Really busy days Feb 27/28

It's been two hectic, but really fulfilling days. I have been on just a few hour of sleep, but the joy of being back at work negates anything else! I'm getting used to the 'hey you?' look that people give - and the surprise that I'm working through radiation. The last two doses of radiation have been peaceful and I'm yet to feel the ill effects. It's just a bit of fatigue at night - that's about it.
Today a patient of our started bleeding in the ward at about 6 in the morning, I had pulled myself out of bed at 5.30 am to make sure I knew enough about the patients before rounds. It was a tense few moments, before this mans bleeding came under control - He had major pancreatic surgery (actually multiple surgeries) and was slowly recovering from the onslaught. The incredible thing was the process of how our chief came in at 7 for rounds and spent a good hour and a half, settling the bleed and sorting him out. But after that, he took time to clean the man with soap and water - because it was many days since he had been cleaned - he cleaned off all the adhesive stuck to his body and then ensured that the mans back was rubbed with oil to prevent bed sores. He then went on to scrub the wall suction bottle with soap, because the contents needed to be re-fed to the patient, a job any attender or even a nurse would have arranged for in their time. He led by example and the compassion with which it was done was just incredible! I am still recovering from the effort that he spent on that one man - at the expense of holding up the team for rounds. I think its these kind of people that make surgical training or any training in CMC so special.
Tomorrow Anne joins her MD, Obs & Gyne course. She will be bust too. The great thing is her first months posting is not too stressing. She will be in charge of the sterilization surgery. I hope Koby keeps still while she's operating and doesn't try to help out. After all he does have surgeon genes! he! he!
I did an appendicectomy today after a gap of over 4 months. God has really been good, the numbness in my fingers has not made operating difficult. Chief has put me on 3 cases on tomorrow’s list and I've been asked to scrub in on Friday for the Liver transplant - live donor. Great privilege. The case will go on an entire day though and starts at 4 am on Friday! Yipes! But I can't wait!

Sunday on call

Sunday on call can be quite an easy day to get through - if the patients decide to behave themselves. I was able to get quite a bit of rest today and most of the patients are doing well.
The nice thing about radiation is that the weekends are off. No radiation on Saturday and Sunday - a break for the technicians, for the machines and most importantly my radiated tissue!
Anne went home for a while to finish getting our room back into shape. She carted a few books clothes and food in the car. Koby is just getting bigger and bigger and can move about quite a bit in her tummy! Its great when just talking to the baby can generate so much movement!
In the afternoon Anne and I went over to meet a patient who I had made friends with sitting outside the Hematology OPD during my chemo days. (I have talked about him in the past). He is back in Vellore for his third Chemo and mid cycle CT scan. It's great the way a malignancy helps break walls and makes it so easy to make friends. We are good friends now and like many of the friends I've made over the past 3 months, I know hey are for keeps!

The Registrar

Today was a routine day in the department of Surgery 4. The day started off with a teaching session, where we had a Quiz organized by the surgical ICU. Nice quiz because it was well made and we also had a hospital in Manali participate over a telelink.
The deparment was really nice to me and let me off yesterday, after my radiation. It was actually a rest I appreciated. The combination of no sleep and an antihistamine, I'd taken for an allergy knocked me out cold for the night!
It's great to be back to work. I'm happy that I've been pulled into this arrangement. It's easy to feel sorry for oneself and tell yourself that you can't work because you are on treatment - but I think the line is a fine one. I'm with a great team and am sure that I'll walk that line well!
The picture above is of the door to my conformal radiation therapy room. This link shows you what the machine looks like.

Back in the deep end!

