Chest pain, fever, phew!

On the night before yesterday's, I had developed a slight pain in the lower part of the right chest. The pain was really so excruciating that it did not allow me to sleep almost half the night. So, yesterday, I had to rush to my doctor complaining about the pain and I realized that I was febrile when the thermometer showed well around 102 def F! So, after a few tests including an ECG, Dr.Niti told me the pain might be due to an infection and suggested me to take an anti-biotic along with Crocin, which is for controlling down the temperature.

Still this pain is troubling me in the nights, dragging me away from my usual sound sleeps! Of course, when I don't get sleep I will drive trains of fantasies - literary, humorous, etc - to keep myself engaged :) I hope I will get out of this ordeal sooner than later.

Double blow with colostomy: A lesson!

For the first time in my experience with the colostomy in the past one-and-half years, yesterday I had a double blow: I had to replace the colostomy pouch twice on the same day! It was a horrible experience!

Ever since I had the colostomy surgery (for more details on colostomy, see my earlier post here) in mid-June, 2009, I have been replacing the pouch every week on an average. The system of colostomy comes with a pouch and a fitting flange; the flange is fitted around the stoma with a set of paper or dynaplast strips and the plastic pouch sits snugly on the flange. The feces/stool gets collected in the pouch and after usually a week, the flange begins to open and it needs a replacement since the plaster strips loosen themselves over time.

So, yesterday, it was my usual time for dressing and replacement of the system, and I promptly got it done at the BIO with my usual gang of sisters working on it. Strangely, by the time, I reached almost home, I realized that the flange this time already got opened and some feces had leaked through touching the surface of my abdomen! Fortunately, it was not too fluid to flow down and spoil my clothes! It was already 5:30 PM with continuous drizzle and I had to return to the hospital again for a fresh replacement! By the time I reached the hospital, it was well about an hour and when I reached back home it was almost 8 PM! It was drizzling even then and with my eyes bloated with continuous driving for more than 5 hours in the city's jammed roads and rainy airs, it was quite a trouble! This had been one of the harrowing experiences for me surviving the disease!

On the positive note, this incident had taught me to acknowledge the presence of crisis and to react to it with a calm mind! (I realized the crisis moments and was tense in those moments when the feces was touching my abdomen and was in a hurry to visit the hospital for the second time. My reaction: acknowledge the crisis, de-stress the mind; get calm! I had tea served by my mother and I smiled! :)) The whole episode gave me lessons on handling a typical crisis situation and made some revelations on how react in those situations! :) Definitely, I have improved. I have arrived. :)

Favorable test numbers - a step closer to recovery

Consequent to the PET-CT scan in the third week of October last and the changed regimen of the chemo medicines suggested by my oncologist, Dr.Niti, I had my blood tested two days back. The objective was to see how the critical parameters such as white blood cell (WBC) count and the INR value so as to gauge the effectiveness of the treatment. And, the test results showed that all the critical parameters fall in their biologically permissive ranges! :) (For instance, the WBC count was 6.17 (permissible range: 4 - 11) and the INR is 2.37 (permissible range: 2.0 - 3.0).)

I am particularly happy with two things: (1) good and favorable blood test results, and (2) the responsiveness and sensitivity with which my doctor reacted to these results. Immediately after getting my test numbers known orally from Deepika Sister, I had emailed the results to my doctor who in her natural way replied back saying that "All looks well!". It is good on one hand to have positive news and to have a responsive doctor on the other, who sits on top of her case with interest and responds with empathy! Thank you, doc! :)

Chemo-24 yesterday - Bouts of depression and renewed vigour

...I would not comprehend the meaning of loneliness since she was always present with me. When I was emotionally down one day, when the entire world around me seemed to divide me into innumerable pieces, I locked myself into a deep thick shell of mine. I would not allow anyone to touch that shell of mine and the shell would not be broken by any one else except its creator. It had no doors, no windows or any other apertures for any one else to peep into. It was the sole creation of mine with stones of my silence, walls of my intense thoughts and layers of serious introspection. Nonetheless, she suddenly could make her way into my own shell! I shouted at her, “How on this shell could you make an entry? It is mine and no one else’.” She replied with a coy smile, “I have no form. I have no body. I have no limits. Reasoning cannot touch me and so does your limited mind. No one can stop this ever-turning wheel of destiny that is created by me. You are but a part of that whole and not the whole. The world needs the creators of the shells like this, but not the shells; for, these shells would add to the disorder of the cosmos and thus would never be the liking of the God. You think you are trapped in this shell cutting down all the communication with the outside world. But then how do you make yourself cut-off from a world that is inside you? Don’t you see that world of yours that is slow in its working compared to its outer counterpart? Don’t you see the world inside you that is so simple in its awesome complexity? Don’t you see the world here with you that is incomplete without any connection with the outside entities? You think your own world is too complex to live. But anything seemingly simple should be obviously complex inside. No one until now could live only with this inside world. Because it simply cannot exist in vacuum. If you make yourself close to your inner world then it does mean that you acknowledge its presence, which is absolutely essential for its existence. If you think that you cannot face the realities of the outside world, then it is preposterous. For, then only you can appreciate the value of your inner world more. Do you think that darkness simply exists because it should exist as per the laws of nature? No, it exists to elevate the importance of the light. Do you think that bad things simply exist because they should exist as per the moral laws? No, they exist to make you appreciate the good things. The particle and its anti form should co-exist so that the Universe would stay in harmony. And this does not mean that you should take an abominable attitude towards one for the other. You might switch the minds between them but ultimately you should learn that you should live midway between them. This is the perspective that you need to ingrain in your mind.”

That was the time I decided to break the shell and never did I have a chance to break it again.

Once I asked her,"Why do I always feel disgruntled whenever I think with my heart and feel with my mind rather than think with my mind and feel with heart?" She simply replied, “Because you just feel more and think less!" That crisp combination of words made me think again on the meaning of life. The moments of loneliness, matters of deprivation and minutes of vapidity were sprinkled in this life as though they were natural ingredients of that. She said, “It all lies in your state of mind!" My state of mind had been the same over its period of existence, and I wish it would be the same for ever; for, that was the state that made me, defined me and created me; that was the state that would take my form into a limitless disposition of self-brooding; that was the state that makes me what I have been...

[An excerpt from my essay titled Living Lonely, 2003]

***

The state of experience from last week's hospitalization was still fresh in my mind. With a little anxiety, I reached the hospital, thinking about the blood counts and the day's chemo infusion experiences. The hospital lobby was as usual crowded and the staff was in day's brisk business. When would be this world free from cancer?

***

The day's blood test results showed an improvement from the last week's numbers, though not a good improvement. The WBC count was just enough to go ahead and have Cetuximab. The rashes on my face were becoming prominent because of this drug.

***

I got the worst moments of despondency during the chemo suffusion after really a long time. Unknown anxiety and apprehensive thoughts persisted for a long time until I again started infusing some positive thoughts into my mind. I visualized the kind of world that I wanted to live in - a small but beautiful world. The world in which I - I alone - live singing, dancing, writing, reading and just looking at the lush greenery which is the lone companion to me. Free from worries and living with my own self. Beauty needs to be felt from within before the senses are drawn to the outside horizons. The wonderful world is within. And I started loving it.

