (not his real name)who was on hospice and expected to die in six months or less. He'd be moaning and refusing to leave his bed. The nurses would tell us to be careful as he was fragile and really we probably ought to get a different patient. Within one or two days of being cared for by a pretty young lady, Johnny would get out of bed and start going to the dining hall and would try to teach the student some dance step or amuse her with a story. We would end our clinicals at the nursing home then I would return in six months or a year with a new group of student nurses and Johnny would still be there at deaths door. A pretty student nurse would once more perk Johnny up. Mark reminds me of Johnny. He may have cancer, but put a pretty nurse next to him or some fun thing to do and he is up and going. He is limiting his outings to one a day or two max, separated by rest, to conserve his strength, but he is still going strong and looks the picture of health.
August 21, 2006
Mr. Mark looks so good, we sometimes forget he has cancer and is sick. Mark needs to rest a lot. When he overexerts himself, he is in a good bit of pain. Today he was up all day and over did it and he is fighting pain tonight. Today, Mark and James set up City Navigator North America on the GPS and they are delighted to have the GPS identify all the restaurants and businesses in our area and exactly how to get to these places and to look at maps of Reno and Tahoe and California (We are all going to San Francisco on Sept 4 and we will drive to Reno and Tahoe. It could sound crazy to you that Mark is going on a vacation as sick as he is, but when your days are shortened by cancer, you don't want to spend all of that short time in waiting rooms and treatment. You try to do some things that are fun and special.
Mark and James went to Amy's Ice Cream and did a couple of easy Geocache treasure hunts with the GPS. Mark read the Austin Chronicle from cover to cover and talked about all the movies he would like to see, the live music happenings he would like to hear and all the restaurants he would like to eat in...in the end all he was up to was going over to Rudy's Bar-B-Que and getting take out brisket so tender we did not need a knife. We are trying to get Mark out to one or two Austin places each day and to see a few people while he is here...but we must remember his need to take it a little easier than today.

Another Trip to the VA in Houston
Left at 9 am headed to Houston for a 2 pm appointment at the VA with a primary care provider who takes the health history; a requirement before you get an appointment with an oncologist. The physician's assistant spent 10 minutes with Mark and gave him a Sept. 1st appointment. We drove back to Austin arriving home at 6 pm having spent minutes in Houston. Wouldn't it have been great if Mark could have seen the PA on Monday or Tuesday when we were at the VA all day each day; but no amount of pleading could make this happen. All hoops must be jumped when the VA staff says to jump. Mark has taken this in stride with no complaints as he wants to see if the VA is a possibility for treatment, so he could come home. It's a challenge not having insurance.
PS August 28 The VA may not be as bad as the private sector. A friend of mine with insurance is trying to get her husband, who has some very serious symptoms, in to see a specialist in Austin Texas and it takes a month or more to get an appointment.

August 15 Mr.Mark's two days in waiting rooms at the Veteran's Medical Center in Houston
We drove to Houston on Sunday and were at the VA by 7:30 a.m. Monday. Two people were ahead of Mark to register for services and "a card." After an hour it was Mark's turn to be waited on. Another two hours in triage before he was called for his vital signs, after another two hours the standing BP nurse took his standing BP and after four more hours Mark was given an appointment to see a primary doctor on Thursday. All around us in the waiting rooms, veterans were grumbling about the long waits. An active duty man was there in triage to get a TB skin test. He had to wait the four hours and get vital signs after two and standing BP after two more while all the time telling staff he just wanted a TB skin test. I could have given him one in two minutes time, but no one escapes jumping the hoops or doing all the wickets. One lady said she was told by a staff person to stop grumbling about the wait as her husband was getting free care. She claims she told the staff that her husband paid for the care with two tours in Viet Nam. I smiled at people and talked to them. One man in a wheelchair, who introduced himself as Nathan, kissed my hand four times for stopping to talk to him and said he and I were family now. Tuesday, Mark went back and managed to talk people into letting him see a doc who was very nice, but he still has to come back on Thursday to see his assigned primary care provider for the first time and to get an appointment to see an oncologist. Mark has a personal letter of referral, from his doctor in Bangkok who used to work at the VA in Houston and at MD Anderson. If Mark is lucky he will be able to see an oncologist before he is due to go back to Bangkok. Highlights of our trip included finding an authentic Mexican restaurant close to our motel and open 24 hours a day, that has great crispy tacos and seeing the Cubs play the Astros in an airconditioned stadium.
August 11
Mr. Mark arrived in Austin this afternoon. It took 24 hours of travel to get home. He was tired, hurting, and ready to take a rest. but he stayed up long enough to eat a Schlotsky's original sandwich. Mark is making a list of places he wants to eat at in Austin. He says he has not been eating out in Bangkok due to watching his money and his energies.
Mark is very concerned that he has a tumor on his chest near or on the sternum which is palpable.
We are headed Sunday for Houston to check in at the Veterans Administration Hospital on Monday to see if the VA can do anything for him.

Fear:Cancer's dark shadow and companion.
While Mr. Mark is very brave, he still has his fears: fear the MRI will bring bad news, fear his chest pain or kidney problems are due to metastasis, fears about finances, fears he will get worse or die before he gets to do some things he wants to do like go to some major league baseball games, go camping with his friend Allen, sail again, and work with me on a novel, and fears that I know nothing about.

He is fearful he will get worse and not be able to come home so we are bringing him home this coming Friday. There are no inexpensive tickets at this time and nothing in the Fall, so far. After he researched and researched tickets as did I, we decided to bite the bullet and just charge the ticket. Uncle Bob and Aunt Dorothy sent money to help as did friend Mark Foster and MEDICO's executive director Lynda Peters. Mark and I will find the rest.

Mr. Mark is so encouraged and cheered up by people writing him notes and helping him. His goal is to get his own apartment in the states and work again. Dr. Theera told him a couple of weeks ago that he has a 50% chance of living a year which really depressed him at first, but his sister, Stephanie, reminded him that he was told 18 months ago that he had three months or less to live. We hope Mark will continue to stretch those percentages and predictions to their outer limits.

Stephanie made some calls to the Veteran's administration and yesterday she and I were in Houston to visit the new VA hospital associated with the Baylor school of Medicine and MD Anderson. Mark's doctor in Thailand was a medical officer at the VA in Houston at one time and is acquainted with medical personnel there. Dr. Theera understands that at some point in time we could run out of money to pay cash for treatment in Thailand. While we are dealing with one day at a time and one problem at a time, we have to think about the future too.

A few days ago Mr. Mark and I talked accross the long distance from Austin Texas to Bangkok, Thailand. He had just come in from a walk in the park. "Sweating and starving" were his answers to the question: "How are you?" Much better to be sweating and hungry than to be depressed. Mark has gotten mail from some of you that has cheered him immensely. Thank-you for anything you do to cheer Mark up and/or for your prayers and positive thoughts for him.

Call for a MAIL BLITZ to Mark, Who is Hitting a New Low in Spirits
After 17 months of chemo, feeling alone in Bangkok, no cure in sight,facing more chemo,a shortened life span, too much time on his hands to think negative thoughts about an uncertain future, and frustrating computer problems, Mr.Mark needs to hear from all of us letting him know we care.Tell him about your dog, pet taramtula or gecko, your kids, your job or something funny that happened to you. If you want to draw your own card or just write a note, take the money saved on a card and enclose it and seal it good with tape. Mark is excited when someone encloses a little money, but he loves just to hear from people. Mail is better than e-mail because he can displays it. He has poems and pictures on his refrigerator and pictures on his bedroom mirror and cards and letters on shelves. Let's flood his box with mail to cheer him up. The address is Mark Richardson Condo 6/11, Las Colinas Condominiums, 6 Sukhumvit 21 (AsokeRoad), Wattana Bangkok, Thailand 10110. This takes 84 cents postage.

