Crusader Kings 2: a new high! (Part 4)

It was only in the immediate previous campaign that I "discovered" these statistics and only in this campaign that I made use of some of them.

CK2 25Mar17_13

Yes, as shown before in map format, Catholic was the overwhelming dominant religion in this campaign, in terms of realm size. Hardly a surprise since my realm, Empire of Alba (the largest realm!), HRE and Mongol Empire were overwhelmingly Catholic.

Shocking statistics: Hindu was the next dominant religion and the only other religion with 100 moral authority. Oh yes, Shia and Sunni had fallen a lot in this campaign. In fact, the heretical Sunni religion, Yazidi, was the most powerful Islamic religion here. Orthodox Christian was almost wiped off. Instead, its heretical religion of Paulician was 3rd most dominant religion, mainly due to Byzantium Empire.

CK2 25Mar17_14

In terms of realm size, I had the most by far (1214 vs 734) :)

CK2 25Mar17_15

In terms of demense size, it was my indirect vassal, Earl of Carrick, that had the most. His predecessors had consistently directly held 10 counties, with early adoption of Primogeniture succession law. I was surprised that his liege, a duke, didn't attempt to curtail his power or that the earl himself didn't attempt to take over the duke's title.

CK2 25Mar17_16

Almost all of them were my vassals. The notable exceptions were Duke Maoilios of Nidaros (Norway) and Duke Zula the Ill-Ruler (Abyssinia).

CK2 25Mar17_17

King Edward of England ruled over the largest realm by far among my direct vassals simply because the Kingdom of England was still quite huge despite a few counties ruled by others. He himself, however, had only 1 county within the kingdom. If the game had continued, I don't think our dynasty member would be the next king (Elective Monarchy). I had this situation before and I did manage to wrest away the title from the then rebelling king but simply couldn't hold on to it long enough change the succession law that would benefit my dynasty because I was constantly suffering the effects of being over vassal limit.

CK2 25Mar17_18

At first glance, there was no difference between this and the above statistic. What was captured here, and not before, but not shown was the emergence of Earl of Carrick with realm size of 35.

I used the above 2 sets of statistics to help me decide how to give away excess counties with the aim of not creating powerful vassals. There were some situation where I was tempted to do so for convenience sake but didn't do so.

CK2 25Mar17_19

It was only within the last 50 year or so of the campaign that I had unequivocally the largest army. Curiously, the Papacy had nearly 33k army with only realm size of 15! How did that happen?

Incidentally, at this point, there was a revolt in the Empire of Carpathia. If they reunite, then a united Carpathia should be place at around the 3rd position.

CK2 25Mar17_20

In terms of ream size, the top two spots were the same as that measured by army size but there were changes to the 3rd, 4th and 5th positions.

CK2 25Mar17_21

It was in the last few decades, I managed edge ahead in terms of score.

CK2 25Mar17_22

These were the titles I held directly :)

That's it for the incredibly outstanding campaign I had. I surpassed by miles the largest empires in terms of realm size and army. A personal score that was about 70% higher than the previous high. Ruled over a very stable realm; never had major rebellion. Oh gosh, can I top this in future?

Crusader Kings 2: a new high! (Part 3)

There's a new game mechanic that was new to me: threat level.

CK2 25Mar17_7

I've reached 100% threat level a few times @@. Every now and then, especially when they wanted to arrange marriage with someone in my court, some rulers temporarily left their defensive pacts. I would quickly checked whether they were rulers that I had been wanting to declare war on as that would be the chance to do so without triggering the defensive pacts.

As often as possible, I offered to join vassals' wars to minimise increase in threat level and avoid triggering defensive pact.

CK2 25Mar17_8

The yellow coloured land is my land i.e. Empire of Alba. The light grey coloured land belongs to Christian defensive pact states while green coloured land belongs to Muslim defensive pact. At one point, when they were still around, there was also Pagan defensive pact against me @@. This significantly reduce the expansion of my empire.

CK2 25Mar17_9

This shows land of "direct vassals". My direct vassals consisted of some kings and many dukes. So in the above, for example, the land labeled "Fes" is either directly controlled by my Duke of Fes or by his vassals (earls/countesses). The land I controlled directly is labeled as "Alba".