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;
Then took the other, just as fair,
And having perhaps the better claim,
Because it was grassy and wanted wear;
Though as for that passing there
Had worn them really about the same,
And both that morning equally lay
In leaves no step had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads to way,
I doubted if I should ever come back.
Somewhere ages and ages hence:
Two roads diverged in a wood, and I -
I took the one less traveled by,
And that has made all the difference.

- From the poem, The Road Not Taken, Robert Frost

Chemo-23 - A saga of low blood counts!

Last Monday, when the usual day's blood test reports came out, I was shocked to see the WBC count! It was 0.8! This was the lowest ever number recorded in my entire history of the disease. I was eager to meet my doctor and want to hear from her on the reasons and her thoughts. And, when I finally met her, I could only see a modest surprise in her face and got no particular reason from her for the sudden and steep drop in the blood count! (See the attached chart for a perspective!)

She had no other option than to get me admitted into the hospital and to take me through the anti-biotic regimen along with a blood improvement medication through Neupogen shots for at least two days, before the regular chemo is administered.

It was thus another ordeal - physical and mental - for me to go through the entire corrective mechanism for the blood improvement and then yesterday (Tuesday), when the blood count improved to 1.47, the regular chemo drug suffused through my body, I got relieved!

***

The low blood counts in the body usually induces in me lots of weird feelings - dizziness, weakness, loss of appetite, feverishness, body aches, etc. - which restrict my mobility and thus make me feel really sick! :( I always tell myself whenever this happens: "There cannot be a low further lower than this! So, wake up!" And, I try to visualize the beauty in this world - all the beautiful things, feelings, thoughts - that really make me smile and help me ignore the powerful fact that I carry one of the most deadliest diseases in this world! After all, I will have a life, and I want to live that fully. With bloody vengeance!

***

The two-day pre-monsoon showers in Bangalore were pretty wonderful to feel. A visual treat. I watched out through the window with the tiny drops of water lazily falling off on the surface as though they were reluctant to leave the source. The moist pane on the other side beckons me to scribble on it something. Some doodling. The pigeons settled on the window's seat-board to protect themselves from the drizzle, occasionally poking the glass with their beaks as though they wanted to connect with me! I watched the drizzle, doodled and visualized the images for the beautiful melody on my radio. Flowers in the distance were dancing to the tune of the rains! Trees did not stop waving too! Where flowers bloom so does hope! What a dazzling beauty Mother Nature manifests herself through.

As I ventured to the wood,
I stopped to draw on dewy air; let
Droplets shimmer in my hair, that
Rested on my tranquil head – as
If a sense of cosy bed.

As I ventured to the wood,
A gesturing cuckoo perched above,
And then in song with cooing dove,
‘You're welcome’, bade he, ’enter please –
To roam our land with gentle breeze.’

As I ventured to the wood,
A dazzling flower waved her face
In blazing show of dance and chase, and
Reddened bright in shade of dawn, she
Flirted like a prancing fawn.

As I ventured to the wood,
A butterfly had graced my arm,
And knowing I bid him no harm, he
Splayed for me hypnotic wing in
Colors for to urge me sing!

As I ventured to the wood,
The radiant sun shone down on me.
He flushed and beamed: ‘I say to thee,
You bless your land; be filled with pride, and
Cherish e’er yon countryside! ’

[Adapted from: Succumbed to Thinking by Mark Raymond Slaughter]

Chemo-22 yesterday - Love for Life

I watched her dance for more than half-an-hour. Her mudras, expressions in her eyes, nimble movements matching the mellowed music made me lost in a world of unknown joy. It was as though I was lost in time and pacing up towards a new horizon. After a long pause, over a coffee, she offered me a book with vintage photographs of dancers of yesteryear. I browsed through a couple of pages. I did not notice that she had been noticing my eyes until I raised mine and glanced her with a sigh of inner satisfaction. "I think you are trying to connect to the art deeply", she quipped intently. "Am I?" I blurted out as though some one caught my moods instantly, after a brief embarrassing pause. I closed the book and walked towards the wide balcony that overlooked the city's skyline punctuated with a streams of greenery. I just felt the cool breezes of the late evening. Does art touch my heart? Why does it make me still inside? Does it stall my world for some time? What is its power that amazingly have a numbing effect on my external senses? I lost in my own array of thoughts when I felt her beside me with her hand around my waist and head leaning on my shoulder. I could feel the dance of her strand of hair on my neck. I preferred not to move since I wanted that feel of dance from her. Every part of her. I extended my hand on her waist. The Sun went behind the clouds as though He wanted to let us have our private world amidst the gentle breezes. Moments later, she left me and stood leaning against the railing looking at me intensely as though she was searching for some unknown images in my eyes of the vast expanse of the scenery before me. I smiled at her. She reciprocated gently. "I do not know what I love you for", she blushed. I smiled again as though I was waiting for a better answer for her own question. "But I do, really. I mean it." She took my hand, caressed it for a while after planting a gentle kiss on it. I took her in my arms and stood there. For long enough to let my heart talk to hers. Lump in throat. Arcs of tears in the corners of eyes. Clouds of happiness.

***

A good night's sleep revved up my moods on Monday morning preparing me for another session of chemotherapy. The day's moods were wonderful until I got to feel a mild and a brief dizziness associated with the suffusion of the chemotherapy drugs in my blood. The day's blood test showed improved blood counts (see the spike in the attached chart) and the weather salubrious. Oh, what a day it was!

***

My doctor, Dr.Niti, attended me when I was in my bed waiting for the standard regimen of medicines to be infused. She looked satisfied with the tolerance of my body towards the cruel therapy! And, only worry apparently for her was the presence of rashes on my face for which she simply commented,"He is sensitive to the medicine!" :) It had been quite a while since I saw my doctor. I usually look at the level of confidence in her eyes for my position and gauge the situation for myself and for my disease. It was a nice feeling to see the normality in her eyes. Elated!

***

"But the hospital records show you are married!", commented Ms.D'souza, the clinical psychologist, to my answer that I am now not in married status! I was meeting her for the first time in my entire spell of the treatment! Her smile was infectious and her eyes were beaming with a faint radiance as though she just had had a revelation!

"Oh, you s-e-parated?", her voice almost murmured in a hush.

It was a sort of an embarrassing moment for me. For the first time in a long period, I was forced to rub the wound that I was trying to ignore, forget and forgive in my emotional space. I was not used to the kind of reaction that I was expected to express for this disconcerting question on a personal issue that left me scarred and wounded for a long and tough time.

"Yes!", I responded in the similar hush. A well thought out and cautious response that was as though I was trying to defend my self from the hurt that it caused.

Ms.D'souza left me at that apparently sensing the economy of my guarded response. She then proceeded on a familiar turf of positive reinforcements that I had to have at these tough times. I listened to her intently not to disturb her train of thoughts and finally she returned after listening to my reassuring words for self and after seeing my stop-worrying-start-living attitude!

***

The standard regimen followed with the nursing staff attending to me in their usual business. The infusion of Irinotecan for around three hours was a bit boring time and made me sleep for a while. The sudden humidity in the ward woke me up and made me to listen to the conversations from the neighborhood on the vagaries of the chemotherapy and other corrective treatments for the suffering patients.