Updates on Everyone: Mr. Mark (Bangkok), Miss Stephanie (England) and the Austin crew: Mr. James, Miss Betty the Mom, Mark's friend Bruce(All the cartoon characters) Plus Mr. Frank)
Mr. Mark has bounced back after chemo although worried he looked jaundiced in the mirror a couple of days ago. Dr. T. said the lab tests are ok. Mark talks to his friend Bruce in Austin on the computer. Bruce asked if Mark wanted to play chess on the computer and Mark said he had not played for 20 years. Bruce says that "Mr.Rusty" had him to check-mate in 10 minutes, so he is looking for a different game to challenge Mark to. Speaking of years ago, I found Mark's first SCUBA card, from 1970, when he was 16, today; we'd given it up for lost years ago. Mark actually got another card somewhere along the line years after the first one, perhaps when he and I were on Roatan diving with the crew from Till's dive shop and some guys from Holland.
Stephanie is in England, about four hours from London, in Plymouth studying educational technology and enjoying the local culture. She told me that the food is great and this time in college she can afford to eat unlike when she was in UT and was a starving college student. Her favorite aspects of Plymouth, though, are the wonderful people and their love of history.
James (Mark's step-father figure, Aggie from the Panhandle) has found a new way to make popcorn. While I was gone James decided to make popcorn. He got distracted before he got the lid on the popcorn pan. Watching TV he was thinking this was some sort of gormet popcorn as it was popping so well and so loud. When he got to the kitchen- the stove, counter, and floors were covered with popcorn.
I (Mark's mom, Betty) am still finishing two text books due on the shelves this fall and I passed my ACLS for all you medical types who know what ACLS is. See information on Miss Betty's textbook(s) at http://www.allbookstores.com/book/compare/1401838472.
Mr. Frank Mr. Frank is a little older than Mark and still a young man by my standards. Frank was recently diagnosed with essentially the same esophageal gastric adenocarinoma as Mark had, but without the secondary liver cancer. Frank expressed surprise that Mark got esophogeal gastric cancer so young as it usually is diagnosed in men in their 50's and 60's. Frank is sharing his experience, with Adenocarcenoma of the esophageal gastric juncture, with Mark and I. Frank went to MD Anderson for evaluation and the plan is for him to get six weeks of weekly chemo: Cysplatin, 5FU, and Taxotere in Austin. This is a different time schedule and a different drug regimen than Mark. Frank has had his first round of chemo and will soon have radiation in the same week as chemo. After the tumor is shrank or gone, he will return to MD Anderson and the area of the esophagus where the tumor was will be cut out and the esophagus sewn (reanastamosed) to the upper portion of the stomach. We will follow Mr. Frank's progress along with Mark's progress.
If you have cancer or friends/family with cancer, keep Mark and me posted about your treatment. We are interested in you and want to support you in whatever way we can. Here is a good British site to look up different types of cancer http://www.cancerbackup.org.uk/Cancertype. I clicked on secondary liver cancer on this site and relearned that the cells that metastacize to a different site are the same type of cells as the original site. This means that secondary liver cancer will respond to the same treatment that your original cancer tumor responded to. Secondary liver cancer is very common according to the experts on this. Mark would love to communicate with someone who is being treated for secondary liver cancer.
Stay positive at all times and find a way to enjoy each minute of your life or at least to convince yourself that you are enjoying it. Perception is what is important. It is perception, not reality, that we act on. If you think you are enjoying the minute, you are. If you are barfing in a plastic bag in the back of a taxi, be thankful you had the forsight to bring a bag and find some humor in the situation. Keeping stress and negative thoughts down helps you stay well or get well.
POST SCRIPT: August 28th. Ross with Lung Cancer is reported free of lung cancer. He had one round of chemo with a horrible reaction to chemo but miracle of miracles...he is said to now be free of lung cancer.

Mark is not feeling well after chemo
Received an e-mail from Mark today saying that he is really sick after chemo this time and is having a lot of pain and he said not to expect to hear much from him for a couple of days. He has been lucky in the last few months in having fewer bad days after chemo and lots of good days. When Mark was first on chemotherapy he was really sick and his sister and I were staying with him for blocks of time. At that time, it was hard to tell if it was the cancer or the chemo, but he had such pain and nausea and vomiting and loss of energy and bizarre chills and fevers, weight loss, edema in his feet,hair loss, depression, and he was fussy. We used to call him Mr. Fussy at times as he fussed at us when he did not feel well and then he would suddenly realize how fussy he was and appologize and tell us how much he appreciated all the help we gave him and he would try hard to socialize with us then would go off into bizarre symptoms like the bone shaking chills while sitting on the patio in the blazing Bangkok sun with a wool cap on and wrapped in a blanket warmed in the dryer. Mark has stuck with chemo for 17 months. In spite of periodically being sick and fussy, he has kept his sense of humor and has been very kind to everyone he comes in contact with. He has always dressed up and looked like he was going to a photo shoot for GQ magazine when going to the hospital or the grocery store. He looks more like the staff than a patient when he goes to the hospital. He hangs in there and sets a good role model for all of us as our daily tribulations seem small compared to his. In a couple of months he will get another CAT scan. The last one was a birthday present and the next one may be a present on his sister's birthday (September 1).

Mark,Mom,and Sister Stephanie in front of the picture of the Thailand King in Mark's condominium lobby when we last were all three together at Spring break

Mr.Mark called me today from his hospital room at Bumrungrad Hospital
Mark is currently getting a three day regimen of chemotherapy.Since his creatinine clearance is a little off normal, his platinol has been decreased and the doctor is considering shifting from Platinol to carboplatin to make it easier on Mark's kidneys. Don't forget Mark. He needs support more than ever.It is the support of friends and strangers that keeps him alive as he wages a battle against liver cancer (a metastasis from the primary tumor which is now gone.) Your support means everything to Mark. Your support can keep him going in his battle against cancer. You can donate to his treatment fund by sending a check to the Highland Park Baptist Church in Austin. (See instructions in the right hand column.) It will help keep him in treatment until medicare kicks in next April and we can bring him home. If we run out of money he will come home sooner.
The King of Thailand is celebrating 60 years on the throne Mark tells me that the beloved King of Thailand, who is the longest reigning monarch in the world, declared that all streets in Bangkok would be clean for the celebration of his 60 years on the throne and people made sure that every scrap of paper and speck of dirt was off the streets and they did not let any dogs on the streets to make sure the streets were clean . Royalty from all over the world were in Thailand to join in the celebration. The King's royal color is yellow so every Thailand citizen and foreigners small enough to find a shirt to fit them bought a yellow shirt and the country was a sea of yellow. The King rode the royal barge down the Cho Phyra River with other royals on board. Citizens turned out by the thousands to see their King and the foreign royals and a huge firewords display. All Thai people love the King and there are pictures of him everywhere. There is a huge picture of the king in the lobby of Mark's condominium. Each day there are fresh flowers in front of the picture of the King. Several months ago James (Mark's Aggie stepfather) was sitting in the lobby of the condominium off and on for several days and he thought that the Thai people were very friendly as they made a wai (y) for him by putting their hands together and bowing. Later he found out that the Thai people were greeting the picture of the King in a sign of respect. Thai, no matter how rich or how poor,are proud to be Thai and often say: "Farang (foreigner)if you lucky in the next life, you be born Thai.
Training a Parakeet
This is the continued Saga of Kuhn Petey bird.This is the miracle bird that I found outside my 11th story bedroom in Bangkok. He was sitting outside the window looking at himself in the glass (see earlier story). Mark told me this week that after cooing to Kuhn Petey for weeks and months to get him to talk and putting his finger in the cage and cooing to get Petey to sit on his finger, he got tired of cooing and just grabbed Petey and put him on his finger and after a couple of times Petey got the picture and now will ride around on Mark's finger and come back to the finger when Mark turns him loose in my bedroom to fly around. Hmm there may be a behavior modification principle in here somewhere.

Mr. Mark sent an e-mail today saying: "lab values suggest my kidneys are not working as well as they should which Dr. T attributes to the platinum. If it persists we will be forced to use something else. Meanwhile he gave me a banana bag with manatol and will repeat the lab tests next week and try again. I loved your dedication in your book. It was very touching and makes me feel very special. Every since I have been reading I wondered who were the people that were mentioned in the first page and I thought they must be very proud to be on that page, and so am I. Thanks for the financial update. Still on the austerity program, the only new purcase was my tennis shoes and a pair of pants. I needed them both and don't feel too bad for spending the money. Glad you are back in Austin, be sure to catch up on your rest. Later, Mark "
What is a banana bag you ask? It is probably slang for an IV with potassium
Miss Betty the Mom has written the dedication to Mark in the preface of two psychiatric case history books showing up in bookstores this fall. The dedication reads: "This book is dedicated to my son Mark who has battled cancer throughout most of the time this book was in progress. Sharing with me some of his innermost thoughts, fears, and struggles has reinforced for me that what student nurses, family, and others see on the surface in a brief interaction with a client can be a very different picture than what is going on inside the client. Compassion, empathy, and therapeutic communication do help us understand that inner person. I am indebted to Mark for all he has taught me.
Additionally, this book is dedicated to all the good nurses in various fields of nursing, not just psychiatric mental health nursing, who apply psychiatric techniques and principles when working with clients who have mental health diagnoses and/or issues."
Mark is still on an austerity program Mark mentions he is on an auterity program (chemo and rent take most of what we can scrape together each month) and he has limited his purchases this month to tennis shoes to wear in increasing his excercise and a new pair of pants because he has gained weight.It is not anticipated that these books will provide much money to Mark's mom and therefore to Mark. Textbook writers do not often get much money from their books. We need to get going on the great novel.

