Tarun Jacob - LIFE'S A JOURNEY NOT A DESTINATION

For unto us another son is born...

2010-09-21T23:32:00.004+05:30

I had mentioned earlier that Anne and I were expecting a new addition to the family. Nishan John K Jacob was born at 9.30 Pm on 18th of September. Nishan means ' a sign' - this has been just another miracle in our lives to know that we serve a living God. All went well and Anne and Nishan are back at home after a short hospital stay. Koby is very proud of 'his' baby and is thrilled he has another boy to play with.

Certain things that went through my mind as we went through this experience of being parents all over again. One was that what ever our education or qualification, despite the fact that Anne conducts deliveries on a daily basis. There are so many things that can possibly not work out and so many things that just need to be left into God's hands. Prayer, and not our knowledge helps keep us from emotionally caving in when we go through a period of vulnerability.

Anne's mum was commenting that Koby while with them for a holiday in the past was all dressed to go to the beach - when it started raining. He walked out and loudly prayed "Jesus, please stop the rain - I want to go to the beach!". The family concluded that since he seems to know where to look if he needs help - then he should be all right for the future!

Another thing I realized was how God places such perfect people to look after us. Dr Gigi Mathews (Anne's obstetrician) stood by her side through the entire delivery, and with such love talked her through. She has stood by Anne through her thesis and with both Koby and Nishan's deliveries.

Being on the patient side of a hospital once again was interesting - I remember how Dr V Sitaram, my teacher and Professor of Surgery would tell us that the doctors visit is the highlight of every patients day. How true it is... Though it sometimes sounds like stating the obvious - each word spoken at that visit will determine the mood, conversation and plans for the day. Meals, visitors and medicines only become secondary.

Anyway - To the larger community that has listened to my ramble for years - Our family is now 4 people strong and bonded in Christ. Thank you for your prayers as always.

Surgery Department - CFH

2010-06-06T12:57:00.009+05:30

Our department (Surgery) made a 2 day drive to Valparai - a hill station about 5 hours from ODC. It was an excellent drive - lovely roads, beautiful scenery along the drive - acre's of lush green tea estates to drive along. We saw a wild deer crossing our path - Anne found the many hairpin bends a bit difficult to stomach and Koby had a lovely time. We had a large group as you can make out in the picture - and we made the trip in 3 cars. Sitting right behind me in the picture is Dr Santosh Benjamin - a mentor and the pillar I lean on in our department - it was his idea actually that we made this trip. The reason I posted this picture was that when I joined ODC - this department was me and for some days - just another junior doctor (usually Justin - 2nd from the left), but now it has grown to have 3 consultants and presently 5 junior's in the unit. We will... God willing, have more join us soon. Our case numbers have grown at least 3 fold and in the last year we have bought a Laparoscope and a new video endoscope/colonoscope for the department and patients can avail these at dirt cheap rates.

I have witnessed a department show incredible growth - far beyond my wildest expectations. There is no doubt that God has blessed our efforts - when I joined this place had no surgeon for 2 months - and even simple cases needed to be referred 2 hours away to Madurai.

I only pray that as and when we move to Baripada that God will continue to bless our efforts. Unless the Lord builds the house - the laborer will work in vain. I have experienced that as true in my department over the last year.

Anne is doing OK and is due with our second in October - Miriam/Nishan are our 1st choice Girl/Boy names we have come up with.... Koby is excited and already planning for activities with his new baby.

Below is a picture of Anne and Koby who came to join me in the operating theater for a surprise birthday party that my department organized. That was a really nice day!

The God of good things

2010-05-13T19:28:00.002+05:30

Anne and I are still in Oddanchatram. We will be here for a little while longer. The picture is of us at the recent wedding of Anandith and Aswathy in Vellore. Koby is dressed up - because he was the ring bearer at the wedding. It was a special occasion for all and Koby pulled the job off well to our relief!

Good news to announce to the larger community - Anne and I are expecting another bundle of Joy - God willing in September/Oct. So thats a another miracle to doccument for all you post chemo's out there... God has been faithful and is a God of good things.

He has brought me thus far!

2009-12-29T22:48:00.007+05:30

The other day - I was quite surprised to hear Koby singing a Malayalam song. The words are about the gratitude we feel in our hearts in how God has brought us thus far! It's unusual for him to be singing alone - let alone in a language other than his usual English tunes.The end of December is a time to look back and also peer forward! Maybe even make a few new year resolutions.. The year has finally come to an end - and oddly enough, today Anne and I were reading entries of this blog from back in DEC 2005. I can hardly believe, when I started this blog that I was hardly months into my surgical training, Anne had not yet joined her Ob & Gyn post graduation, we had a baby on the way and I had cancer. 4 years down the line - I am clear of the tumour, Anne and I have graduated - we serve with our skills where we believe God has led us and we have a son - who is nothing short of our PRIDE and JOY and a tribute to the fact that we are part of a much larger plan.....

Anne and my sister Tripti graduated this year - The entire family was there to watch it happen. You can see the happy faces on the entire family as they received their degrees. Tripti and Santosh are now in Vellore as they wait to finish her service obligation.

We are still at the Christian Fellowship Hospital in Oddanchatram. There is so much to be grateful - for our time here. I have a busy department of surgery to work in and a lovely team to work with. Anne too is happy and able to do many new things.

Christmas at ODC has been fun - Anne and I sang in the Christmas Choir - led by Dr Susheel Tharien. Quite an experience, especially for me - singing Tamil and Malayalam songs was a really new thing to do! We also directed the children's play - difficult work, and I am sure that I will think twice before I do that again. We also helped organize the community barbecue, that was quite a enjoyable affair - with an open air BBQ for about 80 people from the hospital campus and their families. All the kids in ODC - had their own Christmas programme. Koby put in his first 'successful' stage performance as a "STAR" that shone over Jesus - when he was born - his lines ran 'I am the star, I led the wise men to Great King Jesus!'. I must admit - he did pull it off quite well. But I could be a bit biased!!

We look back in thanks, but toward the next year in impatient anticipation. Because, actually if we look back - there is an obvious hand of God in all that has happened. If I think of all the exciting operations we have done here, the close calls in various incidents of the past year, the reasons we have to be happy, thankful or upset - I can only see that we have been led and shielded. And I do wonder why...... Anne was gifted a book - this Christmas. The opening page read "may you and Tarun as a family - be always found at the center of God's will."

Hence why worry? We step out into 2010 with an incredible confidence that we can move mountains.... and who knows, if I read this post 5 years down the line - we may find that with His help and our FAITH we have actually moved one..

May 2010 find YOU in the center of his will always.

2009 - To reminisce..

2009-09-06T22:11:00.009+05:30

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....

2008-11-10T23:24:00.009+05:30

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?

2008-10-12T15:37:00.029+05:30

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!

2008-01-15T12:55:00.000+05:30

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

2007-04-14T00:52:00.000+05:30

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

2007-02-04T05:50:00.000+05:30

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.

2006-12-30T00:02:00.000+05:30

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....

2006-06-26T00:09:00.000+05:30

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.

To Hydrabad again.

2006-06-23T22:09:00.000+05:30

Tomorrow (24 June) will be the PET scan, I have been waiting for – virtually for the past ?6 months! It’s just a confirmation that things are all right. And it will be.
We leave early tomorrow, morning at about 1 am, and drive to Madras. Catch the flight at about 5 am to Hydrabad. The scan will be early tomorrow morning and we should be able to leave, and catch our flight back at 6 in the evening and be home late night tomorrow.
Tripti and Santosh came over to our place in hospital for dinner tonight. It was great to have them over. The advantage of having two maids (one on loan for a month from Anne’s mum), is that we have great food 24 X 7!
Appa as CMC registrar is busy getting the results ready for the selections this year. He’s been really busy and working hard on this year’s set. He will probably kill me for this picture of him, taken at a completely different time and in a different context– but what the heck – it’s lovely!
There is a picture too, of Tripti with her hair that had been straightened out for their reception in Manipal. I quite like it, and I think it’s a good conclusion to the series of their wedding snaps. Thank you, all who wrote in wishing them well.
When they came over for dinner tonight, Koby welcomed them with a broad smile and promptly peed on both of them (welcome!).
I will close now and go get some shut eye - Looong day ahead!

