2009 - To reminisce..

There are few times in life when you need to reminisce "Wow! did we really do that?" / or "were we really in such a situation?", and a wedding anniversary is such a time. Today Anne and I complete 6 years of being madly in love with one another!... no sorry, that would be for a much longer time - but its 6 years since we officially tied the noose... and as we sat to prayer tonight our hearts were filled with a wonder and gratitude to God for another year possible together.

I thought that now would be a good time

to update the Blog. People still keep contacting me through this wonderful instrument - but to update once in a while and let you all know that all is well, is something I must do.

The blog has seen no new post for nearly a year - we are now in Oddanchatram. In the Christian Fellowship hospital, also called CFH, ODC. The hospital is based in a small village that is built mainly along a single main road, is about a kilometer from end to end and has a this hospital nearly in the center. The closest large towns are Madurai and Coimbatore - each about 2 hours away. There are about 300 beds and we have most medical care in terms of physicians and surgical work possible. There are no frills attached and this is a place that really caters to the poorest to lower middle class patients. I have spoken of Dr Tharien - the founder, in an earlier post.

Anne and I are here as the department of Surgery had a need for a surgeon and so we placed our Orissa plans on hold till we tide over that need. Koby has started going to school here - he is in Kindergarden and enjoys a full day at school. He is growing fast and is a real blessing in our lives.

Work is busy and I am gaining valuable opportunities to broaden my surgical expertise -some pretty exotic operations and endoscopic work that I would never have attempted in a larger center with the appropriate specialists. Here most patients here will refuse to move on to a higher center - or can simply not afford it. God has been with us in this place and we place every new challenge before him in prayer!

By God's grace, my health has never been better - I am able to scuttle around 24 x 7 for emergencies and the surgical routine without any problems. In fact, I have to remind myself that I am now 4 years post NHL and need to get my follow up's done when I get back to Vellore!

Anne and Koby are doing well - lot's of friends for Koby and school poses enough to keep him busy and out of trouble. A picture of us swimming in a nearby dam - on a picnic with friends from the hospital.

God has been with us as before in the past year and we do testify to that. We have had the hill and valley experiences as usual - but all with the hand that sustains beside us.

A major MILESTONE on the journey....

November 10, 2008 GRADUATION DAY, CMC Vellore.
Three Cheers for the Silver and Blue!!

Today - I have been given the Degree of Master of General Surgery (M.S. Surgery) by my Alma Mater. It's a HUGE deal. It's not so much the achievement or the relief of being done with a major part of my education - it's the disbelief that I could walk onto stage and walk off having received the accreditation that I have satisfactorily completed my training.
When I started to write this blog, I was uncertain of so much..... questions and doubts were always on my mind - would I complete chemo? what about the radiation? Costs of treatment? what would happen to the baby we were expecting in all this chaos?....My mind kept me busy enough to push finishing my training to an obscure spot maybe in the background - living seemed a priority over the learning!! I took time off (6 months) my course to be treated and it was done in the faith that I would get back to training some day..... I remember sitting after my shots of Vincristine (a chemo drug), my fingers numb and devoid of sensation (a side effect that can be permanent) - banging the keys of the computer as I blogged- without a tactile feedback and silently wondered if the side effects of lost sensation of my chemo, would wear off and let me get back to feeling human tissue as I would cut it...... Today I have my sense of touch as good if not better as the day I started my training...
As I graduate, and look at the 'plot' of the past 3 years- I realize what insignificant a role I play in the list of credits - 'I' actually play the smallest role in putting me on that graduation stage..... My family has undoubtedly been my strength and fuel. Anne, My parents, Anne's parents, Tripti and Santosh, Cherry were so much like solid anchors that I never felt tossed around as the waves hit. My God has, without doubt been my boat. I have had the comfort of feeling his security as I travelled this journey.
As I share this milestone with the world - I really hope that it can be an inspiration that there is NO IMPOSSIBLE, with our creator. The Lymphoma I had could be beaten and similarly I feel the problems that we all face can be challenged. It's just a question of believing, hanging on for the ride and not quitting early on.
Love from Tarun, Anne and Koby.

What's in the crystal ball?