Life interesting as it usually is has thrown a rather unexpected turn my way. Radiation has begun, and as I write this post, two doses are complete. For those who are curious to know what it feels like, It's not too bad. The Primus Linear accelerator is a fairly sophisticated microwave machine that maps the tumour after a pre set programme and delivers radiation only in the field that has been pre set. The trick is for the patient to be in the same position and place on the table everytime. Thats taken care of by a cast that I am bound down into and a great set of technicians.
The time that I'm getting radiated is similar to the sensation of a hot wind blowing on my chest, just that there is no wind blowing, and my chest feels a bit warm within. My skin hasn't started peeling, or there hasn't been any nausea yet. Thank God for that!
The surprise I talked about is that I am back to work. I went to ask for my posting schedule to be altered so I could go to a clinical posting that allowed for me to go for radiation every day and work for the rest of the time and I was offered to join the hepatobilliary unit immediately! Even though it's a bit sudden, I've agreed to take the challenge. It was our turn to cover the ER yesterdy (admission day in medical terms!) and today we were in theatre today doing some cool stuff! The only difficult thing is getting over the loads of sleep I have gotten used to!
Blogging is really going to suffer though! I only caught a few hours of sleep last night, up all night with some trauma, intestinal obstruction and so on - but it is great to be working again. I may feel a bit sick a few days down the line once the radiation really hits me, but God has been so good, I've sailed through Chemo shielded in his bubble and by prayer! - I am sure I will make it through radiation the same way! I get my radiation at about 7 pm evey evening guys, so keep us in prayer?
I'm sorry I have no pictures today, I'm on the library computer - will try and update once I get my room here is hospital back to order and my internet reinstalled.

Still waiting...

It can be quite a bore just sitting at home and waiting for the Radiotherapy doctors to call and sat that they are ready to go! They need to calculate the right doses and I guess that just translates to me doing better after and during radiation. I guess tomorrow may be the day (fingers crossed).
I had a bit of work to finish up in town today and got that out of the way. Our tiny room in hospital has been really neglected since we stay with my parents over the past few months. This picture of Anne and me was taken a while ago, but gives you an idea of our hospital accommodation - single room. The fridge stabilizer had given up and that meant that the power supply to the refrigerator had gone. There was melted moldy ice cream in the freezer and some old fungus infested food, the stabilizer needed to be given in for repair and the fridge cleaned out. Anne had handled the cleaning and I thankfully looked after fixing the stabilizer.
We both get back to work on the 1st of March. I will be able to continue radiation (15 min) a day and work, and Anne needs to start her Obstetrics course. Baby Koby is expected mid April and will put us in quite a toss then!I have put in a picture of my parents grabbing a bite to eat. The two of them have been through such a lot over the past few months. From having to put up with us, our food fancies, chemo up’s and downs and so many things…. Care givers need some time off too don’t they? It’s shallow to say I’m grateful for them, but they are just the best

Waiting for something to happen!

Today was a day spent doing pretty much nothing at all. Anne was preparing to join her course, by getting all the paper work under way. There were all sorts of certificates to be submitted and university fees to be paid. We saw a classmate Rohit there, who has got admission this year for pediatrics. He was been someone who called me regularly during the past 3 months to make sure I was OK. He had quite a rough timehimself, a few years ago and is quite a fighter after completely recovering from some unknown viral illness that left him paralyzed. Its great to hear a success story, isn’t it? We love to hear about those who have done well.
I remember this to be true and particularly apparent as soon as I was diagnosed with lymphoma. I used to wonder why most people try and remember the story of someone who made it through a tough time – such as cancer. This was how they thought I would be encouraged. “So and so made it through a lung ca, prostate ca….” and so on. But it’s natural for people to do that. I know it’s not possible to draw from personal experience in such cases. But the entire point is letting the other know that you care.
I knew my chances from the start, and these individual success stories are not really going to change the mental picture I have of parents losing kids to hematological diseases from my days as a medical Intern. For every success story there are in fact 2 patients where things didn’t work out. I don’t say this with dejection or remorse. I’m just saying that once I am through this disease, I will be some one who can say – LOOK AT ME, I made it. Lance Armstrong calls it the “duty” of a cancer survivor. I think that carries more weight that saying “I know this guy, who is the brother of a friend of a friend…. Who made it thru cancer”. Don’t you agree?
I just have to sip on my coffee and wait for the radiation therapy doctors to call…

Amma's birthday!

Today was a special day. My mother’s birthday! The family decided to take her out on a special dinner to a new sea food restaurant called the Fisherman’s fare. It’s a great place, but a bit far out on the highway to Madras and takes about 40min to get there! Anne baked a chocolate cake and Tripti got some of Amma’s favorite flowers. Here is a picture of me carefully watching Amma cut her cake, with her flowers in the foreground.
There was a call from hospital; my radiation may take another day to get started. Dr. Subhashini was concerned that too much lung was exposed on the proposed plan and wanted to make some modifications to the dosage plan.
I went over to hospital yesterday evening to make some modifications on the research plan for my Cochrane protocol with Prof. Keighley. It’s been quite a while since I have done anything on it, but now all the excitement of PET scan and radiation planning are over I must get back to work on it!