Mark is Dealing with Boredom While Continuing Chemotherapy
Mr. Mark gave me this report. "Everyone I sees in Bangkok asks Where is your mom?" (I am in Austin working to make more money for chemo for Mark.) He goes on to say, " They look at me strangely and and ask: How are you? like they expected me to be dead already and wonder why I am still here." Mark says he is feeling better and getting out for some exercise. He took bread to a nearby park with a lake and ducks. It is On Sukhumvit, near Emporium Mall, if you know Bangkok. He has gone to look at Ferraris at a nearby dealerships. Mark rode the skytrain to a big new mall with a store selling Segways which are a platform on two wheels with a verticle column and handles. You lean back and it brakes, turn the handles to go left and right. and lean forward to go faster. Mark took it for a spin in the store with the salesgirl yelling: "slow down." Mark was trying to see how fast it would go. Mark and I have spent enough cash money for cancer treatment that if we had it all back, he could afford to buy a fancy car and a segway. The problem is that you can't use these things in Heaven so when you have cancer you spend your money to stay alive.

Mark is still cooking and has gained some weight. He claims he is the only healthy looking fat person in the cancer clinic. He is not really fat but just nicely filled out after being too thin. He could go thin again as the chemo,nausea; and vomiting keeps him going between three or four sizes of pants.

Mark reports he recently got to thinking he was so much better and stopped taking some meds including pain meds but after a few days he did not feel so good and started the meds up again. Mark asks for more licorice (red and black) as it keeps his nausea down most of the time.

Mark reads with eyes closed while getting chemo


A Difficult Time for Mark: a time of great uncertainty
For people with cancer, periods of increased uncertainty must be unsettling even when improvement in their condition has occured. This seems true for Mr. Mark.
Mark is so upbeat and positive most of the time and I try to print the good news as much as possible, but the reality is that right now, he is still dealing with liver cancer, chemotherapy, side effects of chemo, and life decisions such as where he will live in the future, which depends on whether he is going to get better and how much better and for how long, which affects whether he can work or not, what kind of work he can do, how close he has to live to medical care, where he can have good access to care, and how to continue to pay for needed care. This is one of the most uncertain periods for Mark. When death seemed a certain thing, what was there to do but accept it and die, leaving all problems to others? Now that progress has been made in the battle against cancer he begins to wonder if he can hope for a future, but in the back of his mind is still the picture of death...not so certain, but it is still lurking there. The condo he leases is up for sale and he will probably get to stay out his lease until January, if it sells. Where will he go in January? Yet another uncertainty. This week I pushed Mark a little too much to do some business tasks and to think about whether he wanted to stay in Thailand, go to Saipan where he was when he was diagnosed with cancer, or come to the states and if so, where. It was stressful for Mark and mom backed off. While decisions will have to be made, stress is counterproductive to Mark's getting better and must be avoided. Mark may need your support now more than earlier as this uncertainty attacks his peace of mind at a time when he has more energy to worry. He truly appreciates any and all support. He told me in an e-mail this morning that he thanks God each day that he has me for a mom and a friend and he thanks God each day for those of you, strangers and old friends and acquaintences who support him in many ways. What may seem like a small support thing to you is really big to Mark.

Price of Treatment and Priceless Friend Petey: Mark continues to take care of Kuhn (Mr.) Petey Bird, the parakeet we found looking in the window of my 11th floor bedroom in Bangkok. He gives Petey a bath using a spray bottle. The little bird and Mark have bonded. As Mark has gotten better, his nerd skills have improved and he's now using Yahoo messenger for telephone calls computer to computer and using messenger e-mail for back and forth conversations. He has challenged me to get my technology more up to date and to get an avitar. He is putting music onto cell phones and making banana bread. He went to check out a restaurant he read about in the Bangkok Post and got nauseated and came home without eating there. I sent him an e-mail message and he wrote back: "I am busy being sick. Will e-mail later." Tonight he called and said he saw the doctor today and doctor T. tells him he is a poster boy and doing so well he should stay on chemo forever. Natuarally this does not appeal to Mark as chemo plays havic with his body and takes a toll financially too. Mark wants so much to hear that his cancer is gone and he can stop chemo. You can send him a card to encourage him. Cards and notes from friends and strangers mean a lot to Mark. If you are a stranger to him, tell him about yourself, your family, your job, your pets, etc. (Mark Richardson, Condo 6/11, Las Colinas Condominiums, 6 Sukhumvit 21 (Asoke Road) Wattana Bangkok, 10110 - 84 cents postage from USA).

Financial Concerns May Have surpased Worries About Dying. These past fourteen months Mark has worried about dying. In past months, it seemed a sure thing that he would die soon. Now that his cancer is responding to treatment, he worries about how he will continue to pay for treatment. We have spent a small fortune raiding our life insurance, bank accounts, and retirement funds to pay for treatment: enough to buy a fine car, small condominium and/or a boat (depending on the size of the boat). When diagnosed with cancer you can spend your money on such material things or you can spend it on treatment in hopes, against the odds, that you will get better. Mark is getting better.

Thanks to friends and strangers who have helped Mark
Some friends and a few strangers have contributed to Mark's care. You are wonderful. To these folks I want to say that we have appreciated, and continue to appreciate, your contributions toward the fight for Mark's life so very much. We love you for helping him while he is alive rather than saving your money for flowers in the event one of us dies. You are definately excused from sending flowers.

What does care cost in Thailand? Mark wanted me to tell you what care costs in Thailand. Here are some frequent and/or periodic approximate charges that are paid at each visit (At Bumrungrad Hospital, you can not return for care unless you pay your bill in full):
Oncologist's fee......$30.00
Radiologist's fee.....$50
Nursing service during chemo......$40/day
Chemo room........................$300.00
CBC...............................$30.00
X-ray.............................$7.00
24 hour urine creatine clearance $10.00
CAT scan.........................$600.00
1 nausea tablet sublingual .......$10.00
IV new nausea medicine.......... $30.00
1 neupogen injection.............$150.00
Ultra sound .....................$90.00
Hospital room ...................$100.00 - $125.00/day
Monthly 3-day chemo regimen .....$2,000 - $2,500
(including overnight hospital, doctor's fees, labs, nausea medicine, a neupogen injection, nurse's fees, IV's and chemo .....approximately)
Taxi fare to the hospital and back home .....$3.00

Many of you are asking...A donation of $30 to Mark's medical fund has paid for 10 trips to the hospital and back home or the doctor's fee for a visit or three pills to keep the nausea away. You can send a check for Mark's care to Highland Park Baptist Church 5206 Balcones Drive, Austin, Texas 78731 making the check out to the church; it's tax deductible. Put a notation on the check: For Mark Richardson Medical Fund. Enclose a note that your check is for Mark's medical expenses.

A Pretty Nurse Makes Mark Feel Better (picture taken April 2006, 8th floor, Bumrungrad Hospital, Bangkok, Thailand - Just before discharge after two days of a three day chemo regimen).
Every 3 to 4 weeks, Mr. Mark has a 24 hour urine done for catacholamines and a CBC. If all are good, he does 3 days of chemo. He is admitted on the 1st day to an inpatient room, but insists on staying dressed. He then goes to Horizon Cancer Outpatient Center for chemo. In the evening he is wheeled back to his inpatient room and his IVs infuse through the night. The nurses insist he put on a hospital shirt at least. Hospital clothing is a hospital shirt and pajama bottoms. This is much more dignified than the backless gowns of most US hospitals. Mark overnights in a hospital room and then goes back to outpatient for his 2nd day of chemotherapy. The 2nd evening he is discharged and comes back the 3rd day as an outpatient to get chemotherapy . The hospital stay drives up his cost but one type of chemo drug he takes requires the overnight stay, by Bumrungrad Hospital policy. The inpatient nurses all wear white uniforms and a nurse's cap. Some wear white high heeled shoes. They are very professional, knowlegeable, skilled, and feminine. They are totally polite and gracious. When Mark ring for the nurse, one comes immediately and gives the impression she has all the time in the world to help him. Nurses in Thailand are much like nurses were in the 1950's and 1960's in the United States. The doctor is like this too. As long as you have another question, he or she takes the time to answer. Review of your case is thorough at every visit.
Mark is always scheduled for a CBC a few days after chemotherapy. If his RBCs or WBCs are low, he gets an injection of erythropoeiten (RBCs low) or neupogen (WBCs low) and either one is costly. Mom gives Mark the injection to save money when she is in Bangkok.
A New Set of Problems Mark is not in as much pain and takes less pain medication. He has less nausea due to taking more nausea medication including a new one more expensive than the last expensive one which he also still takes along with licorice supplied by friends. While chemo still takes a toll for a few days with odd side effects creeping up at other times, Mark is much more energetic and full of thanks for all that others do to support him. The doctor tells him to take good care of himself now that he might win the battle against cancer. Mark shared with me that this takes some getting used to as he had prepared to die. Given a prognosis of three months to live, a person is told towork through the stages of death and dying and accept death. No one mentions that if you happen to live, that requires a whole new process to reverse your total acceptance and welcoming of death. Since Mark still has liver cancer, even if it is improving, he is in the twilight zone where he has to still be prepared to die and yet be exhuberant about life and prepare to live. Cancer is truly a roller coaster ride.
Mark tells me the problems when he was told he might live seem quite different from those when he was going to die. Living brings with it a whole new set of problems. Having run out of money and having no job was not a problem when he was going to die, but now he has to think about where he will live and work, and how to get such things as a job, health insurance, continuing education and licenses up to date, and a new pair of glasses, etc. We put our obituary writing session on hold to have time to think about problems associated with living.

