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6 minutes ago, banK said:

An update.

A bit of an emotional up and down. (Normal I'm told).


Prior to starting the adjudicative chemo on the 16th Feb. I visited immigration in Khon Kaen to ask whether it would be possible to renew my extension early (due on 6th April). This was end of January.

Had my medical records with me and showed the IO the scar! - Too much information! as I still had a feeding tube in my stomach!! She invited me to apply that day, she took a photo copy of one of the medical docs. and asked me to write an explanation as to why I wanted to apply early - I had an embassy letter less than 6 months old, so done and dusted that day.


The next thing was my driving license was due to expire in May this year. Went to Chumpae DVLC and asked the same thing - No can do because the computer says "no"!! They feed in the old license and the computer will only accept that it can be done not more than 90 days in advance. Went back 2 days later on 13th Feb. and the computer now says "yes". This 2 days before going to Bangkok for 1st chemo cycle.

I didn't fancy going in May as am unsure what state I will be in half way through chemo.


I went through the pathology report again with the oncologist - the pluses and minuses. One thing in the blood tests that gave me concern was the ca19-9 numbers. Prior to the operation it was 181 (should be <37). The reading on 16th Feb. was 124 prior to chemo. She uhmed and haad about it on the 16th Feb. Gave me the impression not too good. The following week I did a bit of research on the internet visualising all sorts in my mind. That was a down phase for a day or so. Talked to myself in the mirror to get back on an even keel.

Went through the path report with a fine tooth comb, including the still high ca19-9, a bit reassured on that. Que sera sera...

I am staying in Bangkok for the duration of each cycle and will go back to the village on the 2 weeks off.

So far have had 2 injections of GEMZAR.


Insurance: The cost of this chemo - the initial dose + a battery of blood test cost 74000 baht, the subsequent one was 51000 baht. So for 18 of these at say 50000 a pop will come to about 1 million.


The annual renewal this march is 4690gbp. This compare with last years premium of 3800gbp. However, the prior renewal to 3800gb was 4100gbp - so in actual fact there was a reduction last year. So I'm happy with that.

The only bug bear with the insurance, (Cigna Gold Plan), is if I ever become palliative care then they will only pay 3250gbp for the lifetime of the policy. At the price over here maybe 1 cycle. If I had platinum then they would have fully paid palliative care. Silver plan pays 1650gbp.

If it comes to it, I will go back to the UK to continue with what needs to be done. Again, Que Sera Sera.


I tipped up last Saturday for the 2nd dose and just as they were injecting the GEMZAR they ask will the insurance be paying for it? Of course I said - then the 3rd party insurance dept. in the hospital realised that they did not have a GOP from Cigna. It was suggested that I pay for it! No way I said! A while later just before finishing the nurse came in and said that It's ok all I have to do is sign for it.


I paid the third party insurance dept.  a visit to ask for an explanation. They said that on the 16th Feb. (date of 1st chemo) they applied to Cigna for the next chemo. They didn't get a reply and neglected to follow up the initial request!!

They assured me that it won't happen again......


That's as it stands at this time. Have had no effect from the chemo so far except feeling a bit of nausea yesterday afternoon. Have various meds to take if needed for various things. 

I am doing a lot of walking for exercise did 23km last week! I hope this helps.




Chin up mate, many on here rooting for you.... Or as Thais would say.... Chok dee kap.

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Thanks for the update, banK.


Hang in there! And if by chance the antinausea meds don't work, ask for something else, there are many.


Don't be too stoical about taking them, especially if it is ondanestron, safety profile is good, side effects rare and it works well. Take at the slightest sign of nausea is better than waiting.


With Cigna one has to keep after them, their custom service people are usually pleasant but remarkably inefficient, it often needs multiple contacts to get a response (and phone better than email).


And for your own sake maybe try to stay off google. Statistical averages are just that, averages. Each case is different. there is plenty of time later to be pessimistic if things turn in that direction, no reason to go there prematurely and maybe  unnecessarily.

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  • 1 month later...

Sad update.


Ca19-9 numbers elevated a couple of weeks ago and increased to 600 and something the following week.

Was on the 2nd cycle of adjunctive chemo day 14 and stopped chemo after having a PET-CT scan, as it was revealed that it has revisited my liver (5 masses).

The chemo didn't affect me very much at all, except for slight nausea the first night.


Long story short -flying back to UK asap after organising last minute financials for my wife and her future pension.


Prognosis not good, it is what it is.


Feel nothing untoward at this time except a bit of constipation.


So it's bye bye Thailand after about 12 or 13 years.


I will miss it for all it's faults.


Surprising thing -Cigna says that they can amend the policy to enable me to use them in the UK. albeit for 180 days. But my plan (gold) only covers 3250gbp for palliative care. On the bright side, anything other than cancer would still be  covered.

Since my bad luck period beginning  in 2015 I have had the benefit of about 6 million in health care provided by Cigna.

They have responded very quickly as urgency dictates. i.e. organised a GOP for a PET-CT over the phone for the following day.


Thanks to everyone especially Sheryl - priceless!!





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Thank you so much for your update, I have been thinking of you - as I'm sure we all have.


Please, continue to let us know how things progress back in blighty - don't forget your raincoat. 👍


Remember, it ain't over 'til the fat lady sings.


Wishing you the best.



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Dear BanK


Sorry to hear this news. We all knew, with pancreatic Ca, that this was a possibility but of course hoped you'd be in the minority who do better.


You can take comfort  in knowing that you did everything possible to get a more favorable outcome, it just wasn't in the cards.


You have made very much the right decision in returning to the UK. Palliative care is very poor in Thailand. In the UK it is excellent and patient-centered i.e. orientated around patient preferences and desires not the convenience of medical staff or medical institution rules.  Assuming you have family you can stay with, you will have a full range of options e.g. home care vs inpatient hospice etc.


3250gbp will actually buy a fair amount of home health care - the meds needed are cheap generics - and also you should be able to get back onto NHS pretty swiftly based on permanent return.


Do keep us all informed of how it is going for you. You'll be in all our thoughts I am sure.



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