Pour some suga on me!

Another early morning bolt out of the house today to make it to the hospital and the blood letting counters! Thankfully it was not for me, but poor Anne was at the needles end! The glucose tolerance test is a nasty test that Obs and endocrinologists believe in to test for diabetes. Anne is going through it because Koby is 1 cm too large as measured on Anne's tummy! (naughty baby, causing trouble for mother in the tummy itself!). This test is nasty, because just apart from fasting until you give the test, you have to swallow 100gm of glucose and keep testing blood for every hour for 3 hours! Appa (Anne) kept us company - this picture is Anne and her father outside our coffee shop in hospital.
My pulmonary funtion test (PFT) was a breeze. When you've done it 2 times in the past even those at the machine treat you like a veterean. By Gods grace, that test was normal as well. The picture was of the patient before me doing his PFT.
My next big appointment was to meet Dr. Subhashini for an overview of my radiation course and to clear doubts. As I went into the cubicle to meet Dr. Subhashini her forst question was - "what are you writing on the internet?"! A little surprised, I feebly said "Blog". I believe some patient had chosen to be treated in CMC after reading my blog and they gave me the credit in her consultation room!! So, I guess my blog now has a new role too! - Canvassing for CMC, Vellore - but I hardly need to do that! Do I?
The meeting with Dr Subhashini was really informative. Three and a half weeks of radiation is what I need. 5 days of radiation a week, weekends off. I can expect - ulcers of the Oesophagus, swallowing problems, dry mouth and blackening and thickening of the skin where they shoot. Over the long term my risk for lung problems like fibrosis and heart problems like heart attacks are high. I can start only after 3 weeks of last Chemo, to allow my body to recover from Chemo and I start with a planning session (Feb 10) where they mark my chest using the CT scan for the original tumour size and radiate that area.
Among my first few questions I had, were if I had to keep away from Anne during RT, and there was a definite NO to that. BUT, since the departement may have stay radiation, she would not come for my RT sessions.
She was keen that I had a PET scan done, but Dr. Mammen will make a call on that. I hope I have made sense - everybody?

Back to the Future

Monday - the day, like Doctor Brown of "Back to the future", says in high pitched excitement -is important in space time continuam. Tripti and Anne have their interviews, I was getting prepared to tell a Jet lagged Dr. Mammen the good news that my Gallium was negative and to top things off, Anne's dad has come here from Tiruvalla with good friends Dr. Kunjappan and Vimala. ( in pic)
Dr. Mammen was thrilled to know the result, and said that he had more or less decided on the radiation. He had a pannel discussion with Dr. Alok, the heads of radiation therapy - Dr. Subhashini and Dr Rekha Cherian (Head of Radiodiagnosis), about what they felt as well. This remains to this day one of the strengths of this institution, the ability to consult multispeciality at the drop of a hat.
I've been given another pannel of blood tests in preperation of radiation, an Echo (heart scan) to see how much a heart I have left after Chemo (Adriamycin) and a lung function for assesment after bleomycin.
I am writing this post after my results are ready - my counts have remaied stable and my echo only showed a mild reduction in ejection fraction - within normal limits. Pulmonary function appointment is tomorrow at 11 am. I also meet my Radiation doctor - Dr. Subhashini for an overview of radiation and to answer any questions, if I have any!
Dinner today is Appa (Anne's) treat - we are planning to go out for a steak at Hotel River view. Eating out has been such a dream while on Chemo - now I intend to make it a reality! yum!
So lots done in a day. As I write this at the fag end of the day - I can also add that Anne and Tripti found did their Interviews well. The results should be out in a day or so... In Gods hands now...

Priorites.

Woke up late today, as the general feeling of tiredness continues. I am down to 10 mg of Prednisolone, and at times would just like to pop in a few more pills if it meant I could get back some of that jittery energy of my chemo days! In many ways I'm so happy that the Steroid days are nearly over!
Amma went to her office to try and finish off some work before she goes to Bangalore for a conference.
Tomorrow is a big day for all of us. Anne and Tripti will be having their interviews tomorrow. I'll be meeting Dr. Mammen and planning what radiation if any, the next month has to offer. Appa (Anne) will be here tomorrow as well.
Chapel today was an intersting sermon. Rev. Sunny Philip - a Chaplain in CMC, many years ago - now in Australia spoke. He said 3 points right at the end of his message about Priorities in life, which are worth repeating and I felt relevent to us. The first being that Good Priorities may not be God's priorities, however God's priorities are always good!, seconly God's priorities may not always be problem / hasssle free and Thirdly our Priorities always need to be fine tuned as we move along life. Real food for thought?
The phone at home continues to ring with people so happy to know I'm tumour free. So many e-mails, letters of support and encouragement. Thankyou all -who share our Joy. When it is said that our cup overflows, I guess our life and these events can be described by the verse " surely goodness and mercy shall follow me all the days of my life."

Overactive.

I was so full of beans in the morning, left at 6:45 AM, for the clinical meeting which was by our surgical ICU, about pneumonia's in patients left on ventilators. The Laparoscopic workshop followed and was kicked off for the day by a pannel discussion on liver metastasis in Colorectal cancer. Both were great sessions.
I headed back home at lunch time with Amma. Was quite tired. I have been pushing myself quite a bit and I think the effects have taken their toll on my body.
The sad thing is Cherry had gone back to Bangalore. He has a band that needs to practice, and He's taking his music ministry quite seriously. On the way back from dropping him off on the bus, Anne and I stopped the car on the road once at a lovely book fair in town - all sorts of books at a throw away price. Anne loves to read, so was quite happy to spend time flipping through the books on display. After the book sale, we stopped at a little cafe to just sit out and enjoy a coke and talk. It's been such a long time since we could just stop at any shop on the road, sit out and enjoy the evening and cars driving by! Till now everybody has been just waiting to whisk me back home, or make sure Im wearing my mask while I'm out!

