Double portion of goodness awaits

Greetings to you all in the name of our Lord and Saviour Jesus Christ...! I know its been a long time since my last update, and my wife was insisting I write something. As there were just routine things going on, I didn't have much to share. But she insisted and actually shared verses and thoughts, which helped me with this post. So here goes...

I got back home exactly a month back now, after 53 days in Hospital. I wrote earlier right - about the long wait I had in Hospital for my neutrophils to recover, that contributed to the delay and long stay. Well, DELAY would be in our terms, but I'm sure that in the Lord's eyes, its all timed to perfection. I know HE will satisfy me with long life and show me His salvation (Psalms 91:16).

Even though I got back home, due to the low neutrophil counts, I have been staying indoors as much as possible. The first 2 weeks or so, I had to stab myself with the GCSF injections (yes, the same ones to boost the white cell counts). Only when the neutrophils was above 1 for few days, I was allowed to stop those injections. Post this, the neutrophil counts fell down again, because GCSF causes an inflated value. The very next day the count was 0.4 and I was praying to God that they don't insist me staying back in Hospital (as it was below the 0.5 threshold). By God's grace, got back home that day, and ever since, there has been a slow but gradual and constant increase in the neutrophil counts.

Also, the platelet (for clotting) counts have been low post the transplant, and I was needing blood transfusions (for platelets) every alternate day. For this, I had to go to the Hospital for blood tests, and depending on the counts, they would give me platelets. Its only since a week now, that its showing signs of improvement, and they've asked me to come every 3 days now. The neutrophils are the first to stabilize, and then the platelets and RBCs follow. By God's grace, my RBCs have been holding up well, and I've not had to have a lot of red blood transfusions.

I thank God for the last month, each day is a blessing from above, and I thank him immensely for His grace and mercy. Going to the hospital often has taken up a lot of the last month, but obviously there is a lot of time at hand. Unlike after chemotherapy sessions, I must accept that my body is feeling fatigued. And I have been resting a lot, sleeping more than usual and lazing around...! I really want to do more, as I don't like myself lazing around. Anyways, while I can't do much physical activities, I can surely use this time to share some thoughts...

The power of prayer: Needless to say we have been praying a lot. Its the way the world ticks, when we are in trouble, we begin to pray a lot. But when we get what we want, we forget the giver. I would like to stress the fact that prayer has multiple dimensions - its not meant only to ask for what we want. Its a medium to thank and give praise to the Almighty for all His grace and mercy and blessings. It is our chance to confess our sins and acknowledge the truth that Jesus has paid the price for our sins and also for our healing. Most of all, we should pray for the needs of others.

James 5:16 says - Confess your sins to each other and pray for each other so that you may be healed. When we pray for others, our healing will be manifested too. Prayers move the hand of God. We should especially pray for people who don’t have anyone to pray for them. When we pray for others, our needs will be met too. Now, don't start praying for others just so your own needs are met. :) It has to come from the heart, because the one you are praying to knows everyone and everything.

Forgiveness: Remember Job, and his suffering. The trials he went through. His three friends discouraged him and ridiculed him. He was so mad at them, but that did not bring him healing. The bible tells that God turned the captivity of Job when he prayed for his friends. When he prayed for his wicked friends and humbled himself for them, God healed Job and gave him twice as much as he had before. So as we pray, we must forgive too.

In the parable found in Matthew 18:23-35 - we read about the Master who forgave his servants' debts, but this servant did not forgive the much smaller debt of his own servant. Think of God as the master, we have huge debts of sin mounted up, that he has taken away from us and is able to forgive it all. But then we need to forgive the much lesser things we have against our friends and family. Forgive from your heart, and you will not only free them but free yourself. Its not an easy task, to do good to those who hurt/despise you. But if you submit this need to God and pray about it, He will bless you in this regard too.

Don't condemn yourself: Don't think for once, you are being punished by God. The devil inflicts pain to shake you, your finances, your family, your faith. So don't give in to it. Condemnation leads to fear, which leads to stress and will only pull you down further. God only has plans to prosper you, and not to harm you. We give in to wicked thoughts put in by the devil and condemn ourselves and slip down a slope of despair. So don’t let the devil make you feel that you are guilty. Jesus has paid the price for our sins and for our healing. All we need to do is accept Jesus as our saviour, ask him for forgiveness and turn from evil ways. 

Let us together rebuke the devil in Jesus name and he will flee from you - for there is ONLY one name on heaven or earth, to which every knee bows down - The name of JESUS!