Harvest festival

Our Church -St Johns, celebrated its harvest festival today. The sermon was an interesting thought - King David making an offering to God with the words that what we give you Lord are only from what you have given us.
We are not harvesting today, and except for Amma's father and mother nothing agricultural has come from our family! But we have reaped the goodness of so many peoples prayers for us and the grace that I get to face each day is nothing but a harvest of love and Gods goodness.
All good things around us are sent from heaven above,
so thank the Lord for all his love.
Santosh joined our family to church today. He is a new face on my blog, but a special one! Santosh is a special friend of Tripti's and I hope over this year you will see and hear more about him! He is a resident in at Kasturba medical college, Manipal in Obstetrics and Gynae. and Tripti and he met while both were doing a rotation in community medicine at CHAD hospital. He's a great guy and loads of fun. See guys, always good news on my blog!

Carnival

Today I went in for my CT scan with my markers on the chest mould. These markers help the radiation therapy doctors plan volumes after digitalizing it on their computer. There was a bit of trouble getting the venous line, felt a bit like a pin cushion at the end of it, but that’s the problem with having peripheral vein chemotherapy. Anne was again left at home to prevent her from being exposed to x-rays.
Today is the day for the “Carnival” organized by the first and second year medical students in campus; that’s usually great fun. The event started early evening but we went over after 6 PM. Loads of fun stalls and food. Anne and Tripti tried their hand at a stall where you could make your own clay pot. Tripti made a diya(clay oil lamp) and Anne made a pen stand. There was a potter to help them out, just like the song "potters hand". It was interesting to watch some of the students start off with a ambitious looking pot and watch it collapse in their hands as it got taller and thinner!
I got my head painted. That's Vinay Kuruvilla painting my head! Talented fellow, second year student - he also plays for a Christian rock band called Genesis here in college! I had a dragon, bits of brain matter and a light bulb painted onto my head! Amma had quite a shock when she saw my head, I told her it was unwashable paint! (it washed off quite easily though!). It was otherwise a great evening, we bought a few tandoori chicken and chicken noodles home for dinner.
In general we relaxed a bit today. Went over and talked to pastor Graham, a voluntary chaplain (75 yrs old!) from Australia. He is here to spend time with those in the hematology wards and is a great encouragement to so many patients. He asked me if I was OK after the news of a positve PET scan or just keeping a brave face. A little bit of both I guess!

Radiation planning.

Today I meet up with all my doctors. Dr. Mammen was sad to hear the news that the PET was positive, but said the plans go on as before – I continue with radiation and then we make any further plans if needed. Dr. Subhashini – my radiation Oncologist had a colleague of hers Dr. Rajesh help me with the planning marking. He talked me through the procedure and took my PET scan to discuss with our nuclear medicine department.
Anne came with me to hospital, but stayed away from the radiation deparment to prevent Koby from getting more "exposure" than deserved! She sat in the Library and read.
The planning marking was an interesting thing. A plastic –fibre glass sort of cast is made of my upper torso, onto which radio opaque lines are placed/stuck. These lines will hug my body as I have a CT scan tomorrow and serve as the planning beacons as my tumour is mapped out and angles to radiate it are planned.
The cast was made by heating the stuff and pulling it over me while I was placed on a wooden “pelvic” plank. I had to lie still while it cooled and hardened into place! This ‘second skin has to sit exactly in place, so its markers are the guides to where I receive my radiation. If it moves out of place the wrong part of my chest could get nuked! The lines are drawn once I am placed in a Radiation simulator – that looks like what’s in the picture alongside. The entire process took till 11 am and I was asked to return tomorrow for a CT scan with my markers in place. The volume and dose of radiation will be calculated once the CT pictures are ready. I may be able to start by Wednesday, or so I am told. Each day, radiation will last for 15 minutes and if I tolerate it I can think of going back to work as well. That sounds nice!
The department is so busy that they are up till 10 Pm radiating patients! They said I could choose a convenient time between work and come over for my radiation. I will have it first thing in the morning for the first few days, and see how it goes. CT scan at 10:30 Am tomorrow, that means another poke to get venous access for the contrast injection.
I really appreciate all the comments I received yesterday. Its difficult at times to keep the grin going always, but when there is such incredible support from Family, friends and those who read this blog and have become so much a part of my life I can't help but break out into a smile. Thanks Y'all.