Anyway, started my day full of beans and ended it feeling quite pooped!
Need to learn my limits and try not to overdo my activity for each day. I'llCrash out early because my legs ache and head hurts.. Anne and Tripti have their interviews on Monday - please keep that in your prayers.

Low on Salt.

Cherry came into hospital today, with me for my second Gallium scan. Negative again and there is no need to do a third scan. Cherry sat quietly with me through the scan, getting worried as to why my liver was looking more brightly colored than the rest of my body! I guess brightly coloured livers and spleens can be quite intimidating for a non-medical person not wanting to see a tumour.
We went for a Poori masala after the scan in the YWCA canteen. It was enjoyable, just for the fact that I haven’t eaten in the hospital canteen for the past 3 months during Chemo.
Cherry went back home after spending time in our hospital bookshop - and I stayed on in hospital to attend the Laparoscopic colorectal workshop. It was a really good session. The day concluded with a lively debate about the cost benefits of widespread Laparoscopic colorectal surgery in India.
The interesting thing for me was some giddiness and severe headache I had while sitting for the workshop. I popped over to the hematology OPD, and talked to Dr. A, who told me that steroid withdrawal also involved having salt loss which causes these symptoms. I’m working on increasing my salt uptake now and feeling much better.
We had a lovely singing session last night at home. Cherry managed to get some tune out of our out of tune piano. Songs like Majesty, Refiners Fire, As the deer pants and such like – praise and worship classics that I just love.

My Testimony

I had my primary gallium imaging today – I HAVE NO TRACE OF ANY TUMOUR ON THE GALLIUM IMAGE.
God has transferred all we have asked Him for in faith into a reality in my life. It’s a testimony. I’d give him ALL the credit. I have the healing we have prayed for and that so many have been praying for all these days. Like Appa puts it –“I’m not worried - as much as you are my son, you’re His son too and He will look after you.” And God has, so wonderfully!
The day began at 4 am. My gut didn’t let me sleep (Thanks to the laxatives that are supposed to help clear the Gallium from the system). Appa and Tripti came to hospital with me for the scan. Cherry and his friends Titus and Nithya reached at around 9 A.M from Bangalore.
The scan as such took 35 minutes, and I know as the camera was scanning my body – I was praying / mumbling "please God let it not be there." Faith is such an intense thing – Would I have been crushed spiritually if there was a hot spot? Difficult question really, but when we’ve placed complete trust in God, then He makes things beautiful in his time.
After a celebration Mutton biriyani for lunch - Titus, Nithya, Cherry and I went for a walk around campus, sat in the chapel and sang enjoying the acoustics of the chapel.
The Gallium imaging will continue tomorrow and decisions about radiation will need to be taken next week, but Gods Peace continues to fill this house. God has shown us yet again who is in the driving seat.

RADIOACTIVE AGAIN

Things moved at a furious pace today. I was suddenly called in for my Gallium scan, as the radioactive stuff was shipped in from Amersham (U.K) and ready. The injection of Gallium was over in a few minutes, after which I went down to radiology for a CT scan of my chest. The CT confirmed that the tumour has reduced even more in size compared to the 6 weeks CT, but the residual masses/nodes in my chest may be just scar tissue. That is where the Gallium will tell us if it is active or dead tumour. Active tumour will pick up Gallium and show up on the images I take over the next 3 days.
The down side to having gallium flowing in my body is that since it’s radioactive. I have to maintain a 3 meter distance from Anne, since she’s expecting. What a shame! That means I sleep with Appa today and for the next 3 days!
I have been tagged by Ghost particle, to post a picture of my favorite mug. I’ll post my juice glass, which Amma (Anne) gave me to help reach my 5 lire fluid quota! My trusted Chemo companion!
Tomorrow Cherry comes for a 3 day visit. That I am really looking forward to! Anne’s brother Cherry is an incredible bundle of energy and we always enjoy his visits.

Almond tree!

I woke up fairly late today, compared to the 6 a.m, steroid supercharged me I’m used to. The tapering dose of Prednisolone has reached 25mg, and continues to make me feel sapped of energy, but I’m not pushing the limits too much either!There is a snap of me trying exercise my proximal muscles fit by climbing up and down stairs in the garden. Anne caught me in the act! – Regular He-Man!
I made a quick trip to hospital in the afternoon, there was a presentation on Laparoscopic hernia repair and hemicolectomy at 4 pm in the Classroom, by Dr. David Rodda and Dr. Peter Hewett colorectal surgeons here for a colorectal workshop planned at the end of the week. The presentation was nice, and was interesting to see the fancy equipment that they use in Lap work compared to the stuff we use.
I was quite caught up by a tree outside our house today. This tree got me thinking. This is an Indian badham (Almond) tree that is dead, except for a bunch of deceptive green foliage from its lower branches. I guess that’s like ME before the Lymphoma episode. And now, 3 months of chemo, getting to know God better, spending time reading, blogging, thinking and talking about events,-He has really strengthened me from within. I guess I was a poorly nourished tree earlier, looking deceptively good, making the right outward choices, but probably not as alive within as God felt I needed to be. And maybe lymphoma and time off has been God's way to make me grow better Almonds!

The Future.

