Thank You Dr Terrence Tan, Dr George Goh, and the Liver Team

Dear Dr. Terrence Tan, Dr. George Goh, and the Liver Team,

I hope this letter finds both of you and your team of doctors and staff well. I'm writing to express my sincere gratitude for the exceptional care I received during a particularly challenging time. I especially feel a pang of regret for not having taken Dr. Terrence's advice to come in on 13 October, when my condition worsened, resulting in a day's delay for my treatment.

From the moment I reported at the A&E on the late evening of 14 October, Dr. Terrence, your presence was a constant source of reassurance. Seeing you every morning at 9 am, leading the liver team, gave me a sense of stability and confidence that I desperately needed. I truly appreciate the thoroughness with which you approached my case, from the ultrasound on 15 October to rule out liver connection issues to the scan results on 16 October and all those blood tests! I also want to thank you for arranging the biopsy so quickly on 16 October and having my liver samples sent to the investigation team on the same evening to ensure that the outcome of the biopsy results be expedited by 17 October. This level of dedication is truly above and beyond, and it meant everything to me. Thanks to your swift action, my treatment started as soon as possible. You show that you are clearly in charge right from the start on 13 October. I knew I was in good hands when I saw how competent, conscientious, and tenacious you were in your approach to my "liver rejection".

To Dr George Goh - I met you for the first time together with the liver team on 20 October. Thank you for your prompt and timely intervention on 20 October (Monday) when you noticed that my kidney creatinine level climbed from 99 to 127. The high creatinine level suggests that my kidney function is deteriorating very quickly. You reviewed my kidney issues by immediately putting me on a 24-hour plasma drip to address my hydration issue. For the next 2 days, while the new medications had brought my liver out of the woods, my creatinine level continued to climb up to 131 and 145 respectively. You decisively adjusted my Batrium and then my Acyclovir in the next 2 days in a cool, calm, and collected manner. By 23 October, my creatinine level came tumbling down to 124 with my liver continuing to improve. I am grateful for your competent, professional, and decisive actions. You throw my anxiety out of the windows with your “calm under resolute” approach. Thank you.

To the liver team - Dr Ong, Dr Stephanie, Dr Tan, Beverly, Jessie, Gaya, and Rocky - Your dedication, expertise, and genuine care have made an enormous difference in my challenging journey. While this paragraph may be short, it carries with it my most profound gratefulness for everything you've done. Thank you all from the bottom of my heart.

With warmest regards,

Ding Ting Hock 

A Letter of Thanksgiving

Dear Family of St Hilda’s Church, Vicar Martin, and Pastor Amy,

As I lie here in my bed at home after eleven challenging days in hospital, my heart overflows with gratitude that I must express in words.

First and foremost, I give praise and thanks to God for His mercy and faithfulness. While living with a transplanted liver and damaged kidney, I have learned to lean heavily on His grace. During my recent medical crisis, when all my test results had gone awry, I felt His presence sustaining me. The improvement shown through my treatment and new medications is nothing short of His healing hand at work. “The Lord is my strength and my shield; my heart trusts in him, and he helps me” (Psalm 28:7) – these words have never felt more true.

To my dear church family at St. Hilda’s, your prayers have been a lifeline. Throughout the eleven days of emergency treatment, I felt lifted up by your prayers. Knowing that you were standing with me gave me courage when my body was weak. Thank you.

To Vicar Martin, your prayers for my recovery have meant more than words can express. Your spiritual leadership and care for my soul, especially during my medical crisis have been a tremendous blessing. Thank you for shepherding me with such compassion.

To Pastor Amy, I am deeply moved by your visit to my hospital bed to pray for me personally. In that vulnerable moment, when I was undergoing treatment and uncertainty, you brought the peace of Christ’s presence into my room. Your presence, to me was a profound comfort, and I will never forget your coming to pray for me when I needed it most.

The beautiful fruit-flower arrangement you sent speaks of life, hope, and beauty – It is now a daily reminder of your love and God’s goodness.

Though my journey continues, I know that I am surrounded by God’s love expressed through all of you. May His Shalom peace be upon you as it has been upon me, and may He bless you abundantly for the blessing you have been to me.

With deepest gratitude,

Ding Ting Hock 

“Give thanks to the Lord, for he is good; his love endures forever.” (Psalm 107:1)

SWOT Analysis of my Latest Medical Condition

This is my second personal SWOT analysis of my current medical condition. I did my first analysis in May based on the results of my liver test results. This second one is based on the results of my kidney test done yesterday on 10 October.