Feeding a live young Tiger at the Tiger Zoo: Part of Our Celebration of Good News (the tiger in this picture is real)

After Mark received good news from his CAT SCan (see blog below), Dr. T. wanted to start another round of chemotherapy the next day, but Mark begged for five days off to go celebrate the news and his second birthday since cancer diagnosis. He wanted very much to go to Hong Kong on a cheap package tour to the Disney Park, but we decided we had to save the money for continuing cancer treatment. We settled for Pattaya the nearest city with beaches. Pattaya has a reputation for partying and bars. It also has stretches of beautiful beaches with nice hotels, five star hotels, and even a water park hotel. We opted for the latter and spent three days in the water park going down the huge water slides and playing in the water interspersed with serious resting. The water park costs 100 baht for all day (about $2.50). We walked the beach and toured a fabulous private home on the beach that we could rent, but remember we are saving money for chemo. On the way home, we stopped at the Siracha Tiger Zoo in Chonburi. Mark and I (and especially his sister Stephanie) love seeing the baby tigers and baby pigs which are raised together in nurseries. A tiger mother nurses both tiger cubs and pigs with the piglets dressed in tiger suits. Another nursery has a mother pig nursing baby tigers and piglets but the tigers don't have on pig suits. Lots of big tigers here too and they are quite fun to watch. Feeding a young tiger is a challenge. The tiger behaves only as long as the milk lasts and you have to help him hold the bottle just so.

Mark is Back in Chemo April 25-26 We returned on Sunday night and Monday morning Mark went into outpatient to begin chemo. It is still hard for him to make himself go for chemo. He hates it but knows it is what he has to do. He was hospitalized overnight and gets chemo again today (Tues). The nurses kept trying to get him to give up his clothes and put on a gown, but he steadfastly refused trying to hold onto a feeling of wellness and being in control as long as he could and so he got chemo while dressed.

Send Mark a Note of Congradulations - You can send Mark a note to congradulate him on his progress in the battle against cancer and to let him know you still care. If you are where you can buy Kool-aide, tuck in a couple of packages of sugar free Black Cherry Kool-aide if you can. It is your support that keeps Mark going. It means everything to him. See blogs below for address.

Mr. Mark got a CAT scan for his birthday present and here is the good news! (Picture of Mr. Mark on his birthday with some of his many flowers which thrive under his care.)
You may recall that on Miss Mom's last trip to Thailand, Mr. Mark learned that his esophageal-gastric juncture tumor had disappeared after chemo and radiation. He still had liver tumors and continued chemotherapy. Today on Mark's actual birthday we sat down with Dr. Theera to get good news. This CAT scan report says: The study reveals interval decrease in size and number of multiple liver metastases in both hepatic lobes, largest now measuring 1.7X2 cm. Dr. T was amazed, happy, and excited with this progress in fighting cancer and attributes it to V-P 16 and Platinol. I think Dr. T's constant attention to lab values and correcting problems promptly have been a big plus in addition to support from family, friends, and strangers. Mr. Mark is not cured yet..he is still fighting liver cancer but there are less tumors and they are smaller. Keep the support coming. Mark thrives on it and thanks you for it. While Dr. T. did not agree to radio frequency ablation, he said he would study on it and thought timing important with continuing chemotherapy most important right now.
Dr. T told success stories from his time at M.D. Anderson. One woman with terminal cancer and septisemia, similar to what Mark had. outlived one of her doctors and lived 20 years after diagnosis and treatment of cancer and septisemia.

Today the Suspense Builds.It Is the Day for Mark's CAT Scan
This is the big day that Mark has been postponing. Another CAT scan. He has not had one for awhile. This should tell the story of why he has a large bulge on the upper left chest and chest pain and if his liver tumors are shrinking, staying the same or thriving on chemo...and if he is free from any other metastasis. We leave for Bumrungrad Hospital soon. Latter today we will post the results of the CAT scan, so check back in latter today.
Later (the next day) Dr Theera, Mark's primary doc and chemo specialist, was sick yesterday and is out sick again today. It is funny in a bizzare cartoon show kind of way when the doc is sicker than the patient. We will not learn the results of the CAT scan until tomorrow.
Happenings in Bangkok Songkran is over. It lasted several days during which many stores and the banks and offices were closed. Yesterday was a normal day until 6 pm at which time the bars all closed and all alcohol sales stopped and this lasts 30 hours until midnight tonight . Soi Cowboy the famous street of bars is black. We took a walk there and it was a strange change from bright lights to very dark. It is a time of elections and people from villages who are living in Bangkok must return to their villages to vote. I hear there is another voting day at the end of the month so two chances to vote and you must vote or you loose government assistance in some way unclear to me. This is kind of like Joseph and Mary returning to the village in the bible story.
April 18th Two days until Marks birthday You can send cards late. The celebration goes on for at least another couple of weeks. tune in to see how we end up celebrating on the 20th.

Songkran (Thai New Year's Water Festival on Soi Cowboy, Bangkok, April 2006
Mark got ready for the Songkran festival on the Soi (street). He asked if we thought he should wear his dress jacket or not, thinking it would be funny to wear swim trunks and a dress jacket. At first the thought is to say "no, why ruin a great jacket?" and then "why not?" Life is uncertain when you have cancer and even when you don't so, why not use the jacket if you want to? It turned out to be a great idea as it protected Mark from the cold water that was being thrown and shot from water pistols and hoses on the street: activities to celebrate the Thai New Year. Mark's sister and teachers from Japan that were with her (Phillip and Will) also joined whole heartedly in the fun, with big water guns and then putting powder on peoples faces.
Mark to get his CAT scan on Tuesday - Return to this site on Wednesday to learn the results of Mark's CAT scan. We pray for good news and if good news, what else can Mark do to fight liver cancer? We are looking for that answer.
Food News In the meantime, while waiting for the CAT scan, we are watching movies and doing a lot of home cooking and a little eating out. Wednesday we shopped for big shrimp and vegetables and fruits in Klong Tuey Market. Jin prepared several Thai dishes which I am still learning to cook with her help. Thursday night we went to the Oriental hotel for a drink and dinner with Terry and her husband Jerry. Terry is the principal of the school where Stephanie teaches in Japan. Terry had arranged a table outside on the terrace and we were sitting at the edge of the Cho Phyra River watching the lighted boats going by. We were each given orchid and jasmine garlands by the hostess. The Oriental Hotel is one of the most beautiful hotels in Bangkok. It is very upscale and has a serious dress code. For example in the day time, guests may pass thru the lobby to their rooms in shorts but not stop in the lobby. Non guests are not allowed into the hotel at all in shorts unless going to a guest's room. The dress police are serious. If you want to know what I had to eat, I had a very good lobster sandwich which actually was quite reasonable in price.
Friday night before Steph's teacher friends went to the airport, we piled into two Taxis and went to a great all you can eat restaurant called The Stables, on Soi Eight. For about 10 dollars a person there is a salad bar, soup, baked potato, corn on the cob with all the trimmings, and you pick out what you want put on the grill. Choices are: New York Strip Steak, huge shrimp, muscles, clams, chicken, shish Kabobs of all kinds.
In contrast to the Oriental cuisine and The Stables fare, Stephanie cooked sausage gravy and biscuits for breakfast and meatloaf and brownies for snacking. Mark said: "Steph you are a good cook." I said: Yes a great cook." Steph responded modestly: "Well, at least it is edible." We love to tease each other a bit so I responded: "Well, we wouldn't want to go that far."
Cards, postcards, and letters for Mark's birthday - Mark has cards displayed everywhere and he loves them. If you have not sent one yet, it is not too late to get one in the mail. He loves everyone he gets.
Old posts on the blog - If you have not read all the stories on the blog, go to the archives and click on the oldest one. Skip anything dull and read the ones that interest you. There is a good picture of Mark wearing the Alien Baby Hat. See if you can find it.

Mark and Stephanie with powder on their faces at Songkran festival

Family Reunion Begins In Bangkok
Mr. Mark's sister Stephanie arrived in Bangkok with two of her teacher friends (spring break from teaching in Yokosuka Japan). She brought food stuff that is hard to buy in Thailand, books for Mark, and a crockpot to cook roasts in. The mom is headed out from Austin on Monday, suitcases similarly loaded but with different food stuffs including two large cooked briskits, and sacks of cream gravy mix (a staple of cowboy cooking). There will be a lot of cooking going on and we will cook some Thai dishes too. I have been thinking about eventually co-authoring a receipe book with Mark and a Thai friend and selling it to raise money for his cancer treatment or giving it to people who send donations.
Songkran. This is the Thai New Year. People wear Hawaiian shirts and have the big water guns and hoses and spray each other with water and put powder on peoples' faces. . Fun and laughter add some quality to Mark's life and may be what keeps him going. Does anyone want to join the Richardson Family Reunion in Bangkok this year or next for Thai New Years)?
Mark's Birthday is April 20.