It was an absolute whopper of a day. Chockablock full! Before I get up to what I was up to, I must mention that Professor Mike Keighley who is a famous British Colorectal surgeon and helping me on the Cochrane paper spoke in chapel last night. It was such a lovely message, his theme was of worshipping God, and apart form many things he spoke of seizing opportunities to worship when we least expect, examples he gave were like walking our dog, driving to work for scrubbing up for surgery! Nice thought!
Anne had her checkup in the Obstetrics department at 9:30 am today, so I tried to finish doing an anorectal physiology for a patient at 8 am. My good friends at the department quietly sent me another one as well. So I had to finish fairly quickly to avoid, an irritated wife waiting at the OB & Gyn OPD. Seized chances at worshipping as I had just learnt, while doing my manometry (and gritted my teeth) and got to doing both things on time. Phew! Divine intervention…
Baby Koby is doing OK, or so Anne’s doctor feels – but Anne needs to do some blood tests and to follow up in 3 weeks or so. Its so nice to be a part of the entire process, even thought we men can hardly do anything physically. Koby has become such a strain on Anne’s back, the only physical effort I can offer is an occasional back massage! Getting pretty good at it really!
Today is Jan 23. This day in 1999, Graham Stanes – an Australian Missionary was burnt in India, with his 2 sons in his car. He was a man who did God's work. There is a link to some text about them and the picture where Baripada is on the map.
It is to this hospital in Orissa that Anne and I have committed ourselves to work, and believe God has called us - after we finish our training in Vellore. Keep this calling of ours in your thoughts and prayers too.

I am a druggie!

Slow down, you move too fast
You gotta make the morning last
Just kickin' down the cobblestones
Got no deeds to do No promises to keep
I'm dappled and drowsy and ready to sleep
Let the morningtime drop all its petals on me...Life, I love you,All is groovy (Feelin’ groovy –S & G)
It’s Sunday and the effects of steroid withdrawal are way worse than I had expected. Last night was plagued with bad dreams; I’m really tired and losing appetite. Lethargy is an understatement and all my muscles ache, like I’ve run a marathon. This small article on the net suggests there may also be a component of psychological dependence to the withdrawal. Odd, but it’s funny to think of my self as a druggie, fighting to rid my self of a drug that helped me get better. Too much of a good thing…….
Tripti is currently making an elaborate Anatomy quiz for her medical students. She’s pushing PowerPoint to its limits to make an impressive quiz! Hope they enjoy it. That’s the thing in CMC, and many other places too I’m sure. So much investment into the students – it’s how the student responds that makes the exercise worth it!
Will make a short walk today, and hopefully make it to Chapel for the evening service. Just hope this lethargy settles, I have a patient for anal physiology testing to do tomorrow in hospital and Anne needs to have Koby checked for routine follow up. It just won’t do if I’m not up to the trip!
Its great to know what ever the challenge or problem - a druggie or whatever - God's there to sort it out! Just need to keep my speedlimits within his regulation books!

Off the steroids!

I got off the starting blocks at the crack of dawn this morning. We had the Saturday morning clinical meeting for the Surgery department and it was a useful discussion on a thyroid lymphoma and hypocalcaemia after thyroid surgery. Both surgical topics that I learnt something new about! It beats sitting around at home and feeling sick!
The fingertip pain persists, but my veins are a bit more forgiving. I used to get a jaw/parotid pain after Vincristine in the past, but oddly it’s not there this time. (Small mercies!)
I spent the morning reading a bit of Surgery, but am finding it difficult to concentrate – just sheer lethargy I suppose. I have to buck up. I’m worried that staying at home has made me too soft – wonder how I’m going to get back to the surgical residency life after being treated and acting like a Maharaja for the past 12 weeks! In 4 – 6 weeks I’ll hopefully be holding a pager and doing duty as usual. Wah! Wah!
The steroids are now being tapered. I was on 75 milligrams of Prednisolone which will be brought down over the next 10 days to avoid side effects of stopping suddenly. The most immediate side effect is my loss in appetite – I know my food craving has been blunted, but I did enjoy a lovely Pumpkin pie Tripti made, with fresh cream to top. Absolute yum!
We had a small reflection on Gods will, over dinner tonight and we all admitted that this particular hymn has helped us with respect to His will in our lives. It was in Anne's and my morning devotion this morning, and a Hymn sung in Amma’s college that helped her.
Lead, kindly Light, amid th’encircling gloom,
lead Thou me on!The night is dark, and I am far from home;
lead Thou me on!Keep Thou my feet; I do not ask to see
the distant scene; one step enough for me.

The future!

A day after my last chemo, the day has been so good. Vellore has become so hot that 5 liters isn’t a problem, I’m craving more! The nausea has cleared and the only side effects are a severe pain in my finger tips because of the Vincristine (not just burning) and thrombosis of the vein I got chemo in yesterday, I wonder if you can see it on the picture I’ve put in. It’s the dark red streak on the dorsum of my hand- the pain extends to the axilla though – vein endothelium damage – I wonder if the Rituximab is causing it, because I’m feeling these more after Ritux cycles. Anyone else?
Ruby Ammama has left back to Singapore and Amma has gone to Madras to see her off at the airport.
Anne and I made a heroic attempt at walking this evening, but were bushed after 2 rounds.
What happens now? In a week or so – I take a CT scan with some form of nuclear imaging either PET or Gallium. This essentially tells us what if any of tumor is left. Studies in my type of tumor show a good result if remaining tumor is radiated – even if there is no visible mass, the chances of a relapse are less if you undergo radiation.
Radiation has its side effects too. My skin over the radiated area can burn and peel off, chances for myocardial infarction increase, esophageal ulcers. Radiation is a kind of complex beam that kills cells by cooking them, like an X-ray (well sort of!)
Hey! For those who thought that the end of Chemo would be the end of my Blog, rest assured there is more to come. I’ll continue to write until the still small voice in my head that stated me off, tells me my work is done!
Got another lovely poem today - on thoughts.

