Pinay New Yorker

This is an article I wrote for our batch eZINE at spcqc83hs.com. It took me a while to finish it and will be doing follow ups but would like to give the article extra exposure by posting it here in the hope of helping my friend Jinky and her son, Dave.

A few days ago, Homecoming Chairperson Leni Tolentino-Adriano made an announcement in the e-group message board about the plight of the son of one of our batchmates, Estrella “Jinky” De la Cruz-Tolentino. Pia Katigbak-Escueta was doing the text/phone brigade call to action for the members of the batch when she tried Jinky’s number and a torrent of information and emotion came forth. I decided to write Jinky directly and inquire from her about what her son is suffering from. Estrella, or Jinky, was quick to respond to my e-mail. I wanted to find out more about what’s been happening to her of late, given the sense of urgency in Leni’s appeal.

Niño David Dela Cruz-Tolentino or “Dave” as his Mom calls him is four years old and battling ACUTE LYMPHOBLASTIC LEUKEMIA. Like any typical four year old, he loves Barney, Piglet of Winnie the Pooh and Buzz Light Year. He enjoys having books read to him and like most children, he doesn’t like vegetables. But he’s started listening to his Mom when she tells him he needs to eat them to get better. He was just a normal child until April of last year when Jinky started noticing that Dave was losing weight fast.

The pediatrician they first approached diagnosed Dave as having primary complex, but because she was positive about her diagnosis being unmistakably correct, Dave was not tested for the condition but was instead immediately put on medication for six months. However, even before the six months was over, Dave was rushed to the Asian Hospital in August 2006 due to high fever. The tests came back negative for typhoid, dengue and meningitis, but he started responding to the antibiotics used to treat typhoid and so the hospital discharged him despite their failure to diagnose his condition.

Just a few weeks after, Dave was brought back to the hospital in early October and was confined for a week, again due to high fever and rashes all over his body. The attending pediatrician called in a specialist on infectious diseases and a hematologist, but a comprehensive diagnosis still eluded them. The boy was sent home with only a prescription for iron supplements to help him battle his ailment.

Finally in December, Jinky noticed that he had lost so much weight in 4 days that she rushed him to one of the more well known pediatric specialists in San Pedro, Laguna, and it was through a blood test that the doctor ordered that they discovered he had Acute Lymphoblastic Leukemia. Dave was immediately referred to a hematologist/oncologist, but with Jinky’s healthcard maximum of P100,000, they decided to have him confined at the Philippine General Hospital (PGH) thinking they could avail of free medication. They later discovered that the hospital only alots P1,000 per patient for medicines and medical supplies. Although the government hospital offered free board, they were on their own when it came to the medicines their son needed. While there, it was torture for Jinky to see her son’s ward mates dying one by one from their own ailments.

The Oncologist has prescribed 4 cycles of chemotherapy of 3 days for 4 consecutive weeks. Dave went through the first cycle from December 23-25 and was supposed to come back for the second treatment on December 29, but was unable to do so because Jinky and her husband had no more money to spend for the treatment and the required medicines. Jinky and her husband are hard strapped for cash, having spent an aggregate amount of P150,000 over their healthcard maximum at this point. The decision to subject Dave to chemotherapy was not an easy one to make for the couple because they know that it can destroy otherwise normal tissue while attacking the cancer cells that are killing their son. And while they are willing to take that chance in the hopes that it will help their son to live, they cannot do it if the required medication cannot be administered to him to help his body cope with the treatment. Each chemo treatment costs P20,000, and follow up medication for an extended period will cost almost P10,000 a day.

As a last resort, Jinky and her husband have tried to seek assistance from the Philippine Charity Sweepstakes Office (PCSO), but a quotation for the treatment is required from the doctor, and PSCO will only give anywhere from 10-20% of the estimated costs. And as with any government office, it will take them 30 days to 4 months to release the funds. The oncologist has prescribed L-asparginase costing P2,500 per dose to be taken three times a day for three consecutive days, but this medication can cause fever which will require antibiotics that will cost an additional P3,300 a day. This is the same antibiotic Dave has been on since he started having fever, and the dosage will be increased if chemo induces even higher temperatures which will cost them an additional P9,000/day for anywhere from 7 to 21 days.

