This case study consists of three parts.

Part 1: The High Cost of Staying Alive In a Private Hospital.

Part 2: Eleven to Nineteen Drugs A Day Could Not Cure Her – Rather Die Than Suffer More. 

MM came with her sister’s medical reports and scans below:

Facing Up to Reality

Having seen the scans and medical reports, the first thing I told MM was for her to be ready to accept the reality of the situation. Based on the medical reports, I do not see any chance to cure her at all. Even the oncologist had told MM that at best further chemotherapy would only prolong her life by a few months.  So facing death is a reality and we have to accept that.  I then posed another question to MM. In this case, do we really want to prolong MS’s (patient’s) life at all cost?

At this juncture I remember what I have read.

Dr. James Gordon, clinical professor of Georgetown University School of Medicine, (in Manifesto For A New Medicine) said, Death … needs to be addressed differently. If we do not fear it quite irrationally or regard it as our own enemy, we would be unlikely to reflexively mobilize extraordinary and extraordinarily dehumanizing and debilitating technological measures to prolong lives of patients who are clearly dying. Instead of acting out of blind instinct to preserve life … at all costs, we ought … to devote our time, energies and resources to spending time with dying people and their families.

Richard Reoch (in Dying Well) wrote, We often make the mistake of trying to keep a dying person alive as long as possible, no matter what the cost. There are many occasions when the kindest thing to do is not to hunt for “better medicine” or a “better doctor” but to be close to and supporting the person who is dying. Let them know that you are glad for all the time, the joy and sorrow you have shared … In the last hours, love and acceptance will do far more good than medicine.

Dr. Bernie Siegel (in Peace, Love & Healing) said: It is important that we realize that we can never cure everything. We will never find … cure for all the diseases. Dying can be a healing, ending a full, rich life for someone who is tired and sore and in need of rest.

Three Options

I offered MM three options and requested her to go back and discuss with her sister or her family members in Indonesia.

1. Continue with medical treatment in Penang – do whatever the oncologist wanted her to do.
2. Take her home to Indonesia without anymore treatment.
3. Stay in the hospital but stop further medication from the hospital. Take herbs, i.e., follow the CA Care therapy.

However, I made it clear to MM that the decision as to what to do next must be hers. She had to take the risks and assume all the consequences, especially if she wanted to take option 3. I made it clear that I cannot be held responsible for whatever happens after taking the herbs. Her sister might just die – I don’t know!

MM decided not to continue with any more chemotherapy. And it is also not possible to bring her sister home right now because of her weak condition – she would not be able to stand the journey home. So Option 3 seemed to be the only way out. Let her sister stay in the hospital but take our herbs. When her condition improves, prepare to take her home quickly. The time frame – give CA Care Therapy a try for one or two weeks.

It was indeed a brave decision for each of us to make! Within the next three weeks (from 15 October to 8 November) we wrote 175 emails to each other. Let me reproduce just a few emails to give you an idea of what eventually happened.

18 October 2012:  Yes doctor we have already been informed that her this first or second week will be very hard for her. Hope she can cope with all the problems that would arise.  Her main issues now:
1. Tummy hardened.
2. Hard to breathe.
3. Area on upper abdominal and gastric pain.
4. Swelling on legs.
5. Some redness –  allergy that I observed maybe  due to the vitamin and milk infusion. It had already been stopped since yesterday. But still the redness  persists but lesser than yesterday.
6. Hard to relax and cannot sleep well.
7. Tense.

19 October 2012: After taking your herbs since yesterday 3 p.m. – started with Pain Tea, I observe that she had already passed motion three times, which is in my view is good. Not watery but soft. She passed out urine many times. Pain became lesser a bit but still hard to breathe. The liquid come out from the pig tail is lesser. Yesterday it came out around 850 ml. This morning it is only 150 ml. I have already discussed with the doctor in hospital that we cut off all infusions given to her previously including albumin, vitamin and the other drips. Any other issues I shall inform you later. Hope she responds well with the herbs. Thank you for your kind attention.

