Pep Talk

I just finished having a pep talk with my body. Picture a mother scolding her naughty kid who refuses to finish the homework. I told myself, "Guys we haven't budged from 700 since last 10 days and you still have more than double work still undone. We have to get it done lest you want to face the consequences in your immunity test. So move! Let's aim at celebrating Raksha Bandhan in the tranquil atmosphere of home with you having done your assignment. What's making it so difficult for you to tread forward especially when I know that we are keeping really well? Is it pure lethargy? Share your troubles with me. Talk to me. Give me a signal. All the other readings on your score card are showing variations. In "hemoglobin" and "platelets" subjects you have showed variations - sometimes on the bad side and sometimes on good, but you have shown changes. Then why have you languished in the "immunity" subject? Please get this ingrained in mind that knowing and excelling "immunity" subject is of paramount importance. It is something we will use everyday. So better hone up your skills. You are my son and I love you regardless of your score card with abysmal score. I will be patient but my patience should be manure for your growth and should not be taken as indifference. I will have such talks with you whenever I feel you are slackening. It goes without saying that I will always love you."

Wouldn't It Be Loverly?

My most recent bone marrow biopsy spurred that part of my brain which has an existence in the lala land, a land where reality is thousands of miles away and you have the license to build up anything you like however crazy or repulsive the dwellers of Rationalpolis may find it. Let me take you through an alley of my thoughts in lala land. This particular street's name is Chemo Street. Here is some graffiti that I found written on walls out there. The first one is terse - "Wouldn't It Be Loverly?". As we stride along you see more wordy graffitis and I share those with you.

Wouldn't it be loverly if:

• Chemo drugs came in form of drinkable liquid and if they are indistinguishable from your other beverages? Wouldn't it be nice if you had a choice of Cocoa-cola, Strawberry and Tropical fruits flavors? All you need to do is empty the bottle and then wonder why the dose prescribed just one bottle?
• After consuming chemo drugs you start showing side-effects which are more interesting? For instance the patient, hitherto a novice in mathematics, fluently speaks out the first 20,000 prime numbers and can solve even the most arcane of theorems, enough to make the mathematicians' jaws drop? Or perhaps the patient who couldn't even catch a ball 9 times out of 10 suddenly juggles all the 10 balls nimbly. Or maybe the patient starts somersaulting deftly over the saline stand, much to the dismay of the nurse. Maybe instead of vomiting the patient croons when side-effects are at their peak.
• The dearth of a particular kind of blood cell in you can be replenished by an off-the-shelf candy-flavored pellets? The coloring of pellets would be self-explanatory - red for RBCs, yellow for platelets and white for WBCs. And what's more, again, just like chemo drugs they come in your favorite flavors. Just pop them in your mouth, chew and in an hour your hematologist would look at your normal blood report with sheer disbelief.
• If bad cells could be wiped off using your favorite word processor? Simply enter the pattern that identifies the bad cells in the Find box, select all locations using the ever-convenient mouse and press the cathartic Del button.
• If we had an built-in junk cell filter like the one we have in our email boxes? The moment a bad cell (spam) comes into mainstream (Inbox) junk cell filter catches it and removes it before it gets naughtier.
• If transplanted cells could be labelled? That way hematologist will never lose track of cells with tag "Kartik" on baggage carousel.

Suddenly the writings on the walls on Chemo Street become indecipherable. Maybe something more will come up when you and I visit the wall again in the coming days. :)

P.S.: All the "My Fair Lady" movie fans would know where the blog's title came from :)

Break Time!

Kartik is not exercising his grey matter much these days so I have taken the reins of writing. He is on book reading spree though (mostly fictions) and watches TV once in a while.

Those of you who are interested in meeting Kartik, here is the closest you could get to meet him presently. He is posing for this photo while receiving a bag of platelets. He needs platelet transfusion once every 3-4 days.

On WBC's front, it is still status quo. The more we worry about the growth of WBC's, the more they make us worry. So I guess it is not worth brooding over. We leave that to doctors! The doctors do not seem to be perturbed. However, instead of speculating things, they are planning to conduct Bone Marrow Examination so that they could get first hand report on the marrow.

I thought I will sign off by showing you a short video of our surroundings. Here is the video clip which we captured a few hours back.

Pune remains mostly clouded these days. Showers are the frequent and regular visitors these days which is evident from the flowing waters in the river. This is Deccan Gymkhana /Karve Road area of Pune which is always bustling with traffic. The weather does sometimes reminds us of Seattle.

Patient is Patient

The recovery is taking a little longer than expected. This time WBCs are too stubborn to budge from their position. After several pushes they have soared to 700 but still going slow. Otherwise, Kartik is doing absolutely fine symptomatically. The doctors say that some patients do take longer time to recover.

