A Room With a View

Location: BMT Room, Hospital, Pune My room window offers me a generous view of verdant side of the hospital. It seems that the trees have gathered near the hospital with a purpose - the purpose to bring a feeling of immense tranquility and joy to an ailing patient who looks through the window. Today the trees were swaying as a danseuse would. It was as if they were appeasing Rain Gods for showers to slake their thirst.

If you stretch yourself a little and look at the ground level you will see a swimming pool wrapped in its blueness with swimmers causing random twirls in it. On its edges are narrow streets into various residential areas in vicinity. With the swimming pool, the swimmers, the twirls and the vehicles moving alongside the streets the view looks like a screen straight out of a computer game. My room itself is very quiet, a stark contrast to my semi-private ward. It is sealed from all the side. There is a vent through which purified air is fed into the room. The visitors to my room, including relatives, doctors, nurses and janitors have to clad themselves in sterilized clothes and then before entering my room they have to wear an additional layer of surgeon's gown, cap and a mask. As long as they are in my room they need to remain masked and capped. So attiring is a tiring affair for my visitors. :) Masked faces bother me more than anything else. They hide your expressions. They hide the smiles I am used to seeing. Probably that is one reason we feel nervous when a surgeon steps in with his or her face masked. That mask might be hiding a beaming face that would alleviate your anxiety. Why can't they make transparent masks? I am under constant observation through a window that opens towards the nursing station. Food and beverages have to pass through a steam cooker. Steamed delicacies are passed to my room via a compartment which has a two-way door. Visitors cannot have food with me or use my bathroom.

Today at the stroke of midnight first part of chemotherapy will end. I would have consumed 270 tablets (90 tablets each day) by then. On Wednesday they will put me on the other chemotherapy medicine. It will be only a single dose given intravenously. On Thursday my body will get a daylong break from medicines. Finally on Friday the stem cells will come back to my body after vacationing in blood bank.

Speaking of vacationing so far the known side-effect of nausea and vomitting have also been vacationing. I am feeling absolutely fine as I write this. Thanks for all the prayers and good wishes you all are sending me. Believe me they are playing a big part in keeping me cheerful and hopeful.

No Negatives for This Photo

Location: Home, Pune

That's me, a day before getting admitted to the hospital. As evident the blues never went beyond my shirt. The local theatrical group isn't short of one mustache. That is all mine :).

What's In My Backpack?

Location: BMT Room, Hospital, Pune As I promised earlier I am here with my backpack. If you rummage it here is what you will find:

• Books - of various kinds and sizes. Here is a sampler: Three Men In a Boat (Jerome K. Jerome), To the Ends of the Earth (Paul Theroux), Outliers (Malcolm Gladwell) and POJOs in Action (Chris Richardson).
• iPod Nano stacked with devotional and film songs. Unfortunately I couldn't upload any podcasts in it.
• Laptop with a network card - an absolute lifesaver. Thanks to my wonderful company which made this possible.
• A sketch book - though plans of what I will doodle are still, well, sketchy.
• A Webcam - the third visitor who is duly welcomed to my isolated room. No disinfecting required.
• A notepad - sometimes the slowness of writing with a pen is more blissful than a computer keyboard.

Well, then you would wonder, why is my backpack so heavy and full? It's because it's filled with:

• Tons of memory:
• Maa beside our little mandir perpetually praying for me.
• Smell of the agarbatti after morning's puja.
• Smell of my home.
• View of trees from my bedroom window.
• Mahy running all around the house, imploring Surbhi and me to join as well.
• Our visitor cat coming for her daily dose of milk, brushing herself across any surface she comes close to as she makes her way to the kitchen.
• Pictures of canopy of mayflowers outside my office and those wonderful arches of trees on Range Hills Road and Prabhat Road.
• Sandeep's antics at the office.
• Discussions on just about any topic at the office with my wonderful colleagues.
• Countless blessings and good wishes of my family and friends.
• Kilos of optimism.
• Liters of humor.
• Yards of faith in doctors.
• Heaps of courage.

I wish my backpack was a little bigger. There was so much that I wanted to carry.

B-M-T and Be Full

Location: Home, Pune I am just 14 hours away from starting my final procedure. The battleground - Bone Marrow Transplant (BMT) room, the enemy - the languishing and dwindling army of leukemic cells, the soldiers - fleet of great doctors armed with the most potent chemotherapy and the commander-in-chief - me, armored with all my fortitude and optimism. BMT is not just an empty acronym. For me it is pithy. It tells me, "Be Empty. Be empty of all negative thoughts. Be full of hope." And that is what I will keep in mind when I enter the room , the room where I would spend around a month of time. The isolation will bear fruits - my bone marrow will reincarnate in its original unblemished form. It will be tough to stay physically away from the family and friends. BMT room rules allow only two visitors in a day with no changes allowed. Papa and Surbhi will be giving me company turn-by-turn. Being a month away from Maa, Devangi and chirpy Mahy will be tough. However, I keep telling myself that month will whiz past me before I know. There are lot of things I am carrying with me to make me feel cheerful. More on that in my next post.