Reception 2

2006-06-19T20:36:00.000+05:30

So, just to get some words down to the pictures over the last few posts – the reception in Vellore went off really well. Poor Santosh and Tripti were still recovering from the crowds in Mangalore to get swamped by a couple thousand people again would have been a bit taxing. They are still recovering!

The entire reception was planned around our lawn at home, with various stalls for different foods – buffet style (dosai’s of various fillings, mommo’s sevai, cashewnut rava and various deserts). In Vellore a usual reception is a mutton biriyani served on a banana leaf – it’s what I look forward to in a wedding, but Amma was sure that this idea would work – and to say it in a very tail between my legs way ‘she was right!’. All those who came were impressed by the novelty and lay out. In all, it was a good evening for the couple – more importantly. Tripti’s classmates from college were there in full force being their usual boisterous and noisy self. It was great as they added a bit of life to the events. I have a snap here of a few of the “BONE” class.

Anne and I are back to work in full force. I have been posted on Orthopedic lists for these days and Anne is sorting out a lot of thesis and paper reading presentations. Koby has been his usual goo’ boi self!

I fly to Hydrabad this Saturday for my PET scan, it’s 3 months post radiation as of this week(! ya, I can hardly believe it myself), and this scan will be a confirmation that that I am tumour free.

The reception in Bagayam.

2006-06-18T23:21:00.000+05:30

A great day in Mangalore.

2006-06-13T16:28:00.000+05:30

I think wedding ceremonies can be very difficult to sit through, especially if it is your own sister ‘leaving’ home. We are back from Mangalore and Tripti’s wedding was such a lovely event. The Church was picture postcard perfect, there were so many of our family and friends to share in her happiness and she was looking nothing short of stunning! Santosh too was looking really great! I was given the responsibility, or should I say the honor of doing the bible reading – aptly from 1 Corinthians 13.

We had a choir from Vellore, all practiced and may I ready with a choral blessing and a special song. Koby was really well behaved and was absolutely no trouble to his parents. The inconvenience of the Bandh in Kerala, didn’t deter a good number of our family from Kerala from braving it to the wedding, despite having to walk back from stations, because some socially irresponsible people protested rising fuel prices. The clowns who made the most fuss, probably don’t even own vehicles – but that’s life.

Well I have a few photographs attached and will put in a few more as the days go by. Today – Anne and I got back to work and my parents drove back the cars from Mangalore. The reception in Vellore is still to go, this Saturday.

We have a lot to be grateful to God for, during this wedding, most importantly for Santosh – a partner and friend that I am sure Tripti will enjoy life’s roller costar ride with, secondly for a beautiful wedding that just fell into place when there were so many variables, and finally for providing friends and family that love them and have wished them well as they start of their life together.

Tripti's getting married!

2006-06-10T09:47:00.000+05:30

Tripti is getting married this Monday (12 th June). My sister and my best friend, will marry Santosh. It’s a bit difficult to believe that Tripti is getting married, it seems like it was just yesterday that I was stuffing marbles into her mouth, making her be the eternal wicket keeper as we boys played cricket. We stood side by side in Karate, Piano, dance lesions…. We could and can still share anything with each other - Now life has taken it’s natural course and Santosh and she will start off on an incredible journey together. And knowing Santosh, it’s going to be a good one, she is in good hands – I could have wished for nothing better.

Wish them luck Guys, Tripti means a lot to me. My next post will have pictures of the wedding, we leave in a few hours to Mangalore for the wedding, and we have a reception in Vellore next Saturday (17^th).

Anesthesia posting is going off well, and I am learning as well as polishing up on my skills. Koby still has us up at night, and now that Anne’s leave is over and she has to get to work the next day, we are a bit stretched. I’ve not blogged in ages! Will write in with details of the wedding. A smile from Koby to sign off, doesn’t he just make your day?

Zzzz zzzz!

2006-05-31T22:29:00.000+05:30

So, Plastic surgery has come to an end. Tomorrow I start a month of training in anesthesia. What a change from being on the operating side of the table to the non operating side! I was being teased by my Plastic surgery team, that I am going to be ‘passing gas’ for the next month. That not very parliamentary, but you see (for the non medical person) – Anesthetists and surgeons are usually poles apart. Always at a sort of “war”, the surgeon trying to push extra cases into a working day and the anesthetists on the look out for the crafty con man surgeon!

But jokes aside, I think this next month will be a really important one for me, because I need the experience of anesthesia for my hospital in Orissa. When I was a junior doctor in RUHSA, I used to operate cesarean sections by giving the spinal anesthesia myself and then turning the patient over – the team will pray before we start (by which time the spinal fixes) and then we would start the surgery. It was the norm to be surgeon and anesthetist in one, but I have had a bad experience me and I know better training may have prevented it.

The exposure to all these anesthetic gasses can make one really tired – I can just imagine that every evening is going to look like the picture below!

Koby is going to see his first pediatrician tomorrow! – He has a sort of allergic rash over his face and neck. Dr. Valsan was my pediatrician when I was a kid, and now he will look after Koby!

If some of you have missed reading yesterdays comments - my running partner (Pastor Carlos) during my Non Hodgkins time has been declared to be in remission. Thats great news - God has been so good.

Post endoscopy

2006-05-30T16:56:00.000+05:30

The endoscopy was done this morning and by Gods Grace it's normal. The entire exercise was just God's way of telling us that he is still in control and like Anne and I read today in our devotional - God doesn’t do halfway miracles.
The endoscopy as such was quite an uncomfortable experience. I was given some sedation before they started, and am very grateful for it. “The scope has to pass the upper esophageal sphincter” – Dr. Ashok Chacko (Head of gastro enterology) told me, “and once you help me by swallowing past that I will look after the rest.” Aaagh, it was uncomfortable, and I kept puking through it (thankfully I was on an empty stomach). I think I struggled a bit more than normal so they gave me a bit more of sedation. In the end, I was so sedated, that I can’t remember how it ended. The reports as I mentioned earlier are normal, no sinister cause for the bleed – most probably a little tear that caused it while I was retching on Sunday.

I slept the entire morning through and woke up for a late lunch. Amma is back from Singapore, and Anne, Koby and I drove home to see her. She has brought a whole lot of goodies for us. Koby as usual is the most spoilt of the lot!

Back to work tomorrow, it will be last day in plastic surgery and from next month I join Anesthesia for my next short posting. That will be something to look forward to!

Just another Manic monday!

2006-05-29T21:33:00.000+05:30

It's Just another manic monday
Wish it were a Sunday
Coz that's my fun day!

Today was a busy day in theatre and I am on call again. The planned operation for today was cancelled for some unforeseen circumstance, but we were fairly busy with some new cases posted on the list. A young man smashed his face in after falling off his bike and needed a couple of plates to fix his broken jaw back together. The sad thing was he was drunk and drove. The majority of the trauma we see are people off two wheelers under alcoholic influence.

Anne cut Koby’s hair today. He’s really looking cute with his new hair cut. I was beginning to feel really J of his nice thick black hair. She snipped a small bit and has kept it to put into our baby book – I has a step by step detailed list of things Koby went through since birth.

We had a few visitors home this evening – my classmates from school – Sushil, Jey and Balaji dropped in to visit. It was a nice get together. Sushil is just back from Australia and will soon be in LSE for further studies. He is the only one from my school class that became a lawyer. He’s cut his hair real short – wish I had my camera then, I could have put the pic of all of us up for the benefit of our school class readers.

I am going in for an endoscopy tomorrow. I vomited a bit of blood on Sunday and Dr. Alok feels it’s better to get a look inside to make sure that there is no real sinister cause for the bleed (radiation or ulcers), it’s most probably just gastritis – but I can hardly claim I’m stressed out in this posting! But the thought of having a tube shoved down my throat is YUCK! Anyway will keep you all posted.

