Saturday, June 28, 2008

Cancer - The Middle and The End

I'm writing this at the end of a very long journey. The journey comprised six months of treatment, six cycles of chemotherapy, and 30 cycles of brain radiations. My dad was at my side for the most time, supported by my family from Canada, Pune, Delhi, Chennai... everywhere. Most of all, I can't forget the support given to me by my family in Dubai. Of course, I mean my sister and grandfather, but my family in Dubai is much larger. The amazing support I got from my school, my friends, people I didn't even know who started sending me mails, the teachers at school, and every single person who took the time to pray for me, relentlessly, day after day, until He decided I was too much of a bother and let me go. For that, I am truly grateful.

A few highlights of the ordeal. The relationship and bond that I formed with the doctors and nurses were beyond belief, and the lengths that they went to to make me comfortable were... beyond the power of words to capture. They have such a thankless job, and yet one that thanks them the most, for they have a real influence on real lives, and one for which the lucky people they have touched are truly thankful.

Although I was irritated with it when I was there, I miss the daily routine. It was something like this: 

6:45 - Tea
7:30 - Change the sheets
8:00 - Shower
8:30 - Breakfast
10:00 - Milk
1:10 - Lunch
4:00 - Tea
4:10 - Blood Pressure Check
8:00 - Dinner
9:30 - Milk
10:00 - Sleep

This was interspersed with a thousand people coming in to the room to clean up every day and the occasional head nurse with her entourage coming to visit the favorite patient :P And obviously, the doctor's visits. And even more obviously, the main reason I was there : The chemotherapy and the radiotherapy. The chemotherapy was no big deal. If you read the Lance Armstrong book, it makes a big deal out of it, but that was 1997, and in 2008, it was barely any pain at all, just the initial pricking of needles and stuff. Even that was made redundant by the insertion of a port that ran directly to the heart, surgically implanted near my shoulder. 

And then of course, the exams. I spent the time between 10:00 and 1:00 in the mornings and 5:00 to maybe 7:00 in the evenings trying to cram for the exams, but I felt very very tired so I wasn't able to sustain much of studying momentum. Because of the tiredness generated by the morning I generally slept for about 2 hours in the evening. 

And the exams themselves, what to say. I thought English, EVS, Bio and maybe Chem went pretty well, and it turns out I was right. Only I was wrong when I assumed that I would get awarded Practical Marks. Anyway, people are telling me to be happy with what I got. I can never be happy with 83.5, but I can understand that I'm being too hard on myself, so I just let the matter slide.

And then Dubai!

I came back for a brief 15 days before my sixth cycle (five cycles and then a 15 day gap). It was the most AMAZING thing meeting everyone again, I hadn't seen them for around three months and I managed to miss quite a few school events. 

More on that. I missed quite a bit, but I am SO grateful to Mu'az and whoever helped him for compiling a farewell CD for me, and sending me the little shirt and the invite and book. It REALLY helped cheer me up when I was there. 

So anyway, coming back to Dubai, for however short a time, was AWESOME. I tried to meet at least one friend each day, and since I wasn't allowed out much because my immunity was low, people kept visiting me. 

And then back to Jaslok again, for the sixth cycle. 

Radiotherapy and all was over, just this left. By the way, Radiotherapy is just scary sounding. But its a bird. They take a mold of your head, and then everyday you go down for a few minutes (3 or 4) and they fix it over your head, VERY TIGHTLY, it buzzes for about 4 minutes, and then they take it off. Thank you, come again.

Anyway, back to the sixth cycle. It was nothing great, apparently this was some really high dosage, but they said that about the previous ones, and though this was a different stronger medicine, I really didn't feel much. There's someone looking out for me up there. Thankfully I'm what the doctors call chemosensitive. 

AFP and HCG are Cancer Markers that are used to evaluate how much cancer is in your body. The normal range for HCG is between 3 and 20. Lance Armstrong's at the start of his treatment was 110,000. Mine was a really scary 225. Thousand. 