This time, last year, was the most tumultuous phase of my disease with excruciating pain and indescribable suffering. I moved to the current phase of improving quality of life with vengeance and change of attitude with the external support system of family and friends and the internal system of spiritual and psychological discipline. The way forward would probably tough, but I am all geared up to accept the life as it is and to take the challenges in my own way. I wanted to scream to the sufferers that this phase too shall pass and every one of them will live life royally!

***

It was almost 8:30 PM when I plopped down in the back seat of the cab revving towards my home. I almost was lost in my plans for the next few days - meeting a college mate who had flown in from Hyderabad for an official trip, having a get-together with other college mates in the honor of the visiting friend, taking my nephews and nieces to Coffee Day's local outlet, buying the writing paraphernalia including a set of ink pens, a good pen stand and couple of writing sheets, shopping for summer kurtas, completing the book that I am currently reading, catching up with a Kolkata colleague on phone on his impending trip to US and replying to a loving message in Facebook from an old friend.

Amid the beaming radio voices, I could hear her words, "Are you worried?"

Surprised at the sudden question, I replied,"Why, no!"

"I feel great for you." Her simple answer for my reply after a brief moment of pause.

Khaamosh, ai dil! bharii mehfil mein chillaanaa nahiin achchhaa,
adab pahalaa qariinaa hai mohabbat ke qariinon mein
- Mohammad Iqbal

I looked out of the partly downed window. The flowers in the traffic islands smiled and waved at me. I smiled at them, they shook their petals for me. One of them dropped to touch the moist grass below sensitively. With love. And care. Hitherto unknown. What a world. Oh! what a beauty!

Chemo-21 yesterday - End of Cycle 7

It was around 3:15 AM yesterday, and my mind did not stop thinking and continued where it stopped in the dream - the topic: what if I was suddenly asked to interview a classical dancer! What questions should I pose to her and what should we talk? Do I know enough of various forms of Indian classical dance and of the form where she specializes in?

My mind continued its search for any known answers through mining the areas of main memory but to of no avail! I decided immediately to take up a short course in the appreciation of dance forms in the Indian Classical system! The decision came around 5:40 AM. It dissolved into the realms of vast ocean of such decision repository around 7:15 AM!

***

I gulped pieces of dosa with a dabbing of coconut chutney with some difficulty since my throat was chocking often due to the presence of the chemotherapy drug flowing all along my body through blood. Last week, a few rashes started showing up on my face - especially the chin area, around lips, cheeks and sideburns - which caused enormous pain and irritation while I was my face. I could see a couple of rashes on my upper thighs too! Since I had had these rashes and their effect on my mobility in the last spell of my chemo sessions, I was not completely surprised though.

I waited for my cab to arrive and pick me up. The driver did not turn up until 9:45 AM and I expressed my concern over phone for his being late in his expected duty. "Sorry sir! I am on the way", was his cliched answer all along my calls until he arrived. And, finally, when arrived, he offered an explanation:"The driver who was expected for this trip suddenly was out of station and he informed me in the last minute! Thus, this delayed me in reaching you, sir. I am sorry!" Ah! What a convincing one that was! I know of the internal dynamics within these guys, and I had an instinct to offer my mind on some kind of OD intervention to fix their problems. But, I could not do that for free! :)

There was huge traffic on the Palace Grounds road, Vyalikaval, Le Meridian and Basaveshwara Road, a manifestation of a typical scene on roads on a given Monday in Bangalore! The two-wheelers were crisscrossing with a great gusto and guts in the space that they could get in between the awful four-wheelers! Almost every one seemed to lose their sanity on roads with only one objective - reach the destination by hook or crook, by rev up or jump, by kiss the other vehicles or be kissed!

***

I reached the hospital around 11:15 AM and straight away rushed to the counter in the third floor to collect my requisition form for my day's blood test and to pay for it. I ignored the dull eyes of the elevator operator and what they meant for me! I ignored the breaking English words of the guy in the counter who was facing difficulty explaining a apparently learned woman - with a a big bindi on her forehead and heavily blackened eyes - on the procedure to take a mammography test. I just ignored the foul smell of the strong disinfectant spreading in the lobby like a slow monster!

I went down to the Lab in the second floor and straightened my arm with the technician who collected the blood sample from me. After a few failed attempts to locate a good vein on my right arm, he switched to my left arm with a kind of melancholic looks in his face. I did not wonder at this expression of his since I got used to this situation ever since I had started to have the chemotherapy sessions last year! The prick in my left arm was smooth meaning some how that my blood condition was somewhat kind of okay. Which also might mean it might not be okay.

***

With a strap of band-aid and a faint smell of the traces of the alcohol swab on the pricked area, I plodded along towards the stairs that took me back to the lobby area of the third floor. The results of the blood test would take at least two hours and the time of waiting started for me now!

I looked around the area with no specific expectations. The seats were not completely filled and people had started talking over their cell phones or to those sitting beside them. Some hushes and some shouts making an overall picture of a movie theater just before the movie starts. The security guys were seen pleading some standing in the lobby to occupy the chairs instead, and some kind and polished souls obliged, some did not react! There was a gradual increase in the noise with the seats slowly getting filled up and there was a time when no chair was available with the new patients coming in and the security guys facing hard time convincing and managing the noise in the floor! The frequent loitering of doctors did not impact the environment. Every one was in their own world - the world of one of the most deadly diseases, its effects on the lifestyles typically and the heavy expenses which were sometimes totally unexpected!

I opened up the day's edition of THE HINDU and rushed through the interview of Ms. Melinda Gates, Co-chair and co-founder of the Gates Foundation, who was recently in India. With the motto of every life has equal value, the foundation is working hard on the areas of HIV awareness and infant mortality primarily. Charity is for all and can be done by all in various measures. I thought of all my friends who had helped me in the times of distress and I remembered each one of them and my interactions with them since their help was truly priceless! And, I finally thanked Mr.N.Ram, Editor-in-chief, THE HINDU group of publications, who interview Ms.Melinda Gates, and indirectly influenced my mind in thinking of charity and its effects on the well-being of the human psyche.

I took a brief break for a couple of minutes and kept down the paper. My eyes were fixated towards the entrance area of the lobby where there was some hard discussion going on among the floor in-charge, Ms.Prema, security guys for the floor, and the immediate boss to these security guys. Ms.Prema was complaining on the unavailability of the security in the crucial peak times of the patient traffic during the mornings and the guys were becoming defensive - overly sentimental sometimes with their explanation of their need to have their breakfast! Obviously unconvinced with this, others in the group were condescending enough to make the defensiveness of the poor guys to become completely ineffective! After a protracted discussion, it was decided to tackle the issue later! :)

I dabbed again on my own reading, this time with the day's edition of THE HINDU BUSINESS LINE. The paper was one of my favorites because of its whitepaperish perspectives on the topics of business, corporate management, finance, investing and management. The items that caught my attention and set my thinking were: (a) How could the rural areas in our country be connected for broadband: either through the optical cables or through the wireless network? (b) Of all the newspapers available, what made the Rajeev Chandrashekar-owned Jupiter Ventures to invest in the Kannada daily, Kannada Prabha? What decisions were to be made towards this move? (c) Why ethanol-blended petrol was vehemently lobbied against by the petroleum players? (d) What is Carbon tax and what are the modalities for its imposition?