Better

2006-05-26T21:32:00.000+05:30

I am on duty today, and surprisingly for my rotten luck, it’s been quite an uneventful duty so far. Touch wood.

Anne is busy watching India get clobbered in the cricket match on TV; I care a hoot for cricket and am hardly bothered if there is a game on or not. Koby has no choice and has his face looking wide eyed at the tube light, sitting in Anne’s arms. He is so much better today; he has settled down and is moving his injected leg about – Thank God! There has hardly been any fever and he is his old cheerful self again.

Appa, who is in charge of the CMC entrance exams as the registrar – has been really busy for the past few days. The exams were over today and by Gods grace have gone off well. The co-ordination of any exam centers and examiners is not an easy task.

My pictures are not loading up today, well – will send some later! My new internet connection is dial up for the moment –I have given up my last broadband for a dial up thats much slower but loads cheaper! Hope to sort out a new broadband soon.

Andrew Lloyd Webber for the night.

2006-05-25T22:03:00.000+05:30

It was time for Koby's 6 weeks shots today. He is REALLY irritable, as any parent will recall. It’s incredibly tough for a parent to go through a child’s pain (I’ve mentioned this before). Every time Koby startles in his sleep his swollen leg moves and he howls in pain. AAAAH, I wish I could take his shots instead. He is so exhausted from his crying that he has now literally cried himself to sleep. It’s great to sing him to sleep usually, but today he is in just no mood for the vocals. I’ve been singing Jesus Christ Superstar songs to him, at least the one’s I know fairly well – Lyrics are made up here and there.

Always thought that I’d be an apostle,

Knew that I would make it if I try

Then when we retire, we can write the Gospel

And they will all talk about us when we die!

(sung by the disciples after Jesus dies)

JCS. Rice and Webber.

I’ve been listening to Andrew Lloyd Webber since I was a kid. Appa took us to watch Evita when we were in the UK, as children. Brilliant is hardly the word. These lines from above are so true for everyone. It’s not only the apostles who lived with Jesus who have an epistle to share – it’s each of us. Living with him as a real human being or experiencing him at work in life is fairly the same thing. If I were to keep the stuff I’ve been going through to myself it would be such a selfish shameful waste. Not saying that what I write should be read in church as the Gospels!, but testimonies are to be shared and this blog is mine.

Anne is getting set to get back to work, she is nearly out of maternity leave. It's going to be hard leaving this little gem in someone elses care. God will keep him safe, we are sure.

Settling in to 56 C 1.

2006-05-22T22:25:00.000+05:30

Life is settling down, and we are learning to fending for ourselves. To say that we were doing it alone would be an incredible fib, because we are being supported so much by our families, that I wonder how new parents manage without their parents to help them out.

The child I was talking about in the last post has done well and had a new pretty lip to face the world with. Repetitive trauma to her fingers and toes have caused them to resorb a bit, and since she feels no pain they are still a bit cosmetically unacceptable, but her stay in the ward has also been a place for her to get to know about her disease better and stay out of further harm.

Koby has a steady stream of visitors. My friends Abhilash and Asha are here in this picture. He is still active at night, and this evening we took him out for a small walk with us – till the milk shop. But the little chap slept through the entire walk.

So, what’s happening to me treatment wise, It’s a question, I’ve been getting asked by some on the e-mail and since I have not really been sure – I’ve kept from answering. I had my CT, last month and the results were sort of plus, minus. The mass is down to about 5 cm, that’s down by 3cms after the radiation. That’s good news, but there were doubtful new nodes in the upper chest, which may also be radiated tissue and not nodes. It’s difficult to say now and the PET scan will be the decider. The scan is fixed for the 24^th of next month (June). I will go alone this time – no drive, I will fly to Hydrabad early in the morning and return at night. That’s what I have to expect treatment wise.

Pain!

2006-05-21T11:23:00.000+05:30

It’s the 21^st of May and yes, my birthday presents arrived bang on time. Both Koby and Anne were here on time on the 19^th to celebrate. It was a lovely day. Anne’s mother and a maid from her home are here too. It’s just great to have Koby home. All my carpentry skills came in handy and Anne loved the new home. We still have a lot to fine tune, but our first home is off the ground. I guess it’s such a big step for us.

Koby has fallen in love with a little rattle his grandmother bought him. It gives a sort of musical jingle and it always stops him in the middle of his big cries! This Sunday, Anne and I are just settling in together – sorting out where things go and what sort of schedule to keep. Life has just turned so 180 degrees! Koby, just makes it all worth it! The pictures are from when the family was at our new home on the evening of my birthday. Tripti made and INCREDIBLE, death by chocolate cake, seen in the foreground.

Work is as usual. We have an 8 year old, who is posted for surgery on Monday. She has a disease that makes her insensible to pain. She can not feel any pain, and that is why she is posted for surgery tomorrow. We will never be able to give her ability to sense pain, but we are operating her for its consequences. In her ignorance, she has bitten off her lower lip, poked her eye in so many times that she is blind in one eye and near blind in the other and so on. We are attempting to reconstruct her lower lip tomorrow. Pain is such a nuisance and at times we wonder why we have to bear it, but through this girl, I have realized that it is actually a blessing. I guess the next time I recoil from a cup of tea that’s too hot to hold, I just have to look up and say thanks! And so much so for all that has come to be this year – the pain of chemo, the joy of Koby and family, the expectant hope for Tripti as she sets down the road of a family with Santosh – A look upwards and thanks. This birthday has been special, not because of what I have done over the last 26 years, but for the fact that I have been strengthened and healed through God’s miracle of pain to face and hope for tomorrow.

With Anne and Koby for the weekend

2006-05-13T21:25:00.000+05:30

So, here I am back in Kerala for the weekend, and having a whale of a time with Baby Koby. He has grown so much in a month and looking out at the world with a keen interest. I really doubt he is able to focus too much, but he is a keen observer of sound! I wonder if he remembers all the songs I sang him while he was in Anne's tummy! Here are pictures of him grinning, just before he nodds off to sleep and one with his proud grandparents.
I got a really big package delivered to the department office, yesterday before I left. It’s funny, because it had been bouncing between departments for the past 2 days – the secretaries suspicious of the possible bomb! And refusing to sign for it. I opened it to find a months supply of pampers from Parthi, on my best friends who lives in Africa, it was a laugh! The only “bombs”, will be what Koby creates in them!
Anne and Koby are doing well here; both of them are getting spoilt rotten by her mum. It’s nice to watch Koby enjoy being splashed with water during a bath, bicycle in the air, smile in his sleep; so many things that just make him so special and so much like the miracle that he is!My visit ends tomorrow, and I am back in theatre on Monday (I hope the train is on time). Anne, Koby and Amma will be there in Vellore on the 19th. The house is more or less ready for them; I haven’t brought any pictures of it for them to see, just to keep it in suspense till they reach!
Tonight, I will be on a different kind of duty - Koby is fairly well behaved at night - or so, Anne tells me. I really don't mind, he is more than perfect, and God has given us such a lovely gift in him that at times I wonder if we deserve so much grace. A picture of Koby and me to end with, there is a similar one of my father and me when I was a baby, maybe I should get them side by side!

Blog slacker!