At the beginning, the doctors said I had a 20% chance. But I didn't hear any of this, because my father and aunt went down to the lobby and sobbed their hearts out and then returned with a brave face. Thanks to them I just worried about whether I would give the exams and how I would study for them, not the much bigger worries that they were facing. 

I've strayed off topic again. The 6th Chemo was a breeze, and after a final blood count we headed back to Dubai. Once there, now for a good month until the final checkup, we registered with a Doctor Pentti, who did the flushing of my port (ask me to explain that to you) and is my oncologist in Dubai. Unfortunately, he only visits Dubai for a week every three weeks. So we did blood tests here as well to make sure I'm fine, and it was all good.

Then began the Canadian Embassy Study Permit and Medical Exam thing, but that by itself is worth another blog post, so suffice to say I had to take a medical exam for my study permit for Canada (York Uni) and send it to London for them to evaluate and decide if I can get the permit. This being a major subject of worry, I'll devote, like I said above, another post to it and the updates on it. Right now we've sent everything they've asked for (the examiner in London asked for additional documentation which we just sent) and we're just praying now. More on that later.

So then it was back to hanging out as much as possible with friends in Dubai, visiting school (an overwhelming experience for me, the support I got was incredible, with all people I didn't know coming up to me and asking me how I was, I was blown away. I owe Mr. Bloud and the school a LOT for convincing the board to let me write the examinations in a hospital bed. 

Anyway, the reactions to me returning to school were unbelievable. I really can't put it into words, so I won't even try. I then visited it again for the Prefects Investiture, and then on Prize day (thats a separate post), and sometimes I just visited it with a few guys to pick up some college documents and just roam around the campus one more time. 

Time flew, as it always does when you're having fun, and it was back to Jaslok for a final checkup. Thankfully, however, we had already done a CT Scan of the whole body in Dubai, so when we got to Jaslok, all we needed to do was a PET Scan, which we did on the next day after we arrived, and then roamed Mumbai (FINALLY! I got to see the better side of Mumbai). And then we got the results of the PET SCAN. It sounded really scary, saying stuff like new lesions found and all. So we're like...crap!

But then we visited Dr. Advani, the main doctor under whose name my file is kept, (he has like 5 docs under him of varying seniority who do the daily checks) - By the way, it is REALLY hard to see the man. Hes the celebrity of the medical world. But anyway, he came up to do his rounds of the 16th floor (mine) and saw the report, and said these lesions were just dead scar tissue and it was nothing to worry about. But just in case, he asked us to do a blood test for the Cancer Markers. Now during successive cycles of Chemotherapy and Radiotherapy my markers were reducing by more than half after each cycle, which was an amazing sign. So after the first cycle, it (HCG) became 125K, and then 67K, and then lesser and lesser until in the 5th cycle it was somewhere around 8, which was still slightly on the higher side, and finally it reached 3! The AFP also did a similar vanishing act but the exact numbers don't come to mind. It was equally amazing though. I am one of the lucky ones for whom Chemo works perfectly. 

So anyway, this blood test showed a completely normal AFP and HCG reading, in fact slightly on the lower side of the normal range, so Dr. Advani waved us off and said 'Do regular checkups every two or three months. But you can live normally now.' For my Dad, this assurance was a much bigger event than the Board Results (obviously) and I breathed a sigh of relief too. Of course, the Study Permit Medical would prove to be a pain in the a**(which also gets resolved - thats another post) in the coming days, but more on that later. Right now, its back to Dubai, friends, laziness, books, guitar, music and general relaxation. Yeah!


Krishnamoorthy said...


you write so beautifully, Kiran Kudva directed me to your website and sent me two of your stories, so well written.

God bless you, son, so happy to hear that you are back in Dubai with your family.

Take care and have a happy and healthy 2009!

With love from me and a lot of your fans in Canada,

Shreyas said...

Thank you very much, I wish you a great 2009 as well.