19 October 2012: She can sleep quite well now. She felt and looked very tired. Her first bowel motion started at 12.30 a.m. Back to sleep again and suddenly around 3.30 am she woke up and wanted to vomit. Nothing out only saliva,   nausea. Is the process of taking the herbs like this? As I know that having diarrhea is one of taking the herbs. How about the nausea? So far, I observe her overall condition is ok. She is still very weak, her legs swelling, tummy bloated, tiredness of the back (often asking for massage).  One more thing –  she can turn left and right and without complaining. Before turning her body makes her tummy pain. No complaining of pain now. The redness due to allergy still on her legs, lesser though. She took all your herbs yesterday according to your prescription without any single medicine from the hospital.   

19 October 2012: Since last night she still passed out stools. She cannot sleep well yet. She just told me now that her heart beats so fast since yesterday noon. Her hands and feet are cold. She cannot eat and drink much at this moment, even though she has no nausea anymore. She always feels very full. Does the inability to eat and drink much at this time affect her heart beating faster than usual, the tummy full (not hungry), and at the same time she should take too many herbs in a day? Her tummy looks smaller than before. Her feet are still swollen. The liquid came out was getting lesser to 600 ml yesterday. I took a picture of her while she was lying down. Kindly ask your advice based on her update condition.

Reply: 21 October 2012: The big question that you need to answer is only this: After stopping the doctor’s medication and going on herbs — IS she better or not? I expect life is going to be difficult for the first one or two weeks. Is it worth it? Or do you prefer to go back to the old ways and put in all the 13 to 16 drugs that the doctor gave. You have to decide. I don’t know if her situation is better or not, so I cannot say anything on that. Look at her condition –  before and after the herbs –  which one do you prefer? If you see a glass with water but it is not full with water …you can say it is a glass half full of water or you can say it is a glass half empty … this represents two different basic attitudes and perspectives… I don’t know which she belongs to.  

22 October 2012:  I can assure you that she is much better after stopping the doctor’s medication and going on herbs. Day by day there is improvement. Though she still feels the body heavy, legs swelling, hard to close her eyes to sleep because she feels there is much energy, though walking exercises makes her tired easily. Her passing of stools is lesser day by day. Since yesterday she passed out only 2 times passing stools. Today she has not had one yet. Passing urine is quite ok. Her liquid comes out around 600 ml per day. Her tummy is smaller than before but still swollen. Her pain is lesser day by day. No nausea. Her tummy still makes sound of water flowing. She has stopped all doctor’s medication since the first time taking on your herbs until now, including all infusion of albumin, vitamin and no more asking for morphine Injection. Has she passed through the healing crisis? We plan to go back end of this month or early of November and continue with your herbs. Kindly need your advice. 

22 October 2012: She told me she feels she is getting better and better even though she can hardly move freely. She feels heavy. She just moved her bowels. The doctor just came in and checked on her. He surprised to see her very fresh, and no more complain of pain and nausea. So he cut off the medication for nausea (which I have already done so without his knowledge). 

 23 October 2012:  I notice in this few days, there are some red spots on her arms. What are those red dots?

Since this morning, she started to feel no energy and power, lazy and is slow to respond if we ask something. She does not know what to do. Confuse.  No energy and power to turn her body to left and right. Her face looks tired and sleepy. I think she lose her weight again…only bone and skin.  If I ask her, Are you ok? Her answer is, I don’t know “. She sweat quite a lot.

23 October 2012 at 9:45 PM: Ok. Let see what surprises she will show us in the next few days. Right now, her body frozen, cannot move, do not know what is going on, do not know what to do.

(Note: At this point on receiving this email, I thought the patient’s time is up. There is no more hope. Tonight night, I did not want to check my mail again after reading this. I just wanted to have a good night sleep, expecting to be told the next morning that she is gone. But the next morning it was a great relief to receive this email).

24 October 2012: She has no cold, no fever. Her blood pressure and temperature are ok. Breathing is still ok. She feels her body heavy and stiff, uneasy to move and turn left and turn right compared the day before which she felt a lot energy.

25 October 2012: Her pains is lesser compared to yesterday. She still cannot tell if her stiffness has improved or not compared to yesterday. I tried the e therapy, Detox 2 for her at 10.30 am today. She still has nausea. It comes and goes. Is it also one of the side effects of the 50 mg Durogesic patch? She can eat half bowl of vegetable soup afterwards and rest for a while but after half an hour she feels the nausea again. Most of the time she is stayed lying down. How about the therapy for her tonight? Is it ok for her to eat a bite or two kuih pasar (contained of coconut covered with flour)?