2006-05-12T00:23:00.000+05:30

I am sooo tired… Shifting into a new house, getting it in order and working plastic surgery at the same time can be …..
“‘You are losing it’, ole Chap”–I’m told, by one of my friends who’s been reading this blog regularly and not seen an update in a while. I’m slacking and I can feel it.
It’s true – My page heads with the words – “A guy going through Chemo,” – yeah – that was months ago….and “my life on a day to day basis”….. It’s been a while since I’ve had the luxury of writing every day! I have got to get down to changing my template sometime.
Last night, I crawled into the house at 5.15 am, only to leave at 6.45 again to regular theatre. I was on call and there were so many facial injuries to suture up in the emergency department that it just kept going on and on. It’s election season and the average drunk has a good reason to get sloshed and fall of his bike!! A policeman on election duty came with his face split open, after crashing his jeep into an oncoming lorry. The worst was a 14 year old, who rushed in with his 4th toe (of his foot), neatly wrapped in Ice, but too far crushed and late to re-implant.
I had my first visitor’s home for a meal today, Sabisachi and his wife joined me for a meal tonight. Saby is a fellow NHL patient here (from Calcutta), and we went through Chemo pretty much the same time. I had spent some time with them initially when they came and were worried about chemo, and told them that there was nothing to worry about. Saby has sailed through chemo, and was actually at work in between his chemo courses – he went through CHOP. Through time we have become such good friends that the ‘cancer underground’ will be pleased! His wife Swathi was one of Koby’s first few visitors! They have a twelve year old son, who is his parents pride and joy!
A few weeks ago, I had asked you all to remember Mrs. Chandrika Menon in prayer – a retired nurse, with Leukemia from Coimbatore. Her son in Law had read my blog and we met when they came for treatment here. She passed on to a better place a few days ago, and from the little time I spent with her, I am sure that she would have left so many happy memories with her family through her life. “I have come expecting to see a miracle”, she told me… I only pray she got it.
I leave to Kerala tomorrow, for the weekend. Anne and Koby – here I come!

Cards.

2006-05-07T14:39:00.000+05:30

This Sunday I spent at home at Bagayam; the preparations for Tripti’s wedding are in progress. Wedding cards are probably the most exhausting part – you just keep writing and writing – hoping that you haven’t missed out names!
This is a snap of us at work; Tripti has the nicest handwriting, so she is delegated to the writing, I read and Appa put the cards into the envelopes! Hey, it isn’t as easy as it sounds, OK. We call Anne up in Kerala if we need to know spellings or names of people’s kids!
The picture of three of us is Nirmal, Edward and me, in Madras at Java Green. Nirmal is one of our classmates from school and then Medical College, who just got married a few days ago to Debbie – a German elective student who he met when she came to work in his mission hospital in Allahabad.
Koby and Anne are keeping each other busy. Anne’s dad is out of the country for the next two months, and called to say bye just before he left. I will miss seeing him when I go there this weekend. To end with, a picture that Tripti took in the car. It was on our way back on the drive from Madras. It looks like the sun has set fire to a power cable – Give me Red.

Koby has company!

2006-05-06T21:34:00.000+05:30

Anne's best friend Benny had been over to see Anne and Koby in Kerala. Benny lives fairly close by and she too has had a baby girl just a few months ago. The two mothers have put the two clueless kids together for a great snap! Koby on the right, is blushing scarlet - poor chap! Our classmates from Vellore reading this – here’s a second generation snap for you all!
I'm going over to Kerala, to see them his week end- Hooray!!, I will be there in 6 days, I can hardly wait!
The house is nearly ready - the gas people came over and fit in the gas cylinder. The mattress people came measured, and put new mattresses in place. I have been up for the past few nights, banging holes into the wall to fit up towel racks, plug points, soap and toothbrush holders and the list goes on...
The temperature in Vellore is a bit high, it was 44degrees C. I love the hot weather, but there is nothing Anne hates more. I wonder who Koby will take after. The summer heat reminds me of lazy summer holidays - playing basketball till late, hanging out with friends after school, summer vacations and so on.
Our list on Monday, for plastic Surgery will be tight with a lot of cases to finish within the usual time. I took a sort of class for the department on estimation of burn depth, and talked about various experimental ways to do so. It went off OK, but I miss having broadband internet in the new house (to prepare), I have to get that sorted out soon. Life is easier with Google searches!
So, as I was saying......The house is finally falling into place, the piles of junk are slowly finding a place to stay, I have even put up a painting on the wall - a beautiful oil painting of a village scene. The curtains are ethnic – chosen by Tripti. All that’s left -- is for you to visit?

A new month

2006-05-02T00:01:00.000+05:30

It's a new month, and there is so much new that comes with a new month. A change of posting is one for a start - today I started my Plastic surgery posting. It was actually to be my Thoracic surgery posting this month, but since I spent a year working in cardiothoracic surgery, I have been allowed to do another posting instead. I missed my plastic surgery during the Chemo time, so am making up the time now!
Amma, Tripti and I drove over to Madras over the weekend, to get some wedding shopping done. I was a nice trip, and we got most of what we had scheduled to buy, done. Tripti was keen on a rather different colour for her wedding sari, and so we had a long search for the "right" one. Traditional Indian wedding saris are red or maroon and her Sari is going to be..... well, different. The only tough part of the trip was the heat, it was just incredibly hot, the car’s air con seemed like it was packing up and I had to cover the steering wheel with a hanky, just to hold it- hot!
Anne and Koby are still in Kerala, May 19th and they will be back home - hooray! Anne keeps me updated with latest Koby snaps. Here is one to share with you all.
Amma went crazy in a shop in Madras, meant just for new born’s - she proudly told the shop keeper “If I had more money I would buy all you have in your shop for my new grandson!!” (With all the money she had, she nearly did!). Koby now has a new playpen cum crib to sleep in and loads of clothes and blankets that Amma picked out. Anne's parents too are spoiling Koby rotten, Anne's father has got them an air conditioner to keep Koby from the oppressive May heat. Spoilt brat ! I hope he can live the common life that his father and mother are going to offer him in the new house!

House to home

2006-04-25T22:55:00.000+05:30

Koby has been the hero of the last few posts. Poor chap, he’s not even here with me and his father can’t stop blogging or talking about him! He's pitured here with his great grandmother who came to visit at Anne's home in Tiruvalla. My fathers mum.
I made a trip over to the radiation therapy out patient department today. It’s been a month since radiation was over and it’s time to get a CT scan appointment made to see if there has been any change to the disease with the radiation. Unlike a PET scan, a CT scan will not be able to differentiate between cancerous active and dead inactive lymph nodes, but it will let me know if the radiation has shrunk the mass sitting in my chest – or if has grown oblivious to the radiation. The appointment is for Saturday – this will be the first of my scans I go in for without Anne around. Will miss her not being around, anyway she’s just a phone call away.
The small scabs of burnt skin from the radiation finally fell off today while I was having a wash. It’s like old things have passed away, I a new person…. The CT or the PET isn’t going to tell me something I don’t know.
I got the keys to my new apartment today. Amma and I went to check the place out. It’s a dusty mess, and needs a lot of work, but getting it together before Anne gets back is going to be great fun.
I don’t know how many of you know a song –“Rocky”. Not the movie, it’s a song I love and have sung on stage at various points in life.

We found an old grey house and you would not believe the way,
We worked at night to fix it up, to classes in the day.
Painting walls and sippin wine, sleeping on the floor,
With so much love for just two, soon we found there’d be one more..

And she said “Rocky, I’ve never had a baby before
– Don’t know if I could do it,
But if you let me lean on you, take your hand I might get thru it.”
I said “Baby, O sweet baby – its love that sets us free
– God knows if the world should end, your love is safe with me.”

I guess a lonely mind has time for nostalgia!

Cherry and Koby

2006-04-24T23:09:00.000+05:30

I have hardly recovered from the weekend duty. We were up late in the night struggling with a perforated appendix and then had to go into theatre for the regular list at 7:30 Am. Today I got to assist on an interesting case for chronic pancreatitis in a child.

I was informed today about the passing on of a great man – Dr. A.K Tharien. He was one of the founders of the Christian Fellowship hospital in Oddanchatram and an incredible visionary for medical care in India. He was a person who took a great interest in Anne and me wanting to work in Baripada and helped us follow it through.

Koby and Anne are having a ball in Kerala. Cherry (Anne’s brother) was in Kerala for a short time and was really thrilled to play with his “awesome” nephew! Here is a picture with the two of them having a moment together! I just cant waith for them to get back. We still have not got the keys to our new home - I hope it come by the time Anne and Koby are back, was hoping to have shifted in before they came.... Lets see.

Through it all - I learn to trust.

