Rohan

I heard about him when I was undergoing my first chemotherapy. Nurses told me many stories about this thirteen year old. He was just couple of rooms away from me. They told me how his room was stacked with toys which kept him busy the entire day. They told me how he refused to wear the hospital clothes and insisted on wearing t-shirts and trousers from home. I heard about how he transformed his bedside dinner trolley into a pommel horse sometimes and sometimes into an elevated chair. I heard how he eagerly pulled out all his hair after his chemotherapy just like he would have dismantled a toy at home. I learned that he was a leukemia patient who didn't have a matching donor in the family despite he and his brother being twins.

Rohan's stories made me smile and eager to meet him in person. And then I saw him. I saw him hop past my room with his twin brother. He had a huge smile on his face - a smile which the mournful mask that he wore after his chemotherapy could not succeed in hiding. As days went along Surbhi and Rohan's mother chatted with each other more often since we were separated by only a couple of rooms. While Rohan's parents had anxiety written all over their faces seeing Rohan's slow progress, Rohan was always in his own blissful world, always finding something to amuse him. I still remember how the hospital staff surprised him on his birthday by first making him vacate his room under the pretext of routine cleanup and then decorating the room with festoons and balloons. Rohan in turn celebrated his birthday by distributing chocolates to all the patients, their relatives, nurses, maids and ward boys in the hematology ward.

We parted ways. His counts looked healthier and he got discharged before me. I kept meeting him when he came for routine blood checkup at daycare. His parents weren't keen on going for autologous transplant (the one I underwent) so they were taking radiation therapy in another hospital. Radiation therapy had failed to intimidate the child. He came to visit me in my room when I had come for the next round of chemo. Because of his low immunity he had to spend all his time inside home. His mother told me that he was merrily immersed in all the PC games at home.

I didn't see Rohan for a very long time. Then one day Surbhi bumped into them right before my autologous transplant. Rohan and his mother had come to daycare for transfusing platelets. A tragedy had befallen the family. Rohan's leukemia, which was under remission so far, had relapsed. To aggravate things further doctors said that they cannot perform anymore chemotherapy or radiation therapy. As a last resort family had to try homeopathy for Rohan.

After that we got busy with my transplant and heard nothing about Rohan's health. Today we were shocked to hear that little Rohan is no more. The doctors could not contain the damage done by excessive number of leukemiac cells in Rohan's body.

This wasn't the only sad news which we heard today. We also heard of a demise of a patient who occupied the bone marrow transplant room beside mine. This patient's sister's bone marrow matched 100%. The transplant went off successfully but he succumbed to the post-transplant complications. See the irony of life - on the one hand Rohan had a twin brother whose bone marrow didn't match and Rohan passed away and on the other hand this patient had a sister's whose bone marrow matched perfectly and he still passed away.  I can say with conviction that even though leukemiac damaged every part of Rohan's body they would have failed miserably in damaging the child's spirit. His spirit was impenetrable and unassailable.

Dear Rohan, I will miss you. You probably didn't know what "Carpe Diem" means but you practiced it so well. You never let woe in your life shrivel the child in you. I thank you for teaching me such an important lesson in life.

Platelets Rising?

The table on the right may disappoint some of my readers but not me. Platelets have almost halved themselves. However, take a look at the last day when I was transfused with them. It was a good six days ago. Shelf life of platelets is typically three to four days, at the end of which my count goes into danger level of 5000 to 6000 platelets. But my count at the end of six days is 13,000. Something tells me platelets have gotten rid of their stage fright and have started performing. Today on sixth day, I am still not showing any signs of bleeding anywhere. Would my body pleasantly surprise me by showing a count of 13,000 or more in my next report? Thanks to all the iron-rich food that Surbhi and Maa are feeding me with my hemoglobin is also rising up.

Our trips to hospital have been pretty much eventless. All we go for is my routine blood checkup every alernate day. Everything gets done by an hour or so and we are back home. I haven't met my doctor for quite some time now though I am sure he is keeping a tab on my reports. Till last week the hospital also looked uncharacteristically empty perhaps because of H1N1 panic. The daycare, which usually overflows with patients, showed just two appointments on the whiteboard. The general and private wards were emptier too.