It's over now!

The day has drawn to a close as I write this post. It’s about 9 pm and I am thoroughly exhausted. It’s a significant day – not just in terms of what has been achieved, as well as all the activity that went into it!
By Gods grace, the nausea is only far on the far horizon. I got a shot of anti nausea med before I left. Tripti made me a simple pasta cheese, and I ate quickly before the rest settled down to dinner and upset my tummy with the stronger spicy smells.
Anne and I got into hospital at 8:30 am, but were kept waiting because there was a problem with bed availability. Since we started late, eventually we were able to finish only at about 6:30 pm.
Ruby Ammama and amma brought us lunch and Ruby ammama spent the afternoon with us – gently massaging my hand as the Rituximab flowed, or Anne’s back as she complained that Koby was causing her a backache (no help with the hospital beds).
I had played the part of Jesus in an Easter musical ‘Jerusalem Joy’(Roger Jones) in college that had these words “It is over now, Gone this time of pain, never will we ever have to go through that again”. Appropriae words now as well.
An interesting thought that Amma (Anne) heard in a prayer somebody said for me was “Lord, Cancer hasn’t got a bigger name than you!”. It’s a simple but beautiful thought. Though true, if we allow Cancer to take on a larger place in our minds than our faith we have lost the battle. I must admit that at times the crab does struggle to get on top! Thanks to all my blog readers who have shared the journery thus far with me. A public diary is such a vague concept if you really think of it - but I have so many now making the journey with me, encouraging me and hopefully learining too. A long way to go - but as Lance Armstrong said after he wins the yellow jersey at the tour de France - 'Todays victory belongs to so many others too'.
Whats next? - I'll deal with that tomorrow! Need to crash out!

What?

Today was a landmark day. Anne today took my blood sample for the last ever Pre – Chemo testing. It was a mad rush this morning, I’d forgotten where I left the tubes to send the blood in and Amma was waiting to go to work and take them in! Got our act together just in time and as I write this post I am aware that my counts are normal and hence God willing Chemo should go on tomorrow as planned. Vincristine, Bleomycin and Rituximab ( the grand finalae)
What are my feelings as I draw to the end of what is such a significant part of a chapter in my life? Nearly finishing Chemo and about to start on radiation. There is a sense of awe. I have had an intensive chemo regimen with an experimental drug thrown in and walked through like Daniel's friends did in the fire. Felt the heat but not burnt in any way. There is still a long way to go, all is not over but the fact remains that chronologically my journey is off to such a roaring start that the momentum is able to draw others in on the excitement.
I’m happy with what has been accomplished till date. I have grown in faith through this experience. In writing about it through this blog, I’ve been able to show others a little of what I feel & my faith and encourage / inspire them. And in facing these trials relationships between Anne, family, friends and work mates have taken on so much more meaning. Lance Armstrong in his second book ‘every second counts’ says in effect that it’s impossible to go through a cancer experience and think you can remain feeling an Island / you could have done it alone. I’m enjoying this book at the moment, a classmate Nirmal sent it down for me from North India.
In contrast to my post yesterday about refusing to look back and say why- I’m looking back today and saying what!
Anne made lovely Chettinaddu chicken gravy for lunch and Ruby ammama has been joining us for our walks. Here is a picture on our walk yesterday!

Dont look back in anger!

Today I feel so much better! Ruby Ammama (Amma’s sister) has come from Singapore and, came in about 1 am. I was unable to sleep, and hence was wide awake when she came in. Woke up early today as well, all indications that my ‘down’ phase is drawing to a close and I’m being given strength to face the last battle of Chemo on Thursday. Back to my old insomniac self!
Ruby ammama and I had a meaningful time together this morning, reflecting on many things we have learnt over our various experiences. Anandith joined us mid morning in his self made Go cart – inset pic with us and the cart.
A powerful part of today’s discussion and my thoughts was how far each of us decides to look back into our lives. This may be a bit heavy – so excuse me if you were expecting light reading for today.
It’s easy for me to look back and wonder why I got this lymphoma – as to a viral, genetic or chemical etiology. It could be any odd reason. I lived a year under high tension cables – some associate that with cancerous properties. But heck, does it really make a difference to the way it affects me. Again if we look at why we get sickness, is from God, or is it a ‘gift’ of the ‘devil’. Does it really matter – I really wonder if it does.
I have been thinking about this for a while, and have decided that looking back and wondering why gets us nowhere. It’s how we take on what we have got and move forward is what really matters. And the way we draw on Gods strength and grace to move on is what gives us the ability to turn a disaster into a blessing. So it’s a moot point whether God or the devil gave me lymphoma, but it’s without doubt that God has transformed me through the events around the lymphoma. So I think important to fight that urge to look back…my opinion, I may be wrong.

What lies beneath!

What lies behind us and what lies before us are tiny matters compared to what lies within us. (picture of campus flowers)
Interesting words! Came across that today.
My feeling of unwell continues.. I was so tired yesterday that I slept really early last night and woke up late this morning. The feeling of tiredness, no appetitie and waves of ? nausea (it’s not really nausea, but a bloated, anti food feeling) continue. But adequete hydration improves the sensation.
Anne and Tripti continue to await the interviews, and ammachi is busy in the Kitchen preparing food.
I have got my mobile phone to play “When I’m 64” (Beetles) as a ring tone. Ha! Ha! Tripti is green with envy! It’s funny how your mood for music changes if you are not well. I was so Queen, Floyd just a week ago – now I’m listening to Classical and much slower stuff. (By the way - I wonder how many of you share my view that the Bohemian Rhapsody is probably one of the greatest songs ever.)
But all in all, I’m better than yesterday and hope to be 100% by the time we hit Thursday. Wow! Thursday – MY LAST and FINAL CHEMO!!! Can’t believe it’s here so soon. God's grace has been what 'lies within' in our lives - and I have no qualms in giving him the complete Glory for the fact that Chemo has gone off on schedule and so well!
This evening Anne and I went for a walk as usual, but we kept it to 2 rounds around the Campus. Didn’t want to push it really! I will crash early today as well. My Aunt Ruby Ammama will come tonight; she’s visiting from Singapore - it’s going to be a fun week.