The chain of thoughts on these topics branched off to set other related thoughts on economics and export policy, when I was suddenly brought into the real world, when Sister Lakshmi handed over me the results of the day's blood test. (See the attached trend chart with the WBC sloping down gradually over time!) This time, the WBC count stood at 1.95 which was way below the standard minimum of 2.5 needed for a safe chemo infusion. I was aghast at the result though not completely surprised! We spoke to Dr.Smita over the results and she recommended me taking the infusion for the day reasoning that the main drug Irinotecan was not being infused today, so it would be okay to infuse the other drug, Cetuximab. The former is known to have the effect of reducing the white blood cell count in the body with sometimes deleterious effects, in turn reducing the immunity in the body towards even milder infections!

With a deep sigh and solitary sitting for a while, I proceeded towards the ground floor reception area to complete the admission formalities. After getting the admission into the recliner ward - the ward with a set of eight comfortable sit-backs just to serve for the infusion to the patients comfortably, - I moved to a recliner in one cozy corner so I could veer around the entire ward freely just to satiate my senses of observation! :) There was only a lone woman in her late thirties accompanied probably by her sister, actively engaged in the saas-bahu political issues so loudly as though they wanted to declare to the world that they too were not immune to such kind of family conundrum! The patient lady was getting infused with the chemo drug and often seen just nodding her head for the verbal diarrhea from her attending lady! Both sometimes, for a brief period of time, switch on one of their cell phone spewing the oldies from Kumar Sanu! It was interesting to watch them talking, discussing, listening, all at one time multitasking, while I was zero-tasking all the way! :)

***

After a brief confusion that prevailed on the status and the location of my in-house patient file, the nursing staff prepared the day's prescription of the drugs and other associated instruments, with the help of Dr.Smitha, and promptly set in action the process of getting them from the pharmacy.

Overseeing the labor at work in the adjacent construction through the window beside me, I swallowed down a few morsels of home-packed pongal and washed them down with a warm water from my bottle that I always carry whenever I visit the hospital. The food was just sufficient to keep me warm and satiated at least for a couple of hours.

Brother Harish made his way calmly but in an hurried manner, typical to his style of business. He reciprocated to my smile and in an act of quick business settled down to searching for a vein for infusion, preparing the drug in the syringes, etc. He came, he pricked, he dashed off! What a guy, he was!

The sister and the brother duo on duty took on from there and supervised the process of infusion with diligence. I sometimes would be amazed by the memory of the nursing staff! They could remember even the quantity to the milliliters of the drug to be infused for a specific patient including the time of the infusion! such was their skill that it beats me once in a while prompting me occasionally to think on my own memory! :)

I heard Kumar Sanu singing in a mellowed voice, Teree aankhon sey hum ney dekha hai, ajab see chaahat jhalak rahi hai, over one of the cell phones from the lady patient struggling with her seating in the sit-back. She suddenly stood up, marched towards the weighing machine as though she remembered to check her weight apprehending of the immediate effects of the chemo drug on it! Her attender was joking on her reading and her sudden dawning upon checking her weight. I smiled at their innocence in thoughts. :)

And, the infusion regimen for me started off and ended smoothly with the usual sequence:

NS (Normal Saline) - 15 minutes
Cetuximab (through a calibrated syringe pump @ 80 ml per hour) - around 1 hour
NS (Normal Saline, again for flushing purposes) - 15 minutes

The whole regimen lasted around one-and-half hour and the IV line was removed around 5:45 PM, when my father proceeded towards the billing section to settle the payment process and to get the No Dues certificate without which we would not be discharged from the hospital.

I called up the cab driver to pick us up around 6:45 PM, the request he promptly adhered to.

***

The weather these days was warm and humid with occasional bouts of cool breeze. Sonu Nigam was answering the wonderful Shreya Ghosal, "Aaramage idde naanu, ninna kandu arey yenaithu..." in the background radio. The cab driver was driving cautiously as though he wanted to concentrate more on the music! At a long pause in one of the road signals, I suddenly desired to climb down the cab, stand in the middle of the cross roads stretching my arms feeling as though I was being drenched in the rain. The rain of hope. The rain of new life. The rain of vigor. Life was good. It gave me enough perspectives to decide on what was important and what was not. The present became more interesting with all its hues. And it is raining music in the air. What a moment it was!

***

Chemo-20 today

The clock ticked 3:33 AM and I woke up with a heavy breath, almost with my nose chocked. I still carried the feeling of flying in the air alone that was in a dream - colorful dream - just a few minutes ago. My feet were itching and I resisted the strong urge to touch them! The weather was quite relaxed with coll air coming in from the window in the adjacent room! Was I overwhelmed by the feeling of heat within my body because of the toxicity of the chemo drugs? Was I living with the thought of giving up life in exchange to the life in woods - relaxed, cool and blissful? Was I nurturing the feeling that some one had started suddenly stalking me? I looked at my mom - sleeping with a perfect calmness in her face after a day-long struggle with sometimes meaningless chores. I caressed her arm - it was smooth. As ever.

"Yes, the cab arrived." My dad announced. I got into the cab with an impish feeling that I should have danced at the very moment, as though I was going to attend a wedding of one of my dearest friend! That was not be a wedding, dimwit, it was to be an another physical terrorism act, called chemo! Be prepared for that!

"Should I wait for you at the hospital, or just drop and go?", the cab driver, asked me with an expressionless face, as though the question had come directly from his mind through the center of his eyebrows! I looked at him. He had just kept the vehicle on the run. I chose to have the question dissolved into the cool breeze in the wonderful morning. The query came back to me. "You may just drop and go." My reply was like a counter stream of air to prevent the query boomerang onto me. The driver was silent. Probably, the answer cooled the channel through which he ejected the question at the first instance.

I looked through the window of the cab as it raced past the buzzing streets of the city - the test-takers were flipping the pages of their notes as a last minute attempt to digest all the subject material with either their fathers or brothers riding; the kids plodding along as though there was some heaviness in their minds; the office goers were zipping with arbitrary speeds through the narrow conduits between the bigger vehicles as though they might miss some thing that would decide their life! My mind, at its back, was continuously engaged in compressing whatever the vehicle numbers that it could sense into a single digit. It spawn another thread of computation that would always take out all the possible nines from a given number! Oh, what an algorithm, damn it! Ecstasy! Was it really!

***

The security person was whistling and directing the vehicles to be in line in the shorter parking space available at the hospital. I got down the cab and helped my dad in doing so. I smiled at the cab driver only to get a composed curve in his lips in return. I cared for it! I walked towards the elevator lobby and reached the third floor, where I found my dearer Sister Lakshmi to get a requisition form for the day's blood test. It had been customary process to have my blood tested for at least a complete blood count before a chemo session would start. This would not only give an idea of the state of the blood corpuscles, but also helps in deciding whether the chemo could be infused or not. I helped Sister Lakshmi, in filling out the form with my patient details and I proceeded toward the second floor after a prompt payment at the single-clerk counter.