So we just wait and watch the WBCs soar high!

Room Shift

Yesterday our doctor surprised us by telling that I am to be moved from isolation room to a normal private ward. With 80% of my WBCs being neutrophils (infecting-fighting WBC) doctor feels I can weather the hostile environment of a normal room. Today the isolation room would be occupied by another patient who is in dire need of it. Hospital has only two such rooms.

I couldn't be happier by this move. I get to see more people now and people who aren't masked. Surbhi and Papa don't have to inconvenience themselves by putting surgical gown every time they enter my room. I hear more hustle-bustle in the corridor which makes me feel closer to reality. And most importantly I can meet my family members. Yay! Another week or so and I should be able to invite more people to my room.

Having said that my sojourn in isolation room wasn't half as bad. The room was peaceful and the folks taking care of me - doctors, nurses and maids - were excellent.

They just collected blood few hours back. Let's see what WBCs have in mind today :).

Pit Stop at 400

It seems WBCs have decided to take a breather this weekend. After all their host diligently observes 5-day work schedule, so why should they be discriminated? :) They have a lot of work to do in the coming week and so the rest is well-deserved.

I have been keeping myself busy seeing a lot of TV these days, especially movies. Here are some movies that I saw this week from which I thought couple of them were worth discussing for one or the other reason.

• The Jane Austen Book Club - I saw only the last 3/4 th of movie. It is about a bunch of Californians who decide to study works of Jane Austen. They pick a book for the month and then discuss it. A time comes when they realize that their situations in real life relationships can be compared to similar situations in Jane Austen's books.
  I liked the movie because I always wanted to be a part of such a book club. It's such a wonderful concept. Who knows I might start one or participate in an existing one after I am out of here. And I don't mind starting with Jane Austen's books since I must shamefully admit I haven't read any.
• Cool Runnings - This is a movie based on true story of four Jamaican sprinters who could not qualify for the Olympics sprint event and hence decide to become the first bobsled team from Jamaica in Winter Olympics game. It was quite entertaining and inspiring movie.

I saw quite a few movies this week but most were forgettable. Besides movies I watch "Whose Line is it Anyway?" quite regularly. Aren't those guys brilliant?! And how could you not watch the legendary battle between two great cricketing nations - the Ashes?

I hope to catch up with some lost reading in the coming week. I left Mr. Paul Theroux midway when he had just started his wonderful narrations on Bed and Breakfasts in Europe.

As always thanks for all the encouraging words you all are sending me. Believe me they are helping me big time.

Leap of 100%

Yes! The WBC's are showing an upward trend. They have boarded a local train though and not a super fast one. : -) Today the counts are at 400. Overall Kartik is doing good. There aren't any fresh complaints of fever, headache etc. However, in the entire ordeal, he has lost a few kilos which we would make sure he regains it back in the coming weeks. One of the reasons is that the chemotherapeutic drugs not only hits the unwanted cells but also the normal cells as well as other tissues and muscles of the body. The best treatment I can perceive right now is as prescribed by Sanjay Dutt in Munnabhai M.B.B.S. - "khavanu, peevanu ne majha ni life".

Thank you all for your best wishes and encouragement. Keep them coming!

Groundhog Day

I don't know how many of you have had a chance to see a wonderful movie called "Groundhog Day". In this movie the protagonist, Phil, is cursed to wake up everyday into the same day - Groundhog day - a day of celebration for local residents and a day which Phil didn't look forward to before he was cursed. There is no tomorrow for Phil. Every morning he wakes up with the same date on the calendar, same news on the radio, with same weather and with same people on the street. Exasperated by his predicament Phil tries various ways to get out of the vicious circle, sometimes even taking extreme measures. However, he still wakes up on Groundhog Day. Eventually instead of ruing over his condition he decides to use the time more constructively. He starts thinking with a more positive mindset and betters himself as a person. And finally the tomorrow dawns for Phil.

I liken my existing state to that of Phil in the movie. For past so many days I wake up only to learn that WBCs are still stuck at 200. I will get discharged only when WBCs exceed 3000. Daily Neupogen injections seem to be going in some void where there are no WBCs. The 24 hours' wait to know the next report is frustrating. Like Phil I hope I find some way to get out of this loop quickly. Maybe I need to use my sense of humor more to keep unpleasant thoughts away, maybe I need to write some code, maybe talk to you all wonderful people more and gain courage and maybe I need to pray with more earnestness.

Just At The End Of The Tunnel

And waiting for the light to enter! The ups and downs in Kartik's health continues. Kartik was a little low for last two days, however, today he seems to be a bit better. The bacteria were on a rampage for some time but I guess now they have been taken care of.

