Final histopath diagnosis:

I don’t know if I should see the word malignancy in this.

The second opinion CT reading had nothing about lymphoma there but it says “suggestive of gastrointestinal tuberculosis versus peritoneal carcinomatosis if with a known primary malignancy.”

As expected, the AFB and TB PCR were negative for MTB. Is it because when the biopsy was done, the patient was already done with Day 10 of her anti-TB meds therefore there is not enough MTB to work with? I don’t know. Dr. Google is making me nervous.

But then, a Philippines-based research showed only 10% of the samples showed positive AFB for peritoneal fluid.

I have to go back for the MTB culture after 6-8 weeks.

For now, I would just have to wait until Saturday and see what our hema-onco would tell me. Then our IDS next week.

Should I ask our hema-onco for some more tests?!

And this is how the world looked like when I left the Malate/UP Manila area this afternoon.

And it was not just Manila; it’s most of Metro Manila.

Sis-in-law and I stopped by Makati Med so she can visit her friend who just had her benign cysts removed from her uterus. While I was waiting for her to conclude her visit, I loitered around Ayala North Exchange, which was attached to the hospital.

I need to bring Twin I to the hospital tomorrow for the TB blood test, just to make sure she is TB-free and not incubating inside longer than Twin A did. I’ll have CBC in the mix because her cousin next door is contagious. He has bacterial flu. Twin I started having colds yesterday and full-blown asthma now.

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Since I knew this day would be stressful for me, I wanted to start it with something nice for my brood before driving off to PGH.

I grilled porkchops for lunch and dinner for them since I knew I would be coming home late.

I don’t have to worry about producing too much smoke to disturb the neighbors. Well, my neighbor is my mom and I’m too far back to cause coughing or bring smells into her house.

Meanwhile, my cats are watching.

I’m happy to report that Sushi has been getting thicker compared to how she was when we were still in QC. She seems to prefer this environment from the previous one she grew up in.

Who the hell wrote on our home care docs that it would take 8 weeks before I could claim our histopathology report?!

Good thing I was persistent in pursuing it with PGH Surgical Lab the entire day today (calling trunklines non-stop) or else I would have waited 6 weeks before retrieving them! 🤬

So tomorrow I will be driving to PGH to get the results from the Medical Research Lab and Surgical Lab, plus the final CT scan reading. To settle this once and for all. Then we march to our hema-onco’s clinic at St. Luke’s BGC on Saturday. I can’t wait for this to be over and done with. If it’s lymphoma, then at least we can already get the course of treatment set. If it’s really TB, then hurrah! We can finally move on.

I hate this suspense. It’s driving me nuts. It sends my anxiety to the stratosphere and my gastric acids are having a field day that I needed to pop Omeprazole into my mouth.

To make matters worse, I am needed in Singapore ASAP, but I can’t move until I get clarity over my daughter’s health. My senior reporter refused to travel to HK in November for our APAC-wide event because he got tired from his travels last month while I was out of commission. Now they know how I feel when I was flying out every month before I halted travel last month to concentrate on my daughter. I was supposed to be in HK last week but I cancelled everything while we were still in our local pediatrician’s clinic because I knew it was a dire situation. At that time I was only thinking surgery was my biggest worry. How wrong I was.

So come what may. I just need a final—really final diagnosis. For all we know it could be an autoimmune disease that is accompanying Twin A’s TB that’s why her TSH and uric acid are high. My aunt had lupus so it’s not impossible.

I wish I could relax like my cats. I wish I could finally take a holiday break from all these.

Negative for MTB.

Our IDS already somehow expected it. She told me before we were discharged that she is still confident it is TB even if GeneXpert comes negative given the surgical pathology report.

Maybe this is false negative???Attached with the GeneXpert result is the waiver signed by Twin A’s dad, saying that the result could be inaccurate due to the less than ideal or below-lab standard specimen submitted.

But this does not help my anxiety. I was told at TB DOTS that GeneXpert is already highly sensitive and I feel the AFB tests could be negative as well…that they may not have enough bacteria to work with or may not even have cultured any MTB 😓…I have yet to claim the AFB, GSCS, and TB PCR from PGH Medical Research Lab. And it my not tell me anything, too.

What’s worrisome is my daughter’s uric acid is still persistenly high despite regular intake of allopurinol. Uric acid as of yesterday is 9.18 mg/dL, normal value is 2.6-7.2.

But I was told at TB DOTS that it’s not that yet too worrisome since it’s not 5x higher than normal.

FNAB result and cytology report are not accessible to me yet…

The problem is our IDS took a leave of absence this week and we were scheduled to have the check up on Thursday. 😱 And I have been referred back to our hema-onco regarding the high uric acid.

The only thing that is keeping me hopeful is that Twin A is improving, ergo, the anti-TB med is working. The fact that she can walk back home from church is already a huge improvement over how she was two to three weeks ago.

But then, the threat of lymphoma is still there. My fear is that we might become complacent because we relied on the surgical pathology report, believing it is TB when we might be delaying treatment of possible lymphoma.

But I can’t do anything about it until the other test results, especially the FNAB and cytology reports come in.

Maybe I could request for an MRI, earlier than scheduled, which is originally set two months later? What would an MRI reveal? Maybe nothing. Maybe it would show less inflamation or the level of inflammation is the same because the anti-TB med is not addressing it?

I am killing myself with worry.

To keep me calm, I bought myself ice cream. That’s all I can do.

And pray.

I am going nuts.

Showed up at our local pediatrician’s clinic to request for a uric acid test order and also to update her on the diagnosis and what are the home care orders. She said Twin A’s tummy has shrunk compared to the time she sent us for hospital admission a month ago. And she assured me that it’s ok, the joint problems are normal since it has only been more than a week since my daughter is back on allopurinol.