Down!

"I am not what I want to be.
I am not what I hope to be.
I am not what I ought to be.
But still, I am not what I used to be.
And by the grace of God,
I am what I am." John Newton
Beautiful words, and probably most appropriate for me! I read them in chapel this evening from the order of service. The new batch of students had lead the service in Chapel and it was well done. The vesper they sang, "Shepherd of my Soul" was a song our batch had done as theme song in our first year too. It brought back memories of those days, preparing for these services of the CMC worship community.
The Staff entertainment has probably taken it's toll on me. Even though it was an exciting evening, I think I was really dehydrated through the programme. (I neglected taking a bottle of water with me). The entire day today, has gone with a feeling like I've been run over by a steam roller. There has been a lot on my mind, but I guess the effects of chemo causing tiredness can not be taken lightly. I'm making up for it now, Anne has been making glass after glass of fresh lime juice and I'm feeling a bit better.
It's only a week to go, and when you are down..even though it's just a week - there are voices in my head that say enough! I've just had enough - at times...! I was greatly encouraged this week by Anna and Dr. MC Mathew's card to us. The poem will be on the thoughts - "Begone unbelief, with Christ in the Vessel we will smile at the Storm". Because even though my storm is clearing, my boat still rocks.

Staff entertainment

(Dr Sunil Chandy and co. dancing in staff ent)
What an exciting day! I woke up early to go for the class in hospital, for the Surgery postgraduates. We have some interesting cases discussed there. The Nausea has settled down and life is really looking up. The ulcers haven’t healed, but since they are mainly on the left of my tongue I just need to channel food down the right and avoid spicy!
Anne came as well to hospital, and we did a bit of card shopping, visiting and she studied a bit.
We had a surprise visit from Anne's cousin Sangeetha and her husband Jose this evening. Was great because I'm actually meeting them for the first time!
The main event of the day was the staff entertainment this evening. It’s an event by the staff ( senior doctors) for the Medical students of the college. Such fun! The point is to make fun of them (students), showcase some talent, and have a good laugh. The theme was a new stem cell research lab, and there were a lot of skits, jokes, music and dance.
I have put in a few photographs, hope they speak louder than words!
Left - Appa and Dr Prakash Rao acting in the bagayam tea shop
Right - My boss Dr. Benjamin dancing
Below - A song by Dr. Asha - Tripti is backing vocals!

Post Chemo 11

Last night was not as great as I thought it would be. Needed to crash early, but managed a very basic dinner of curd, banana and boiled rice. Sadly my tummy didn’t want to keep too much of it down. It’s really a drag to feel nauseated and keep fluids down. The drug Cyclophosphamide that I got yesterday has a very serious side effect – it can cause the mucosa/ lining of the urinary bladder to bleed if you are not well hydrated. Hence the doctors and nurses keep telling me to make sure I’m drinking a lot of water when on this drug. Sometimes it’s easier said than done.
Anne has started her preparation for the interviews, she is doing a little light reading, while I fool around with the computer or read. I’m reading a book by Max Lucado at the moment, enjoy his style of writing. Maybe I’ll put a few thoughts on my thoughts page once I’m done from there.
We have been enjoying Pride and Prejudice (Jane Austen’s), on the DVD – watching bit’s and pieces of the 6 hour saga.
Sadly I have no fab food pic’s for today – Once my nausea settles I’ll make up for it!
The old e-mail address that people have been using to communicate with me has crashed. I’ve been getting spammed (sad). All in regular correspondance, please use the new account that I have written at the top of the page at gmail. And if you have ACNE cream to push, Viagra to peddle or business deals to sell – leave me out of it please.
Candid snap of Appa kissing my bald head - Bald IS BEAUTIFUL isn't it?

Chemo 11

I am writing this post hardly 4 hours after receiving my 11th Chemo. The anti emetic is taken good effect and I am not too nauseated as I type now. This picture is the notice at the entrance of the Haemat OPD, to give you all some idea.
Dr. Mammen was really busy today; a senior Hematologist from the Mayo clinic is in town. But he still saw all of us (his patients) in his methodical, complete sort of way that inspires confidence.
Dr. Mammen was not happy that my mouth was full of ulcers. He used the term ‘bald tongue’, ‘multiple shallow oral ulcers’ a lot and was even thinking of reducing my dose of Chemo for today so as not to give me a tough week. But since my counts were holding out, he decided to give me the regular dose.
We met a lot of people outside the Chemo room today, every week the number of familiar faces just keeps increasing, and it’s great to see people week after week – even though we share a commonality that’s not worth boasting about, we all share a camaraderie that is.
Baby Koby is now more active than ever – I can actually “see” the kicks through Anne’s tummy and that is just too exciting. I sleep talk a bit, and Anne was making fun of me the other day saying I was rubbing her tummy and singing in my sleep! (embarrassing or what!) Appa says Koby will turn out to be a hyperactive clown like his father… Grrr!
Amma (Anne) had a safe trip to Kerala, by Gods grace. We were a bit worried because the train was really crowded.
Hope the rest of the day goes off this well. Pic -us in Chemo room getting my Chemo 11!