Golden Harvest Production

Location: Blood bank, Hospital, Pune

It had been only a few minutes since the contraption had started a dialogue with my body through an assemblage of tubes, when Surbhi excitedly pointed to the TV which had just started showing a new movie. By sheer coincidence, and quite sensationally, it announced that movie was a "Golden Harvest Production". That was how we wished the harvesting would turn out to be and that is what the clairvoyant TV announced.

In these two days 30 litres of blood was processed, out of which 570 ml of WBC goodness was extracted. On the first day 68% of the extracted WBCs were stem cells, which is a respectable count. Day two stem cells percentage is still not known. Be that as it may doctors are very happy with the results.

Next week I will be making a trip to hospital to get my central line installed again. I will get admitted for transplant on Saturday. So stay tuned.

Off for Harvesting!

My treatment will gain further momentum starting today. I will get admitted tonight. Tomorrow they will put a catheter in my groin area to extract the stem cells. They do this because the vein in that region is wide enough to handle the suction from the machine. The procedure of extracting and storing stem cells will take a good 5 to 6 hours of time. They will repeat extraction on Saturday.

My WBCs have soared from 4300 to 25K in just 2 days flat! Harvesting will only commence if the count exceeds 50K.

For most of the time tomorrow I will be horizontal on the bed and might not be able to use my laptop. I will be back on Sunday to share the details of my harvesting.

Until then it is goodbye from me. Please don't worry even a bit. I am keeping in good spirits.

Magnificent Shaven!

Recently one of my uncles gave me the best compliment for my hairless face. He said it resembles that of Yul Brynner - the "Magnificent Seven" fame. I am flattered and cannot ask for more. :)

Stoking, Stocking Stem Cells

Location: BMT Room, Hospital, Pune

The magic potion is meandering through my veins - two vials worth of magic potion so far. Its destination - my bone marrow - the breeding ground of stem cells. Once it reaches there in Merlinesque style it would perform incantations, incantations that would mesmerize the stem cells. They would throng in multitude. And while they are still in the spell of the sorcerer they would realize that they are in the midst of their replicas - everywhere that their eyes could stretch. The incantations would continue ceaselessly for next three days. Eventually, the sorcerer would do a disappearing act but the replicas would thrive. On fifth day the dwellers of bone marrow will meekly surrender to a strong suction force . The old dwellers and the new dwellers alike will make an uncontrolled march through the vein. Before they can realize what's happening they would be hurled from a slit in the vein into a reservoir- an inorganic bag. Before they gasp and die they would be frozen under -90 C. They will be in trance for some time. Sixth day will see this exodus recur. They will be homeward bound, soon, but they have to be patient. Another magician now dwells at their home. His agenda is not the same as previous one. I am feeling like Don Quixote today and I refuse to accept the reality that all that was done today was 2 vials of Neupogen was injected to induce my stem cell growth. Believe it or not there is a theater inside my body and every moment is like an act from a play. :)

Tiring Day at Hospital

Location: OPD at Hospital, Pune

It was one of those days where you spend countless hours for work which could have been done within an hour.

The counselling session did happen. Most of the things doctor told us were already covered in our last session. However, the protocol has changed slightly. Apparently this protocol is the one which haemotologists prefer now for patients receiving autologous transplant. At the end of session we were told to get few more blood-related tests done along with X-ray and 2D Echo Doppler test for my heart. Unfortunately we had to make two trips to the hospital to get everything done today (and driving through Pune traffic in peak hours is no heartwarming experience).

For the 2D Echo Doppler the waiting time was 1.5 hours and actual procedure took less than half a minute. While we waited we noticed that we were surrounded by a sea of medical representatives. They were hard to miss with their formal attires and traditional leather bags that possibly carried samples of various pharmaceutical companies for which they must have rehearsed their spiel. They outnumbered the number of patients who were waiting. It almost seemed like they were having some kind of birds of feather conference.

My cardiologist concluded that my heart, only the physical one, is good. On that good note we ended our tiring day at the hospital.

Next few days will be uneventful, thankfully. On Monday the injections to induce the growth of my good blood cells will start. So I will have more updates on my treatment then.

