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

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

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

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

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

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

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

Mark has had laser surgery on his eye.

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

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

Mark has called me about several problems he has.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thusday, 12 May 2005-Last day in Amsterdam

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

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

Amsterdam, the adventures continue.

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

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

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

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

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

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

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

A rough day today...

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

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

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

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

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

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

It was a great New Years.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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