I am aware that this post is 9 months after my last. However this blog has never slipped my mind. That's an amazing thing about blogsphere in that over the past 9 months - even though I have not written anything in - people continue to mail in to check how I am doing or let me know that they are in CMC and need a boost of morale. But hey - as Cherry (my brother in Law) reminded me lately "From everyone who has been given much, much will be required..,Luke 12:48)" What is happening in the Tarun Jacob family?? Well, I have just completed my exams - (in addendum... and passed.) I have joined the surgical endocrine unit in CMC till Anne finishes her exams. The pain of the 'sit and cram' is over for the moment. Though it's difficult to believe. Anne has 6 months more to go for her Obstetric course to be completed - and has completed her thesis submission and just has the exams left in March / April. Koby is two and a half now, going to school and as naughty as anyone that age could possibly be. He makes each day worthwhile - and though he often behaves as though the world revolved around him, he would be surprised to know how close to the truth that is for Anne and me. He is a miracle that was born in such a period of uncertainty that he reminds us every day that a rose can spring forth from ashes! The reason I have blogged now is to say that I've peeked into the crystal ball of our future. I just made a trip to Baripada, Orissa to visit the Graham Stain's Memorial Hospital and had an idea of what the future has in store for us. God willing we will go there after Anne finishes her course - and work in that hospital. Baripada is north Orissa, and boarders the states of West Bengal (Midnapore) and Jharkand. The place is incredibly beautiful and green - and the closest station is Balasore - that is on the coast (60Km) away. The roads are not really great in some places and resembles the surface of the moon with its craters and sand. There is a lot of malaria in the area and the hospital lab technician prides himself in being able to pick up cases from the blood tests each day.
The trip from Vellore took over 26 hours - by train. There was good weather during my stay, even though it was the monsoon season. The hospital a little over 10 beds for in patients. There were only 2 admitted when I visited (one a small child with multi-drug resistant malaria!). The picture alongside shows the hospital compound, with the hospital to the far right and in the left is a baptist church within the same compound. The hospital has a simple staffing structure. 2 doctors (Dani and Dheeraj). Dani has been there for about 5 years now and has recently been joined by his wife Baamini. A single lab tech, Medical record keeper, store keeper and 4 nurses keep the medical work moving along smoothly. They have not ventured into accepting surgical cases or deliveries. Anne and I will do that, once we get there. There is a simple operation theater room and a delivery room. These need a bit more funds and equipment to become operational, but the point is that there is great potential there. The hospital lies in the first floor, while the residential area is in the floor above. There is a need for a little more building - but funds are limited and there is a general difficulty to get funds for residential buildings. A pity though that's reality as things stand. There are sister concerns in Leprosy home, rehabilitation and a boys hostel. The Leprosy home is home to many inmates who do small farm work on the campus land and at various small scale projects and make an income for themselves. Graham Stains family did an incredible ministry there, his care for those affected by leprosy showed in so many little ways around the compound. There is a patient who has mastered making Micro cellular rubber (MCR) footwear, and others with gardening, skills etc. There are groups (pic to the right) who make grass based bags, place- mats,floor mats etc. The self sufficiency and renewed purpose in these lives is commendable. There is a lot of aspects that I can help out surgically with - Leprosy patients tend to get claw deformities of their digits and bad infections on their feet, because of the decreased sensation. Another compound of the mission is a boys home - about 21 boys till grade 6 live there and go to the local government school. The live and study in the home. Their parents support them as far as they can - they study and live in the home. The picture alongside is a few of them, the rest had gone home for the short Puja holiday.
The team at the hospital shown below. So.. I am glad I made the trip this time. I went to a school that Koby can potentially go to - an ICSE school, about 5 km away. We met the principal, I am quite relieved that schooling will not be an issue. The entire trip left me at peace and itching to go get started! There is a great challenge ahead of us - and with God's help and wisdom I'm sure we can face it.
So whats in the crystal ball?..... as I look, I see what's always been there - that we sometimes fail to see.... A promise that God's along with us as we take the journey of life.

2 years past and doing great!

It's been nearly a year since I had last written. Koby is going to be 2 years old in a few months and it also marks a land mark for me -post treatment 2 years and going strong by Gods grace.
The snap above is one taken of the family this Christmas. Koby in his Chinese costume my aunt in Singapore had sent down for him. Santosh and Tripti now together in Vellore as he works in CHAD, CMC.
My General Surgery post graduation course is nearly over - I am done with the surgery part, but need to mop up some time due in 'peripheral posting' i.e Orthopedics and Neurosurgery that I missed during my course due to chemo time. I write exams in September and with that hope to be done with studies for a while.
Anne has a year left and will complete her training in gynecology and Obstetrics in march 2009. Koby as you can see alongside, has grown faster than we could imagine! He is talking nineteen to a dozen now and has a whole bunch of friends to play with in the building we stay. He spends some of his weekends in parents house - where he is spoilt rotten by his grandparents and enjoys goofing around with Santo acchachan and Peepi (Tripti) ammama.