The guy in the Lab threw his head up backwards with almost a loud laugh! I could not resist asking for the reason and after it came out, I too joined him in a moment of camaraderie. Reason - my sex was mentioned as female in the requisition form! :) Wish, I were really born a female! Hm! A saucy thought in my mind! I came to the senses when the needle was pricked in my forearm to suck in 2 ml of blood required for the day's test. I agonized briefly for the pain the prick had inflicted on me! Of course, this is the beginning of the anatomical terrorism for the day, I thought and came out with a warm sigh oozing out from my head, touching more warmly my chest.

***

I preferred to wait in the elevator lobby of the third floor - waiting for the blood test results to come out. It usually took around two hours for the results to be out and the waiting time was too trivial to just ignore! I pulled out the latest edition of Frontline, the premier magazine from the publishers of The Hindu, and started browsing the pages. The glossy pages and the deep content dragged me in its world instantly as I perused a report on the youth of India on their several sociological preferences.

Suddenly, the noise started trickling in. A coffee guy with two flasks in one of his hand and a pack of large-sized paper cups in another rushed through the little crowd in the lobby into the serving area. There was a sudden commotion in the staff - nursing, housekeeping and paramedical - to follow the smell of the coffee as though they had a famine of it for eons! Groups of staff would load their cups with coffee and settle themselves down in the chairs available. Gossip flowed down through their minds as natural as an accompanying coffee sip!

"Your mother-in-law prepares upma daily in the morning, uh!" (a loud laughter among the female staff followed targeted at the bewildered male counterpart!)

"I do not understand why I am posted here in this ward for next three weeks! I was good in the earlier ward!" (a moaning staffer to her probable mentor and friend. The mentor-friend raised her brows evincing interest!)

"You cannot be married and free at the same time, guru!" (a male staffer sharing his agony through a jocular statement with another male staffer. An element of surprise was evident in the gape of the female staffer who was following him!)

A free zone in the serving area was bursting with people shouting at the top of their voices to be heard on their cell phones. A mix of languages ranging from Kannada to Marathi to Malayalam to Tamizh to Hindi! It was as though a sante of cell calling!

The noise distracted me and avoided me to carry on with my reading activity. I immediately decided to discontinue with it and just posed motionless in my chair. I saw my oncologist, Dr.Niti, hurrying towards the elevator with her usual energy and gusto. I had an instinct to wish her in the morning, but the momentary mingling of our looks did not last long to allow for that. And, she slipped through the elevator. For the day!

***

"Oh! The TC (thrombocyte) count fell down to 2.65!" exclaimed Sister Lakshmi looking at the results of the day's blood test, which were orally conveyed to her by the Lab.

"So, is it OK to have a chemo today, Sister?"

"I think I need to check with Dr.Smita or Dr.Niti. Can you please just wait here for a minute?" She imploded in a plain voice and a wide grin.

A minute was unusually longer for me - in the previous spell, there were instances when I was admitted into the hospital for low thrombocyte counts! My fingers were crossed, so were my legs!

"Yes, doctor says you can have your chemo today. It is perfectly OK with this count. Ma'am is confident that you would tolerate the chemo!" Again a grin in Sister Lakshmi's face! Heavens to be thanked!

We proceeded to the ward and I took up a bed in it without talking much to the nursing staff there. I lied down on the bed. The smell of the disinfectants was so strong that it would kick me out of this world! The heavy curtains that enclose the bed and separate from the others were flapping slowly under the mild movement of the air conditioner. I smiled at the part-steel, part-plastic made rod supporting the curtains as though I was missing my friend for a week!

Ah! A week had passed by since the last chemo! And, how terrible was that by the way! Rashes on the chin and groins; severe ache in the joints of thigh and calves; extreme and unknown pain in the head. A melange of thoughts in my mind - on life, on future, on friends, on family, on career, on colleagues, on books, on music, on crushes, on love, on poetry, on this, on that, on what not! Was it a gift to me from my prescient forefathers? Or, was it a boon for my life from Him? Or, was it a phase in which I was throwing out the scrum out of my life? I loved it. I hated it. I felt it either way.

***

"Did you apply any ointment for the rashes?", asked Dr.Smita, with a casual tone. She was searching my rashes-filled chin as though she wanted to find the solution in the problem itself!

"No." I simply quipped.

"Fine. We shall prescribe Betnovate for you for these rashes. That would work better."

"All right, doctor!"

She left. And, I was left again too with my mind and heart. Alone on the bed. With me looks again fixed on the weird set of three small holes in the false ceiling directly above me.

***

I was woken up by one of the staffer on duty, Sister Vidya. My eyes were paining a bit and I opened them forcibly as though to see an angel before me! Two nursing interns were curiously accompanying their senior on duty. They were just thrown in awe probably thinking on the maze called treatment to a cancerous person! One of them readied his tone to request checking my blood pressure. I obliged me seeing a strange innocence in his face. He did it in a jiffy and left without noise. And a weighing machine summoned me to record a perfect century! There was an element of sarcasm in my own self thinking that the century that was just recorded would simply cut down by at least 30% in the next few weeks because of the imposing cruelty on the body!

I flipped my head only to meet Brother Harish, the ever helpful and affable staffer! And, a talented pricker too! He reached me with a broad smile and with all the paraphernalia of medical tools and instruments.

"So, you started getting rashes, uh!"
"Chemos are like this only. They inflict misery! Pchch!"

He just returned a bright smile as I hoped for a day very soon that would see me out of this misery! And, he immediately stuck to his job - checking for a good vein for a chemo suffusion, pricking the intra-vein (IV) needle in the found vein, infusing the pre-chemo medication, preparing the chemo injections and directing the other supporting staff on what to observe during the infusion. Great job, dude!

The things were then carried in a perfect symphony!

A 100-ml NS (normal saline) for 10 minutes.
Cetuximab, 500 mg for one hour.
Another 100-ml of NS for another 10 minutes.

Yoohoo! Done with the chemo! For the day! For the week!

***

"All this process of payment and clearing is done. I shall ask the cabbie to get and pick us up." My father quipped in the background of a melodious Kannada number that was beaming through the radio into my ears! I smiled at myself. Sister Vidya had just come and removed the IV needle from my hand so as to free my hand to have more degrees of freedom. With the latest attained freedom, I wanted to wish her a happy married life as I had gathered that tomorrow would be her last day as a staffer in the hospital and would be soon starting her new phase of life! However, she disappeared with a whiff of wind and long gone before I could bunch up the congratulatory notes for her!

And I was whistling mildly! With an unknown air of freshness in me!

***

I walked down the reception in the ground floor as though I was victorious in the just concluded battle. The battle against the malignant division of cells. The battle against the concomitant by products of death of the cells. The battle against those phases of mind that would see me in a languid condition. After all, I won the battle. War would be the one which was to be won!

***

Picture on top: A leafless tree on Basaveshwara Road. It looked lifeless too and reminded me of the labyrinth of life.

Picture down: My own portrait before the chemo had started. On bed with my own.

Chemo-19 yesterday - viaje de nuevo!

I had a minor jolt when my cab driver asked me while I was feeling a relatively gush of cold morning breeze through the back seat window: "Which way shall we go: Mathikere or BEL Road?" I looked at him coldly and replied:"One of the either. Whichever way carried less traffic." The driver, Shivu, of Maasti, locally a popular cab service, did not look back as though he had accepted the response coldly too!