Walking.

Today is Wednesday again, woke up at 7 a.m for the repeat round of blood tests. It’s not that I’m complaining, but this week, it seems chemo has come just too soon. I’ve not completely recovered from the ulcers of the Methotrexate and my right arm is still sore from the long infusion from last week.
By Gods grace all the blood tests have been normal. 8,700 white cells/ CU MM. That’s ample for tomorrow’s next Chemo. Gosh, after tomorrow, I just have one last one to go.
Today was one for walking. I walked a bit with Anne’s amma and Anne in the morning and with ammachi and Anne in the evening. The great feeling of Anne and Tripti getting called hasn’t worn out on me at least – when people call out to congratulate them, I was shouting “Thanks” back! (Fat lot I’ve done!). A picture from one of our walks. Anne with her mom.Amma’s classmate Dr. Geetha from her medical College days has come to Vellore after a long time, and we went over to meet her in Dr. MC and Anna Mathew’s house. It was a nice informal gathering. Tripti, Anne and I left early because Amma (Anne) was leaving back to Kerala and they were going to send her off at the station.
So, Tripti and Anne have to start preparing for their interviews and I have just 2 chemo's to go before the Radiation therapy is planned. Life is really getting better and better - it's in God's hands, so there is little to worry.

Good results!

My steroids are playing havoc with my sleep! I was wandering around the house till 2:30 am last night, unable to fall asleep. It’s a royal pain, because hunger pangs set in every hour and I’m eating only just enough to tide over till the next hunger pang! I think of all the chemo drugs I’ll be glad to get rid of, the Prednisolone will top my list.
It's a happy day for me today – Anne and Tripti have cleared the first part of the Post graduate exams.Yeah! Yipee! Tripti’s friend called to tell us that the results are on the net! They have both been short listed for the interviews on Jan 30. There will be about 3-4 candidates contesting per seat. God has been so good. Anne has been by my side for each chemo, not really able to read, entertaining visitors, helping me with food, dressings, bloods etc and still God has honored us so far. The doors may still close – there is still an interview to go, but we put our faith in Him as always!

Amma (Anne) made a beautiful chicken biriyani for lunch and I have put in a picture of Ammachi and her standing proudly next to it. It’s amazing how I can put biriyani as my preferred choice of food – any meal!

We made a visit to town and hospital again today. A friend of ours is recovering from a surgery on the kidney and we spent a little while with him. I must confess that I would have been the last person to visit/ spend time/ pray for an admitted relative or friend in the past - but my lymphoma and subsequent stay in hospital has changed my entire outlook to that. Some of the great words of prayer have been said by different people who visited me in the ward – and except immediate post op or right after my chemo (?duh), I welcomed such intrusions of our “space”.

Toss the salad!

Today was a really action packed day. Anne’s mum has come down from Kerala for the next 2 days and with ammachi, they have taken over the kitchen! A special chicken curry for lunch, loads of fresh peas and so on! But what took the cake today was a salad that Tripti made for dinner – lettuce, cheese, nuts, olive oil, and loads of stuff that made it just too good! A picture of the 3 women cooks tossing the salad and spoiling me rotten!
My tongue has blistered at the edges and my method of stowing away the bitter steroid pills in a large cheese dosai and swallowing in a gulp has backfired, because the large bolus has cut an ulcer on the back of my throat – not too bad, but those who have taken Methotrexate, remember that the mouth becomes so raw, it’s easy to ulcerate it!
Amma (Anne), Anne and I did quite a bit of roaming around today. We tried to visit a friend in hospital, gave in some photographs for printing, and tailor stitch cloth for Anne – Koby is making all her older clothes too tight! We also managed a walk this evening – Ammachi joined us, 2 times around the Campus!
Nachiketh came over to visit in the evening. Nachiketh is a post graduate in Anatomy and we became good friends in the 3 months I taught there. He is one of the best anatomy teachers / colleagues I knew and one heck of a great guy! He finishes his training in CMC soon, and will go back to Bangalore. A big loss. (Nachi, Tripti and me in my jammies!)
Tonight, Anne and I read a passage from Mathew for our devotions. It’s a passage that asks all to come to God, who find their yokes/burdens heavy, and find rest in him. He offers a life with a yoke, but his yoke is easy –he claims and his burden light. How true. The last 2 months have been restful. We thought we had a large yoke, sitting in the ICU, Anne and I wondered how we would face what the future held, but He gave us the grace. He does make our burdens light, it’s when we worry about them that they seem too heavy to take on!
It’s all the matter of a well made salad, I guess. The more we are roughly tossed(lettuce, cheese or tomato) in the olive oil salad dressing(God) the better we turn out.

St Johns - Sunday

Today was a lovely Sunday. We had first planned to go to the 7:30 am service at Church, but since Anne and Tripti needed a good rest, we changed plans and went for the 9:30 service. St. John’s Church is a beautiful 18th Century Fort Garrison Church in the Vellore Fort. A lot of Christians from Vellore attend the 2 services and many of the Vellore Kids are part of its Sunday school. We've been there since kids, taught SUnday school there too - but havn't been so active now that we are into PG and stuff.
I’m happy we went for the second service, because it was a sung communion service. And I just love the CSI sung service. There is a song “We do not presume to come, to this thy table, merciful Lord, trusting in our own uprightness…” It’s a preparation prayer for Lords Supper and stirs so many emotions that it’s powerful. Dr. Mammen Chandy (yes, my hematologist) gave the sermon today and it was wonderful. The topic was sharing the word of God and I think his thoughts on the subject were beautiful. In essence he said that God’s word – if it impacts us then we become the best News castors there is because the “sharing” is out of our own experiences and life. We may choose to ‘share’ Gods word in various ways – and that is each individual’s choice, be it by action or words. He gave an example of a young Hindu boy’s father who had written in 15 years after they had been cured of Leukemia to thank the team and say he saw Jesus in the team that treated the Boy. What a testimony!
We had a major shopping session on the way back from Church. It’s been a while since I’ve been allowed to freely roam the supermarkets and had great fun filling up trolley with drinks and cheese! How silly the simple things in life are, but how we take them for granted!
My father has driven down to Bangalore to bring my grandmother. They should be home later in the evening. Else today seems to be what God intended – a day of rest. Zzzz. No complaints!!

