Left arm MRI - inconclusive findings

Dr. Wakelee examined Gohan's left arm

Gohan has been feeling soreness (he does not like to use the word 'pain' ever since he fought cancer) in his left arm since November. It started in his lower arm but travels up to the upper arm intermittently. We have brought it up to our oncologist but she thought it was muscle strains. Advil reduces the pain from 4 to 2 in the scale of 10.  As time passes, the soreness persists and sometiems wakes him up at night. I have learned that pain that doesn't go away is suspicious of something bad. So I requested for a MRI of his left arm. Dr. Wakelee wanted to do a Radiograph instead because she thought the soreness was a result of stroke and she didn't want to make Gohan go through the MRI, a safe but stressful procedure. Unfortunately she called me on the day of X-ray result and said we need to do a MRI because there are abnormalities. I went online to read the report, the radiologist noted that the abnormalities suggested metastasis. I was depressed and had a good cry, because only a few days ago I happily told my friends Gohan's health seems to have stabilized and I felt I finally could breathe for the first time in six months. 

As I felt distress, I remembered Pastor Huang I-Chen's wife, Irene, recently has been urging me to practice praying in tongues. So I did that day. Surprisingly, I felt relieved and edified as the Bible said we would when we pray in tongues. 

"The one who speaks in a tongue builds up himself"  1 Corinthians 14:4.

"Likewise the Spirit helps us in our weakness. For we do not know what to pray for as we ought, but the Spirit himself intercedes for us with groanings too deep for words." Romans 8:26

I practiced it a few more times the following day. I felt regaining my strength and was ready to fight again. 

Gohan has done MRI scans countless of times, he knew what to expect and what to do. However, his experiences does not make the procedure more pleasant. The loud bangs of the MRI machine are deafening, he said, as he lay in the MRI chamber for one to two hours.  It would have been easier if he could sleep, but he has to stay awake the entire time otherwise he may unknowingly move his body making the images blurry. 

The MRI scan of his left arm took 1.5 hour, longer than expected because he had moved his arm despite ever so slightly, therefore the technician had to retake some slides. I knew he was tired because it had been a long day. 2 hours of dental work in the morning and MRI scan in the afternoon. Getting to the clinic took 45 minutes. He had only 30 minutes of nap instead of 1 to 2 hours as he usually needs.  We ate packed lunch in the waiting room of radiology department. The day was rushed and stressful, but he did not complain. He still thanked me and our caregiver for helping him. Every time he thanks me, I would let him know that I thank him too for being a wonderful husband to me and a great model for all of us. 

The MRI report was inconclusive. The 7 cm 'lesion' that was noted in the X-ray of his upper arm was 'nonspecific of cancer' despite that there is 'a tiny spot that is suspicious of early metastatic focus'. So Dr. Wakelee said she would ask an orthopedic oncologist at Stanford to look at the image and get back to us. She advised to monitor his soreness and do another scan in a couple of months to compare. She still thinks Gohan is doing better clinically than before. 

A few days later, we got a call to go in for a MRI of his forearm. Evidently the last scan was only done for his upper arm. I got an appointment for mid April. 

Although the problems are not solved yet, I let out of a sigh of relief. We still have time. 

Walking!

This is a day to remember. For the first time in six months Gwohann can walk by himself! It was like when I saw my one-year-old kid walking toward me for the first time, my eyes were wet, and I couldn't stop laughing. It takes faith, hard work and a never-give-up attitude to come to this point. I know there are more challenges ahead of us, but I have learned to cherish everyday and celebrate every success. 

Long term disability leave begins

Given the poor prognosis that the doctor gave us six months ago, with much grief I didn't expect Gwohann will live past the short term disability leave (STD) which I initiated for him last September.  So when I received the call from MetLife, the administrative company for the Mentor Graphics disability insurance, that Gwohann has used up six months of STD benefit, and he will start long term disability leave (LTD) benefit. Despite the 40% cut in benefit, I was ecstatic because I realized that we have made it past six months!