And Jesus Christ is the same yesterday, today, and forever (Hebrews 13:8). So with great confidence I can say that like Job I have a double portion of goodness and blessings in store. God has a definite plan for my life, and I surrender my life to His works - in whatever way He seems best. I will LIVE and declare His works... I am NOT a victim, but a VICTOR in Christ Jesus. Halleluiah, Amen...

Stem cell harvest...

5.51million... I wish this were a figure in £ or $ or even Indian Rupees... :) None the less, its a very good figure that was achieved. In terms of the #stemcell harvest that was done over the last 2 days. As some of you might have read my previous post (on injecting myself), I was due for this procedure, in order to collect my own stem cells. This would be one transplant option for me down the line (if the collected stem cells are MRD-negative, cancer-free), in the form of an #autologous stem cell #transplant.

Anyways, just wanted to share my experience to all those concerned about my health and also to potential #stemcell donors. Firstly, I feel NO different to what I felt before the stem cell collection. I've had a normal day today, watching television, surfing the web, making lunch (my wife did all the chopping, and I had to just grill my healthy sandwiches) and now I'm blogging... Oh yes, the grill was messy and I spent over half an hour cleaning it too. My dear wife and friends had grilled all sorts of stuff on it during the charity fund raiser last Saturday, and it took me a long time to get all the grease out... :)

So if someone who has gone through so much chemo can tolerate and be fit the next day, I'm sure all you healthy people out there will do just fine.

For those who are new to this, the stem cell harvest is done by #PBSC method, where an #Apheresis machine helps extract the stem cells from your peripheral blood. It's a really clever piece of equipment which centrifuges the blood and because different components of the blood have different densities, they separate and can be extracted. The nurse technician was saying its not the machine thats key, BUT actually it is those stimulation injections (like #GCSF and #plerixafor) which have really boosted the power of the PBSC procedure which is being used more and more now.

What to expect on the day?
Well, it's pretty similar to whats advertised and shown on the web. You get two pokes (initially a needle, but thats removed once the vein is found) on each arm. The exact location depends on where they can find a straight bit of vein. If you're scared of needles, think about the greater cause and the life you'll save. It takes some time to setup, but once started its a 4-5 hours process. The initial needle pain settles soon and then you have to just relax and wait. The nurse was always besides me incase I needed anything.

While on the machine, your movement is restricted a bit, but you can carry on eating, talking or sleeping as normal. I tried sleeping, but being me was not able to shut down... I was texting, whatsapping and even did a google hangout session with my parents and sister, to see the stunts my little nephew Jordan was doing in #Pune. Mid-way, I felt a slight tingling feeling on the lips, but on a scale of 1 to 10, it was around 1-2. And towards the last 15-20mins the tingling sensation was a little more, maybe a 4 on 10. It a known side effect due to the anti-coagulant used to keep the blood from clotting.

For me, the worst part of the procedure was controlling the urge to use the toilet. On the first day, before the start of the procedure I went to the loo twice, and still the last half hour was a real stretch. I was counting minutes, to be taken off the machine, so I could rush to the toilet... lol... The finish of the second day was much much better. Why? Because I didn't even last half the way... ;) I guess I didn't drain enough before the start, and half way through the sensation started. I tried controlling, but there was no way I could last another 2-3hrs, so I asked the nurse for a urine bottle. Then the curtains closed and there was a looong sigh of relief (with zero spillage). That's why when the procedure finished, I was in no rush... So best advise I can give, don't bother controlling...

Also, on the first day, I was treated like a king, because a kind lady was going around the hospital, with a huge Classical #Harp, and playing melodious tunes. I thought it would be for some charity or fund raiser, but she was doing it completely voluntarily. Using her own estate car, to lug that huge Harp (she had a trolley for it too) and playing music for patients at the hospital. I'm no good appreciating music, but the gesture was awesome. Going completely out of your way for strangers...!!

Finally, about the numbers... When donating stem cells, the required count depends on the weight of the recipient. In my case, as I was my own donor, they wanted atleast 2millions stem cells and 4millions would be much better. You know the CD34 count I was talking about, the unit is actually in million. So earlier when they wanted my count to be over 10, it meant 10million. Out of whats in the peripheral blood, the apheresis machine can extract 8-10% only. On the first morning, my CD34 count was 33, and they were able to collect 3.06million. Second day, it was around 21, and they were able to collect 2.45million. And thats how we got to the 5.51million figure.