Bumrungrad Hospital, Bangkok Thailand is Joint Commission International Accredited.

Mr. Mark Tickles the Doctor Over a Cat Scan and a funny Cat story after that. Mark wrote that he had been to see Dr. T., his chemotherapy doctor at Horizon Cancer Center, Bumrungrad Hospital, Bangkok. The doctor suggested Mark get another CAT scan to see if the liver tumors are responding to chemo, whether the esophageal tumor is still gone, and what else may be happening in his body. Mark fears bad news and often postpones tests due to this. Mark says he told Dr. T. that he wanted to wait until his mom came to Thailand on April 11th and he would ask her to give him a CAT scan for his birthday present. Mark says that this struck Dr. T. as funny and he laughed so hard that the nurses came and shut the office door. He says Dr. T. pretended to listen to his lungs, but was laughing so hard he could not have heard anything.

"Baby"


The Black Cat Gets A White Butt (Temporarily)
Some of you may not know that Mark's father died of Cancer some years ago. There are many interesting things to tell about his Father. His hobby was collecting and selling diamonds, antique gun locks, Ruger pistols, and antique firearms. He was also a gun maker and made some beautiful muzzel loading and flint lock guns. There will be more about Mark's father in a later blog. Mark's step-father figure is James, a slow talking Texan from the Panhandle of Texas. Mark loves James' cowboy cooking and claims that early on in his cancer battle, when James visited Bangkok, the cowboy cooking helped keep him alive. James is an Aggie (graduated from Texas A and M). Aggies are notorius for doing things in a strange fashion: often backwards. When it started to rain recently, James decided to paint the door trim on the front door. The mom did not realize the threshold was painted until she looked down and saw her footprint in the wet paint. James pointed out that she was not the first to get into the paint. The cat had earlier sat in it and slid off the threshold onto the porch. The curious black cat named "Baby" then had a white butt.

Is leprosy contageous? Mark cracks the mom up. Mark e-mailed that he was entertaining two small children from a village near Laos, a little boy named "Boy" and a little girl named "Baylee". They were watching cartoons and eating lemon popsickles with Mark. This was a big adventure for them. They told Mark that no one in the village would believe them when they went back to school and said they had been up high in a building where a "farang" (foreigner) lived and ate popsickles and watched TV on their holiday from school. The nurse in the mom cautioned Mark about entertaining people, telling him to be certain none of the children or adults had a cold or anything contageous since his immunity is down due to chemo. Mark wrote back saying: "Okay I will try to screen out sick people from my social calender. I can't remember if leprosy is contagious though. " This cracked the mom up and she nearly fell out of her chair laughing. It is good to laugh about the things surrounding cancer that are so hard to manage and Mark always seems to have a good grip on life with his keene sense of humor .

Mark's Sister, Stephanie at this year's Nagoya Fertility festival

How we will entertain ourselves in Bangkok
The one without the mask is Stephanie. Mark is still in Bangkok and resting up for the visit from Stephanie and "The Mom" in April. He says he is very excited about seeing us. We want to take him on another adventure, but he thinks he may not be able to go far, although he will try to be in good shape and inbetween chemo treatments when we arrive. If he is unable to go very far, we will of course enjoy the Songkran festival and shoot water at people on the streets and get powder put on our faces. In addition, I am thinking about starting our novel and maybe entertaining ourselves by writing our obituaries. The newspapers in Austin, Texas, and Bangkok, Thailand, let you write just about anything you want and charge you by the size of the obituary. In some places such as my old home town Jacksonville, Illinois an obituary is free, but it is prescribed and perhaps not quite as imaginative or creative as those in Austin, Texas. Austin's moto is "Keep Austin Wierd", and sometimes this is revealed in the obituaries. Seldom do people in Austin die..They cross the great divide to play golf with God or dance their way up into heaven or ride their motorbike on the golden streets. It is a challenge to write an obit when you can write just about anything you want.

Former Texas Governor Ann Richards has esophageal cancer, a different type than Mr. Mark's esophogeal cancer was.
Ann Richards has squamous cell carcinoma, a type of cancer attributed to effects of smoking and drinking which she admits to doing years ago in a difficult period of life. Ann Richards was the 45th Texas Governor from 91-95. Miss Betty took some student nurses to see the legislature in action during Governor Richard's term in office. One of the students had a wish to get her picture taken with the governor, so Betty asked governor Ann if she would mind posing for a picture. The governor talked with the students and posed for the picture. Not every governor has been as accessible as governor Richards was.
Mark did not have squamous cell cancer of the esophagus like Ann Richards. Mark had an adenocarcinoma of the esophagus at the junction of the stomach: a type of cancer associated with acid refux and not associated with smoking and drinking, although Mark comes from a line of smokers and drinkers. His grandmother smoked Raleigh cigarettes and saved the coupons in shoe boxes to get prizes. She turned the ceiling black with smoke and the plastic flowers always were covered with gum from the nicotine. When told "Mom, you will die from cancer if you keep smoking", she replied: "Lot's of people have cancer and don't smoke." and sure enough she was correct. She did not die of cancer and there are cancers not caused by smoking or drinking. Mark's grandmother also said she would not die from cancer because she had taken out cancer insurance and although the logic was faulty, sure enough she was correct in that she did not die from cancer.
Mr. Mark's type of esophageal cancer, adenocarcinoma, is often diagnosed late because doctors try to treat the symptoms with antiacids then more and stronger antiacids until they finally decide to scope the esophagus and by this time, the cancer is often metastasized. Mark's cancer had metastacized to the liver. Although Chemo and radiation caused Mark's esophageal tumor to disappear, the five liver tumors are still there and that is why he still gets chemo. In the right column are links to some cancer sites. Click on the one that says treatment for liver cancer if you want to know the various treatment options for liver cancer. Let's pray that Ann Richards does not have any metastasis to the liver or elsewhere. She is seeking treatment at M.D. Anderson in Houston.
Strangers Become Friends
George Wolff, from Ontario sent Mr. Mark a large package of licorice. He is a kind man that Miss Betty the mom talked to on an airplane crossing the Pacific Ocean Once more a stranger becomes a friend to Mr. Mark. The kindness of strangers, as well as that of friends, is again truly amazing.
Cancer Surrounds Us
Talking about strangers becoming friends, Miss Betty met Olga in water aerobics class. In a short conversation, it was revealed that Olga's father was a pathologist in Springfield, Illinois where Betty had worked for Dr. Tom Masters, an internist who specialized in diabetes, some 30 plus years ago. Olga's family had been friends with Dr. Masters. Olga had a brother die with cancer. She has a living brother, a psychiatrist, who is now waging a battle with cancer. Weeks and months after Olga and Betty met, Olga found out that she has cancer and she began her chemotherapy just two days ago. Cancer surrounds us. As we age, our chances of cancer increases. Get regular check-ups, so cancer can be caught quickly before it spreads. Eat lots of those vegetables and some fruit and keep your stress to a minimum. Giving up smoking and avoiding alcohol or keeping it to a minimum is best for putting the body in the optimum shape for fighting cancer, but we have to keep in mind that giving up smoking and drinking isn't the whole answer as some cancers are not attributed to smoking and drinking while others are.