Feb 14,15,16.A set back

The trip to Hyderabad was great. 650 Km slated to be done in 12 hours; we made it in around 9 hours. He! He! The roads were all right and the scenery was beautiful, especially the Ghat section between Cuddapah and Kurnool. We took a little while to navigate within the city, because the traffic is insane.
Once we got settled, we went over to the famous biriyani centre –Paradise for dinner. It was great food and a lovely ambiance. Definitely a must for any one going!
The PET scan was at 10 am on the 15th. Despite the fact that the result was not great, the experience of going through the scan was lovely.
The Apollo hospital Hyderabad has a PET CT machine in a separate building, away from the main hospital building. I first met the doctor, who took a history and made sure I was ready for the scan. I was then taken to the procedure room, where they made me check my weight and calculated the dose of FDG I needed. My veins are still quite scarred from chemo, and Anne usually has been starting lines for me. I needed a couple of pokes till they could secure a venous access. Ouch! but not their fault!
The scan requires you to sit in a dimly lit room for a while, till the drug is taken up in the body. Since the base molecule is glucose, any talking or excessive movement will cause the radioactive FDG to concentrate in those muscles giving a false result.
The scan as such took 40 min, and not much trouble through it. I was sent to a room to wait after the scan was done. Anne’s dad was with us in the hospital; he had meetings nearby and adjusted things to be there as well.
The doctors at Apollo were great. We told them that we hoped to drive out, and they got all my scan reports and CD’s ready by 3 pm.
My reports? The PET sadly shows features of residual tumor. That’s not great news, what the Gallium scan thought was negative. The PET has said that there still is active lymphoma tissue in the chest. These images could just be the result of chemo scarring, but that would be wishful thinking - a PET is more sensitive than Gallium in such imaging. The good thing is it is in the radiation field and can be tackled by radiating the residual lymph nodes.
Am I upset? Well, I have placed it completely in Gods hands. I can’t say that I am happy about not having gone into complete remission, but there is still radiation left and this may be Gods way of saying that I still need to leave things up to him. It’s not over yet!
The trip back was great; we drove half way and spent the night at Kurnool before setting off early the next morning. We stopped for coffee in a restraunt that is cut into a rocky area – very nice place. The picture has a bit of it in focus.
So I get back to Vellore with the news of still having the tumor in me. The results have already been conveyed to my radiation oncologist – Dr. Subhashini and she has fixed my radiation planning session for 9 AM on Friday. Seems like there is a lot more to go before I finish this lymphoma saga! It can get a bit bugging and long drawn out at times. Wish I could just get back to work like in the old days and shed this patient role.

A day spent running around

Today was spent running around hospital. There are a couple of things I need to take with me to Hydrabad for the PET scan. The last images from the CT and the Gallium are required, and since CMC is totally an imageless hospital with all scans on the internal computer system, getting CD's of all my stuff was a bit of a job.
Dr. Sitaram (head of Surgery) saw me walking around hospital and called me to sit in on a talk he was giving his unit on live donor Liver transplant. That was really sweet of him. He showed us the images of a few cases he had observed in HongKong, where he had trained. It was a good learning experience. I havn't been to the hepatobilliary unit yet, so my knowledge of liver anatomy is quite fuzzy. Got to see Arpith there too - he is the single registrar there and was looking quite tired.
Anne's OB appointment went off well. Koby seems to be behaving and all pressures, sizes and shapes seem within normal limits.
Tomorrow we are off to Hydrabad! Yeah! 12 hours each way on the road. And a chance to finally taste Hydrabadi biriyani. Paradise restraunt, is I believe the place for the stuff! Better tank up on the good stuff before Radiation burns holes in my oesophagus! The only down side is I spend Valentines day away from Anne. Sigh!
As soon as we get back I hope the Radiotherapy starts soon. There has already been a delay of 3 weeks and I'm getting itchy to start. The planning session - where they draw lines on my chest and plan how deep and how much should be this Friday. They want the PET images to co-relate, before they nuke my chest for 3 weeks.
Anne's father will be in Hydrabad on the same day as us - for a meeting, so we will meet up there in Apollo hospital most probably! I have a really nice picture of him and Amma before we left back to Vellore, taken in Kerala with him modelling a new blazer!