2006-04-21T20:21:00.000+05:30

The poor lonely father is clicking through pictures on the computer of Koby and Anne. They are in Kerala and enjoying the constant stream of people in to see the new baby. Koby behaved himself on the trip to Kerala. They were in an Air conditioned train coach, and he had another tiny baby on the opposite seat to keep him company. He must be having a great time in Kerala getting all the attention he just loves to have! ( just like his dad)
This picture alongside shows how Koby has more hair than his dad! He has his hands on his nose, but I doubt that it's because of how I smell!!
My sister - Tripti is just itching to get married. The countdown has begun and I can imagine her pushing time faster to June if she could physically do it! It seems like eons ago when Anne and I tied the noose, now with Koby around and all – but it’s probably the greatest thing I’ve done in my entire life. “Go for it girl” is all I can give her as sagely brothers advice!
The Pediatric surgery posting is sadly drawing to an end. This weekend will be my long duty and I am nearly done. I wish I hadn’t missed 2 weeks to radiation therapy, but I guess it just had to be. Dr. Viju John is a senior registrar with me and he was quoting the popular Hymn – “through it all – I learn to trust in him”, while we were talking about how God splats us into trouble rather than helps us skirt it or escape the easy way because through the tough times is when we see him work us through. I couldn’t agree with him more. Viju finishes his training here and will also be going to a mission hospital in Lumptaput, Orissa.
Today all the senior doctors of the CMC senate are biding farewell to Dr. Chacko Korula -our head of Nephrology, as he retires. His son Sushil and I studied in school together. His leaving CMC will be a great loss.

Eddie in town

2006-04-20T05:57:00.000+05:30

Eddie has come down from Madras to see Koby. Edward is my best friend in Medical College and was my best man at our wedding. He has just got into a medicine residency with a hospital affiliated with Yale and will start in July. Once he is off to the United States – I doubt we will get to see him again. Anne took a good half an hour to get to the church from her home, when we were getting married and Eddie kept me company and kept reassuring me that she will come!

Koby was thrilled to see Eddie; he sat peacefully in his hands and then did both a big job and little job on him! Naughty boy!

Today is an important day for Anne and me – we have applied for a house on the hospital campus. Now that Koby has come along, it’s going to be impossible to stay in a single room – we will need a maid as well, once Anne is done with the maternity leave. The applicants are many for houses and the houses are few. Let’s see what happens. That’s something to pray about. The pick is at 12 noon today.

Anne, her mum and Koby leave to Kerala today – I hope I finish my operating list before they leave so I can at least see them off at the station.

Koby has been really spoilt - many of my college classmates are in CMC doing their postgrads - they have all been in to see him and carry him around. To the left Abhilash, Subhash and Patra. Annie on the right!

9pm - Anne and Koby are on their way to Kerala. Sob!

God feeds the sparrows! - We got the house!! The picks were good and we have a house in "the 'old' PG quarters". Thats the great news for today. It's actually such a great thing. It was quite doubtful, but God helped it work out in the end.

Home for Easter

2006-04-16T10:33:00.000+05:30

It's great to be home, Koby is back with his grandparents in the college campus. He needed phototherapy because he was a bit jaundiced. His blood group is special - I am A negative and Anne B negative blood groups, he is AB negative ( perfect - because those are universal recipients - i.e. they can be transfused with any blood group if they need a transfusion).
Koby is a real bundle of joy, he's up all night, and hungry virtually every half an hour- but all the effort of changing his nappies, feeding him is just sooo worth it, when he clings onto your shirt and sleeps - oblivious to al the commotion about him.
Anne has recovered from the delivery, her blood pressure is back to normal. Back home for Easter is great - full house. Amma's mother and sister Lizzie ammama are here. They are thrilled to see the latest addition to the family - Koby is luck because he has all 4 great grandmothers alive. One is 96 years old - In Tiruvalla - Anne's grandmother and she just can't wait to see her great grandson. Anne's mother is here and they will leave with Anne and Koby to spend a month in Kerala - to recuperate and be spoilt silly by her parents! Sniff! I'm going to miss them, but I have to sadly grin and bear it as such is the "custom".
We went over to the Scudder Auditorium this evening to listen to the Celebrant Singers. It was Anne's first outing after the delivery and my mum and Dad were left in charge of Koby.

Here is a picture of Koby and me with a big and little chocolate Easter Bunny! It's been a great Easter. Thank you - all of you who have shared this most beautiful experience with Anne and me. The e-mails of congrats and comments on the blog. I hope Koby will grow up to be and do as God has planned in his life. To be a channel of Gods love. As the leader of the Celebrants today said - when we enjoy a sip of cold lemon soda, we don't say what a lovely staw - we appreciate the drink. It's the same way we need to be the channels of what God wants in our lives. Koby is nothing short of a gift, to Anne and me - when we least expected, but he has a purpose and I only hope God reveales to us what he is to be and do.

Koby!

2006-04-13T06:49:00.000+05:30

On April 11 at 1.02 PM, a 3.56 Kilo screaming Koby was born.
Anne is exhausted but doing well. This is the greatest thing that God has done in our lives. I usually have a lot to say, but this little chaps pictures speak a thousand words. All I can say is thanks God, we are so undeserving.
Pic1 - Anne, Koby and me day 1
Pic2 - Koby
pic 3 - My Appa, Tripti and Koby.

Prayer requests!

2006-04-09T22:30:00.000+05:30

Today I have no great blog entry, just prayer requests. Anne has been admitted with high blood pressure (Pregnancy induced hypertension is the medical term) and is in the ward. The pressure is still on the borderline high range, so if the pressures stay high – her Obstetrician Doctor Jiji may induce the labour, without waiting till the 17^th when Koby is actually due. Please keep us in prayer, Anne is well now sitting around and reading books in the ward. She’s actually threatening to walk down to the Obstetric ward and do some work. My pediatric surgery ward is just a floor below where Anne is admitted, I am on 24 hour duty tomorrow, but I can keep popping in – it’s just ten seconds away. How God works things out! My normal ward would have been the other end of hospital! Here are pitures of the "expectant father and mother!", Z z z z .. .. passing time in the ward.

Another Aunty, who I had mentioned in the past, whose son in law had read the Blog and brought her to CMC, is not doing too well. They have a diagnosis of AML (Leukemia), and since she is quite elderly, a high mortality is a possibility if she chooses to go through Chemo. Palliation is an option, but from what I have come to know her by, she is a fighter. Please keep her – Mrs. Menon in your prayers.

A new friend I have made on the Blog, is battling Spinal Muscular atrophy – Pranay is a 2 year old who is battling SMA, his mother had read my Blog and got in touch with me. He is a fighter, just like me (his mother Kavitha e-mailed to say).. SMA is a difficult disease both for the children and the care givers in Pranay’s case his dedicated parents. Here is a link to a short write up on him. Keep in in your prayers too. In the last few months, I have come to realize that through prayer there is nothing that God can’t do, and that there is no weapon greater than prayer.

Actually there is a really cute wall poster in Anne's ward room - "Before you go to sleep, hand over all your cares to God - He's up all night anyway!"

Falser hood

2006-04-06T22:17:00.000+05:30

Every time I think that I am on the verge of becoming a father - the entire dream fades away in a few fizzled out contractions! Anne and I made our first false trip to the labour room yesterday, but since it was all her friends are in charge there, they kept her for an hour or so, on the fetal monitors and let us go after they were sure that she was not in labour! I’m happy about the trip because I have a trace that looks like and ECG, with Koby’s heart beat on it! The pitter patter of Koby’s heart on the monitors was like music to the ears! Funny, I hated those monitors when I was posted in Labour room earlier– they were just a noisy irritation!! Guess when the person behind the noise is your child the noises are more important and sound better!!

Work is as great as usual. I am just getting the hang of duties alone. The system is tedious, but once you get the hang of it – it’s all right. I have a picture of Shaji - one of our registrars, when we went to the neonatology nursery to put in a couple of cut down venous accesses. Threading a catheter in a neonate’s vein in a pretty difficult thing to do, I keep praying that Koby doesn’t need any thing remotely similar!