I feel that my ascent towards recovery is finally ending. I am looking forward to seeing all my woes, lying at the base of the mountain I just climbed, looking trivial and unnoticeable like specks of dirt from the summit.

Lolling in Lull

Yes I have been very quiet since last two days. There haven't been any visits to the hospital. There hasn't been a transfusion since almost two days. I am lying to you. There has been a transfusion which happened outside the walls of my hospital - transfusion of quarter of a bag of "nine-to-five" working day. And even with just that quarter of a bag I felt so invigorated. I dearly miss the full dose of working eight hours at office and that wonderful tiredness that you experience once you get back home, a tiredness that says you had a really good day at work. I am hoping that I get transfused with innumerable eight working hours days really soon.

Tomorrow we will be going for blood report again. From my bodily symptom it seems that my platelets are still at healthy level. In the last report the ANC (Absolute Neutrophil Count) was still on the lower side. It was roughly 540 neutrophils in 2000 WBCs. We want ANC to go above 1000. And my body just whispered to me, "dude, don't worry - we will get there!" :)

WBCs In 2000 Club!

Rewind back to 31st July when I had just stepped back in home. My WBCs' stubborn stay on 700 was still there. Forward all the way to today the count has risen to 2000. What's more gladdening is the fact that the last WBC inducing injection was given on August 9th - a good 8 days back. So my WBCs were left to grow pretty much on their own. Isn't that a great progress? I have a long way to go though. The next milestone is that the neutrophils (infection fighting WBCs) should be at least 1000. The technical jargon for this is ANC (Absolute Neutrophil Count). Tomorrow I will come to know where it stands right now. I know platelets have been having a hard time growing but I am still patient with them. They have a little stage fright and I am giving them pep talks to make them perform :). In the meanwhile tomorrow another kind soul is going to donate me his platelets. God bless him! In other news I started working on office work after an unduly long break. It feels wonderful to be on my laptop surrounded by my tools of trade and talking nothing but techno-babble with my colleagues. Here's wishing the WBCs reach the normal range quickly, now that they have gathered momentum. Stay tuned for the ANC update tomorrow.

Mystery of the Wavering Hemoglobin - Part II

When Watson walked in he found Holmes sunk in his armchair. There was infinite bliss, like that of sage, on his face. The smoke from his pipe was dancing in front of his face. His eyes were shut as if he was in a trance.

"Watson!," said he. "Pray sit down, my dear friend. How was your visit to the countryside this morning? And I know you are anxious to know the outcome of my Indian mystery."

"Holmes!" said Watson incredulously, "how is heavens did you know that I had been to country side and that I was dying to know about your Indian client?"

A smirk appeared on Holmes meditative face. "The smell of the grass and moist mud from the soles of your shoes suggest you were out of London and in the greener pastures, Watson. And today you opened the door with more urgency than you usually do which suggests your anxiety about something, dear friend."

"Ha, haa!," said Holmes and drummed his long fingers on the side table. "You have cracked the affair of mysterious hemoglobin, haven't you Holmes?" Watson said with twinkle in his eyes. "Yes!" said Holmes and paced towards fireplace. "Mr. Kartik's hemoglobin was at a healthier 8.3 and not a paltry 6.7. The WBCs also were much livelier 1600 than the bleak 1000 which the suspicious report suggested. This time the blood was drawn through a prick in the hand and not through the central line."

"So it was the diluted sample which was the cause?" queried Watson.

"Unquestionably!" said Holmes stoking the fire, "the bad sample had traces of the anticoagulant which might have crept inside the blood sample because only 5 ml of blood was disposed before taking the sample instead of the conventional 10 ml. My only regret, Watson, is that my telegram arrived a bit late I couldn't prevent Mr. Kartik from undergoing an unwanted blood transfusion." Holmes settled back in his armchair.