Treatment Delayed By Few Days

Location: Hospital's Daycare Room, Pune

I had to make a trip to the hospital today to get my central line (which surprisingly is not in the center of my body but on my left arm) dressed again. Central line is a catheter that relieves me of all the pricks to draw blood or to inject intravenous medicines. The only downside of central line is that it can be easily blocked if blood clots inside it. To prevent clotting an anti-coagulant is injected inside it. I make a trip every week to get the central line region cleaned and anti-coagulant reinjected. A colleague of mine tells me that with the bandaged arm I look like a batsman all set to enter the field with a protective elbow guard.

I met my doctor in the daycare. He announced that my biospy report was good. What it means is that my bone marrow has undergone remission - no bad cells in the vicinity. The report came few days later than expected. Consequently, my treatment will be delayed by a few days.

Tomorrow I will be visiting my doctor again. He wants to have one more counselling session with me before the treatment starts. Will it be a counselling session or a "cancelling" session where he would euphorically announce that I don't need a transplant? The escapist in me never seems to give up!

In-clay-dible!

In-clay-dible Originally uploaded by kartiksurbhi

Three aclaymed artists in the family, Mahy (2 year old prodigy) and her uncle and aunt (Kartik and Surbhi), united to carve out some of the finest clulptures that had the admirers in rapture. A motley of artwork consisted of rolling pin with its base, a plate, a glass, a bucket, a spoon, a car seat, a soup bowl, a rickety table, a boat, few coins and a couple of dahlias.

The exhibits have caused a stir in the arts fraternity who have been befuddled by the sheer lack of coherence in the exhibit. Why did the artists chose such diverse exhibits? What message are they trying to impart? Is the message of hope or of despair? Is it mirthful or melancholic? Luminaries of art world are gathering to find an answer to this conundrum.

Readers are welcome to hazard a guess and contribute their interpretations. Should your answer bring an end to the eternal quest the sculptors have embarked on, you will be idolized (no pun intended).

Drill Diya Dard Liya

Location: Hospital's Post-operative Recovery Room, Pune

My apologies to all my English-speaking friends who might not have understood the pun in my blog caption today. However, my experience in the recovery room could be aptly described by this Bollywood movie title, after brushing it up a little with a stroke of pun.

I got what the doctors promised me. The moment the anesthetic drug was injected into my vein within seconds I started feeling drowsy. When I woke up both anesthetist and doctor had packed their paraphernalia and gone away. I had woken up after a good hour of sleep. Had it not been for the slight pain in the pelvic area, I would have felt I only came to the hospital for grabbing forty winks. After I woke up I was allowed to take water after two hours and then an hour later I was given a sumptuous treat of cardamon-flavoured tea and Parle G.

While I was still drowsy my doctor visited me and talked something about a new protocol that he had come across for my chemotherapy. Protocol as I have understood is the medicine plus its dosage to be given to a patient. How is this new protocol going to be different? Will it have lesser side-effects? Will my hair grow instead of falling? :) We are still to talk with him and educate ourselves about this new protocol.

The good news is that the rest of the week is event-less, so I can spend uninterrupted time at work and at home. Next week will see me going to hospital to get injections to induce the growth of my blood cells - hopefully only the good ones :).

So that is all from my side for now. Talk to you all really soon.

P.S.: I didn't know that "Dil Diya Dard Liya" was based on Emily Bronte's "Wuthering Heights".

Bone Marrow Biopsy Tomorrow

Location: Home, Pune

It's that time in India when various education boards are declaring results of exams for the 10th and 12th standards (grades). My bone marrow's scorecard is also long overdue. My last examination was done 3 chemotherapy cycles back. Since then my bone marrow has weathered onslaught of strong chemicals. It has shrivelled and then miraculously rejuvenated. What state is my bone marrow in now? Does leukemia still have its bastion there or seeing the hostile environment it was under, it has decided to call it quits?

I am not sure if my bone marrow scorecard is going to alter the course of my treatment in any way. Even if my bone marrow is squeaking clean of leukemia my doctor assures me I am a high risk case and remission shouldn't be mistaken as permanent cure. I think the purpose of this biopsy is just comparing the state of my bone marrow with the previous biopsy and to donate my sample for some ongoing academic studies.

On previous four occasions the biopsy was done under local anesthesia. Even though the suction causes sharp pain, the suction is usually performed only once and it's over within few seconds. This time though the doctors require around 30ml of my bone marrow, which might require more than one suctions. I was given an option to continue the biopsy with local anesthesia or to go the general anesthesia way. I decided to give my body a little relief and opted for the latter.

Everyone assures me I wouldn't know a thing when the biopsy is performed. I will be a little nauseous after I wake up - that's all. Is it really that smooth? You will get a first hand account from yours truly tomorrow. :)