They also need to increase his neutrophil count through medication costing P6,500/day for 6 days. Totally at a loss for the money required to come up with all this medication, Jinky and her husband decided to hold off on the second cycle of the chemotherapy and instead opted for alternative medicine by using a Japanese probiotic which Dave is now taking, costing P6,000/month. He appears to be responding to the probiotics but while his condition has improved, he has not been cured. They have found comfort in the thought that the probiotics appear to be helping Dave, as it contains 12 strains of good bacteria that is helping him fight the infections that can cause his temperature to rise again.

With help from batchmate Pilar “Lisa” Tejada-Dayaw, MD, I got a layman’s explanation of the illness plaguing Dave:

“Acute Lymphoblastic/ Lymphocytic Leukemia or ALL is a cancer of the white blood cells. It is also the most common form of malignancy in childhood, and is most common during the ages of 5-10, affecting the bone marrow and other tissues that play a role in the development of cells involved in the immune reactions that are required to fight even the simplest of diseases. This means that the marrow cells that are destined to develop into mature cells that can fight diseases and trigger the cascade of reactions needed to bring about an immune reaction do not mature into the cells that they were destined to become. Because these cells are immature, they cannot do their job.

A child suffering from ALL is prone to infection, bleeding, difficulty breathing, and other organ involvement. The cancerous blood cells, as in all other cancers, invade different organs including the brain, spinal cord, liver, spleen. When left untreated, the disease is aggressive and spreads fast. Therefore, induction chemotherapy has to be started early and as soon as a diagnosis is made. This is logical,knowing that the induction is needed to kill as many cells as possible, reduce the rate of production, and proceed to consolidation and maintenance chemotherapy.

There is better prognosis with remission achieved after the induction consolidation phase where most of the blasts are killed. However, all chemotherapy sessions are intense, and in each phase, there are several sessions. Treatment with chemotherapy will take several months, averaging 2 years. You have to remember that a child who undergoes chemotherapy is exposed to disease still with immature cells, and simple infections during the time when the child has decreased ability to fight infection may result in death. Chemotherapeutic agents also affect other organs. Therefore, not only does the care nvolve chemotherapy, but supportive therapy as well.

Overall, with intensive chemotherapy and good response with initial remission and no relpases, 80% of ALL patients are cured. If chemotherapy fails, or there is frequent remissions, bone marrow transplantation is an option. The prognosis with relapses is poor, so the earlier chemotherapy or bone marrow transplantation is started, the better the prognosis for the child. To expose him to one session and not allow him to continue to a full session is denying him the chance to give a good fight. I think the chemotherapy should proceed while the child still has the strength to put up a good fight both emotionally and physically.”

Jinky was working at a call center until she had to go on leave last December 4, 2006 when Dave was diagnosed with leukemia. She has since then suffered a threatened abortion with the baby she is carrying right now. She is currently 6 months pregnant but all the stress of the previous months is beginning to take a toll on her health. She also fears that she might be terminated at any time by the call center she is presently employed with because of her extended absence, but she is trying to make her case with the company so that she can hang on to her job. Her husband works as a technician for Universal Robina Corporation, and by her own admission, their combined salaries cannot cope with the financial demands of Dave’s illness.

They have a healthy 9-year-old daughter who goes to school and have held on to the hope that Dave can one day go back to school himself. During one of our earlier e-mail exchanges, Jinky even said in jest that she would appreciate any sideline work, perhaps as an extra in a commercial for a known brand of milk supplement for expecting mothers. She is obviously trying to keep a cheerful countenance in the midst of this crisis, but she carries a heavy burden on her shoulders, and a heavier one in her heart.