This mode of map was very useful when I was awarding newly conquered land so as to avoid concentration of power among my vassals.

I tried to confer titles to kinsman as far as possible. Later, when I was reasonably powerful, I took note of plots discovered by my spymaster. If the plotter was someone whose title I wanted to transfer to someone else (especially a kinsman) and the chance of success at imprisoning was very low (e.g. 1%), I triggered the imprisonment attempt so that I could put down the ensuing rebellion and thereby empowering myself to legitimately revoke the rebel's title. It was only at the the end of the game, I discovered that I could legitimately revoke 2 titles!

CK2 25Mar17_10

Yes, once again the Catholic religion was the most superior of them all. I had only a few counties left to convert at the end of the game.

CK2 25Mar17_11

Naturally, I tried to convert my vassals and consequently the populace to Scottish to eliminate cultural penalties and risk of revolt. I was, however, thwarted by my Anglo-Saxon and Irish vassals a few times if I didn't check on them regularly. I needed to bribe every now and then to appoint Scottish guardians to their heirs.

Oh, on a related note, the very first crusade was for Jerusalem (it almost always is the case) and for the first time in my games, a duke won it! Yes, an Irish duke. Goodness, I don't know how they did it.

CK2 25Mar17_12

This shows territory by dynasties. Yes, House of Zee Mau was prominent :)

Now vs Later

We informed Dr D that my dad decided to undergo radiotherapy for his leg at that hospital ("MM Hospital"). The quoted fee was RM500 cheaper than that at Dr A's hospital ("Adv Hospital") i.e. RM7500 vs RM8000.

So recently, we arrived there in the morning where they took a "planning scan" of his leg as well as some blood for tumour marker tests. Surprisingly the total fee, including the tests, was just over RM3k. Much cheaper than quoted. Something about using only a "fraction", rather than a few fractions @@.

We also requested to speak with Dr D because we were not clear about why she suggested doing chemo later rather than now. Despite her busy schedule, she managed to squeeze us in, patiently explained to us till we were satisfied, and did not even charge us for that! My dad is comfortable with her because not only is her explanation is detailed, it is also clear to him.

To summarise, her points are as follows:

(1) My dad's cancer is mucinous adenocarcinoma, which is quite rare. There's also few studies on this cancer. So in terms of treatment, specialists based on what they know of adenocarcinoma pancreas. In short, efficacy of treatment is a guess.

(2) Condition of patient is usually stable initially ("flat line") for a while before it gets worse exponentially ("exponential part"). Since for the past 6 months, the only notable development is suspected cancer on his left leg and a small dot of suspected cancer in the lymph node, it's her opinion that my dad's condition still lies in the early stage i.e. the early part of the flat line. Hence, having chemo now would not improve the current condition. Moreover, it's hard to determine the success of the chemo treatment as it's only a small dot to begin with.

(3) If undergo chemo now to treat that small dot (left leg is treated with radiotherapy), the cancer cells may develop resistance to the preferred chemo drugs when chemo is really needed (the start of the exponential part).

(4) So her aim is to catch the inflexion point i.e. condition about to worsen exponentially and then recommend chemo to treat the (expected) several spots of cancer.

(5) Throughout the discussion, she regularly goes back to her aim of treating stage 4 cancer patients i.e. prolong life, quality of life and control/manage symptoms.

Some concrete steps

So we met Dr A and here's what he said:

(1) Re my dad's red eyes: nothing to do with cancer but need to seek help from an ophthalmologist immediately.

(2) Re my dad's left leg: almost certain there's cancer on the neck of the left femur. As at now, it's not endangering the bone but if left untreated, it can cause fracture of the bone and that will be catastrophic since it's a weight-bearing bone. "Strongly" suggested radiotherapy to treat it.

(3) He was worried about the spot in the lymph node near the right kidney bed. So at this stage he recommended chemotherapy that helps to control the growth of the cancer. There is usually no or only mild (and hence tolerable) side effects. He, however, did advise us to take a little time to consider whether dad wanted chemo or not.