What do you want?

As you look around this room tonight
Settle in your seat and dim the lights
Do you want my blood, do you want my tears
What do you want from me
Should I sing until I can't sing any more
Play these strings until my fingers are raw
You're so hard to pleaseWhat do you want from me
You can own everything you see
Sell your soul for complete control Is that really what you need
You can lose yourself this night
See inside there is nothing to hide
Turn and face the light-Pink Floyd
Picture of Anne & me just before the exams last year !
I was thinking about Anne and Tripti going in for Post grad enterance exams today. What would I want? Naturally for them to get in this year. Anne was first on the waiting list (O.G) last year, and that was really hard for us to understand why. But in retrospect God had better plans, if she had got in – we realize she would not have been able to spend as much time with me over the last few months as she has been able to. Life would have been so different... It’s nice to have life planned out I guess. I like to have things planned, very clearly for the future. Have a 5 year plan so to speak. If I’m going to finish Chemo and radiation in the next 2 months I’m already planning when to join back, when I write my final surgery exams, when we leave to Orissa and so on. I don’t think planning your future is wrong, because even if your plans are off track – God gently pushes you onto the right path (sort of like a carom coin bouncing off another). Maybe the key is to make plans and then listen for the corrections.
I feel so much better today. Food has some taste, though the mouth feels like it’s been sandpapered. The jaw pain of Vincristine has started too, but that’s only when I chew. My fingers continue to feel numb, there are small blisters at the creases of my fingers (like the feeling after pulling on a tug of war rope).
6pm update -
Anne and Tripti are back. Both feel it was so-so. I feel the relief of the exam being over more than they seem to show it! ANy way it's in Gods hands now!
My Cochrane class was really good. I was able to concentrate and it was great to learn the theory behind what I have to plan for the protocol publication.
Picture of Anne and Tripti before leaving for the exam.

The day after

This has probably been one of the worst Chemo’s that I’ve had in a long time. I went to bed early last night. Anne and I had our prayers as soon as dinner was over and I just crashed out, she stayed up late studying. There is just one more day for her exam. Both Tripti and Anne are nervously prancing around the house unsure of what last minute heroic attempts to make at scratching knowledge from their books!
Anyway I was hoping a long sleep would have helped the feeling of being nauseated, feeling tired but woke up feeling just the same. The Drug Methotrexate acts on rapidly dividing cells like all chemo, but this causes a lot of mucosal ulceration. My mouth and throat are all feeling raw; the effects of this chemo go on until I “rescue” it after 24 hours with a medicine called Folinic acid. This stops the action of Methotrexate from doing too much damage to my healthy tissue as well. Just ate my first one a few hours ago.
Tomorrow is my first class with Dr. Prathap and Dr. Benjamin for the Cochrane study. Wish I wasn’t feeling this bad a day before, I mean I’ve sailed through so many Chemo’s and been walking 3 rounds around the campus before, now I have a bad Chemo day before my class. Hope things clear up soon. I hope if I sleep it off and eat enough of my anti nausea pills I should get through this one soon. “The righteous shall live by faith” that was my mornings reading from Galatians. I have faith that this will soon be over, bad chemo day or not!
A picture of our sit out in our room, where Anne and I read at times.

Chemo 10 K.O ed

Today was chemo 10. Thats 10 chemo’s complete out of the planned 12. It sounds just too good to be true! Since my blood counts were normal, I went into the out patient department at 9 and met Dr. Kannan who examined me and then took me to Dr. Alok. The only thing that came up on the checkup was my finger tip burning and numbness. This caused Dr Alok some concern and I understand the implications. A surgeon without his finger tip sensation? The idea hit me deep in my gut for a moment! What sort of a trade off would that be? Anyway, the point is to get better and the numbness and finger tip burning is supposed to get better with time after Chemo, and compared to the millions of other side effects that could have wiped me out God’s given me only what I can bear and work with so far. A little finger tip burning will be part of the plan.
Today the regimen was 2 medicines. Vincristine and Methotrexate. It took about 4 ½ hours to administer intravenously. Anne wanted to sit with me through it, even though her entrance exam for Postgraduate is in a day. Amma kept coming in and out and relieved Anne and Tripti for lunch. We are back home as I write this post, but today’s Chemo has knocked me out. I sat nauseated in the car ride back and despite my anti nausea pills feel worse than I have for a long time. I’m also tired. I remember Partho (a junior in college who had NHL too) had told me that methotrexate can leave you feeling quite weak, especially the later doses – a cumulative effect probably. I read a magazine and listened to music as Anne was doing Multiple choice questions on my bed. Tripti joined us for a while and we were humming out some old favorite tunes that played on the walkman - Billy Joel's - "still Rock & Roll",Garfunkle's "Brighteyes" and UB40's "I've got you babe!". The other patients on the adjacent beds must have thought us looney!
I think I’ll crash out early today.
A picture with Amma!