Today is the third day. She still feels lazy, no energy to talk, and weak.  

26 October 2012:  This morning woke up at 5.30 am and I gave her a little bit Naturex to drink, and help her to sit up in   her chair closet to pass urine. After that I try to make her calm and relax by explaining that she is still in healing crisis and hope the condition will get better afterwards today or tomorrow because she is afraid of her condition had weaken and she has no energy this week. One thing that her nausea is getting lesser after the Durogesic patch is reduced to 25 mg. But, she feels a little bit pain on her abdomen. Seems she can bear the pain. If she cannot bear it, I plan to give her only Pain Tea whenever the pain comes.  What do you think of this situation? Do you think the sodium level dropped? Or  anything on your mind? Anyway, let see again later after she wake up. I will keep you informed. 

26 October 2012:  If it is found that she lacks of electrolytes and need infusion, can I still give her the herbs during infusion? Yes, she is still easily tired, lazy and no energy till now, she cannot sit too long and she feels uncomfortable for the whole body. Terrible she said. She still feels hard to swallow. Every time she eats and drinks make her nauseous so that is why she does not drink water. The liquid (from her abdomen) comes out yesterday. It was only 450 ml. Lesser. A lot of blood clots came out. Thanks a lot for your advices all this time, guiding me what to do.

27 October 2012: Around 9 a.m. this morning, I gave her the therapy for Anxiety and before the program finished she was already wanting to sleep. Succeeded to make her sleep even for only half an hour.

Her current condition is:

1. Still weak, lazy, no energy, tired easily.

2. Worried and fear of her condition right now that she feels terrible and getting worse

3. Hard to swallow

4. Uncomfortable body.

5. Legs swollen

6. Red spots still on her arms

7. Tummy still bloated even lesser day by day.

8. No passing stools yet only passing gases.

9. Passing urine only one or two times. The colour is also yellow dark.
Yes, I believe her condition will get better in these few days. 

27 October 2012: Doctor is curious because her stomach is getting smaller, the fluid also did not come out too much. No complain about pain anymore and no nausea after the Durogesic patch was decreased to 25 mg. So, the doctor plans to take the blood test on Monday to check her cancer marker and will do ultrasound to see the tumour inside. Do you think this Monday is the appropriate time to check as her condition is still weak and the red spots are still there along her arms? What do you suggest?

28 October 2012: The results of ultrasound showed not much liquid inside. The size of the tumour is still the same. Some tumours spread to spread out but still in the tummy. Sounds bad? Doctor will give her 1 pack of blood transfusion tomorrow morning, and keep giving her sodium infusion until Friday. On Wednesday, she will take the blood test again to make sure the platelets, sodium, Hb , etc., are ok before we go back. She is still weak with no energy, but she can swallow better than yesterday. She is very moody today and ask to go home already. She continues taking the herbs. 

29 October 2012:   Good morning. Last night when I get back to the hospital, she has just passed motion a lot and smelly after 1 week of constipation. After 4 packs of platelets infusion yesterday night, and 1 bottle of sodium chloride she looks more energized but she still feels weak. Her main issues since last night until now:
1. Her chest pain –  the feeling of something pressing the chest.
2. Her difficulty to swallow. Doctor found out that her throat has a lot of white fungus.

3. Her cocyx pinched so even after we cover it with duoderm, she still feel the pain and uncomfortable. No wound found actually.

30 October 2012: Her condition suddenly changed. She told me at around 5.30 a.m. she passed out stools and urine on the bed. After everything cleaned up, she cannot open her eyes, she is in coma state. It happened for almost one hour and suddenly she woke up by herself and asking to change position for her buttocks.  Doctor is going to take the blood test again to make sure that she has the electrolytes she needs at the moment. While in coma, her oxygen level, glucose, blood pressure and temperature were good.   The doctor explained to me that the cancer may have spread of to the brain. The cancer had attacked the brain so we should be prepared that she will be in this state on and off. Or it may be also because of low sodium. That is why he arranged to take another blood test just now.

He cannot dare to give blood transfusion at this moment as the risky of allergy is high. So, he planned to give her Eprex instead of blood transfusion. Her chest is now bruised because this morning a nurse tried to rub her chest very hard and of course this happen because the platelets are too low.