Given that my previous experiences with the first spell of chemotherapy sessions were terrible and cruel on my body and mind, I was a little bit weary with the thought that I had to undergo another spell of three cycles of chemotherapy starting from Monday! I know that there was no other option to drive the disease out of my body. However, the very thought of probable reliving of the past experiences shuddered me in my mind and in my body!

I woke up with an agitated mind on Monday morning - agitated because the previous night I could not sleep with a variety of thoughts lingering in my mind! With pangs of helplessness, I lumbered through my way to the bathroom and got made up in a couple of minutes to my journey to another spell of treatment - the journey that might be unfairly demanding on my body, which would then start resisting every treatment step against one of the deadly diseases ever prevalent in this world! I sat
silently with a meditative mind and closed my eyes to feel the thoughts in my own mind. I wanted to consciously view them as they were and acknowledge them as my own ones generated from my mental factory! I wanted to catch the patterns intrinsic to those thoughts and wanted drive away the negative ones so I could fully be prepared for the journey ahead.

I spewed out a regular cliched question to my mother that morning when she offered a hot cup of coffee:"What's up?" My mother simply nodded her head, probably indicative of the state of her mind on my journey to the treatment that day! I did not force her for an answer and after a couple of minutes, I simply retracted my looks and fixed on the wall before me!

Part II

I arrived at the BIO, exactly at 9:50 AM, with my cab driver pulling up a smooth stop at the entrance of the hospital amid the prevailing chaos of the traffic on the main road. I hinted to the driver that it would well late in the evening for my pick up and I would call him an hour before to arrive. He was looking coldly with his head still fixed through the front mirror! I climbed down the cab and directly went to the elevator area in the ground floor in the main building of the hospital.

While I relegated to the farthest area inside the elevator and was lost in my own thoughts with a still agitated mind, we had met Dr.Smita, the assistant to my medical oncologist, Dr.Niti, in the first floor. She joined us in the elevator and she was mysteriously brief in her conversation with only one question for me: "Getting admitted today?" Still pondering over her enigmatic show, I just answered in affirmative.

We reached the third floor of the building and immediately dived into the regular admission process. We collected a requisition form for the blood test from Sister Lakshmi, one of the helpful staff available in the floor. I was surprised that she could still remember my name even after a three-month gap separated us since our last meeting in the first spell of the chemotherapy sessions late in November last. I paid the requisite fees for the blood test at the counter and descended myself to the second floor to present my blood sample to the Triesta Lab.

I was grumpy when I could not find the Lab person in the sample collection area. After waiting for a while, I peeped through the service counter window of the Lab, and had to shout at a lady, "Excuse me, ma'am!" The lady responded with a rather unusual warm smile and inquired me of my requirement and dispatched immediately a person to be present at my service. The guy looked a regular with no special airs and scribbled my name and patient number on a small and long white scrip on the collection tubes. I was looking for any specific expressions on his face and when I failed to see at least one, then made an attempt to identify his name by fixing my eyes on his identity card. He was moving so fast that his card did not lend itself for open and clear view! I came to my usual senses when he asked me to stretch my right hand to find a vein on it. After a couple of minutes of search in vain, he asked for my left hand! I was forced to make a comment on my veins,"A series of chemo sessions downed my veins!" The guy smiled for the first time faintly and did not look at me. He kept his eyes fixed in my left arm, pressing his finger in specific areas near open elbow gently. He offered another smile as though the vein connected with his finger aroused by his gentle touch! I countered his smile with a characteristic one of my own until he pierced the needle into my vein and sucked the blood out of it! Oh, what a cruelty on the cutie!

I thanked the guy who now looked more relaxed. I returned to the third floor and dumped myself on a corner seat of the reception area. I could not do more than waiting for the results of the blood test. The results, especially the TC (thrombocyte) count, decides whether I can take the chemo drugs for the day or not! The lines of chairs in the reception area were almost empty with my father diverting his attention to the plasma LED TV fixed to the wall before that beamed Animal Planet. I made my eyes wandered around the room and suddenly I threw my head up and had a deep sigh. I gulped down a few drops of water from the bottle I usually carry and thought carpe dieme! I dragged out Lance Armstrong's Every Second Counts from the blue bag that I had brought along with me. Without paying a heck of attention to my surroundings, I was totally immersed in the pages of the book as though I had been hungry for long for the words and feelings!

Part III

I was living in another world with Armstrong until around 11 AM, I involuntarily looked up as though my wait was over for someone! And, I looked my oncologist, Dr.Niti, passing through the reception area towards her consultation room. The room's door had a name plate in brown embossed with her name Dr.Niti Raizada Narang, DNB, Consultant Medical Oncologist. The name sounded, for the first time, familiar to me! The very mention of it drew back all my experiences in my encounters with her during my first spell of chemotherapy. I had faced vagaries of the chemo drugs with chemical burns in my body looking as though they were tattoos designed by the Nature, loss of hair from all sides of my head, loss of appetite, sores over my lips and groins and rashes and cracks on my legs in entirety! Of course, I came all through that with the support of my doctor. I got the 100% hell out of her experience and knowledge! That was the beauty!

I was still waiting for the results of the blood test to pour in and in an attempt of pure trial, my father asked Sister Lakshmi whether she could get us the oral report of the test from Lab. She happily obliged and we got the oral report, conveyed over the telephone: TC 4.25! Yoohoo! Time for a chemo suffusion! :)

It was my usual practice of talking to my doctor before I take the chemo drug into my blood. That day was no exception. I and my father entered her room which was around 12"x6" area with an examination table laid on one side with a consultation table and chairs in the middle and a long book rack holding an impressive list of books! The one that caught my immediate attention as I occupied my seat opposite to my doctor's was Principles and Practice of Oncology, though I could not quite dissect the author of the book! I wish I knew the author so I could add the book in my wish list! :)

My doctor was perusing my file and broke the ice: "So, Mohan! How are you feeling?"
I looked straight in her face and with a curl in my lips answered plainly: "Doing good, doctor!"
"That's good!"
The pause that immediately set in was eerie in the room where even a rattle of a hair strand would produce enough noise that would make us feel we still stay in the room devouring the silence!

"So, I read your blogs, and all the other things that you have been doing on the Net!" She commented suddenly without raising her eyes towards me! That was a surprise for me since a doctor and a medical oncologist, who was one of the busiest professionals among the fraternity, could invest some time in reading a patient's blog! Unbelievable! I was impressed with her interest in her patients and specifically in my case. I was bowled over! The feeling lived so long enough in me that I had to control the intensity with brute force!

"So, as you see, Mohan, we shall continue the same protocol as we had last time, since it was effective in your case."

"All right, doctor."

"I guess you have gained a little weight these days!" She smiled. Unusually though. I offered to check my weight and when the needle stopped, Sister announced it was 98 kilos! I gained 6 kilos in the span of three months! Good or bad thing, uh?

"Good that you have gained weight! But, there is a bad news! We need to give a higher dose because of your higher body mass!" Again a mystic smile!

