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!