Jinky can be e-mailed at jinkytol@yahoo.com. You can check the e-group message giving her cellphone number here. (Only e-group members can view this message. If you are serious about helping Jinky, please e-mail me at pinaynewyorker@gmail.com and I will give you her phone details.) For those who want to make a direct contribution, you can deposit the money in the name of MARIA ESTRELLA D.C. TOLENTINO, Equitable Bank SA #0579-04607-4.

.. but it’s not.  So we’re making the most of it by just taking things easy at home.  Father and son are locked in an embrace on the couch taking their afernoon nap.  I just finished whipping up some dough for banana bread which I’m afraid I might’ve grossly damaged by adding twice as much mashed bananas as I should’ve.  It’s more banana than bread, but with a house full of banana lovers, I’m sure they’ll take it even if it’s not quite the usual consistency.

Mom’s sat down to watch a Bollywood movie on AZN.  It opened with an MTV style number with two pop artists talking about their love for their motherland.  I told Mommy it looks like an action movie and I am trying to figure out how they will be able to put in a song and dance number as they do in practically all their movies.  She realized it was a replay so she went back to bed to rest.

I only have one more errand to do and I’m good.  I have to do the grocery.  I can’t believe I’m out of sugar — that can’t happen if I’m baking!  I already have a stash of carrots in the fridge for another carrot cake I can make during the week.  While I was mixing the banana bread batter, I couldn’t help but wonder if I’d be doing this if I were back home in Manila.  With Red Ribbon, Goldilocks and the many other bakeries there, buying baked treats from one would be so much easier.  But I enjoy baking and I find it therapeutic.  There’s a different sense of fulfillment when I come up with something from scratch.

I almost succumbed to buying ready-mix bread batter at Target yesterday, but I pulled away and decided I loved the carrot cake I did last week, and I can still improve on that.  (I substituted the vanilla extract with pandan extract and kept the cinnamon to a minimum).  The recipe was moist and just right — it stayed fresh until midweek.

Time to check my banana bread and do some scrapbook layouts.  (Yes, I haven’t quite abandoned that..=)  I love the smell permeating the house just now.. it smells of the promise of a good snack later on.

We had to postpone our valentine date to Friday because Valentine’s Day saw us snowed over.  Rather than risk getting stuck in bad traffic on the way home, we called the restaurant and rescheduled.  They were kind enough to waive the cancellation charge given the circumstances, and we were all set for the 16th.

This year’s valentine rendezvous was at Artisanal Bistro located by 2 Park Avenue on the 32nd Street side. 

As luck would have it, the picture on the frontpage of the restaurant had a view of the table where Alan and I sat

Artisanal is well known for offering over a hundred varieties of cheeses and wines, and I decided to take their three-in-a-plate cheese offering for appetizers.  I told our server Heidi the types of cheese I preferred (Camembert, Pont L’Eveque) and based on that, she suggested the following:

	HOCH YBRIG is a mountain cheese is made from cow’s milk in Canton Schwyz, Switzerland during summer months. It is in the Alpage family of cheeses, developing its unique character from being washed in a white wine brine. The cheese has a slightly granular texture and a wonderful full nuttiness! It is excellent in a fondue or accompanied by mostarda (grape mustard) on a piece of baguette with a glass of Riesling.
	SAINT MARCELLIN is a small cheese from Dauphine in southern France is made mostly of cow’s milk, but was originally made of goat’s milk. It has a soft, creamy texture and a slight mushroom aroma when young and must be packaged in a small terracotta pot. As it ages this cheese becomes firm and salty. One of the best cheeses produced in southern France, it pairs well with Gigondas. One piece weighs approximately 3 ounces.
	VALENCAY is one of the classic mold-ripened chevres from the Loire Valley in the center region of France. This young goat’s milk cheese is distincly identified by its pyramid form which is blanketed by an ash mold. After ripening in the caves at Artisanal, the texture is smooth and dense with a mild flavor. One piece weighs approximately 8 ounces.