Sunday at the shops

To me, a good trip to Madras means - good food and a good drive. My favorite desert is the black forest cake and there is no better place to have it than Java Green with an ice cold slush! I have a picture of mine, though it's greedily gotten at already!
We stayed the night at the YWCA international Guest house. It was a pleasant stay, save a few mosquitoes. The picture below is me standing at the entrance.
Anne and I spent the rest of the Sunday morning window shopping. My steroid induced tummy means a larger waistline. I got a pair of jeans at a sale and a pair or corduroy pants as well.
The Valentines day hype is so on in the shops. It's incredible to believe anyone can forget Valentines day with the kind of advertising and jazz that goes on in the big cities. Ask anyone off the street in Vellore and they would say "enna pa, intha valentines day ella?"
We got some Subway sandwitches to eat on the drive back. We even managed to squeeze a visit to one of Anne's relatives who live on our way out of Madras, but were in a bit of a rush to get back for the chapel service at 6 in campus.
It was a lovely 2 days and God was with us on the road. The number of accidents we saw were terrible, but we were cared for and kept safe. All we need now is a good sleep and a clean bath! Tomorrow is another busy day. Koby needs a check up (- Anne too!)

Highway star!

Nobody gonna take my car
I’m gonna race it to the ground
Nobody gonna beat my car
It’s gonna break the speed of sound
Nobody gonna take my head
Now that I’m on the road again
Oooh I’m in heaven again I’ve got everything
Like a moving ground an open road
Eight cylinders all mine
Alright hold on tight
I’m a highway star - Deep purple

There is nothing that can compare hitting the road. Now that we are able to travel, the Madras trip has been something we have been talking of for a while now. The ride as such was lovely. The new highways are open nearly all the way and that makes driving great - we saw a great sunrise as we drove toward Madras and are sharing it with you. The Zen behaved and being Diesel was not too heavy on the pocket!!
Anne's hair cut was first on the list and we stopped at "Bounce" a fancy place to get it done. I guess Husbands waiting, while their better half is geeting a hair job is an uncommon sight - and since I have no hair, I was asked if I was there for an eyebrow appointment. How crazy is that?
Anne looks Fab after her hair cut, shorter hair is easy to manage in the Labour room and hence the need to get this done.
We then bought a lot of Medical books. I wish I had Bruno's advice on where to buy books earlier, but we ended stacking them up in a cardboard box and put it into the boot!
We then lazed the rest of the day in Spencers Plaza.
The trip continues...

No parking.

Anne has finally recovered from her viral. For a second , last night I thought she passed it onto me as well! I spent last night sneezing continually until I fell asleep, but by Gods grace that was all I had!
We spent most of today lazing around. I read a bit more, about the spleen - but subject talk is always boring and I'll leave it out of the blog!
We made a trip to hospital, in a hope to get some work done. The clerk at the staff clinic wasn't sure if Anne needed a pre-employment checkup, since she was working here till 3 months ago! He asked us to come back tomorrow. I handed in a long overdue letter asking the university to officially allow me 6 months off for medical reasons. My request needed to be backed up with a recent medical report and that was where I had delayed things. I kept procrastinating asking Dr. Mammen to write me a report.
We saw an interesting thing, a bike parked outside the Medical students - women's rest room under a sign that says " Strictly no Parking." I found it so funny that I snapped it and have put it on the blog. The sign can hardly be read on this picture though! It's sad but that's how people in India care two hoots for signs or authority. I guess we can be very similar in our lives - spiritually too, even though the signs show us the right way, we do just what we feel like. Maybe God has a laugh at us too- then gently nudges back on track with some event or someone's wise counsel.
Anne and I are going to drive down to Chennai tomorrow (140 Km). We have a couple of things to shop for and do there. Vellore is not a good place for things like good shoes and medical books. There are a couple of things we have been waiting to buy and because we were stuck with the chemo restrictions - we kept adding them to our shopping list for when we could go! We don't want to the journey to be too taxing on Anne, so we will stretch it over 2 days and stay over in the YWCA guest house.
I hope you enjoy the serenity prayer on the thoughts page, again on another beautiful card from Dr. MC. This was printed onto the inner cover of our Students Association constitutions as Medical students and makes great sense.

Geez it's great to be back home!