Mark's weight fluctuates and he continues nausea off and on. He was thin and ill last year when he posed with the tiny car of the Amsterdam Fire Chief
Mr. Mark is either up and down in the roller coaster ride of cancer or "sugar-coating" news to his sister so she won't worry. His mom is in charge of all worrying. I beg him to tell me the true news, as it is, so I can better help him. He has been telling me for a week that he is nauseated and vomiting. He reports that he is in between his largest waist pants and his smallest waist pants and has one pair that fits. He tells me that he rests a lot, feels great, gets up and goes to water the plants or goes a block or two to buy food and is exhausted. Hopefully he will bounce back like he has before. This is definately chemo at work. My friend Audrey experienced the same loss of energy when she was on chemo. I went to pick her up one time for a cancer support group and she could barely walk from her house to the street to get into the car. She desperately wanted to go but she decided she was too weak and could not go. There is a temptation to stop chemo in order to stop the weakness and the nausea and vomiting. My hat is off to Audry for finishing all her rounds of chemo. My admiration for Mark and his continuing to stick with chemo in spite of all its side effects, so he can stay alive, increases.
Licorice
Mark called today desperate for licorice as the only thing that he can keep down and occasionally it helps so he can eat something else. If you can send him some licorice it would be wonderful. Both Stephanie and I have individually sent some, but neither batch has arrived yet. We need some more mailings to keep it coming in. Send birthday cards and/or licorice to: Mr. Mark Richardson
Condo 6/11
Las Colinas Condominiums
6 Sukhumvit 21 (Asoke Road)
Wattana Bangkok
Thailand 10110

The Water Gun Story
In April 2005, I was in Bangkok for Songkran, which is the New Year's festival in Thailand. All over Thailand the Thai New Year is celebrated by spraying people with your water gun or a hose or bucket and putting talcom powder on people's faces. If you walk on the street you expect to get wet and have powder on your face. I bought the largest water guns I could find for Mark, Jin, Steph, a couple of friends, and myself. After Songkran, I decided to carry back to the USA one unused water gun in the package and one slightly used one. When I got to the airport in Bangkok, security was tighter than usual as the Miss World Contest was in town and there were bombings in the South of Thailand. Security had been tightened in the big department stores and the airport. I had to have my suitcases examined thoroughly before I could go to the counter to check in. Everyone entering airport had this extra check with several tables and lines set up. During my turn for check, the young man went through all my underwear and dirty laundry and then got real excited when he came to the guns. I explained they were water guns for Songkran. He got more excited and yelled for a supervisor who came running and made me fill out a form that my guns were unloaded: a flurescent orange sticker that went on the outside of my suitcase. There was another check at the line to go to the ticket counter and I went through one more round of gun hysteria until they sorted it out and let me pass. All these checks before checking in are not taking taking place at the airport now...just extra safety during the Miss World Contest...and to think I did not even get to enter the contest. This year, I don't think I will bring any water guns home.

3/1Phone Call from Mark...
Last night I was typing an e-mail to Mark to tell him I'd sent some magazines and Gatorade mix, when the phone rang. It was Mark! He sounded good...He's finished this round of chemo a week ago and didn't have too hard of a time with it, but the docs are talking about adding a new chemical in with the next round. The Thai medical system is wonderful for someone like Mark, because they aren't afraid to try various methods. Are other doctors like this, or are they too afraid of being sued? At any rate, the mix that they gave Mark the first time a year ago seems to have done well- he's lived almost a year beyond expectations.
Mark was happy that he had some friends coming over for dinner tonight. One British-Japanese friend is called "Retro" for his 70s-style attire. Another friend is going to help Mark get some form of internet at his apartment... again, people's kindnesses and thoughts mean all the world.
Apparently Petey-bird is not learning his whistling as fast as the lesson plans forecast. Mark says he stays on the balcony sometimes, and that he enjoys it, but apparently he has two bird-friends who come to visit him everyday, and one sports a bald head with a few feathers sticking up "like a punk-rock bird", Mark commented. He sounded a little like our parents, back in the day, when we would wear something that didn't meet with their ideas of suitable. Mark is thinking of adding a baby bird to the mix, in the hopes that the baby would wear off on Petey, rather than the other way around. Ah, the woes of trying to parent!
I'm planning to return to Bangkok for spring break, which will be Thai New Year again (see last April's blogs)... this time I will be prepared, with ski goggles, plastic shoes, and throwaway clothes! I probably won't take any water pistols with me - after hearing Mom's tales of the misunderstanding at the BKK airport, whereupon she had to have a flourescant sticker put on her suitcase because it held "unloaded WEAPONS" in it (call them water toys, NOT water guns!) I'm looking forward to celebrating the milestone of the one year past-expectations with Mark, and his second birthday after diagnosis will be April 20th. Again, he'd love it if y'all would take a moment to send a card or note. Stephanie

Mark Feeling Bad After Chemo. A Major Difference in Thai Hospitals Compared to Those in USA
Mr. Mark is e-mailing every day : a major feat for a guy with cancer who felt so bad much of 2005 that he e-mailed only a few times when he felt an urgent need to check on close friends or to try to deal with finances. Mark is sick after chemotherapy early this week. He may be over the major vomiting and is eating only "small bits of food" as his digestive tract hurts.
Mark had a chest x-ray this week because he had a strange bump on his chest after coughing bouts and is having pain in that area. His x-ray showed 7 old rib fractures which he attributes to a skiing accident from hitting a moguol at a high speed and doing some involuntary acrobatics. "It hurt a lot at the time, but I just kept going", he says. I recall skiing with Mark one time when although he had brought his own skis, he rented high performance skis. We even bought some tire chains for our car because the road was closed to the slopes to anyone without tire chains. We were determined to get some skiing in.
I wonder if Mark might have broken one or more of these ribs when he was into sky diving and broke his leg. Speaking of injuries, Mr. Ron Cruzan one of Mark's friends from Junior High and High School called tonight. My uncle Bob had tracked Ron down to tell him about Mark. Ron relates that he was recently in a serious multi rotational roll over accident as a passenger, and had to be cut from the car and taken by helicoptor to the hospital. He is back to work, but it looked like he was trying to beat Mr. Mark to the pearly gates.
Mark is concerned about the cost of treatment After one year of chemotherapy and radiation, Mark and I have passed the $100,000 mark in spending for his treatment out of our pockets. He has run through his life insurance and I am into my retirement fund. Early in his bout with cancer, some people from his work on Saipan donated money and sick time. After that we received a check from Dr. Brown and his wife Kris and some money from a special fund at our church and from our sunday school class and some family and friends for a total of 2,400 dollars. This really helped. Some people sent money in cards and letters. A stranger from Hollywood sent talking books and a cassette player. Mark wants everyone to be thanked. He does not want to miss anyone. Every gift, big or small is very important to keep him in treatment and to keep him believing that people care.
One big difference between hospitals in Thailand and the USA is that you do not run up a bill and not pay in Thailand. Mark pays everytime he gets treatment. If he does not pay then no more treatment. A friend in the USA who has cancer lost a spouse about 5 years ago to cancer. The spouse died in the hospital and my friend has not paid the spouse's hospital bill yet. There are some extenuating circumstances in this case, but circumstances or not, this does not happen in Thailand. Friend Ian could not get the hospital to release Pui's body until he went back to his hotel and got information to use on the web to download proof he had wired money from his bank to the hospital to cover the entire bill and the finance supervisor reluctantly gave approval to release the body. Pui died in the afternoon and it was very late at night before the finances could be taken care of and the body released so her family could make a long trip home from Bangkok to their village.
Advice today: You may sit on someones tombstone after they die and talk to them and they may hear you and appreciate it, but why take a chance? Call everyone important to you or go see them or write a note today. Take a look at what is really important in life. No one knows if they will be here tomorrow. Do more hugging and enjoying and less complaining.

Mark on right and friend in Bangkok on left...now I ask you this: Whose hair sticks out more, Mark's after chemo or his friends??


Chemotherapy Makes for Strange New Hair When it Falls Out and Comes Back In.
Mark's tells me his hair has come in coarse and it sticks out, particularly at the temples, in strange ways and he has not found any products that keep it down. His hair came in kind of salt and pepper after it fell out from chemo. My friend Audrey's reddish blond hair fell out and came back snow white with not a grey hair and it is also coarse but not as curly. These changes are worrisome to those who experience them. This may not seem big to you or I but it would if it was our hair. I think Mark's Hair and Audrey's hair is beautiful but it is not what I think, but what they think that is important. Here is what Mark said about his hair in an e-mail entitled "Hair I am" ..."My hair is stiff and coarse on the sides, it sticks out and makes me look like an aeroplane trying to take off. Nothing seems to make it stay down, so I am growing it longer and maybe it will help to stay down. I took a pair of scissors and tried to cut it a bit but now I have a hole in my hair on the right side. If anyone says anything I tell them its the chemo and a patch fell out on that side."
Report on Kuhn Petey (Mr. Petey Bird) - Mr. Mark is concerned that his pet Mr. Petey bird does not seem comfortable around people and thinks he is to old to learn new tricks. He is thinking of getting a baby bird. He can't give up his Mr. Petey the miracle bird so guess he will have to have two birds in one cage if they get along or two birds in two cages if they don't. Does anyone have some bird advice for Mr. Mark? Chirp if you do.
Pui's Brother Shaves His Head and Becomes a Monk - Look up the story in an earlier blog about our young friend Pui's death. I learned from Ian that a picture of a single Monk standing by Pui's casket that I sent him by e-mail is a picture of her brother. He shaved his head and became a monk when she died.