It has been a really good 2 years of being well. There have been the occasional scares and checks, but God has seen us through. The good parts of these 2 years have been the friends made -patients that have come through this hospital, read the Blog and got in touch. Anne and I lost a good friend too in this time, due to lymphoma having spread pretty badly to his brain and rest of his body. But in all out friendships we hope that we have instilled a sense of purpose and a encouragement. God has made our lives examples that show that he is the light of the world. The bad part's of this time was some scary nodes that cropped up in my axilla - one minor surgery later, we were reassured that they were not tumour and not significant!
Anne and I are reminded every day as we spend precious moments with our Son, how God has gifted us a second chance. And I doubt that second chances are to be wasted in feeling sorry about one's self or worried about how long it will last, but to savor the fragrance of the moment and look in gratitude to the giver.

Koby is a year old

There are many things that we can be grateful to God for, and this week as Koby turned a year old - Anne and I thanked God for a list of things. This was no short simple list- it started from me being able to celebrate this occasion with the family, the joy that Koby brings us every day and the support we have from our parents and siblings that we are so crippled without!

Koby was oblivious to the fact that there was a whole lot of fuss being made about him. He just enjoyed the attention that he was given with his usual two tooth grin.

We started his birthday celebrations in church on Easter day. Annes parents were here and Cherry as well. Tripti and Santosh were in Manipal on Sunday as Santosh finished and passed his final exams.

Koby went up during the birthday announcement - but was fast asleep and Anne received his card for him. We had a special lunch after that - Koby was dressed for the occasion in a juba and dothi.

We had another cake and party when Tripti and Santosh got back on Wednesday. Koby was thrilled by his red car cake and ate a fair amount of it.

Our little boy is growing up fast. God has been just so good in our lives and Koby is the best example.

The Surgical resident

Over the last few months, I have been neck deep in work. Our Surgical departments work with a single resident for 4 months in a year, during the time our final year residents go on study leave and the new first year residents join in March. Which means we are on call every day for a 4 month stretch.
Life is actually good over these months in terms of a learning curve, where a lot of responsibility is given to us and our decision making skills are sharpened. One does wish there was more time to spare, but with so much to operate and so much to learn, there is really no room to complain.
I was prompted to publish again after getting to meet up with an interesting chap called Tanweer. He has exactly the same lymphoma as I did and his symptoms were similar too! He is currently on MACOP-B + Rituxan and his wife joins him in Vellore today on their anniversary. Keep them in your thoughts and prayers. They too have a young son. Tanweer keeps a blog too, but his was from well before his chemo - it makes interesting reading . Link up here. I had mentally decided that my blog had done it's job and it was time to quit. I guess it's worthwhile keeping the chronicles going for people to realize that the life after Chemo is just as it was before - it's just a matter of holding onto the roller coaster tight enough to get through the ride as well as to keep your eyes open to enjoy the trip.

Koby is growing up by the minute! It's just like any time spent with him is not enough time spent. His latest favorite is a game of peek a boo! Being busy in the wards does mean that I get less time to be with him. But it's not all that bad, living on the campus means I can pop in and out whenever and we are blessed with good house help- who look after him like a little prince.

I met up with Dr. Mammen with my test results and he said there was no logic in repeating PET scans regularly. I need to do just chest X rays and a thyroid function test to make sure the radiation had not nuked my thyroid gland.

6 months down the road.

It’s now 12 at night and Anne and Koby have fallen asleep. I was fairly sure I’d never open my blog again to make a new post, but something made me write today…. It’s now 6 months since I had been declared tumour free and a lot has happened in this time.

It’s been just 3 days since I went for my check up CT scan and was reassured that the lymphoma is gone for good.

Work keeps me busy, I will be the only surgical resident in my unit for the next 3 months as our seniors study for their final exams. Anne is neck deep in her postings as well, with frequent labour room and ward duties.

Koby (baptized – Nathan George Kochukaleekal Jacob) is now a 8 month old bubbly baby who keeps us just waiting to get home. He has slowly started to stand and coasts around on the furniture; he says ta-ta and just loves music. His grandparents always complain that they don’t get enough of him, but then neither do we!

God has continued to be good to us and we know we would not be this happy smiling family if not for his incredible grace.

Hope you all reading have a great new year.

In Conclusion....

The report of the PET scan reads as follows:
"Considerable reduction in size when compared to the previous imaging, PET-CT findings negative for viable tumour."

I hope that through this blog in the last few months; this chapter in my life has and will continue to give strength and encourage those who feel up against a wall. I would have never made it without so many who held Anne, Koby and me in prayer. God has shown me in so many ways, nearly every day that he looks after the smallest of things.
Thankyou Friends, family and all those around the world who held me up before God in prayer and in their thoughts.
God has given me a second chance at life and I am sure he will do the same for all who find it in them to trust him completely.

This will be my last entry in this Blog. Continue to uphold us in prayer. God bless and goodbye!

In his time, he makes all things beautiful.
Lord please show me everyday as You teach me your way
That You do just what You say, In Your time.

PS- my e-mail ID, will still be active in the future, please get in touch if anyone reading needs anything I can help out with.