Encouragement

It’s funny, but I’ve been feeling rather exhausted at the end of each day. I had done a total of 4 walks around the campus yesterday (5 Km) – one with Anne, one with Appa and the last 2 with Appa’s night walk companions –Sarah Aunty, Suranjan Uncle and Pushpa Aunty. I could barely keep my eyes open by 11pm– steroids can actually decrease the amount of sleep that you need, and I was actually having problems falling asleep earlier. Let’s see how that goes.
I got a phone call from Dodo, last night. I don’t actually blog my phone calls – but this one needs mention. Dodo (Daniel) was a senior in school, and a friend. When I was Sunday school superintendent in St. Johns Church, I could count on him and Eddie (another close College friend) to take over a class where the teacher had not landed up - at the drop of a hat. He has saved my skin that way many a time. Dodo is also a major Bullet man – He borrowed my bike, way back in 2002 and took it for a ride – brought it back with a broken starter and accelerator cable (wasn’t his fault really). Anyways – he saw that I’m saying bye to my Bullet and called to offer a loan of any of his 5 bullets when I need it. Touched? You bet! I may never take it up, but it gives you an idea of the little offers of support that keep life worth it everyday. Its God sent encouragement that makes me wonder how people can doubt God's presence in their everyday lives.
Reshma’s class went off well today. I had a patient who came for his pressure studies and so I showed her how the equipment works too - reinforcement to my class. She is a keen and clever learner. The guy who handles charts in OPD came and asked me why I’ve changed my hairstyle! He! He! At least he thinks I’ve got style!
I gave in my bloods before class and the results are in. My white counts are 4900/ cu mm. Thats high enough to get the next Chemo tomorrow. Yeah!
A snap of friends in my hospital quarters a few months ago to finish!

Priceless light

Today the old star with its 40 watt bulb within - that hung outside our house through this Christmas season finally came down. As Appa and I set off on our walk yesterday, we commented about how that star has been with us for 3 years now, and every year we take it out pat out the dust and plug it in. We bought it by absolute chance, when we went to the bakers shop, I saw it hanging across the road and paid 25 rupees for it. It’s the simplest things in life that bring the most joy. I don’t think the most animated or sophisticated e-mail greeting from hallmark.com would be able to provide the kind of ministry of our one star that hung outside the Jacobs house. Bit like that mastercard advert on TV, with the baby contently playing with the cardboard box instead of all the toys the credit card could have bought! – priceless!
My class for Reshma went off well today. She seemed to grasp what I said. Kept quizzing her in between though! I made both a power point presentation and gave her some typed notes to go through later. She had done some reading of her own too and that was impressive.
My shares have gone up by 2 rupees, so that means I have made 200 rupees over the last week! Maybe we can buy Koby a toy car with these profits…. Heck I think a cardboard box will do!
I have one more class for Reshma tomorrow and then I am done with that. We had some running around to do today for registration papers, related to our MS course. Its funny how all official paper work is given with such short deadlines!
So the star will sit in our store until next Christmas, but its message for me as I close the store room door is that however simple we are if used willingly for a greater purpose we achieve more than we realize.
Better get back to preparing for class tomorrow!

Life is a road and you gotta keep runnin'

A new year sets off and now we jump off from the moments of recollection or reminisce, into a new year that just lies ripe with challenge and possibility.
My Uncle Balan acchachan, Naomi, Rahel and Ammachi set off, back to Bangalore mid morning. There is a snap of them just before they left! Sniff! Sob! Had a nice time with them for the short while that they were here though! It' s Balan acchachans bullet (bike) that I had been using through college and because of problems with registration and legal papers we were planning to now send it back to Banglaore to ? sell. Sniff again. (Mental note - will probably buy a Bullet again later in life - Koby may enjoy it too!)
The technician Reshma of our manometry room needs a bit of training, and Dr. Benjamin has drawn up a schedule. He gave me a call and has assigned me to take her classes tomorrow and the day after. What fun! I’ve been making a power point presentation for her class tomorrow – it involves the nerve supply of the rectum and anal canal.(yuk! - I know). I need to keep it simple because she has no real medical knowledge and talking about nerve plexus may just make her run away!
Anne is in hospital today, doing some 'combined' study with a friend of hers. Koby is slowly limiting her ability to sit for long times and eat too much either! Wish I could take over for a while? Especially this week, I'm sure she'd be grateful!!
The number of hit's on my Blog has crossed a 1000, "thats a great feeling !". Thanks all who read and those who write in / email. I started with no clear purpose, still don't have one really except that I hope through this endevour people realize Jesus as my strength. And that my experience of Chemo and stuff helps others going through the same or similar circumstances.
2006 - I've hit the floor running and I'm going to keep the pace going!

Fellowship of the new year

We passed into this New Year as a family, sitting is College chapel. It was a beautiful service. The watch night service is one we have attended for many years. As medical students there was the worry of University exams to write just a few days away, and then as we closed our eyes at 12 MN and the bell was rung, it was full of prayers for our studies! A few years down the line and we still have prayers for the New Year, but different in their content.
Shikha was at home last night and so we got her to take a family picture just before we walked over to the service.We were all a bit late in waking up after getting in only at 1 am. Breakfast was a royal affair and I really enjoyed it. Amma made cheese omelets and Appa fried sausages. Anne and Tripti were supposed to get to study, but Tripti insisted on explaining the plot of Miss Saigon to Amma and me and Anne fell asleep again! I guess the New Year is a cruel time to expect someone to study.
Lunch was a lovely roast Chicken. Amma had outdone hereself as usual. Balan acchachan, Naomi, Rahel and Ammachi ( Father's mother) are with us for the New Years. They drove down from Bangalore and it's been great fun catching up. Today has been a day for group photographs and so I have attached a picture of us.
The beauty of family and the fellowship of being with those we love is like a gift. Welcome 2006!