Mark gets another round of Chemotherapy at Bumrungrad Hospital, Bangkok, Thailand
Mark in front of Bumrungrad International Hospital., Bangkok

Thanks From Mr. Mark to Everyone Who Sent Valentine's Cards. If you missed the Valentine's Cards, You Can still Send a Card for his Birthday. Send it Now.
On this recent Valentine's Day, Mr Mark passed the one year mark after a diagnosis of Cancer of the esophageal-gastric junction with metastasis to the liver and being told he had less than three months to live. Many of you sent him Valentine's day cards and he is in the process of making a list of the cards he received, which he has on display to reassure himself that people do care about him.
Here is a special thanks for the Valentines day cards that Mr. Mark: "I received lots and lots of cards in the last month. I will try to sort them out and let you know who they were all from. Received cards from relatives, neighbors in Austin, people from Jacksonville, Illinois where we used to live and still have friends and relatives, Austin Family magazine (mom writes a monthly column for this newsmagazine), people I used to work with, old nurse friends of mom, the Highland Park Baptist Church and Sunday School people, Rotary Club people, and my sister's students and former students , including a poem that jennifer Toffler sent that I want , to be at the end of the blog when I kick the bucket (slang for pass on to cook brisket in paradise or the more common term "die"). Thanks a million for all the cards, letters and pictures. "
Your cards and letters mean a lot to Mr. Mark as you can see from his note. Every card, picture, note, drawing, poem is on display in his home away from home in Bangkok, Thailand where he is still getting treatment for cancer.
Mr. Mark's birthday is coming soon. Last year he thought he wouldn't live to see another birthday, but he did, and now it looks like he will soon be enjoying another one. Let's all send him a birthday card. If you want to send him a present, he is really wanting some licorice (both black and red) as there is none to be bought in Thailand.
Mr. Mark, his sister Stephanie and I are very interested in other people who have cancer or have a family member with cancer. Please write and share your story with us. We realize we are exceedingly fortunate that Mr. Mark is still alive and we can enjoy his humor and being with him. Our hearts go out to people who are not so fortunate and whose loved one has died of cancer. Our hearts go out to all who still live with a diagnosis of cancer and who are suffering from the pain, nausea, vomiting, uncertainty, fear, and emotional and financial stess that goes with this diagnosis.
Our friend Ian recently lost a friend Neil to cancer after just loosing his
young wife, Pui.
You will recall reading earlier in the blog about our friend Ian who married the golden girl with the wonderful laugh: Pui, our Thailand friend, and about her untimely death at a young age shortly after their marriage. After her death, you will recall my telling you that he named a star for her. He also had a butterly tatoo with the name Pui in Thai put on his arm in honor and memory of Pui. Ian is an engineer from the UK, living in Switzerland, and working now temporarily in Taiwan. Ian had told me about his friend Neil in the United Kingdom, who was diagnosed at Christmas time with Liver, lung, and kidney cancer, which later turned out to be adrenal cancer. Ian was most fortunate to see his friend at Christmas time, when he was home visiting his mother. It was the last time he would see Neil. Ian received word just this week that his friend Neil has died...Like Mark, Neil was given a short prognosis and unlike Mark, Neil left his family and friends quickly...far too quickly and far too young. Somehow, we hope this blog could honor and comfort his wife, family, and friends who miss him greatly.

Mom is back in Austin. After months of being too sick to e-mail, Mr. Mark (this is what he is called at Bumrungrad Hospital, Bangkok) began e-mailing me when I came home. He still has liver cancer even though his primary Gastro-Esophageal juncture tumor is gone after ten months of radiation and chemotherapy. He is still getting chemotherapy in Bangkok and riding the roller coaster of cancer with all its ups and downs.
It has been a challenge for Mr Mark to stay positive since fighting cancer is difficult and takes a hefty toll physically and financially, but he has done it and sets an example for us all. He recently purchased some inexpensive classic books: Dicken's Great Expectations, Doskiveski's Crime and Punishment, and Verne's Twenty Thousand Leagues Under the Sea. Mr. Mark has always been an avid reader and it provides a great diversion from his worries about cancer, nausea, vomiting, pain, money, and the future. He hopes to stay positive by reading books to help him gain insight and he tells me he is setting small goals and a big goal for each day. If he makes even his small goal, it makes him happy. I miss the face to face heart to heart talks and the laughter that we have each day when I am in Bangkok, however we are e-mailing about important things on our minds. News on Mr. Petey Bird The miracle bird Kuhn Petey (Mr. Petey) shares the beautiful Bangkok sunset every night with Mr. Mark, from his balcony. See story of Mr. Petey Bird in the archives (check right hand column).
Mark Thanks You all for Your Cards, Letters, Gifts, Prayers, and Most of All for Caring
Mark enjoys your cards and letters and prayers. He tells me to thank everyone who has helped him in any way (e.g. taking valuable time out of your day to pray or write a note and/or taking money out of your pocket to help him in any way, or helping his mom). You are all special to him. Support makes all the difference in the world in how long a person with cancer survives and how successful they are in dealing with it. His sister has some of her students, who don't know Mark but know about him, writing lengthy notes to him to break up some of his monotony and take his mind off his pain.
Anyone who wants to help Mark financially, in any amount, can send tax free donations through Dr. Larry Lake (email: petroprof@aol.com) or send a check directly to Highland Park Baptist Church 5206 Balcones Drive, Austin, Texas 78731 with a notation on the check: For Mark Richardson Medical Fund. If you want to read all the blogs, you can go back to the first one by clicking on the oldest one you find and it will pull up with older ones after it.

Yokosuka Japan and Miss Stephanie (Mr. Mark's sister)

I stopped in Yokosuka to visit with Stephanie on my way back to Austin, from Bangkok. The morning after we arrived in Yokosuka, I awoke to a winter wonderland of of snow on the ground, trees, house, car, and everywhere. It was beautiful.

I have spent a lot of time with Stephanie in her classroom on the base where she teaches Japanese and English. We have exercised in the gym overlooking the bay and the ships.

One Saturday we went driving along the coast looking not only at the ocean with windsurfers and surfers and sail boats on our left, but also seeing a clear view of Mt Fuji in the distance coming closer as we moved into the mountains. We went to the hot springs and spent the day in a variety of hot spring baths: in doors and outdoors, a bath of coffee, one of tea, and one of sake, one of Dead Sea salt to float in, large ones and small ones, clothed in the tubs and pools for both genders and in our birthday suits in the tubs and pools for women. What a fun day! I return to Austin, Texas Friday. Tonight we had a pretty strong earthquake. The house really shook. We have had snow, rain, cold, warm, and now an earthquake. I think it is time to return to Austin.

Japanese Cemetary: note angel mailbox on right. Purpose: to send messages to Hide, a Japanese musician who died, was cremated, and is interred here.
Respect and Love for Those Who Have Died - Pui and Ian
Did you read the story I wrote about Pui (Puey) the young girl from Bangkok who died and whose funeral I attended? If not, see it in an earlier post. Ian, the heart broken husband she left behind has had a star named after her. The star is now called Pui. Ian sent a copy of the certificate.
Toshiko-San
I found a new friend in Yokosuka. Her name is Toshiko-san. She has taken me shopping and sightseeing, taught me many things about life in Japan and life in general, and has taken me to the cemetery where she has a family plot with a stone and small flower gardens she designed herself. The cemetery is on a hill overlooking the ocean. People are not buried here. Their cremains are placed in special vaults under the marbol on the plots. Hide (pronounded He day) the musician has a large plot and monuments here where his cremains are. His group was called XJapan. There are lots of flowers from fans. Most of the plots and monuments are well taken care of.
While in the cemetery we saw the mother of a man, who died at 27, come and sit on the monument on his plot and eat lunch. I was told that she comes throughout the year, hot or cold, and sits on his monument and eats her lunch.
A young man and woman came with two huge bouquets of orchids to place in vases on the family plot which was large with marble benches and seats. There were many kinds of orchids in the bouquets including blue checkered orchids. I have never before seen a blue checkered orchid.Some monuments have a slot for the card of visitors. The Japanese seem to respect and care for the resting places of their deceased family members and friends.
My friend Toshiko even planted flowers and placed a collection of stone owls on the monument stone of a 12 year old boy. He is no relation to her and she did not know him, but she has a stong feeling for him and his family.We visited the monument of the son of her friend Kuruda san too.
In this cemetery there are some large plots owned by groups such as churches where members can have their ashes together after death. Some plots are owned by business associates or a village. Some monuments have names in white for the dead and red for the living members. It is a very interesting and beautiful cemetery. Since my son Mr. Mark has cancer, I think more about dying and more about living too.