A picture of the Sun diving into the CMC, Vellore skyline as the day draws to an end. There below is the old dirty hospital, filled with all it's thousands of patients, yet life still looks calm - inspite of the chaos withis each of these buildings. Like many of our lifes, is it not? This picture is from just outside my pediatric surgery ward. Tomorrow is another day….(Koby, where are you?....)

Just another Manic Monday

2006-04-03T21:59:00.000+05:30

It’s funny how a single day can carry so much excitement! I have started independent duties from today in the department, and was posted in the out patient today, and to cover all the cases posted as emergencies in theatre. It was great – all Mondays are however terrible days to work on I guess, after the lovely rest of a weekend! Getting one’s engine running again to face the week is a task that all Mondays put us onto!

Anne got us a bit worried today, with a bit of tummy pain. It’s difficult to say when it’s the real Mc- coy! If we should take the pain seriously and pop off to the labor room to check… But the fact that she is OB-Gyn is a useful because she’s able to use their criteria and tell the mild contractions from the real thing. I’m on 24 hour call in the ward tomorrow, I hope like anything that Koby doesn’t plan on arriving tomorrow! That will really bug the rest of the registrars in my department if I hand over the bleep to go and be with Anne … but if it has to be done – it has to be done!

I went to make a visit in the hematology ward today. A few days ago, someone had left a comment on my blog post and said that they were bringing their mother in law for evaluation of leukemia, and it was their first time in CMC. I popped over to meet them – It was a treat. Once again I’m convinced that I went through Chemo to tell other’s who are worried about it that it’s something that can be faced, and that God has a plan even for those with cancer! I’m a living example!

I’ll end with a picture of my sister Tripti and Anne cutting up a watermelon – one of the cool respites in Vellore’s hot summer! This is in our Kitchen at home... And yes, Kumar the picture on yesterday's post is of my parents house in the college campus!

Back to the past!

2006-04-02T12:09:00.000+05:30

One of my all time favorite movies as a child was the “back to the Future” series. Doc Brown and his time machine…. It’s a bit like that now. But I’m back to the past. I went for my first haircut today. Not much of a haircut, but the barber used a razor the demark the back of my hair line -– and trim all my “baby hair”, that’s growing in all crazy directions! Small things like that is like getting back to a routine that was all so familiar – but at times seems like it was so long ago. When was my last hair cut – I can barely remember, all I do remember is getting discharged from hospital after the first chemo and getting my head shaved as a pre-emptive strike.
Today we are spending our Sunday at home. This week onward – I start to do independent on call duty in Pediatric surgery. That should be all right. I just hope and pray Koby doesn’t want to come along when I am on duty. That will not be any fun at all!
It’s so uncertain when Kids can pop along. Anne’s mom has been making and canceling tickets from Kerala to Vellore at weekly intervals, so when her grandchild does arrive, she won’t be left without a reservation! The other day, Amma called me in the ward to ask me something, and since it’s quite unusual to get a personal call in the ward – I went charging off thinking Anne had gone into Labour!
False alarms, False Alarms!

Rosters

2006-03-31T22:36:00.000+05:30

There is still no sign of Koby. Anne and I live in a little room in the Men’s Interns quarters that is barely enough for two. When Koby comes along we become eligible for a small house (flat) on the hospital campus. The list of those eligible is a long one and the vacant houses are few. Anyway a larger accommodation is something great to look forward to.

It’s a great work environment in pediatric surgery and I have been seeing some great cases over the past few days. There are loads of hernias for me to do, tongue tie releases and venous cut downs will be among other out patient procedures that we can do in Baripada. We had an unfortunate kid that swallowed a coin, that was stuck halfway down the esophagus on the way to the tummy – was an experience watching a senior registrar of our getting it out under a continuous X ray image intensifier!

All of us were on a roster duty a day ago – the roster system is when we have a sick child, we take turns to sit in the ICU with it, making sure all is well. The children we do rosters for are usually on a ventilator and need a little intensive monitoring, so we all rotate a couple of hours each and then the next person relieves you. The only thing is that you see stars the next day in theatre with the lack of sleep!

Anyway, once Koby turns up everyday is going to be a roster, and only the two of us to do the duty!

Keeping me in focus

2006-03-28T22:50:00.000+05:30

Ok! OK! I am sorry, what I actually meant was that I thought that I had finished narrating what experiences in my life would make any sort of benefit to a third person reading it. 10 thousand people reading it was just an observation, not a finish marker! In the future our life will be a blur of dirty nappies, duties, a crying baby, nappies, surgery, paper readings, thesis, nappies, being a “family” – and being good parents. Do you all want to hear such mundane stuff? I will have as much a ‘story’ or ‘experiences’ as anyone else at my stage in life. Anyways – I have so begun to enjoy the blog that I’ll keep at it when I have a chance!

But in retrospect, I think this forum has helped me keep focus – when it is so easy to lose focus along the way. On some days, it was the only “useful” thing I did between throwing up and avoiding food. Imagine if I was 3 months post chemo with nothing constructive to show for the time I spent under the needle! Maybe this blog classifies under constructive? (Not that I have anything more to offer!). And I think it was also a way to keep thanking God actively and consciously, even when the going was tough – I hope that is a message this blog can teach others- because miracles do occur if only we keep our hearts ready to realize them.

Anne and I went to amma’s office in the evening; she is a pathologist and has just got a fancy new microscope! Here is a picture of Amma showing Anne a biopsy of somebody’s sweaty head!

Waiting for Koby.

2006-03-27T21:30:00.000+05:30

Isn't it difficult to wait and wait for a good thing? Can hardly wait for Koby to pop along..... maybe if we give a little push?
My blog has crossed 10 thousand people on the counter. Thats great! Maybe it's time to pack up?

Weekend!

2006-03-26T11:17:00.000+05:30

The exams for the final year students went off well. We were “skilled assistants”, what skill we have, I’m not sure – but it was a great experience watching how the exams were conducted. I will be taking them in another 2 years, so it was worthwhile having a taste of what to expect!
All the radiation changes have started to resolve, my skin is nearly back to normal and I am feeling better when I swallow food. It's like the picture of college hill alongside, when one phase of life hits the sunset and the new dawn breaks to life with a new purpose.
We had come back home yesterday, and are spending the weekend at home. The pediatric surgery department where I am working now went up the college hill with most of the doctors and their children. It was a nice, fun time! The pictures are from the hill climb. Anne gave the climb a miss, because she is just too close to popping to attempt a hill climb! The climb was followed by dinner in one of the consultants –Dr. Sudipta Sen’s home. (Mutton Biriyani again, my favorite!)
Appa, Amma and Tripti have gone to Madras to finalize the printing of Tripti’s wedding card. They left early this morning and Anne and I are left at home – we slept late and were just saying that once Koby comes along these small pleasures in life will go down the drain! We have just about 3 weeks for the expected date to see little Koby, maybe sooner?

Out of my cage!

2006-03-23T23:47:00.000+05:30

Today marks another special day in this online diary of events. I have officially completed my radiation today. I met Dr. Subhashini in her out patient chamber and she looked over my x rays and decided that one extra dose of radiation would be enough (i.e Today). Went down for my last nuke with a grin on my mug! It’s great to have another chapter of this saga completed.

I have a picture of the cage I was in for the radiation, one of the technicians were nice enough to hold it for me while I took a picture of it on my PRIMUS radiation machine. I was basically strapped into this plastic cage and the lines on its surface were a guide to where I was positioned in the radiation field. From tomorrow, I have no more cages to face. Even of the mind - I think it’s easy to worry now. Questions like “Am I through it all? or will my PET scan 3 months down the line show tumour again?; there are so many doubts that can crop up, and I don’t deny that they exist. But they are not caging me in, I’m sure I’ll be given the strength to deal with it when and where the situation exists.

What’s next? Well, I guess I just sit and wait – a check CT scan in a month and a PET scan after 3 months to see if the crab is around or not!

