Retire Early Lifestyle
Retirement; like your parents, but way cooler

In 1991 Billy and Akaisha Kaderli retired at the age of 38. Now, into their 4th decade of this financially independent lifestyle, they invite you to take advantage of their wisdom and experience.

Meeting Dr. Death - My Intimate Journey with Cancer Part 6

Billy and Akaisha Kaderli

Chiang Mai Ram a famous well-known hospital in Chiang Mai, Thailand

Big “Yeses” - one after another

When we were in Japan we made inquiries at Chiang Mai Ram Hospital in Chiang Mai, Thailand for what I thought was a fibroadenoma. These emails were returned within hours. Questions were answered. Appointments were made.  

Everything fell so easily into place, that for us, it seemed to be a big “YES” so we continued to move forward.

We met the very nice elderly gentleman doctor at Chiang Mai Ram Hospital who gave me the examination then wanted me to do a mammogram but I balked. He then accommodated me quickly and professionally and arranged for a sonogram and biopsy the same day.

This also seemed to be a big “YES” and a verification that we were on the right path.

When we asked for copies of the data taken, as well as the biopsies and the sonograms, they were emailed to us promptly… another big “YES!”

Each time we met with a doctor or had tests done and then discussed the testing with a professional, we were treated respectfully and promptly. We were excited to be moving ahead.

The Cancer Track?

Somehow during this time, I was placed on the “cancer track” and we made an appointment with an oncologist there at Chiang Mai Ram who would be discussing the next steps.

We moved further into the hospital building and registered at another desk.

It just so happened that the doctor we were meant to see was there with the clerical staff, and Billy approached her. Basically he said: “If you are waiting for yet another result of the biopsies, there’s really no reason to meet with you today, right? We should just wait until the results come in, and then set up an appointment with you at that time.”

With a broad smile, she agreed. She said very cheerfully, “You are right, there’s no need to meet with me now. I’m quite busy. Don’t worry. Go on and live your life.”

Go on and live your life – her poker “tell”?

I felt a little twinge regarding the last statement about “living my life”… Of course I’d be living my life…

Why would you say that, --- unless you already thought something was quite amiss…

Dentists don’t say “Go on and live your life” neither do plumbers or accountants, or… I think this was her poker “tell.”

Something bigger was going on and she just told me so.

Should I be worried?

And what do you mean you are “quite busy” – is "everyone" getting cancer these days? What does that suggest?

I thought… perhaps I’m just nervous.

But my antennae were up.

We returned to our hotel room, pleased that we saved ourselves time in the waiting room, plus the time and cost of an unnecessary visit.

We wait again for test results

We had a total of 3 weeks in Thailand. We had considered having the cryoablation done here, and voila! Back to normal.

But then I was placed on the cancer conveyor belt, and now I was looking at a lumpectomy or a mastectomy. We needed the second results of the biopsy taken the week before. We had mentioned to all of the doctors that – while we used to live here in the past – currently, we were here as tourists and our time staying in Thailand was limited.

Billy started doing research on lumpectomies, mastectomies, recovery time, and costs of procedures. 

Should we try and get our visa extended, cancel our planned trip to Vietnam and have the procedures done here in this country?

The medical care in Thailand is world famous. In Bangkok, world leaders, sheiks, presidents, prime ministers, kings and queens all come from around the planet to take advantage of these advanced services at Bumrungrad Hospital. So staying here in Thailand was a reasonably good choice to make.

The waiting room at Chiang Mai Ram Hospital

Confusion, clarity, sealing the deal

We weren’t sure what to do.

Billy and I were having conversations several times a day regarding this situation we found ourselves in.

If I did have a mastectomy… I would need to recover in our hotel room. Billy wouldn’t have the support he needed to replenish him. We wouldn’t have access to our kitchen (Chef Billy’s stress release) in order to control the when and the what of our food intake.

Emotionally, for a procedure such as this, our support system was stronger in Mexico. Not only that, but after a mastectomy, a woman cannot carry anything, or lift her arms above her head.

Well… that sealed the deal.

If I couldn’t carry my own pack and and manage my rollie, literally “everything” would be on Billy, and neither of us liked that idea.

And meanwhile, as we continued to wait for results, the days dragged by.

Ooops

After another week passed, we contacted the hospital once again. We would like to know how the results were coming, had the hospital or doctor received them, could we please have copies?

The woman at the coordinator’s desk was slow to respond. This was the first time that there seemed to be a snag, or some kind of resistance.

When she did respond, she pleaded ignorant, and didn’t seem to know anything about the results.

Again, we reminded her that we were on a tourist visa, our time here in this country was restricted, and in any case, we’d like to have copies of the results so that we could take them to the next hospital and set of doctors who were located elsewhere.

After these requests, there was still no response, no answers, nor directions given on what we should be doing.

Moving things along but hitting a wall

Finally, I called the hospital, gave my patient number and the name of the oncologist I was to be seeing.

Please.

I needed this report as we were leaving in a matter of days.

There was balking, there were delays, and finally, three days before we were to leave for Vietnam, we receive an appointment with the oncologist for the following day.

On the appointment card it was stated that I needed this x-ray, that test and a couple more blood tests before I met with the doctor at 1pm.

Well,... but,... how was I to get these done by tomorrow morning?