I settled calmly in the chair again lost in my thoughts! My doctor approached me and wanted to examine for a few nodes in my body. She pressed at specific points below my neck and put her stethoscope at work on my back. She then later asked me to lie down on the table and pressed on my abdomen inquiring cautiously whether I had any pain in my abdomen/pelvic area. She seemed relieved when replied in the negative.

"I can suggest you another drug instead of the regular Xeloda, but that would be cruel on your liver with all the deleterious side effects. Though I am confident that your body might tolerate that, I would however wait for the CEA test to confirm the level of antigens in your body. If the CEA levels are below 20, then you take Xeloda. Otherwise, the alternative! Done?"

"Yes, doctor!"

She immediately scribbled on the file that the CEA test to be done as an emergency and suggested me getting admitted for the chemo session. "Great! Thank you, ma'am!" The words came from me as a routine farewell from her when I exited from the room towards the reception in the ground floor to complete the admission formalities.

Part IV

I got the admission in the male general ward since the usual recliner admission was not possible with all of them fully occupied. There was no other option for us left with the time already clocking 12:45 PM and we had to expedite the process of chemo infusion to be discharged on the same day!

As I entered the ward and proceeded toward my bed, the strong smell of disinfectants and the crumpling of the plastic sheet on the bed made me recall that typical hospital environ! I smiled as though I came the cozy world of my friend back! And, I slipped my head in dejection when the staff announced that I should be back in waiting mode for the CEA test results to arrive!

I was awakened by the loud banter at the staff counter of the ward when I heard a rather boisterous voice of a staffer boasting about the availability of pani poori and bhel puri in any area of Karnataka state with ease. His argument: it wouldn't be so easy to get them say, in Kerala! Ah, silly mind and inane tongue! The Keralite staffers were heard agreeing with him with all possible meanness probably for some unknown fear of disagreement and a collective ridicule! What made the guy fanatic! I wondered and decided to throw myself back in a nap until someone woke me up!

Part V

Brother Harish was lean with a small and well-featured face. He had been an excellent nursing staffer all through my previous chemo sessions as he handled every thing for me - from setting up an IV (intra venal) line to preparing the chemo drugs for infusion to setting up the infusion pump. He even inquires my general state at the time of discharge and was very helpful and patient in answering my questions, sometimes as silly as "Can I have water now?"!

Brother came to me with the CEA result showing up 15-point something (that was less than 17-point something during the Cyberknife treatment last month; the lower the CEA, the better for me!) and he announced that chemo would be started soon. He set up an IV line for me in my right arm and prepared as usual the chemo drugs in their allotted syringes as though a robot was working on a programmed set of actions. His voice would not be audible unless one focused on his lips to hear the words!

Alas! The chemo session was started around 4:15 PM with the drugs getting suffused in my blood! I was feeling jinxed and somehow forced to sleep for a while. The sequence of the chemo infusion:

NS, Cetuximab (400 mg), Irinotecan in NS, NS (flush)

By the time, I looked at the last drop of the NS dripping into my blood, it was quite past 9 PM!

Part VI

I called up Shivu, the cab driver to pick us up as soon as possible since I was not ready to stay in the bed any more! I wanted to jump out of it and run and dance on the floors of the very reception area where I had to wait for around two hours in the morning. I wanted to dash off a hot sip of coffee into my drying throat. I wanted to watch the IPL Cricket pat with vengeance! I wanted to say to the nursing staffer on late night duty: "You know what! I want to will and whip this disease away from my body soon! I don't want to come visiting your hospital again!"

Yes. All that can wait. Not for long. I thought finally when my father arrived announcing that insurance amount was approved for only Rs.40,000/- and we would get to see home that day only when we pay the remaining amount of around Rs.54,000/- in cash! What a sick procedure, I thought! Why can't the guys at the insurance act fast? Just fast enough to meet my needs! All right! I told my dad to swipe the debit card for me for Rs.50,000/- (my daily withdrawal limit) and asked him whether he could adjust the remaining in cash. He went down and did exactly as I wanted and returned with the mandatory no-dues form to submit the staffing counter. Lo! We were going to get to see home! Yo-yo!

Part VII

I remembered again the gushing cool breeze in the morning on the way back home in my cab. The back seat was like an emperor's throne to me as I hummed song after song after song in mild yet self-audible voice! There was no radio, to my unpleasant surprise, in the cab! And when the vehicle dragged on to the Chalukya Hotel road, my voice stopped quivering and set on to the higher realms. I started playing self-antakshari:

"Thukraao hum sey pyaar karo, main nashe mein hun; chaho jo mere yaar karo, main nashe mein hun."

"Hui shaam unkaa khayaal aa gayaa, wohi zindagi kaa sawaal aa gayaa!"

"Yaad aa rahi hai, teri yaad aa rahi hai; yaad aney sey, din jaane sey, jaan jaa rahi hai"

"Hum tumhe chahte hai aise, marney walaa koi, zindagi chahtaa ho jaise!"

I almost reached home, but not until I suddenly heard "Aapki aankhon mein kuch mehek huey se raaz hai, aap sey bhi khoobsoorat aap ke andaaz hai!" popping up in my mind.

I paused for a moment and a weird smile slipped through my slips. What an evening and what a day! I was to fight it for the strain and the inevitable. And, I fought it! With vengeance! Another day, another moment! Carpe diem!

Cyberknife-2 completed

Today, I have had the final dose of my radiation to the periportal lymph node (the lymph node near liver) that carried a tumor. It was a hectic three-day dose starting last Monday. Phew, what a cruelty on my body! :( Of course, the strategy of taking Cyberknife (with the concomitant chemotherapy that would most likely start next Monday) is the best one in the sense that the tumors are attacked in the best possible way!

Now that the Cyberknife is over, I have to gear up now for another slew of cycles of chemotherapy! Though radiation does not effect in sever side-effects, I am wary and anxious to have the chemo drugs in my body because of the terrible side-effects that it would result :( I would never forget the chemical burns and tattoo-like marks left over on my thighs and legs resulting from the previous spell of chemotherapy. Nevertheless, the treatment plan is given and there is no option for me to fight that way against the disease! :)

Planning CT scan for Cyberknife-2

Yesterday, I had a planning CT scan wherein I was given an intra-venal (IV) contrast and exposed to the CT scanning radiation. This scan would be used for the Cyberknife planning and is similar to the earlier planning scan I had for my first Cyberknife.

My doctor, Dr.Kumaraswamy, told me that radiation might start once the scanned images were integrated with the Cyberknife system. I guess the actual sessions might start next Monday.

Meanwhile, out of concern for the delay in my planned concomitant chemotherapy sessions, I had called up my medical oncologist, Dr.Niti today morning. She suggested me taking the chemotherapy sessions after completing the Cyberknife. Thus, I plan to meet her in the mid of next week post-Cyberknife.

Lots of anxious days lay ahead for me! :) Hope everything goes fine and I will come out cleaner and free out of the disease this time, post-Cyberknife and post-chemotherapy! :)

My own blog avatars

Please see this special post in my other blog where I give the list of all my blogs that I maintain in this web! I enjoy having avatars! :)

Gold and golder!