Over the past few months, I have been closely monitoring my post-liver transplant recovery and my kidney function, which has shown signs of deterioration. My most recent blood test on 10 October indicated that my creatinine level had risen to 111 µmol/L and my CKD-EPI eGFR had fallen to 58, compared to 102 µmol/L and 64, respectively, from four weeks earlier. This decline suggests that my kidneys may be deteriorating faster than expected. I have since alerted my liver team, and they have scheduled a repeat test and a review of my FK (tacrolimus) level to determine whether my Advagraf dose can be reduced to lessen the impact on my kidneys.

To better understand my current condition and identify what I should do next, I have chosen to apply a SWOT analysis—a tool commonly used in business—to my medical situation. This helps me to see not only what is happening medically to me, but also how my personal strengths and circumstances can influence my recovery.

Strengths—One of my greatest strengths lies in my being resilient and my commitment to follow medical advice from my medical team. I have made it a point to take my medications punctually, maintain a liver- and kidney-friendly diet, and stay hydrated with around two liters of water daily. I also have strong family support, especially in managing meals and helping me to stick to my dietary restrictions. I monitor my condition carefully and promptly alert my liver transplant coordinators whenever I notice changes, as I did with the recent kidney test results. My being attentive has allowed my medical team to respond quickly. These strengths form the foundation of my recovery despite the challenges.

Weaknesses—At the same time, I face a number of ongoing weaknesses. Insomnia continues to disrupt my sleep, leaving me with about five hours of total sleep in short segments across the day. I often feel drowsy and fatigued and experience blurred vision and weakened legs, which may be linked to my medications or my declining kidney function. The anti-rejection drug (Advagraf), which is essential for protecting my transplanted liver, is now contributing to kidney damage, creating a difficult trade-off between two vital organs. My mobility has lately been affected too, and my physical stamina is lower than before. All these weaknesses have limited my independence and sense of normalcy.

Opportunities— Despite these setbacks, I see opportunities in my hope for a meaningful recovery. Because I am under the care of a highly competent and coordinated team of specialists in SGH who work closely together on liver and kidney functions. The upcoming retesting and FK level assessment on the coming Monday may allow for a dose adjustment that can spare my kidneys while keeping my liver safe. With advances in post-transplant care, it can offer hope for newer, more kidney-friendly immunosuppressants or supportive treatments. On my part, I can further make an effort to improve areas such as rest quality, strength, and energy management. Most importantly, I believe this is still an early stage of kidney decline, and timely medical intervention can make a real difference.

Threats—However, my current situation also carries significant threats. The most pressing is the potential for rapid kidney deterioration if my current medication levels remain unchanged. The side effects—tiredness, dizziness, weakness, and blurred vision—already impact my daily functioning and could worsen. Managing the delicate balance between liver protection and kidney preservation is medically complex, requiring precise adjustments. Beyond the physical issues, there is also the emotional strain of coping with chronic fatigue and uncertainty, which could affect my mental well-being. Finally, being immunocompromised means I remain vulnerable to infections and other complications that could further burden my health.

The conclusion from my SWOT analysis is that it has helped me to view my medical condition with clarity and structure. It reveals that while the threats and weaknesses are real and serious, they are counterbalanced by my strong internal strengths—discipline, awareness, and family support—and by external opportunities such as expert medical care and evolving treatment options. The key lies in how to leverage my strengths and opportunities to mitigate the risks (coming from the weaknesses and threats) ahead.

In practical terms, this would mean maintaining close communication with my liver transplant coordinators and doctors, continuing my disciplined routines, and staying open to adjustments in treatment or lifestyle that protect both my liver and kidneys. My journey after transplant remains challenging, but it is not without hope. With proper and timely management of my changes, close medical consultation with my medical team, and my resilience, I believe I can continue to navigate this recovery journey towards a more balanced and stable situation.

You Are What You Think You Are

I was reflecting on "you are what you think you are."

Fifteen months ago, I had a liver transplant. That was 11 July 2024. The liver came from a deceased person. The transplant gave me a second chance at life. And I begin a journey that I hadn't fully anticipated—one where my body doesn't quite feel like mine and where my recovery has been anything but linear.

