Sameer celebrates his birthday at home
From Kumar, Sameer’s father,
Sameer has had a challenging time for the last couple of weeks. This was expected and fortunately his side effects while quite uncomfortable were less severe than the average. The chemotherapy and the radiation had caused his mouth to become sore and the immuno-suppressants had caused his throat to get constricted. As a result, he suffered from mucositis (http://www.cancersupportivecare.com/mucositis.html) where the mouth produces large quantities of mucous causing him to cough and spit frequently into a paper cup. The cup was getting full in 2- hours and the nights were particularly difficult since the mucus interfered with his sleep. The throat constriction made swallowing difficult and he had to be fed liquids via the IV hooked up to his Hickman line. Talking caused discomfort and pain. His right shoulder was quite painful and the left shoulder was slightly painful. It was difficult to see him suffer like this even though we knew that it was fortunate that he did not have any fever or diarrhea which are not uncommon in his situation. It seemed to me that all the prayers, blessings and love form everyone were allowing him to ride the ship of prayers and blessings through turbulent waters which otherwise he would have had to swim through on his own.
I was with him on the early morning of the transplant (Oct. 3 ) and then I visited him that evening. I realized that I had developed a cold which turned into a mild infection in another day. Therefore, I could not visit him and only could talk to him and Reena on the phone. Prashant was visiting each evening to give them company. Also, my friend Eli was visiting them almost every other day. Several other friends came by as well when they were either visiting Seattle or making a special trip to see Sameer. Reena was looking after him with much love, and making sure that he was as comfortable as he could be. Sameer also was managing his care by making sure that he was getting the right medications at the right time as the nursing staff rotated each day. Among Sameer, Reena and the nursing staff, he was being looked after very well. The medical team was monitoring him closely and adjusting his dosage as necessary in response to his symptoms. The medical team also told us that his Peripheral Blood Cell Transplant (PBCT) contained close to 10 million cells. They are generally satisfied with 5 million cells and the increased number of cells improve the chances for a successful engraftment. Once again, we thanked the anonymous donor who generously provided this wonderful gift.
I was better by Monday, October 8 and was able to go to work with slight remnants of a cold. Since I still could not go to visit Sameer, I decided to go to Detroit for a conference leaving on Oct. 10 and returning on Oct. 12. I was able to follow Sameer’s progress over the phone by talking to Reena and Sameer. I was finally able to visit Sameer on Oct. 13. His blood counts had reduced and his neutrophil counts were hovering around zero as intended. At this point his immune system was almost non-existent
We had been told that the engraftment takes place between days 12 and 16 after the transplant. We therefore looked forward to the day when his blood counts would start to recover. The medical team had told us that the patients notice the engraftment even before the blood counts start recovering. The patients feel their mouth sores improving and feeling more comfortable due to the immune system rebuilding itself. It happened as expected. Sameer started feeling some improvement in his mouth and was able to swallow with less pain than before. The mucus was also starting to decrease. On Thursday Oct. 18, the neutrophil (http://en.wikipedia.org/wiki/Neutrophil_granulocytecounts) were showing an increase, and the medical team was thinking that he could go home the next day. However the neutrophil counts dropped the next day instead of increasing. The medical team explained that sometimes the neutrophils get used up by the tender areas such as the mouth and actually can show a drop. We were a bit disappointed but at the same time did not want to have Sameer come home prematurely. The medical team indicated that he might have to stay the weekend and might be able to go home on Monday. However, on Saturday (Oct. 20), the neutrophil counts increased significantly and they decided to allow him to go home.
Saturday, Oct. 20 was the annual Durga Puja celebration at the Vedanta Center retreat where Swami Bhaskaranandji conducts a traditional worship. Reena and I went to Durga Puja in the morning while Sameer was still sleeping. Before we reached the retreat, Sameer called us to tell us that he can go home that evening. We were really happy. When we returned from the retreat to Sameer’s hospital room, we found Sameer with 5 of his friends from San Francisco who had flown to visit him and surprise him just before his birthday on Oct. 22. Robert, Dayal, Brady, Nick and Nick’s fiancé Caroline were in the room and all six of them were very happy. I knew that Robert , Dayal and Brady had planned their trip and bought their tickets in August. It was fortuitous that they came on the day Sameer was leaving the hospital. We all came home and all had a good time playing a word game till late night (I did beg off and go to sleep early!).
Sameer went to the clinic for a check up today, and his blood counts have improved further as expected. He will be closely monitored at the Hutch clinic by the transplant team for 100 days following the transplant. He is not allowed to travel or even go to any crowded places. Even though his neutrophil count will be close to normal, his new immune system is like a new born baby’s immune system since it does not have immunity to viruses. This immunity will be developed over a year similar to how babies develop their immune system during the first year of their lives. Sameer has been very careful and intelligent about taking precautions to avoid the chances of infections. I am sure that he will continue to use the advice of the transplant team to stay healthy. We expect that there will be some Graft Vs. Host Disease (GVHD) effects but we are fully confident in the transplant team’s ability to manage these with the least possible discomfort to Sameer.
Oct. 22 (today!) is Sameer’s birthday, and for me it is a day of thanksgiving for Sameer’s recovery and cure. I pray for Sameer and Reena to continue their life together as ideal Hindu Householders.
Once again, my sincere thanks to each and every one of you for your prayers and good wishes for Sameer. Please pardon us for the delay in responding to your nice emails and phone calls. Please feel free to write and call, and we will definitely respond even though we might be late. If you happen to be in Seattle, please let us know. We will love to see you. Take care.
With Best Wishes,
Kumar Bhatia