Under the LTD plan, the monthly LTD benefit will be combined from three sources of income to make up for the 60% of Gwohann's salary:
1. MetLife - max benefit 40 months (calculated based on Gwohann's age), with the deduction of the following government disability benefits
2. California State Disability benefit - max benefit 52 weeks.
3. Social security disability (SSD) benefit - max benefit 6 months.

Because the government benefit takes about six months to get approval, MetLife will pre-pay the LTD benefit to meet 60% of Gwohann's salary, with the condition that we will forward MetLife whatever benefit we may receive from the government. MetLife requires us to sign an agreement that we will apply for the government benefit and will appeal if denied (SSD denied 90% of the applications). Because the application process is so lengthy, MetLife is afraid that their insured will not follow through. So MetLife wants their insured to use a third party agency (integrated Benefit Inc.) to apply for SSD and will pay for the agent fee out of the payment we may receive from the federal.  If we don't use the agency, we will remit the full payment anyway, so it is to our best interest that we use the third party agency.  It is interesting that there are companies make a living by applying for federal money for people. The SSD website even has pages advising how to use an agency.

So I have a lot of paperwork to fill out with each institute (MetLife, Cal State, SSD, Integrated Benefit, Inc) in order to get the LTD benefit. My challenge is finding a long stretch of free time so I don't have to keep reading the forms over, but I shall finish them soon.

How about medical insurance during LTD leave? We can stay on Mentor Graphics healthcare benefit for six months, after that we will use Cobra, which premium will be about 120% of what we are paying under Mentor Graphics. Thank God we can afford it.

Dental defence

I still remember when we lived in Texas many years ago, our dentist asked Gohan for permission to take photos of his teeth, because he has never seen anyone's teeth so perfectly aligned and healthy without any dental work. So the photos were taken, and every time we walked into the dentist office, we would see Gohan's teeth smiling on the wall. Gohan's teeth were so strong that he uses them as tools albeit against our dentist's warnings. He uses his teeth to pop open soda caps, to crush ice cubes, and to open anything that he can not open with his hands. In fact, he would use his teeth first before he uses his hands. 

Dr. Windsor Wu, our dentist of 25 years, was shocked to see Gohan's four cavities

So when our dentist Dr. Wu told us that Gohan had four cavities, two of which were so deep that are at risk for root canal procedure, we were shocked. Gohan had only skipped one semi-annual dental cleaning in last August, when his health had suddenly spiraled downward. But he has not felt anything strange with his teeth. After discussion with Dr. Wu, we learn that the reason for his cavities were 1) lack of saliva which was caused by chemotherapy and the whole brain radiation, both of which damage the salivary glands. Evidently, Saliva has antimicrobial effects and is critical in oral hygiene. 2) food trapped in his teeth for an extended period of time and became an incubator for bacteria growth. He had lost some of his senses in his mouth due to his stroke in Dec. and couldn't feel the food residue in his mouth. I had to check his mouth periodically to make sure there was nothing left in his mouth before he naps or sleeps. So the four cavities were most likely developed after his stroke, three of which were on his left hand side, the side where the stroke impacted.

Gohan who had perfect teeth since youth, had developed deep cavities in mere few months

Thankfully we have a wonderful dentist who teaches us how to put up a dental defence with products and procedure that were designed for 'very high risk' patients. Now after every meal or snacks, Gohan follows a 5-steps regimen to reduce his risk for cavities, which include electrical brush, prescribed tooth paste with high percentage of fluoride, floss, gum brush, baking soda rinse and xylitol rinse and spray. The regiment takes three or four times longer than the common daily dental hygiene, therefore taking time away from his already precious waking hours. But I have no doubt that Gohan who is well known for his perseverance will do it diligently to regain his dental glory back!

The regimen to fight off cavities