"Well what's important Holmes is that you brought relief and smile on the faces of family members of Mr. Kartik, who probably had a harrowing time seeing a report which was out of place."

Holmes had suddenly became more reflective and said, "yes undoubtedly. Rindanis are breathing a sigh of relief. However, Watson, there are so many things which my logical reasoning fails to see sitting here, seven seas away from my client. For instance, why weren't eyebrows raised by doctors on seeing this dip? Why was patient not asked questions that would ascertain if he was bleeding or not? Why a new sample was not asked for? Sitting here logical deductions will not help me find out if this lapse was due to sheer workload pressure on doctors or due to apathy? Regardless wasn't it imperative to have these checks done for a patient in such delicate state as Mr. Kartik?"

Mrs. Hudson walked in it with supper before Watson could answer Holmes. "Come join me for supper Watson. Mrs. Hudson has made some fine baked oysters, cream soup with broiled fish with Mrs. Hudson's piece de resistance - plum pudding." "Mr. Holmes, please ring the bell if you find anything malodorous in the courses!" said Mrs. Hudson with a mischievous smile. Holmes chortled knowingly.

"Watson, I have two tickets for immersing ourselves in the divine music of this new violinist from Vienna. Let's forget everything and anything related to blood for the next two hours. I am not taking a no for an answer, Watson."

Mystery of the Wavering Hemoglobin

The breakfast had gone cold much to the dismay of Mrs. Hudson. She gave a look of disapproval to Holmes who had immersed himself reading a pile of documents. They had just been delivered to him a few hours ago. They were from his client - a certain Mr. Kartik all the way from India. Watson stormed into the room excitedly to share an episode that took place with one of his patient when Holmes gesticulated him to stop by waving his arm and thereby making the storyteller in Watson livid.

"Humbug!", said Holmes, "Bah!" "It defies logic," he continued unfalteringly, "How can hemoglobin dip to 6.2 from 9.3 in matter of two days, Watson?"

"Well, it could happen to a patient who has profuse internal or external bleeding, or, someone who is in the midst of chemotherapy," said Watson, who was noticeably taken aback seeing Holmes uttering jargon from his field of expertise.

"My dear Watson, you always impress me with your excellent reasoning," said Holmes. Just when Watson was showing a countenance of satisfaction Holmes said, "But I am afraid, my friend, on this rare occasion you are wrong."

"My client showed no signs of bleeding except for a couple of petechial spots and neither is he undergoing chemotherapy. Petechial spots explains the dearth of platelets but doesn't explain the huge drop in hemoglobin," said Holmes. "Watson, let's step out and wire Mr. Kartik to get his hemogram done again because I smell something really suspicious here. Can you please shout out for a hansom, Watson. Mrs. Hudson, please take the malodorous eggs from the table! I am already nauseated by something else which smells fishy," said Holmes and stormed out of the room wearing his deerstalker cap.

:) For all you know the drop in hemoglobin can be explained but you know the dreamer in me always finds a route which isn't always the logical one. We intend getting the hemogram done again tomorrow to make sure that the drop was genuine and not due to a diluted sample. Chances are it was genuine - and chances are really strong. Stay tuned. Rest assured Holmes will get to the bottom of this :).

P.S.: Writeup is heavily inspired from one of the Sherlock Holmes episodes that I saw recently (Jeremey Brett version - the best Sherlock Holmes portrayal in my opinion).

Miscounted Count, Discounted Count

Often mistakes made by someone irk you or even make you livid. Occasionally though they don't because the fixed mistake turns out to be favorable for you. Yesterday was one such day. In the morning when we called up our doctor to find out the blood counts he told us that WBCs had dropped from 1700 to 1300. When we looked at the printed report today it turns out that it wasn't 1300 - it was 1600! So the drop was insignificant.

In light of yesterday's report, the drop from 1600 to 1400 today is not bad at all. Platelets are also keeping themselves up and running wonderfully. Seeing the good behavior the doctor said that I need not come for my daily blood check tomorrow and come after a day's gap. I obviously agreed to that immediately :).