It is interesting to know the cause of infection. Infection spreads from inside the body and not from outside. The bacteria residing in the body themselves take up the swords and cause the riot. They have a free rein because our dear neutrophils have put down the swords! Neutrophils (which constitutes around 40-75% of WBCs) serve as a major defense of the body against a host of infections. However, neutrophils couldn't survive in the highly toxic environment of chemotherapeutic drugs resulting in Neutropenia (abnormally low number of neutrophils in the blood). Taking advantage of this situation various types of bacteria manifests in the blood causing the infection. But as Kartik rightly said, "God Bless the inventors of antibiotics" - the doctors resort to very high antibiotic doses to bring the situations under control.

In order to make the patient recover from Neutropenia faster, the doctors take help from an outside army of soldiers by a means of an injection known as Neupogen that stimulates the bone marrow to increase the production of Neutrophils. Most of the problems are taken care of when sufficient Neutrophils accumulate in the body. Kartik's WBC counts are at 200 today (Normal range is 4,000 - 10,000). Hopefully they should increase in next 4 - 5 days.

Latest update on Kartik before I sign off - he is pulling his hair apart - and quite literally : -)

(You sensed it right! - This one-liner is from Kartik.)

Mucocitis Waning

Location: BMT Room, Hospital, Pune

Two saline bottles tether me by means of tubes.  To a distant observer it would seem like the saline trolley is the puppeteer and I - the puppet.  And I would lie if I tell that I am not one. Rewind a day back and you would find me bedridden, with fever and high pulse rate, barely able to speak and making frequent trips to the bathroom because of loose motions.  Couple of antibiotics "strings" were attached to me on that day and here I am, writing to you, feeling much much better. Mucocitis in mouth has almost disappeared.  Body temperature and pulse are also normal.

God bless the inventors of antibiotics!

Mucositis Makes Kartik a Dull Boy

I know you all are eagerly waiting for the virtual voyage to the transplant room as Kartik had promised earlier. However, you need to wait a little longer and bear with me in the meantime. :)

Side effects of chemotherapeutic drugs have taken a driver’s seat presently. Kartik is feeling a little fatigued and listless mainly due to mucositis and stomach ache. His taste buds have gone for a toss, still he forces himself with whatever nutrition he could get. He is able to have soup, rice, milk etc. Don’t worry about this – if nothing else it is a consolation that drugs are working. These are the known side effects.

And what does he do all day long except being bored? He sleeps, makes frequent trips to the bathroom, watches TV, listens to radio and gives me company – after all we both have exclusive personal time in the hospital! :-)

The best thing - he is maintaining cool and taking all the challenges with a stride.

Post-transplant Hello!

Location: BMT Room, Hospital, Pune

Dear friends, finally I have reached the other side of the fence.  It took over a year, 4 chemo cycles and lots of positive thoughts, prayers and encouragement from you all to reach here.  I am doing very well.  The reports so far are rightly showing that my older blood cells are taking a plunge.  They will go down further.  In the 7-21 days' time frame stem cells will graft and start generating new cells. I hope the stem cells find the working manual lying somewhere inside the marrow!

Since last two days my appetite has markedly gone down.  There are early signs of  oral mucositis, a fancy name for ulceration and inflammation of mucous membrane lining the mouth.  However, it hasn't become annoying to the point that I cannot eat anything.  It's barely there.  Let's hope it stays that way.

Some of you might be interested in knowing what exactly happened during the transplant?  Let's talk about it in my next post :).

"Pun-Gent" Is Doing Good!

In case you are wondering about the title of the blog, this is how Kartik is nicknamed by his friends :-).

Stem Cells Transfusion went on very smoothly. The cells are busy meandering in his body presently to find their way home - his Bone Marrow. The cells would have to continue their efforts for next 10-12 days before they reach their destination. I wish them all the best. Kartik is doing fine - just a little headache which is giving him little discomfort. I gave him a break today but I am sure he would be back in action soon to take you all through his journey of words.

Our heartfelt thanks to everyone for all your Best Wishes and Prayers.

The Moment Has Arrived!

The day we all have been waiting for has arrived. Tomorrow I will be shifted to ICU for an autologous transplant. Please don't let the word "transplant" scare you. The doctors are not going to puncture my bone marrow to inject the stem cells. To an outsider the process would look like a blood transfusion and in essence that is all it is. The transfusion would be done in an hour's time. They would keep me under observation till evening and then shift me back to BMT Room. While in ICU I will be hands of some of the best doctors, nurses and assistants. So rest assured I am in safe hands. I am not nervous at all and feeling absolutely calm. I shall be back with a report tomorrow. Talk to you all really soon!