As a first step towards having another Cyberknife treatment, yesterday, I have had another golden metallic marker (called fiducial) implanted in my periportal lymph node near the liver. I already have five other gold markers in my liver as part of my first Cyberknife last December. As noted earlier too in one of my blog posts, the fiducial implantation is a minor surgical process under local anesthesia. Compared to my previous implantation experience, yesterday was a better one in that I had less breathlessness and discomfort. Of course, I had one of the best suites for resting post-fiducial implantation :) The gold marker now would help the robotic system of Cyberknife to accurately locate the tumor in the lymph node while treating it. The next step towards the Cyberknife treatment would be a planning scan to be done some time next week. Meanwhile, I was advised to be on a couple of antibiotics (both oral and IV). The disease, among other surprises, gave me another one: I have become golder now with one more gold piece inside my body! :) I hope this marker would mark a new beginning in my life towards making it a disease-free one!

Another scan and further treatment. Gold again!

Yesterday, I had another PET/CT scan, the first one after the Cyberknife surgery, but the eighth one overall ever since I was diagnosed with cancer! And, today, I met my team of doctors - Dr.Ajai Kumar (Radiation Oncologist and Cyberknife Specialist), Dr.Niti R. Narang (Medical Oncologist) and Dr.Kumaraswamy (Radiation Oncologist) - with the scan report and the CEA test results (this time CEA value increased to 17.4 when compared to the earlier value of 7.2!)

The scan report is a mixed bag of both good and bad news for me; the good news is that the Cyberknife radiosurgery technique on my liver that I had last December has been very effective and my liver is fine now :); the bad news is that there is a bit metastasis of the disease, which means that the disease has gone further up a bit in the body with its presence in the form of a small nodule in the mediastinal lymphnode - this lymph node lies between the lungs in the chest. Already there has been another nodule in the lymph node near the liver and this was not considered for the Cyberknife treatment last time since it was too significant to treat. Now, this nodule has increased in size a bit. So, there are primarily two nodules to treat, both in the lymph system - one, near the liver and the another between the lungs.

Thus, my team of doctors, after thorough discussions, have decided to take a strategy of a combination of chemotherapy with another dose of Cyberknife radiation. The advantages of this strategy is that the radiation will treat the nodule near the liver completely and the chemotherapy will take care of the other nodule, or any other one in the body! I am convinced with their plan and hence decided to go ahead with it. Consequently, as a first step to radiosurgery, there will be another fiducial implantation in the form of a gold seed marker in the lymph node near the liver. This process will be done tomorrow as part of the usual process for the Cyberknife radiation. And, the chemotherapy will start in parallel this week too with the body exposed to the maximum effectiveness of the treatment.

I hope with this aggressive strategy of a parallel combination of radiation and chemotherapy will produce excellent results and work wonders for me. :) Keep watching this space for more updates :)

Small line of silver in the cloud of life

I had been closeted for more than 50 minutes and when I finally wanted to hit the Exit button on the screen and informed the Coordinator, who was sitting in her small cabin next to mine, I was forced to see a wry expression in her face and was told to revise all my answers in the test since I had around 40 more minutes to complete the test. I did not relent and badly wanted to exit the test. I insisted and persisted. She gave another dry look at me and grudgingly allowed me to exit the test screen. Boom! My eyes widened and my face lightened up by the horizontal rectangular bar in the test results page: it showed that I had passed the test with 89% way above the required 59% for a pass in the test! Wow! I am a proud owner of my first IBM certification. I am an IBM Certified Database Associate now! The words of congratulations naturally flowed from the Coordinator's voice, as though she could not believe the test results!

Often, among the distressing events in life, there might be some interesting asides in the form of broken lines of silver in the cloud of otherwise traumatic life. And, last Thursday, I had my first such line of silver as I had passed my first IBM Certification test for IBM's database DB2. I had planned to take the test almost three weeks back and the journey since had been an interesting one with my planning, collecting the resources for the test, studying, practicing, thinking, revising for the test giving my best and living in the present most of the times!

It had been sometimes tough for me given that my body does not often cooperate with me! I had to often study the material lying down on my bed since my back would not permit me to sit straight! And, often, my eyes would slow down and stand still with moisture in them filled to the brim! I had decided to test my own limits both physically and psychologically by planning for this test. And, finally, all my efforts paid off! When I saw a kind of strange and proud glow in the eyes of my parents and an ecstatic stream of words from my sisters and friends, I felt I did something at least for myself. After all, an achievement in these times of distress and trauma in life, at least makes me feel that I have a life! And, after all, this one silver line lightened up my little own world! :)

Reconnecting the relationship dots

Often, we tend to slide besides our self-created shield beyond which we think there can be no value and within which lies our entire world! And, in this psychological process "readjusting" ourselves, we fall prey to the proclivities of escaping from the relationships that lie both within and out of our shield. We suddenly realize the significance of these relationships when often we are out of it! Reconnecting to these dots of quarantined relationships will give us a new power of engaging ourselves with the higher levels of bliss and joy, coupled with new experiences associated with the freshness of feeling!

It has been a good 15 years and 10 years now since I jumped out of the network of my graduation and post-graduation friends respectively! Phew, that has been a real long time indeed! And the interesting part of my disease-ridden phase of my life is to regain those lost connections of those fun-loving hearts!

First, I shook up the network of the hearts that connected a few with whom my own self was hovering around for quite some time. Then I would email those friends, or leave a message to them on either Facebook, Orkut or LinkedIn, or dig into my address book to get the personal numbers to call them. Then, I would invite them to my home in Bangalore or propose to meet them in a location of my convenience, for which most of them kindly accepted. And, I cannot describe the happiness when I see them personally before me! It is just a bliss and any ode to my feelings would not be sufficient enough to offer tributes to them! :) I am still reeling in this bliss of having these dots in my visual space. I now find a kind of indescribable joy in reconnecting the old friendships and filling them with new aura of freshness! After all, the older the connection, the sweeter would be the reconnection!

Droplet on a lotus!

I am somehow left with a feeling of happiness when I saw several posters in the Bangalore Institute of Oncology (BIO) congratulating Dr.Kodaganur S. Gopinath on winning the prestigious Padma Shri award for the year 2010. (He is one of the 81 persons conferred with the award, which is to be presented in New Delhi by the President of India in March. See the complete list of awardees here.) The award usually is given to a person who has offered/offers distinguished service in his chosen field. Dr.Gopinath surely deserves the award not only for his service in his medical profession, but also for the fact that he is more humane in dealing with his patients.

I am fortunate that I had been operated by Dr.Gopinath for my diversionary colostomy in June 2009. Not only he was reassuring me on my health, but also was extremely sensitive to my painful position at the time. He was more caring that I had seen any one else and was constantly driving me to have positive hope towards life and living. Congratulations Doctor on winning the award and I am happy for you! You have won the Padma Shri and I am just one of the droplets on the Lotus who touch you and get a feeling of healing touch! I wish God give you many more years of lively service and many more droplets be fortunate enough to have your warmth and touch.

Today, I met the team of my doctors at the Bangalore Institute of Oncology (BIO) with the CEA test result. The latest test showed a value of 7.23 - which is a marginal decrease from its previous value of 7.64. This is a marginally good news! :) The doctors suggested me continuing the chemotherapy tablets orally until the next PET/CT scan in Feb last week, when more information on the disease inside the body will be available from the scan results.