We are back in Vellore. The holiday is over and we are back to the grind! Anne and Tripti start their Post graduation courses on the 1st of March and I hope to go back to work at the same time, even though the radiation will be going on, Dr. Subhashini feels that it is possible to work during radiation.
Anne's father made it back just in time to see us off. He was in meetings in Bombay.
The PET scan has been fixed for 10 am on the 15th in Apollo, Hydrabad. I have been e-mailed a set of instructions that include fasting for 6 hrs prior and to bring all the latest CT scans with me! We will most probably drive down to Hydrabad for the scan - on the road again! It's a 12 hr drive and I look forward to that!
We need to make a trip to Chennai as well, both Tripti and Anne want to buy a lot of medical books and the prices are much lower there. We also need to catch up on other shopping and Anne's planning to trim her hair too!
The trip back on the train was good, but Anne had developed a bad throat and cough which has not settled. I met another NHL patient on the train and spent a little time with him, comparing notes. He had just finished his chemo in a Govt. hospital and was on the train back home. He'd relapsed twice and was not able to have a bone marrow transplant because he had liver disease as well! His doctors were afraid he may not be well enough to transplant with poor liver function. As a result he is on titrated doses of chemo to keep the disease in check. It's tough to say something to such a person. But I have seen miracles in my life, we can only assure others that it's possible to expect the same.
Another nice thing was meeting an old surgery patient of mine from about 6 months ago on the platform while waiting to board the train. To recognize me bald and steroid bloated is difficult, but in doing so - it really makes your day!
So we have a lot to get done, Anne needs a medical check up, before she joins and we both need to dig out our books and read a bit before jumping back into work. I contacted Dr. Subhashini today and she has forwarded the radiation planning appointment after the PET scan is done. This is a picture of one of our teaching buildings - the ASHA building.

Kottayam trip

(Our House in Kottayam)
I have just got back from a 2 day trip to Kottayam. Anne and I took her fathers car and drove over to Kottayam which is an hour away from Tiruvalla. We left early on Sunday morning and joined my grandmother to her Church. It was a lovely service; I was really impressed by the pastor of the church who took the first few minutes of his sermon to say a story to the children in the church. I feel that a pastor who takes an interest in the children of the Church needs credit. Anne and I stood in front of the congregation and were prayed for, a thanksgiving from the Church; who were praying for us through the entire Chemo time! In the past I would have been embarrassed like crazy to do this, but now I know we are like an example to others that we have an awesome God, capable of anything!
We spent most of the day after Church visiting those who had been praying for me and close family members. My Grandmother lives alone and the main traveling she does is when one of us goes there or with her sister who has a car. It was great fun catching up with family. I think the greatest fun was convincing people that I was OK, cured and could drive a car around town.
Kerala is hot though, and the end of the day you end up gulping down liters of water! No chemo mug needed at present, I’m craving water, and sweating buckets of it too!
Anne and I made our first long walk today after we got back from Kottayam. This is the first time I’m walking 2 Km after my knee ballooned out and I have no probs! A picture of me in the rubber estates as we walk!
We had an interesting dinner with soup, Shawerma and Appam, Anne’s mom’s family had joined us for dinner.
2 more days and we will be on a train to Vellore! Sniff!

The walking stick!

Koby will spend his 30th week of existence on Kerala soil! Mallu baby, and will probably be born out of Kerala to non resident Mallu parents! This was always a great debate in my class at college if the non resident Malayalee’s were a better lot than the pure oileee’s! I prefer to make no further comment!
We are enjoying great cuisine. Amma (Anne) is making really good food but Anne’s tummy is really struggling to put away as much food as she was previously used to – Koby sits pressed against it!
We made another trip into town today, to do a spot of shopping. Its great fun to visit these large clothes shops, sit around and look interested in clothes for a while and you get something to drink! I find shopping a royal pain in general, if you find something you like I would just buy and leave – Anne in contrast, wants to see every color in the range and with her mom to join her…. Walk the plank mate!
Tomorrow we leave to Kottayam. That’s my father’s home, and I will not make a post from there.
Anne’s grandmother made an interesting analogy that I liked about what we are going through. She compared our last few months to a walking stick being made. The stick needs to be cut off the main tree, all the leaves stripped and then left out in the sun to dry. She also added that not any odd branch was good enough to be a walking stick!

A great train ride.