Classes were suspended today because our stupid mayor heeded the call of irresponsible students (NOT from our university and the private schools around/within the university) who chanted “class suspension” for Monday because they attended the hotspring festival last Saturday and they were out until the wee hours of Sunday for the revelry. 🤬 Because the mayor wanted to be popular and “cool”.

And to think he already suspended classes on Friday in preparation for the festival. 🤬🤬🤬

Ghad, no wonder the reading comprehension and general literacy and numeracy of Filipino kids today are the lowest in Southeast Asia. Wasting precious school days for something stupid like staying up to party.

Yes I partied hard in my youth but I made sure I still come to class, even if I was so wasted and hungover. Because that was my only profession at that time—be a full time student, so I better haul my butt over to class, even if my blood vessels still contained 90% alcohol.

Yes, I sound like an old crone. I don’t friggin’ care. I care about not producing vapid and shallow people who only know how to TikTok and be “content creators” and post several selfies a day, everyday, but they couldn’t spell properly, even in Filipino, and resort to writing using jejemon language 🤮. I’m triggered. As an educator who had come from a family of educators, this really pushed my wrong buttons.

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To melt my anger today, I just sought the company of my cats in between editing and blasting emails.

Meanwhile, my solar outdoor light is working well but I need to buy another one for the lower staircase. Then solar fairy lights for the balustrades and the trees.

I’ll see tomorrow if I encounter deep discounts (lights and other DIY stuff, and a new vacuum cleaner) in Filinvest Alabang tomorrow after I claim Twin A’s TB GeneXpert assay and MTB PCR results from RITM.

Even though I know that my daughter has TB and the meds are working wonderfully, I still have this debilitating anxiety over the possibility of it might not be TB…so I have apprehension about what I would be reading from the results from RITM tomorrow. What if the AFB smears show it’s negative???

But it’s there staring at me in the face, the surgical pathology report (of the lymph node from the biopsy) says chronic granulomatous inflamation consistent with a tuberculosis etiology. This was the basis of our IDS’ order to bring back the anti-TB meds. So I shouldn’t doubt… Maybe I should have contacted my pathologist friend in PGH and asked him to do the pathology work for us, to give me some comfort. But then probably it won’t make any difference. Granulomas are granulomas with necrotic debris. Consistent with the CT scan that showed there is central necrosis. The misreading in our first hospital said there are nodules on the liver (a characteristic of lymphoma). But CT scan reading in PGH said there are no nodules on the liver but rather they are calcification (as told to me by our IDS fellows). Dr. Google told me calcification is caused by caseous necrosis—a very distinct characteristic of TB. While lymphoma may exhibit necrosis, it does not result into calcification.

But I shouldn’t believe Dr. Google.

So I’m still terrified. What if GeneXpert, PCR, and AFB show negative for MTB? Lymphoma and TB can coexist in one body, according to literature. That’s why our hema-onco is still not letting us go.

I should sleep now. I am creating my own monsters in my head.

Saturdays are for chores and errands. Sundays are for families and friends. There should be another day, like Monday, for self care. Like a whole day for you to recover your strength and sanity for the upcoming week.

Last night I cooked spaghetti and meatballs for my brother’s family here in my house after Twin I did our grocery shopping last Friday evening. Prior to that, my girls attended the “hangout” for high school kids at church and everyone was waiting for Twin A’s first public outing since being discharged from the hospital. She did well, considering they had to walk back from church to our house, together with their kuyas, because traffic was bad so I couldn’t pick them up in my car. It’s nice to have your male cousins protecting you. ❤️

Twin A looked very frail so no one wanted to bother her that much but she mistook it as snubbing, like no one wanted to do anything with her. She was so sad coming home. Twin I said, “why didn’t you tell me?! We thought you wanted to be left alone that’s why you chose to stay in a corner.” I told both of them to communicate better and to tell each other their needs, especially when the time comes when Twin A goes to school in a week’s time.

I also spoke with a high school classmate of mine after church service this afternoon and I hugged him and gave thanks for leading the prayer warriors all throughout our three-week ordeal. The church also sent their care/get well package to Twin A last Friday.

A fellow reporter and his wife sent Twin A also their get well gifts, drove all the way here (since they’re dropping off their niece, who is a freshman here).

All my close friends had been keeping tabs on us. Fairy gaymother K had been asking me every other day how we are. While we were n the hospital, he has been calling me and trying to keep me sane.

We are loved. ❤️

I took it easy today and just consumed leftovers or made instant stuff since I want to take a break from cooking. I should just have ordered Grab or Food Panda instead. 🤔 I just wanted to rest…

Ah yes, this power washer is part of my hardware/DIY store hauls last Friday. I had been planning to buy this for quite a while since I need this to clean my stairs, my carpets, and now our water tank. Need to drain and clean our tank every month, clean the tank walls with a clean mop and cleaning chemicals every 6 months, and with Clorox once a year.

I wonder if there are water tank cleaning service providers around here…oh there is! Will contact them tomorrow. *sigh* The headaches of homeownership.

As added security for my home, I bought a 25-watt solar-powered floor light to illuminate my stairway to discourage intruders and alert us if there are suspicious movements at night. I have a lot of outdoor lights on my eaves but they consume too much power so I can’t leave them on for more than 8 hours every night.

I will be returning to Handyman the dead bolt that I bought and have it exchanged for a barrel and chain lock instead. My contractor said my current lock system is already deadbolt so it’s better to have another system for redundancy. I also plan to install solar-powered torch lights for the garden and pathway.

Aaaaannndddd CCTV camera.