The request date of these tests were from the week before, but nothing was ever mentioned to us about them a week ago.

Did I need to fast for the blood tests? Were these x-rays and other tests already scheduled for me? Do I just show up?

What was going on here?

The easy flow we enjoyed before had hit a wall.

I emailed the oncologist directly mentioning my concerns, asked about fasting, and pointed out that if she had wanted other tests to be done, I should have been told last week. Not the day before our appointment.

And… by the way, do you have the results of my tests?

We would like to have copies please, so that we could do some research on them before we had our discussion together. This was the 4th time we had asked for the reports.

In our experience of Medical Care outside of the US, this treatment and behavior was unusual, and something was off.

Other registration desks, people waiting for service

An attitude? Or a style of administering medical care?

I distinctly got the impression that this doctor wanted complete control.

She would decide whether or not I would get copies of my tests.

And she would decide when the other tests would be done.

I could just come in early, she said. No I didn’t need to fast (yes I did!) and the results would be given to me that morning.

Again, something didn’t feel right. I clarified that I wanted copies of my biopsy report before our meeting together, and due to our limited time here in Thailand, I would not be doing any of the testing she requested.

I wouldn’t be having any surgical procedures done in Thailand anyway, so I would wait until our next location to further this medical journey.

We had still not received copies of the biopsy, so we changed our appointment with the doctor until we received them.

And... as we weren’t receiving them, Billy finally went to the hospital himself to pick them up.

A new language

This was the reason we wanted the report so that we could research what ER-positive, PR-negative, HER2 and Ki67 all meant. There was the Allred method, the DISH method, rating numbers and the Nottingham Histologic Score all listed.

We had a lot of homework to do in the half-a-day before tomorrow’s appointment.

Meeting Dr. Death

We arrived for our consultation with the oncologist and were escorted in to her office.

The doctor was cool, distant and seemed agitated – not exactly aggressive, but her manner gave us the sense that we had “disobeyed” her.

We had not followed her orders to get the extra tests done at the last minute. And we don’t think she liked the idea that we wanted copies of these reports for us to go over on our own first, before seeing her.

Truthfully, I think she preferred that we be ignorant and not know what questions to ask. That way, she could “tell” us what we needed to do next, and become dependent on her word and expertise. No independent thinking allowed!

She asked if I had any symptoms and that confused me.

Symptoms? Symptoms of what?

At this point, I had not been informed of any Cancer diagnosis, and was still in the frame of mind of having open possibility, and doing a fibroadenoma removal.

Did I have any headaches? “No.”

Have I been losing weight? “No.”

How have I been feeling in general? Well, besides the fact that I’m on the fast track to having my breast removed, I’ve been feeling fine.

On the examination table once again

That’s when she placed me on the examination table and checked both my breasts, my lymph nodes on both sides, my belly, and my neck. She listened to both my heart and my lungs. Everything checked out. I seemed to be normal.

At this point, the doctor said basically that I was in big trouble, with the data points being what they were. If I was not choosing to have surgery there in Chiang Mai, Thailand, – and as soon as she could schedule it – then she was directing me to get back to Mexico ASAP.

Like TODAY.

After all, the cancer could have already spread to my brain, in which case I would wake up paralyzed and have to be medi-vacked back home – and that would cost a LOT of money.

Did we want to do THAT?! She said with emphasis...

Or – and this is a strong reason we nicknamed her Dr. Death – She said the cancer could pierce the skin of my breast and explode like a cauliflower and flies would lay eggs in there, and that would simply be terrible.

Um… ok…

WHAAAAT?!

A doctor just said that to me?!?

Billy and I were simply flabbergasted.

She wanted me to leave Chiang Mail right now, get a brain scan to see if the cancer had gone there already, and she listed several other tests that I should have without delay.

Am I SURE I don’t have a headache?

Again, she reiterated, we needed to leave RIGHT AWAY, cut our trip short (how irresponsible of us to want to travel and “live our lives”!) and get going on this breast removal.

Another view of Chiang Mai Ram Hospital

Knocked off course

As I mentioned previously, both of us were feeling pretty good. I had no symptoms, no headaches, hadn’t lost weight, my lungs were good, my heart was strong, I wasn’t nauseous, hadn’t lost my appetite, and I still had joy for living.

But after speaking with Dr. Death, we were clearly knocked out of the water.

Do you have a headache? How many times did she ask me that?

Did you ever realize that you can get a headache after so many times of being asked if you had one?

Billy and I took a day or two to discuss the new turn of events. He had researched a cancer hospital in Danang, Vietnam our next destination, and there were 2 hospitals close to the hotel we booked.

Looking at options

We assessed where we were.

Billy had been simply amazing with deep support, strong energy and unfailing love. I felt very blessed to have him as my partner. We continued our conversations (life, death, our future, wills, how we wanted to live with the time we had left), and I pursued my meditations and psychological/spiritual sustenance.

I was learning about making the most of a challenging situation, the difference between having opinions and what my intent was, and how our definitions of something create our perspective and therefore our experience of what happens in Life.

Seriously, I was grateful for this opportunity to learn so much.

The doors to my psychological and spiritual awakening were being blown wide open.

Retire Early Lifestyle appeals to a different kind of person – the person who prizes their independence, values their time, and who doesn’t want to mindlessly follow the crowd.

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