(Ammachi and Anne - Katpadi staion)
We all had a lovely journey to Kerala. I imagined it would be difficult to continue blogging away from home, but Anne’s had broadband internet, and I am all set to keep writing on the days that I am here!
The trip on the train was really comfortable. The train was fairly empty and it was possible for each of us to spread out and sleep all the way whenever we needed it. This is the first time I have been on a long distance day train; except for losing the day in travel it was a great experience. Our usual experience in traveling to Kerala involves getting into a night train and sleeping, getting up in time to get off at the right station!
We reached Tiruvalla at 12 midnight. It is Koby’s first long distance trip and Koby seems to be enjoying all the new sights and sounds based on the frantic kicks and movements in Anne’s tummy! Travel baby!! I hope Koby enjoys hitting the road too, but we can experiment after Koby pops out!
My PET is finally fixed up! Dr. Mammen had called home and left word with Appa that I was expected in Hydrabad for the PET on 15th Feb. The PET scan gives us a confirmation of the Gallium findings, and is supposed to be more sensitive than Gallium imaging. The logic of doing it now, is if we find a small focus of lymphoma then it can be included in the radiation planning field. Well – that’s another trip to look forward to!
The day in tiruvalla was spent in meeting up with friends and family. There were such a large number here who prayed for me, and I meet them and am grateful for them remembering us in prayer. We also drove into town for a little while; I was just enjoying driving Appa’s (Anne) new M-800, though wary of its brakes in comparison to the car at home!

Ticket to ride.

So it's official. No PET scan for the moment, Dr. Mammen has allowed me to travel. I'm off travelling for a week! - It's such a liberating sensation. For the last 3 months during Chemo, I knew I could'nt travel out of Vellore. There was always a Wednesdays blood test or Thursday's Chemo......
If all goes well, I'm calculating being able to work from the first of March. I think I'll be in Paediatric Surgery rotation then, and Anne will start her course in Obstetrics -maybe in the wards or labour room.
I guess just the notion that I can go, is more liberating than the fact that I am going! A sense of boundaries being lifted, and limits being reset. I'm sure many thought I'd never see the day..... My knee is behaving itself as well, and all the swelling has subsided.
So we leave in a few hours, no tickets yet on some day train to Kerala. No, this picture is not us, and if the train does look so crowded, we'll cancel the trip! We plan to visit Anne's parents in Tiruvalla and my Grandmothers place in Kottayam. Back on the 9th for my blood tests and then to plan my radiation. I'll try and blog from there, but I'm not sure. Funny how making my daily weblog has become such a habit! I remember being encouraged to keep a diary as a kid, even for the holidays I could only get to 2 pages (days) if I was lucky!

Yipee! for Higher ways

(Tripti(my sister), Anne and Ammachi( my grandmother) happy after the results were out!)
Yeah & Yipee! God has been so great. Both Anne and Tripti have got the post graduation seats of their choice. Tripti for M.S. Anatomy. Anne has in fact has been given a direct MD Obstetrics and Gynecology, which is such a rare thing (it’s usually given to candidates with a diploma). This actually translates - 3 years later, to us being able to finish our studies at a similar time, and with the highest degrees in her field. God has such a perfect sense of timing, His plans and His ways are so much higher than our ways and plans. When we were so upset that Anne didn’t get in for Diploma last year – we could not understand why then, but in retrospect….. Anne was able to study, we are able to have a baby, she was able to spend time with me at Chemo, and to top it off God has saved her a year by her getting in directly for MD. Where is the doubt guys? God is good all the time!
I have my own little miracle today to boast of too. We can’t let the Obstetrician and Anatomist steal all the limelight now, can we? Last night my left knee got really painful and swollen. A bit of fluid got accumulated and it was so bad I was on my mother’s crutches (left over from her ankle fracture). Dr. Alfred (orth) and Dr. Suranjan (PMR – Shikha’s dad!) had a look and were talking in terms of aspirating the fluid and scanning it etc… Yipes. But with some pain killers, rest and a good night’s sleep – the knee is nearly back to normal! Went to check up in hospital today, and we are going to just observe it. It may have been a small bleed into the knee or a viral infection. It’s settled now; I just need to rest it. Healing….!
Anne drove, into hospital - so I could rest the leg. I’m a real male chauvinist when it comes to driving, and always prefer to be behind the wheel! Dr. Mammen will give me the final verdict on if I need a PET scan today! If not, I plan to take a vacation – catch a train to Kerala for the next week with Anne and Ammachi. Look out y’all! – There may be no blog for a few days!!!