Tomorrow I need to get up early and go as an assistant for the final year Surgery residents, as they give their practical exams. I need some rest, but I needed to blog the good news first, before I crash out!

Patient, we must all be!

2006-03-22T21:46:00.000+05:30

The next few days will be the last of my radiation. Dr. Subhashini had asked me to continue my radiation for one more day, get an X ray of my chest and meet her in her out patient department tomorrow.

My chest is now a sort of scarlet pink, but the skin hasn’t thankfully peeled off.

Our final years are doing their final exams this Friday, and all of us from the second years will be the skilled assistants for the exam. That means making sure X-rays and instruments are ready for the practical and that the examiners are comfortable. I guess we also get a taste of what our exams will be like in a year’s time. Since I have lost time on Chemo, I give my exams 6 months later, and in some other center in the state! That’s a bit tougher, but hey I’m thinking that it’s not too bad a trade off!

I spent a while in Amma’s office today, we had a baby in theatre who was suspected to have an absent ganglion (nerve) network in her colon (Hirschprungs disease), and we needed to know an urgent biopsy to decide how much to cut off. I sat in Amma’s room while the biopsy was being done. It’s not often I see Amma, even though we are working in the same hospital!!

Anne has a presentation on cancers of the Vulva, to make this week in her department and that means I have to patiently wait my turn for the computer! As you can all see!!

Can you feel the Love?

2006-03-20T21:59:00.000+05:30

Can you feel the love tonight?
It is where we are
It's enough for this wide-eyed wanderer, that we got this far.
And can you feel the love tonight, how it's laid to rest?
It's enough to make kings and vagabonds believe the very best.

Ya! I’m listening to Lion King. Lots of music playing in the room now, for Koby’s benefit! Today’s checkup was interesting – Anne’s obstetrician is also her consultant. So she pops into her out patient cubicle with patients for her opinion as well as in between today for her own check up! Koby is going to be a big baby we are told. I am happy, Anne groans!

I have been busy reading a really good novel. Q & A is the title – Question and Answer – Vikas Swarup. For a guy who doesn’t read much, this book kept me glued from start to finish. Great fun – It’s about a waiter who wins a quiz show for a billion bucks, just because the questions were from incidents and trivia that passed his life at various parts in his life. You could credit fate to such things, but in real life - I would like to credit a God who is great at orchestrating 'fate'.

So, this wild eyed wanderer is thrilled to be so far down a path to getting better! Appa was in the main hospital for a meeting, he came down to the radiation room with me – but it was crowded and so I decided to come back later. I met Dr. Subashini too, she will decide by tomorrow if I need the extra radiation. She could hardly believe that my course of radiation was over so fast. Neither can I. It seems like yesterday when I met the Linear accelerator for the first time. Maybe God speeds up time too?

Todays picture - My desk, in the room – with my old trusty laptop!

Changing the world!

2006-03-18T22:49:00.000+05:30

I wonder how many of us can really change the world. Isn’t changing the world what each person wants to do? My thoughts were kicked off after I met a good friend of mine, who in college, believed that getting into the Government set up for health care, with CMC training and values would be the best way to create a social change. However today 2 years into his tryst with government health care, he does not sound as hopeful as before. Disillusioned and given up trying to make a difference.
I hope Anne’s and my plans for the future do not reach such an end. It has to be different when we are sure God had a part to play in us making our choices. There are so many reasons we can say we have had enough – poor facilities, Koby and his education, a need to study further, lack of stimulus to improve or learn new things. One of the things that has repeatedly been repeated to us during this illness, is that for those to whom much is given, much is expected. Anne, Koby and I have been given so much, I’m sure that the future will sort itself out and we can give back to both God and man.
Today is a day off from both radiation and duty. Pediatric surgery is a great specialty and I am really enjoying the time there. Anne is on call, so we will miss the music competition that the medical students are organizing in the college, buts that’s all right – we will be able to spend the day at home tomorrow, and that will be a treat.
36 G of radiation will be completed on Wednesday; Dr. Subhashini will reassess me and decide if I need the full dose of 40 G. That can mean another 2- 3 days of radiation. The end is in sight!

of Lymph nodes and trauma...

2006-03-17T21:22:00.000+05:30

Paediatric Surgery is not as busy as I thought it would be. I missed lunch today, but that was because an intersting case started at 11 am and went on till 4 pm. Anyway, skipping a meal is a routine thing in our main Surg rotations. This ward is so full of kids, each with a different kind of illness. The great thing is there is no sub-specialization, each consultant is good at a different specialty and we get to see the entire gamete.

Today was the last day of radiation for the week. The weekend will be off and then, I will finish by next week – God willing. I have sneaked a snap of my radiation machine. The board I lie on is there, as well as a black cushion I rest my head in. The cage I am fixed into is not in the picture. Since the cage(cast), I’m fixed into is custom fit, I am going to ask if I can take mine back and keep it once I’m done! Just for memory sake!

There is a technician in the radiation room – her elder brother had large lymph nodes in the neck and I had biopsied them in the out patient last week. I think she was really worried that he had a lymphoma (she sees so many patients), but while I was doing the biopsy – I found these lymph nodes to be quite full of pus. So I had reassured her that it would probably be tuberculosis. She kept pestering me about the result for a few days, every time I went for my radiation. I finally did get the result, and lucky for him it was tuberculosis – but when I went for radiation, I was told by the others there that she had gone to be with her younger brother was in the intensive care unit after an accident on his motorcycle! Life can be so tough at times….

A day for research.

2006-03-15T14:14:00.000+05:30

I start my next posting tomorrow, a rotation in the department of paediatric surgery. I have always loved kids and I wonder if I will enjoy this posting, which combines the joys of children and surgery. It is a great unit to work with, with some great surgeons, and I can hardly wait to get there.
I will miss the hepatobilliary unit. I really enjoyed the last 20 days there. More than the fact that it was great to be back to work, I wonder if you remember the uncertain days a few weeks ago, when I struggled to button my shirt because of the pain in my fingers. Those days, I wondered if I could really continue in surgery, with decreased sensation. But working with these people, really supportive and who gave me a lot of responsibility to shoulder - renewed my confidence in what I am doing, and I'm now more sure than ever that God needs a surgeon in Baripada.
The few of us, registrars - Arpith, Balaji, Mohan and Gregory went out for dinner last night, and it was a nice parting meal..a 'last supper', so to speak! I will miss this gang, because they made my easing into work so easy!
Today, I had taken some time off to finish the protocol writing for my Cochrane collaboration meta ananlysis. I had hoped we get most of it done today, because from tomorrow - life will become a blur and one crazy rush of work. Sadly there are more changes needed in the protocol. It's difficult to get my teeth into the exact way this research has to be tackled. Anyway, I'll keep making the corrections, and hope things fall into place. Time to get to sleep - I have to get to work tomorrow!

A God of peace.

2006-03-14T14:32:00.000+05:30

Amma came with me for last night’s dose of radiotherapy, it was nice to show her the room and how I get caged in for the radiation. She was invited to the opening of the new conformal radiation therapy room last year as a professor of the institution; and was shown the new fancy machine – but little did she know that her baby boy would be there for 4 weeks of his life, and that too so soon.

She had so many questions, does it hurt, does it burn, and are your ulcers hurting when you eat? Anne’s parents too are so worried, and I suppose my being so casual and optimistically cool about it may give them the impression that I am having difficulties but refusing to show it.

On rounds last week, boss stopped an old lady who was the attendant of a patient from chewing tobacco and told her it was harmful for her. “It makes a difference if one in a hundred modify lifestyles from what we tell them”, he told us. “I would not wish carcinoma cheek even on my worst enemy; it’s the worst disease to have, and the treatment even more terrible than the disease.” He then said “in life it is good to live it well and then to die in peace and dignity. We must also if possible die after our parents” he added “for it is, by far the most difficult thing for parents to watch their children suffer”. He looked at me and said “I’m sure you will know”.