After the procedure, like I mentioned, I'm feeling perfectly normal. They do repeat blood tests at the end of the cycle and top up any missing nutrients. For me, they gave me some magnesium and potassium supplements as only those had dropped a tiny bit. Because almost all the blood (sans the stem cells) are returned to your body, there is no lose to you anyways. I've felt much much worse after a day long session of cricket. Trust me! I've had days after cricket, where I have had to have pain-killers and rest my back and use all sorts of massagers for different parts of the body. :)

Potential Donors: You will be healthy enough to have much more stem cells in the peripheral blood and so in most cases will require only 1 day of this procedure. The Doctors and nurses are always around to help and advise in your particular case, all depending on the needs of the recipient. So no matter what happens, don't back out when the time actually comes to save a life...

Take care,
Jeson
Thank you Lord Jesus for keeping me save and blessing me so abundantly...!

Injected myself today... twice...!

As the search for an unrelated donor continues, the doctors are trying alternative options too. First being to collect my own stem cells, test it and make sure it is cancer free and give that back to me as a transplant. This is called an #autologous #stemcell transplant. They tried collection off the back of my third chemo cycle, but I didn't mobilize enough to go onto the #apheresis machine. Let me explain that line in more detail first...

• Off the back: that’s the lingo used. Simply means at the end of my chemo cycle, they give me #G-CSF injections, to boost my stem cell counts, and push it into the peripheral blood.
• G-CSF (Granulocyte colony-stimulating factor): As per wiki, it is a glycoprotein that stimulates the bone marrow to produce granulocytes and stem cells and release them into the bloodstream (peripheral blood).
• Didn't mobilize: They do a test called CD34 count, to check the amount of stem cells in the peripheral blood. And for a good collection it needs to be above 10. Mine wasn't even 1 at the time, hence they used to lingo didn't mobilize.
• Apheresis machine: It is the machine used to separate platelets or in my case stem cells. The blood is drawn out of one arm, goes through this machine which does the separation and then the remaining blood is returning into the other arm.

Now, back to why I injected myself... Since I did not mobilize earlier, they have slotted me to go onto the apheresis machine again, on Dec 18th (coming Wednesday). And prior to this, as any normal stem cell donor would have to do, I have to get these #GCSF injections. I have started the injections today, will do the same tomorrow and on Monday too. On Tuesday I go to the Hospital where they do blood tests and if need be give me another #mobilization injection called #Plerixafor. Before I got 300µgrams (that’s micrograms), but this time it’s a higher doze to get me to properly mobilize. They come in different syringe sizes and I got the 300µgrams and 480µgrams syringes, making a total of 780µgrams for my body weight. That’s why 2 syringes and hence 2 injections.

Why I did it myself...? Well, if not I would have to travel to the hospital in the cold, or else wait a whole day for a local nurse to come and do this simple injection. And for those who know me, I don't like waiting. I was never scared of needles and it never bothered me. But injecting myself was different and I did not fancy doing it. Yes, there might have been a little fear. But towards the end of the last chemo cycle, when I realised that eventually I'd have to get some injections at home, I decided to brave it and under the supervision of the nurse, injected myself the last two days in hospital. These injections are specially made and can be easily self-administered with very little risk - extremely thin needles, with spring action that pulls out the needle quickly after the doze is given (check the pic above). I must say I didn't do the second injection properly and it didn't click, so had to manually pull out the needle. So had very very little blood came out, like a tiny rain drop. Absolutely normal and I’ve had a bit of blood come out even when the nurses did the injection in hospital.

Why I'm writing all this in so much detail? I thought of two reasons:
1. To give courage to all you potential stem cell donors.
There have been many new donors who have signed up during the various drives conducted for me and others like me, and that is great. But IF and WHEN the time comes and you are identified as a match for someone (your gene twin), PLEASE don't have second thoughts. You would be the person's only hope, so don't let any fear or doubt come to your mind. If I can inject myself and be perfectly fine, you can take a few stabs too right? Remember, it is to save a life and it cannot compare to the highly insignificant pain you ‘might’ have to go through.

2. To pray for me.
Pray that these injections work well, and my body produces good stem cells. Pray that I properly inject myself the next couple of days… :) Pray that the stem cell collection process goes ahead smoothly on the 18th of this month. And most important, pray that the collected stem cells are fully free of blasts/cancerous cells.

Once the CD34 count goes above 10, next step is going on the apheresis machine, and I'll let you all know about that experience too.

PS: Please don't think or say how brave or strong I am. My strength comes from the Lord, who made the Heavens and the Earth. Who came down as man, and died on the cross and has already paid the price for my healing... Please read John 11:4


Keep the faith, believe and be positive...