The Rollercoster Ride of Life and Cancer Continues
Mr. Mark met with his chemotherapy doctor and the lady radiologist recently and a heated discussion occurred over whether Mark should have radiofrequency ablation (RFA) for his liver tumors or not. Mark's primary physician: his chemo doctor says: "No RFA, Just chemo...more chemo until it doesn't help anymore" . The lady radiologist had suggested RAF would reduce the tumor load on the chemotherapy. We were excited about this idea, but for now the idea is vetoed. I think about finding a way to get cyberknife for Mark in the USA at a reasonable price, if it will help him, but not the $50,000 plus for those not on medicare. Mark is currently discouraged and admits it. He wonders if he just stays alive in order to wait out the two years to get on Medicare so he can die under Medicare when he really wants to get well and go back to work helping people as a respiratory therapist in the hospital.
Keeping Cheered Up - Kuhn Petey bird, some money his sister and I put in his bank account, and cards from people keep him cheered up and he keeps his sense of humor. He got a laugh out of a hat that jin, who helps take care of him, was knitting for me. Mark described the hat in an e-mail as being of green flourescent yarn and suitable for an alien baby. He told Jin to save it in case they run into any aliens.
Things are up and down and sometimes crazy. For example, on the way to the hospital to see the chemo doctor, Mr. Mark's taxi crashed into a truck and the taxi door would not open so Mr. Mark kicked it open, jumped out and got another taxi and continued on to the hospital to see the chemo doc and told me: "Wouldn't that be something to be killed in a taxi accident on the way to see the cancer doc?" But Mr. Mark was not killed and the roller coaster ride of life and cancer continues.
My best to you, Miss Betty the Mom

Mark Wearing Alien Baby Hat and Trying to look like an alien

Jin -Knitter of Alien Baby Hats

More on the Alien Baby Hat and Mark Creates the Perfect Caesar Salad
In an earlier blog, Mr. Mark shared that his friend Jin was knitting a neon green ski type hat that he 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.

"Kuhn Petey" Staying With Mr. Mark as his Pet

Last Thursday, the day before I was to leave Bangkok for Japan, was a day of good luck all day long. Mark got the good news posted below, he got waited on right away twice in the grocery store when other people were in long lines which strangely enough caused him to be very happy and excited, and a parakeet appeared on my window sill after dark. I was in my room/office doing some computer work and decided to rest my eyes by looking out the window at the traffic. Usually I look straight out never pulling the curtain out away from the window, but this time I pulled the left curtain away from the window for some strange reason and I was looking at a blue parakeet admiring his reflection in the window. It was a little tricky, but he was brought in and spent the night on the inside window sill waiting for his cage to be purchased. Mark named him Petey after a bird his grandmother had for years. Mark is now caring for Mr. Petey (Kuhn Petey). Note: Men and women alike are addressed as "Kuhn" rather than having a Mr., Miss, and Mrs. as in English. The men say a slightly different greeting than the women, saying Sawadee Cup whereas the women say Sawadee Kah.Possibly birds have a different form of address but we are sticking with Kuhn Petey. Mr. Mark gives Mr. Petey his bath and covers his cage for his nap and at bedtime. It is good for someone who is very ill and getting so much care everyday to have something to care for. Mark wanted a little dog (Chihuahua), but Mr. Petey, a small miracle bird, dropped in to be Mr. Mark's houseguest/pet and is now under his care.

Great News Follows Depressing News
Mark received chemotherapy three days this week, staying overnight in the hospital the first day of chemotherapy. He asked his chemo doctor how long he would have to have chemotherapy. Answer: "Indefinately until the cancer eventually takes over some time." Wow...spending all this money and Mark being really sick from the chemo and weak and having so many strange side effects, as well as pain and doing this indefinately. It was not exhilerating news.
Even so, Mark looked the picture of health getting his chemo. He has pink complexion and is alert and well dressed. He has gained weight while I am here. He is cheerful, jokes with the nurses, and on the second day of chemo was exercising in the hall with his IV stand in tow. He was doing stretches including bending over and palms to the floor.

Yesterday during the third day of chemo Mark ran into his lady doctor who did his radiation and was asking her about cyber knife and other options and she told him she would go over his options with him if he would make an appointment. He made an appointment for today. She went over all his records with us. We will get copies tomorrow. The Cat scan report from the hospital on Saipan said something about a small lesion in the lung. There was not a lung lesion in subsequent Cat scans in Thailand. The endoscopy done recently actually shows the Gastro esophogeal tumor gone..not there. There are five lesions in the liver all about 2.5 cm each....and a few very small ones. Unless something changes, a radiofrequency may be a possibility on the ones under 3, though we worry the doctor will only be willing to RF one or two of them at a time; this is major surgery.

Young monks by the refrigerated casket of Pui
Pui's young friends and "The Mom" By Pui's casket (colorful box)

Wake and Cremation of Pui, Buri-Ram, Thailand about One Hour From Country of Laos.
On the 5th and 6th of January we went to the ceremonies for Pui our young friend who died. We went to her parent's home in Buri-Ram. I rented a vehicle to take us and we stayed at the beautiful home of friends of Jin's just down the street from Pui's parent's home. At the parent's home, the body was in a colorful and elaborately decorated refrigerated box which was on a platform in front of the house against a wall of the house. It was surrounded by huge arrangements of flowers sent from England, Europe and Thailand. Three huge portraits were displayed: one of the beautiful Pui and two of Pui and Ian on their wedding six months ago. The street in front of the home was blocked off and two huge awnings covered the street in front of the home. A loud speaker played music and chants by priests. Food and drink was served nearly all day and night. Huge kettles of Thai food was cooked outside. Tables were set up on mats in front of the house but were taken down when monks came for various scheduled ceremonies. At one time 17 monks were chanting in front of the mourners. On the second day we were there, the monks talked and chanted from early morning until about two pm and then the refrigerated box with the body was loaded onto a truck and a woven palm rope tied to the truck with a huge ball of string tied onto that. The mourners all ceremoniously pulled the truck holding onto the string. Our friend Ian, husband of the deceased carried her portrait and the string draped over his shoulder. We held to the string walking the long distance to the Budhist temple. There were more ceremonies, more chants, more talks. Each person in the large group of mourners who asked to be put on a list and who gave an envelope of money went up the steps to where the box with the body inside was displayed along with the beautiful flower displays. We each caried a robe for the monks and the envelope of money up the stairs, lit insense, and knocked on the box with the body. We went back down. Three times during the afternoon we went back up the stairs and said goodby, the last time the beautiful box was gone and a plain white box with the top open to view the body was there just outside the open crematorium door. I was holding the widower who had his back to the crematorium door, crying, unable to look upon the body of his beloved. We were at ground level and I was facing the crematorium up above. All the cloth things in the casket were being thrown out of the box which was then pushed into the crematorium. A man started putting wires together and then stepped back. Sparks flew and wooden pieces we had each carried up in one ceremony had been put in the box. These caught fire and the flames were quite visable. The door was not closed. Coins wrapped in gold paper were thrown to the crowd. Candies were thrown to the crowd. We next went to the home for more food, drink, and chanting and ceremonies...more insense, people walking around a carved pole three times, and other ceremonies. This will go on for sometime, but we eventually have to leave. The ashes will remain at the parent's home for 100 days and then go to a small Budha house at the temple with maybe a few ashes remaining with the parents. The ashes will be brought out each April and flower water sprinkled on them and they will be honored in ceremonies.

Adventures of Mark Richardson

Adventures of Mark Richardson

Unexpected Death of One of Mark's Young Friends and Mark Bakes Cookies

Mark and I started our day thinking about making cookies, but we got a call that Pui, a young friend we had visited in the hospital last week was expected to die soon. When we saw her last week, she knew us, greeted us, talked to us, and was expected to go home in a few days. Two days ago I could not find her in the hospital and thought she had gone home, but instead she was taken to ICU.

After the call came, Mark and I jumped in a cab to go see Pui, our Thai friend expected to die. This young Thai girl had married friend Ian six months ago and moved to Switzerland. She had recently come back to Thailand to visit her family. She became ill and was hospitalized. It was very sad when we arrived at ICU. The ICU room was filled with Thai people from the small village she was from including her mother and father and her husband, Ian who is from England, but lives and currently works in Switzerland. We all cried and said our goodbyes. When I said mine I saw she had money in each hand. She was unresponsive and she was having difficulty breathing. She was on a respirator. It could not be removed. I learned that this is not an option in a Thai hospital. Once on the respirator there is no pulling the plug, however the parenteral nutrition and medication could be withheld. Pui had been coded earlier and that could be with held. As a respiratory therapist Mark was very interested in figuring out what was going on. he talked with the doctor and nurse in charge and looked at the medications and the EKG strips and he studied the ventilator settings which were off a bit in his mind, but it didn't really matter since Pui was dying. When Mark and I left and were waiting outside for a cab, I asked friend Jin about the money in Pui's hands. I learned that this money is for Pui to spend for herself when she gets to Paradise. When she is cremated at the temple in her village, the money will be burned also. The Thai people firmly believe she will have that money when she arrives in Paradise and that she needs it. I thought to go back again tonight and put some money in her hands, but I'm not sure I will get that chance now.
Mark and I came home to make cookies and finish cooking a gallon of spaghetti sauce that we are making. Ian and maybe others will come for supper.
We had just finished baking the cookies when we received a call that friend Pui had died. Our golden girl, who always had a really big smile, who could eat crispy fried bugs, who was able to charm everyone she met, and who seemed to have the world by the tail, was gone.

Pui's unexpected death brought home to Mark that he will not necessarily die before me or before all his friends even though he has cancer and it has metastacized to his liver.