30 October 2012: Doctor will continue to give platelets, 4 packs today. And sodium chloride. For blood transfusion it is a bit risky because my sister’s antibody is positive. So the doctor said it is a bit risky due to allergy. 

30 October 2012 P.M:  We change our plan to go back tomorrow night to Jakarta. Doctor suggested to go back as soon as possible. Doctor still gives sodium and we are still waiting for platelets donor. No blood transfusion as the risk of allergy is high. The chance is 50%.

Her stomach swelled because I stopped giving her Abdominal Distention tea, only Lower Edema. But this morning I give her Abdominal Distention. After infusion her stomach becomes bigger and the fluid comes out more. She passed out less urine. This morning she passed a lot of stools together with urine. Leg still swelling sometimes looks bigger and sometimes smaller. Doctor suggest to give the blood transfusion in hospital in Jakarta, because if giving now may be  afraid of allergic reaction such as swelling on face, arms and redness. Afraid we cannot go back this Friday.

30 October 2012:  Yes. Thank you doctor.  I will keep the pigtail (tube from her abdomen) to Jakarta, as the internist doctor in Jakarta whom we have already contacted was also suggested that we keep the pigtail. Yes, I have got the tickets back to Jakarta tomorrow night. My brother and sister will come tonight to help me bring her home. She is now having the platelets transfusion, 4 packets. During the day, she has no complaints of pain or anything. She is just calm, alert and silent. I only give her Capsules A, C, and D. After we get back to Jakarta, we will continue giving her the herbal teas. Thanks a lot for all your kind attention, support and good cooperation. I will keep communicating with you and and updating her conditions.

3 November 2012 (in a hospital in Jakarta):  Good morning. Since yesterday night 7 p.m., she had to struggle to drink water. Until this morning, she has not eaten anything. She is still continuing the sodium concentrate 3% (2nd bottle) and amino acids (2nd). She told me last night that she felt getting worse, she couldn’t even open her eyes, her body has no energy, and now it is really hard to swallow. What do you think of it? What we can do? Is there any solution for her esophagus? So we stop the herbs at this moment cause her difficulty to swallow. Need your advice.

4 November 2012:  Dear Dr. Chris, with this email, I would like to inform you that she has already left this world today at 18.30. Since this morning, she is very calm and peaceful. Thank you very much for your kind attention and assistance during this period. Kind regards.

Reply: Thank you for telling me this sad news. Though sad, I also feel that this is the best medicine for her. You have done you best to help her and it seems there is no cure. It is no use to prolong her suffering so much. Though I feel it is sad thing to happen but I also think there is no other choice. Please take care of yourself now. Chris 

8 November 2012: Good morning. This morning my beloved sister will be cremated at 10.00 a.m. May her rest in peace.

Once again, on behalf of my sister, I would like to thank you for all your kind attention and good cooperation. Thank you and regards, 

Reply: Thanks so much MM for writing. Please take care of yourself. You have done your best for her. Chris

 

Would I Take On Such A Case Again?

Perhaps I was sticking out my neck out too far. But I agreed to take on this case because at that point in time, I felt inside me that this unfortunate lady desperately needed my help. And I had to do it. Would I do this again? Probably never again, unless I hear a loud thunder from heaven asking me to do so!

I just wonder what would happen if this story ended up differently, would I be made a scapegoat? Would they say that I kill the patient by giving her herbs and not the doctor’s medication? You can never guess the fallout from this case and what others may accuse me of.  But I remember telling MM this, I may not be able to help your sister because her case is way beyond me, but I may be able to help you – the one who is still living and not sick. Perhaps the experience you go through with CA Care can help you in some ways in the future.

On reflection, did CA Care make a difference in this case? Make your own conclusion! Cast your first stone if you may.

Let me end by quoting Glenn Miller, M.D., (in the Introduction of Ancient Herbs, Modern Medicine):

• Throughout my career in medicine, I have always had great respect for my patient’s opinions and have advocated using whatever it took to give patients the best results.
• I come to understand that there is more than one way to effectively treat patients. If Western medicine did not   have the right or best answer, I was free to search for a better answer. When we integrated Chinese and Western medicines, the battle against disease had a much greater chance of being won.
• The efficacy of Chinese medicine can rival that of Western medicine – and for many chronic illnesses, Chinese medicine is actually more effective and a better choice. The strength of Chinese medicine comes from three thousand years of treating illnesses and promoting health.