The medications that keep my transplanted liver functioning have compromised other parts of me. My mobility faltered, and I feel unsteady, with weakened legs, blurry vision, and dizziness most of the time. Initially, I found myself relying on walking aids like a wheelchair and a walking stick. I was navigating a world that suddenly felt smaller and less accessible. This wasn't the recovery I had imagined during those difficult days before my transplant. I thought that, after the transplant, I would simply be feeling normal again.

Then in April 2025, something in my body shifted. I cannot pinpoint a single moment or reason, but suddenly I felt like myself again. I could feel that my physical condition and mental state had returned. I was like a new version of myself that I could actually live with. I discarded my wheelchair and walking stick then. My dizziness seems to have receded into the background. I began taking public transport to my medical appointments alone, feeling the independence I had lost slowly returning to me. For those weeks, I was convinced I had turned a corner. My body seemed to be catching up to my will to be well.

But this past month has told a different story. My dizziness, unsteadiness, weakened legs, and blurry vision have intensified. My walking stick, which I had proudly set aside, is back in my hand. The independence that I felt so solid in April now feels fragile and conditional. With these physical changes, I am faced with a troubling realization: I am becoming what I think I am.

When I believed I was recovering in April, my body seemed to follow. Now, as doubt creeps in, I feel myself declining. I wonder—am I creating this reality with my thoughts? Is my mind dragging my body down, or is my body simply telling me truths my mind doesn't want to accept?

Conventional wisdom tells me to "think positive," to visualize healing, and to believe in my recovery. And there is truth in this—April proved that my mental state matters. When I saw myself as being very resilient, I became better. When I believed in my strength, I found reserves I didn't know I had.

But there is a darker side to "you are what you think you are" that I rarely want to think or talk about. When my body genuinely struggles, when medications create real limitations, when dizziness, weakened legs, blurry vision, and unsteadiness are not just in my head but a physical consequence of keeping my transplanted liver alive—what then? Does positive thinking become a burden when my body just won't cooperate?

I find myself walking a tightrope between two dangerous extremes. On one side is the belief that I can think my way to wellness and that my current struggles are failures of mindset rather than realities of my medical situation. This leads me to the exhausting work of maintaining relentless positivity even when my body screams otherwise.

On the other side is resignation—the belief that I am simply declining, that April was a brief illusion, and that this is who I am now and will always be. This thought leads me to give up on the possibilities that might still exist—the good days that might return—and on the independence I tasted and might taste again.

The truth lies somewhere in the uncomfortable middle. Yes, I am partly who I think I am. My mindset shapes my experience, my willingness to try, and my ability to push through challenges. When I believed I could walk without my wheelchair, that belief helped make it possible. My thoughts opened doors that my body could then walk through.

But I am also who my body tells me I am. The medications are real. The dizziness, weakened legs, blurry vision, and unsteadiness are real. The compromised mobility is real. These are not failures of positive thinking but consequences of the complex medical reality I now inhabit. My transplanted liver is keeping me alive, even as the medications that protect it create new limitations.

Perhaps the wisdom isn't in choosing between mind and body, between positive thinking and physical reality. Perhaps it's in holding both truths at once: I am affected by what I think, and I am also living in a body with genuine constraints. My thoughts matter, but they are not omnipotent. My limitations are real, but they are not the whole story.

April taught me that improvement is possible, that my body can surprise me with its resilience. This difficult month reminds me that recovery is not a straight line, that setbacks don't erase progress, and that I may need my walking stick today even if I didn't need it yesterday.

I am who I think I am—but I am also learning to think more complexly about who I am. I am someone living with a transplanted liver. I am someone whose body has real limitations and real possibilities. I am someone who has good months and bad months. I am someone still learning to be both hopeful and realistic, both determined and self-compassionate.

The question isn't whether I am who I think I am. The question is: can I think about who I am with enough nuance, honesty, and compassion to honor both my struggles and my strength? Can I accept the 2 persons—the person who walked unaided in April and the person who needs a walking stick today—and recognize that both are equally real, equally me?

This is the transplant journey no one prepares me for: not just receiving a liver, but discovering who I am becoming in a body that is saved.

On My Own - A 'First'

With summertime approaching, trees are starting to show their vitality and growth.

Preface: This journal entry was made on the 2nd of May 2025. It was a time when I was beginning to feel alive after a long, deep slumber. I was in high spirits and looking forward to returning to a normal life. At that time, I set myself several milestones, or rather, things that I hope to do. After 5 months, I look back to see where I am now.