I never really looked at it that way. I know it has been tough on the family, both mine and Anne’s. But I’ve always thought if I show strength and a face that everything is all right (which it has been!), that they would feel easier about the entire situation. I wonder how I would feel if Koby had to face something similar, even if he said that all was well. I guess that at this point a God of peace makes perfect sense. He has to exist, because I have felt him at work in me and the entire family, despite this crazy situation.

knowing what its about

2006-03-11T00:30:00.000+05:30

It’s been a few busy days and I have been on call for the past 3 days. It’s great to have the weekend off from radiation. The wards have been busy and keeping everything under control hasn’t been an easy task. Anne has been doing well; Koby is not being very forgiving though – lots of small pains and aches.

I hope I can get back to my regular postings this week, there will be 4 months of work to catch up on at the end of the posting, but I guess that’s a small price to pay for getting well. It’s really tough to blog though, I really thought that I would be able to get a little time to type my thoughts in but sleep always seems to be a greater priority.

Amma called today, she wants to come with me for my next dose of radiation tomorrow and see what its like. That’s great! Arpit had come last week too, but he was so tired that he fell asleep waiting outside the room! As surgeons we have no exposure to radiotherapy as part of our training. Going through it personally changes the way I look at the entire process and in future when I recommend it – I will really know what I’m talking about!

This is a view of a part of the hospital outside our ward!

Neck deep!

2006-03-08T22:13:00.000+05:30

Life has been so incredibly busy that I just keep procrastinating writing my blog each day. I reach my room usually at some unearthly hour and the last thing I want to do is waste time booting up my computer and typing when those extra moments can be spent in sleep.

I know I am a lazy bum!

I really on cloud nine because I got to do a hepaticojejunostomy – an operation that connects the bile duct to the intestine, in this case because of a suspected cancer in the duct. Feel good about that!

Radiation is still going on as planned; I run every evening to keep the appointment at 7 O’ clock. There is just a little burning that is probably due to small ulcers due to radiation of my esophagus (food pipe), but that settles with an antacid solution I drink occasionally.

I have a great group to work with. Mohan, Gregory and Arpit are the registrars with me. These chaps are fun to work with and since we have a great time at work and we have great consultants - waking up every morning is with a sense of wanting to go to work!. This is a picture of us grabbing a Pepsi outside hospital, in a little restaurant. The picture on top is one of my ward, or should I say – second home!

Today I have some time off, we have an arrangement where Arpit does some days and I do a few. Tonight..... I sleep well!

Out of the tunnel

2006-03-05T22:20:00.000+05:30

It’s been a great Sunday today. Last night the department of general Surgery held a dinner to bid farewell to the final year postgraduates and welcome in the new ones. It was nice - a statement that kept coming up was the final years telling our teachers that they each leave having become a part of each of them! How true! A surgeon can only learn by doing and watching small techniques that only an experienced teacher can pass down. As we learn we pick up the best from different teachers and in many ways become a bit of each one.
Arpit was on call today and so I got some time to myself today after the morning rounds. Anne and I went home for the afternoon and enjoyed a good steak that Appa made. It’s great to eat great food after a while; in hospital food itself is a luxury at times and good food even rarer!
Today I was reminded of an analogy of life that Dr. Prathap had given me when he came to meet me earlier in hospital – just before Chemo. He said he thought of life like a train ride, at times life is great and we are on the top of mountains looking at the most beautiful scenery and at times we are in beautiful planes with green fields around. But there are times we enter dark tunnels- and it’s the way we react in the tunnel makes that part of the ride enjoyable. We all have the option to crib about going into a tunnel and maybe about not having lights in the train for a short time or we can make the best of it by sharing our food with our neighbor, picking up a conversation with some one there in the train and making the best of the tunnel. I guess I’m making it out of the tunnel now and the ride has been a good one.
Good news- the Echo scan (heart) I had yesterday shows my heart is ticking allright and the engine is going well - there was a worry that my heart function had decreased post Adriamycin Chemo, but thats improved now. My hair is on it's way back! I was keen on keeping the head clean shaved, but I have neither the time nor the energy! A pic of us and bits of stubble on my head! God's been great and its another reason to say thanks!

A day off!

2006-03-02T21:36:00.000+05:30

I am off today and it’s so great to have a few moments to myself. Getting back to an active work schedule is like jumping onto a running bus. You really have to run fast to gain momentum to jump on safely. It’s been a week since I’ve joined and this week has really been exhausting. I met my Radiotherapy doctors today, and was given an echo (heart scan) request – because there was a bit of worry about the effects that radiation could produce on my heart.
Tomorrow is the live donor liver transplant – we start at around 4.00 am, and will go on for probably the entire day. I’m posted on the team that’s working on the recipient – in this case a child. The donor of the liver is his father. It’s a great privilege to be on the case, hope it goes well for the team.
I’m really thrilled about the improvement of my fingers. I remember about a month ago, worrying about whether I would be able to operate with chemo having numbed the sensation and caused a burning of my fingers. This week I managed to do an appendix, breast cancer, opened an abdomen for a cyst and quite a few more smaller cases alone – and am now fairly confident that I can do it. 3 weeks ago buttoning my shirt was impossible because of the pain, and now I’m operating – I can only say that God has been really good.
My hair is also on its way back. I had half a mind to keep the bald head, but when 4 hours of sleep is a difficult proposition, shaving my head is the last priority on my to- do list. A post pancreas operation chap in my ward shaved his head just like mine – they say imitation is the best form of flattery….!
To end a snap of the good ole dayz!

Really busy days Feb 27/28

2006-02-27T23:17:00.000+05:30

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

2006-02-26T23:07:00.000+05:30

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

2006-02-25T22:46:00.000+05:30

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!

2006-02-24T22:41:00.000+05:30

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...

2006-02-22T19:18:00.000+05:30

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!

2006-02-21T16:04:00.000+05:30

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!

2006-02-20T22:01:00.000+05:30

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

2006-02-19T16:13:00.000+05:30

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

2006-02-18T22:27:00.000+05:30

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.

2006-02-17T15:05:00.000+05:30

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

2006-02-14T05:02:00.000+05:30

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

2006-02-13T15:01:00.000+05:30

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

2006-02-12T19:59:00.000+05:30

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!

2006-02-11T05:56:00.000+05:30

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.

2006-02-10T20:44:00.000+05:30

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!

2006-02-09T10:41:00.001+05:30

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

2006-02-06T21:36:00.000+05:30

(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!

2006-02-04T22:20:00.000+05:30

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.

2006-02-03T21:33:00.000+05:30

(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.

2006-02-02T06:07:00.000+05:30

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

2006-02-01T14:54:00.000+05:30

(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!!!

Pour some suga on me!

2006-01-31T14:44:00.000+05:30

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

2006-01-30T19:03:00.000+05:30

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.

2006-01-29T20:53:00.000+05:30

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.

2006-01-28T20:24:00.000+05:30

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.

2006-01-27T17:55:00.001+05:30

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

2006-01-26T16:25:00.000+05:30

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

2006-01-25T14:41:00.000+05:30

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!

2006-01-24T20:24:00.000+05:30

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.

2006-01-23T15:06:00.000+05:30

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!

2006-01-22T15:44:00.000+05:30

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!

2006-01-21T20:17:00.000+05:30

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!

2006-01-20T20:18:00.000+05:30

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!

2006-01-19T21:16:00.000+05:30

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?

2006-01-18T15:33:00.000+05:30

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!

2006-01-17T14:33:00.000+05:30

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!

2006-01-16T22:27:00.000+05:30

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!

2006-01-15T20:30:00.000+05:30

"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

2006-01-14T22:06:00.000+05:30

(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

2006-01-13T14:20:00.000+05:30

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

2006-01-12T15:07:00.000+05:30

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.

2006-01-11T16:41:00.000+05:30

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!

2006-01-10T22:31:00.000+05:30

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!

2006-01-09T14:22:00.000+05:30

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

2006-01-08T13:01:00.000+05:30

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?

2006-01-07T11:34:00.000+05:30

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.