I have always loved cheese and like pairing it with a mild wine like Riesling which I found to be the perfect accompaniment to the cheese and the bread.  It brought out the flavors and textures of the three different cheeses that were recommended to me, and it prepared the palate for the main course. 

I had the Prime Hanger Steak Frites and Alan had the Roasted Chatham Bay Cod over a paella type rice.  The meal was heavenly!  We ended it by sharing a slice of what else, their artisanal cheesecake which is one of the better cheesecakes I’ve sampled anywhere.  Definitely something to look forward to and come back for.  I highly recommend the restaurant for a special occasion, or when you feel like gathering some friends to have some fondue which we plan to do soon.  Bon Appetit!

One of my all time favorite great artist: Billy Joel.. I listened to the tune just a few minutes ago and was, as usual, bowled over.  One thing I like about Billy Joel is that he is a transparent artist.  You will learn of the story of his life in his songs.  A perfect valentine tune…

	"All My Life" Premieres Today On People.com Beginning today, "All My Life", Billy Joel’s first new release in over 13 years, will premiere exclusively on People.com. Written as an anniversary present from Billy to his wife, Katie Lee Joel, the romantic "All My Life" will be available from now until Valentine’s Day (February 7 - February 14), where you can listen to the song and incorporate it into an e-card for your special someone. "All My Life" will also be available on iTunes beginning Feb 20.

Yahoo featured this photo of an archeological find in Italy. It depicts a haunting picture of a young couple in a warm embrace even in death. Thought to be 5,000-6,000 years old, that is indeed love for all time. Click here to read the article.

(Enrico Pajello/Handout/Reuters)

Yahoo featured this photo of an archeological find in Italy. It depicts a haunting picture of a young couple in a warm embrace even in death. Thought to be 5,000-6,000 years old, that is indeed love for all time. Click here to read the article.

(Enrico Pajello/Handout/Reuters)

I left the office at 1PM and had an unscheduled lunch date with Alan in Bobby Flay’s Bar Americain on 52nd Street, between 6th and 7th Avenues.  This is one of the things that keep our relationship "fresh".. we sometimes "regress" (if you may call it that) to dating — and it is something that try to make time for. This is one of Alan’s current favorites for lunch near his place of work, so it was convenient and fortunately, there was a table available.

For starters, we had the Artisanal Ham Tasting which Alan himself recommended I try.  You get three different preparations of the same ham (a special ham from Kentucky whose name I cannot now recall).  The portions are really a single serving only and are not to share.  The ham was served with a mango salsa as one of the three varieties, another between a bite-size biscuit and the third atop mozzarella cubes in a special sauce.  (Our waiter, Kent, described each one to us with such flair your mouth starts watering just thinking of the flavors he is describing!)

My entree was the spice rubbed Hanger Steak and served with Fries Americain (which is still French Fries to me).  Alan had his favorite Burger Americain, also served with Fries.

Don’t be fooled by the name and its menu proclaimed as regional American cuisine because the restaurant takes it French twist seriously.  (Yes, it’s spelled Americain — not American.)  The fries are not served with ketchup but actually with two different mustards and a mayonnaise concoction.  (I would suppose you can ask for ketchup, but they won’t give it to you unless you ask.)  The steak was a good portion but again, a single serving only.  The burger, though, was a man-size burger.

For dessert, Alan had the expresso as we shared the 5 fruit crepe.  Magnifique!  It was quite a meal!

Alan and I never quite run out of things to talk about during moments when we’re by ourselves like this.  I guess we’ve proven that marraige doesn’t mean silence at the dinner table just as what one saw in the movie TWO FOR THE ROAD.  It may be Bar Americain or Wendy’s — or even just coffee and some marble loaf cake at Starbucks — I always fint these dates very special because it’s part of our "couple time".

Alan and I actually sat by one of the tables by the wall on the left