We asked what's the expected remaining life. He asked whether we really wanted to know and which party wanted to know. My dad confirmed that he himself wanted to know as he would want make plans accordingly. Answer: 2 years. Without chemo, it's 1 year. He, however, encouraged my dad not to give up as there were patients who lived for, say, 5 years.

As we know the treatment at that hospital is expensive, Dr A was understanding when we said we wanted to check out another hospital and he recognised Dr D from that hospital ("ah yes, she's a nice lady"). Our plan was to have chemo at the nearest public hospital if there's no long waiting time. If not, it'll be at that other private hospital. Dr A is willing to write a referral letter if needed.

Since we had few hours before meeting Dr D, we quickly visited Dr W, an ophthalmologist, at Dr A's hospital. After 2 check-ups (the second time after dilating the pupils and waiting for 30 mins), Dr D concluded that it was an infection. Prescribed medicine and asked us to get Johnson Baby No-More-Tear shampoo for cleaning.

Hours later, after giving Dr D all the necessary info, she said this:

(4) Aim of treatment during stage 4 cancer is to (a) prolong life, (b) maintain quality of life, and (c) manage symptoms. So she too recommended radiotherapy for the left leg.

(5) On the other hand, she differed in opinion on the likelihood of cancer in the lymph node. Given the aim stated in (4) above, she recommended an initial 2-monthly CT scan to check for anything serious.

(6) The eventual chemotherapy programme would be the same as what Dr A recommended. We can of course to choose to start anytime we like, instead of waiting for when there's multiple metastasis.

For certain, dad wants the radiotherapy to treat his leg as it's causing him severe pain and affects his sleep significantly. As for chemotherapy, we'll wait until his leg has at least significantly improved.

On our side, we have many things to do to enable my parents to permanently move to my sister's place in Butterworth.

I'll always love you

When I'm at my younger sister's home, I volunteer to read storybooks to my nephew each night before he sleeps. Usually, he'll ask me to choose books that I haven't read. Recently, I read this book:

I'll always love you

I know that my sister chooses books that are age appropriate for her children and so, as expected, the words used in the book are of course simple to me. However, the way it is written and its content itself effectively convey powerful message about showing your love and care to your loved ones while they are still alive.

Although this is not a typical light-hearted children story, it is done in a gentle matter-of-fact manner. It's realistic too, as I'm sure many dog owners would agree :)

You can read some reviews here in Goodreads.

Interlude: Subway's interesting promotion

Subway 12.20

Here's the interesting bit: some of these sandwiches were priced at RM12.20 from the ala carte menu. So basically, Subway was paying customers RM0.30 to take one of these drinks.

Mispricing? Or competition was simply too strong that they had to do this?

Downturn

We followed Dr A's recommendation back in February and here's the results:

(1) This time PET/CT scan showed more findings. There were mostly "maybes" and even those that were "likely", we didn't know how serious they were. We consulted the public hospital's urologist, whose team knew we were doing this scan. Based on the report, the urologist said there was indication of cancer in the right kidney bed and the left leg, and thus the cancer had "progressed". Recall that they had all the while stuck to the notion that there was cancer somewhere in the body and chemotherapy was recommended. Incidentally, my dad started feel pain in his left leg almost a month ago but this was confounded by the fact that it occurred at an old injury site.

When we told him that we got 2nd opinion from a private oncologist (for some reasons, they didn't have record of all the information we gave them earlier!) and therefore was doing follow-up tests, he disbelieved us and said that it was us who wanted to do that. I disputed it right away. The audacity!

So the urologist team referred us to the oncology department to get an appointment there. Meanwhile, we made an appointment to consult Dr A once again.

(2) Latest tumour marker still showed nothing for pancreatic cancer and borderline elevation for colon cancer. For the latter, refer to (3) below.

(3) Specialist recommended a repeat of OGDS and colonoscopy in 3 years time (after the last one which was done in late 2016.

So our best guess now is that Dr A will also recommend chemotherapy when we see him next. Hopefully it'll all work out fine.