• “You never know what you can do until you try, and very few try unless they have to.” — C.S. Lewis 

Actual journal entry:

Today is 2nd of May, 2025. For the very first time in a long while, I went for my medical appointment "On My Own”. I challenged myself by travelling on public transport (I was not familiar with public transport as I had been driving since the day when I was in the University). Sue was worried, and protested repeatedly. She insisted that she must accompany me, or if not, then I should take a cab there. But I was determined to do it "On My Own." I strongly feel that there must be "A First."

I started my journey at 6:30am. The bus took me through Telok Kurau, Joo Chiat, Tanjong Katong, and Old Airport. The journey brought back plenty of fond memories. Sue and I used to stay at Telok Kurau and Amber Gardens, and we are very familiar with these areas. It was like walking down memory lane.

I arrived at the Singapore General Hospital at 8.20am. The whole journey took one hour and 50 minutes.

It's really no big deal for others. But for me, at this stage and condition, it's really a big deal. 

Having done it "On My Own—A First," I now set my sight further...

• I hope to be able to go back to church. Pastor Amy and Pastor Calvin have been visiting me regularly, praying for me, and having holy communion with me when I was languishing at home and in my hospital bed.

(Update: Unfortunately, I am still unable to go back to the church because of mobility and physical issues. Furthermore, because of my morning medications, and my inability to sleep at night, I am normally in a drowsy state between 9 am to 11.30 am.)

• I wish to travel to Malaysia to visit my mother, who is living in Klang. It has been 10 years since I last visited her. And, lately, there is this unfamthomable emotion in me, urging me to see her. I also hope to see my sister Sau Ching and Adeline.

(Update: Sadly, my physical condition has not recovered sufficiently for me to be able to travel to Klang. I have figured out and planned my transportation mode, be it by air or coach, the duration will be too long for my body to cope. But I am still determined to visit my mother within the next 2 months. Time and tide wait for no man.)

• I want to invite my best friend, Richard, to my house for a meetup. I have known him since I was 9 years old. We lost contact after our secondary school, but managed to get in touch with each other again a few years ago. Since then, he has been there praying for me, encouraging and motivating me.

(Update: Alas. I am still not in the condition to invite him to my house. It seems that, I am unlikely to fulfill this wish of mine any time soon.)

# I hope to be able to start jogging again. I used to jog very often after I retired in 2001. I love jogging, especially early in the morning, during daybreak, when the whole world is still asleep. There is also the priviledge and bonus of watching the beautiful, but solemn sunrise. Jogging gives me tremendous amount of peace, as well as an unexplainable feeling that it's a new day, and a new beginning. It's the best time for me to reflect on issues and life. My target is to tone up my body in the next 5 months, and to begin jogging in October.

(Update: October has arrived. Unfortunately, I am still in no condition to even go for walk in the park. My wish and desire to jog again may not be able to come true. Up till now, I am still struggling with my walk from one point to another. I have not even started my morning walk which my endocrinologist has asked me to. For now, I can only look forlongly to the day when I can start jogging again.)

# I wish to travel with Sue again. Maybe, a long cruise. I can still remember those days when we often go for drive trips. Once, we did a 5-day drive trip to every part of West Malaysia. From Singapore Tuas 2nd link, we drove to Johor, then to the east coast of Malaysia, passing by Pahang, Terengganu, and Kelantan (up to the Thai Border). From Kelantan, we drove westwards, passing through Perak, Kedah, and to Butterworth. At Butterworth, we boarded a ferry, together with our car to Penang. We stayed in Penang for 2 days. On our return journey, we set off from our hotel at 8am. We crossed the Penang Bridge, driving along the NE highway, passing through Perak, Selangor, Negri Sembilan, Johor, and to the Tuas 2nd link in Singapore by 5pm. It was our most exciting and memorable drive trip. And one of our most memorable time in life.

(Update: Sadly, right now, in my current condition, travelling seems to be out of the question for a long time to come. The logistics involved - like food, medications routine (drowsy period after medication), my body ability to cope, and in the event of emergencies (which I have many) would be unattainable.)

At this point, my recovery tells me that I am very resilient. On my way back from hospital today, I saw bushes of Mexican Petunia with its beautiful bloom of trumpet-shaped blue flowers. The Mexican Petunia is known to be a very resilient plant and has always been a symbol of Resilience to me. It was a wonderful sight, and a timely reminder of being resilient.