Sunday, 29 December 2013

A blessed Christmas season

How I am blessed to be home during this Christmas season. How I am blessed to be able to attend Church, visit friends and spend time with close family and friends... How I am blessed to be His son. Jesus's death on the cross bought us salvation, and redeemed us from suffering due to sin. Simply put, Sin is absence of God. How blessed I am that Jesus died for me and paid the price NOT ONLY for my sins, but also for my healing...

My health is great, and I am keeping well. Eating and resting well. Next appointment with the Doctor is on Jan 8th, and I should have the results from the stem cell collection and also other results from donor searches. It is going to be a BIG day, when most likely a final decision will be made about what transplant option to go for... So keep praying for me...

Btw, not sure how many of you saw the this post I put on FB on 25th Dec:
=====================================
Today is not about Christmas trees, snow, bells or santa... Even this Christmas season is here for a reason... Let's remember today for its real importance...

For Jesus Christ was born this day, to save us from the bondage of sin...! In his death on the cross, He has already paid the price for our sins and our healing, we only need to have faith and believe...

I find this story about the birds, one of the best ways to describe why Jesus Christ had to be born amongst us. Please read it...
http://t.co/PnTM19SS8c

Quote from the Daily Bread:
"The birth of Christ brought God to man,
        the cross of Christ brings man to God."


Wishing you ALL a blessed Christmas season... Love one another and spread peace and happiness...!

=====================================

Sadly, only 19 people have liked it so far... :) If it were a funny clip or joke or a selfie, it would have gathered likes by the dozens. Even more if I were a woman... ;) [Please, don't call me a sexist, its a fact about behaviour on social media].

Anyways, I hope this post reaches more people now and they can get to know my Saviour better. Please do read the story about the birds. It's a great example that describes why God, the Creator had to be born into this world, to save us from impending doom...

"And the Word became flesh and dwelt among us" (John 1:14)

Once again, wishing you all a blessed Christmas season and a wonderful blessed New year...

Friday, 20 December 2013

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...!

Saturday, 14 December 2013

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...

Friday, 13 December 2013

Not so free afterall...

So, the PIC line was removed last Saturday. I was glad that finally I'd be free and can use my left arm better. But guess what, I've been tied down since and its gonna be another few more days I guess...

For those who haven't read the last post, I was developing some rash and blisters due to the plastic dressing used to cover the insertion point of the PIC line. It had been in there for over 3 months, and the skin was not taking it anymore. So when the line was taken out, there was a few blisters and the skin was tender. The nurse put a cloth dressing till the PIC wound heals and said I can take it off in a day or two. I took the dressing out on Monday, and guess what - the whole upper arm was inflamed. The skin was all red, and it was all covered in blisters...!!!

Since it did not subside, they called me back to Hospital, and I spent most of Wednesday in the day unit. They were suspecting #Shingles, so I was kept in isolation and given a nice bed too... As it wasn't the usual sitting position of the day unit, I didn't mind the usual long wait. Shingles is caused by a virus similar to the chicken pox virus. It's contagious by touch, and for those who haven't had chicken pox before, it seems they develop chicken pox. So Ancy and me were a bit worried as she has never had chicken pox before.

Anyways, they took blood samples, blood cultures, swabs of the pus, etc. And finally, they decided to send me home on antibiotics for the rash, until the swab test results get back.

The skin is terribly itchy and I can't tell you how I am controlling the urge to scratch all over... :) Although the last few days have been painful and it doesn't look like subsiding any time soon, the good news is that the swab tests and blood tests were all negative (no shingles). So amidst the severe rash and uneasiness, its good to know that its not gonna be worse. Praise God...

Please do continue to pray for me, so that this allergy/rash subsides soon. I'm due for #StemCell collection next week, so need to be well by mid of next week...

Monday, 9 December 2013

PICC removed last weekend


My left arm feels relaxed now, as the PIC line has been removed. It was in there for around 3 months now and was used for the 2nd and 3rd chemo cycles. As it was in there so long, the skin around the insertion point had got really sore, with blisters forming. It was getting really itchy, so I requested the Doctor if it could be removed, as there was another few weeks before the transplant happens and they could put a new line in at that time.

Now, you ask what a PIC line is? Let’s start from the beginning of my treatment, so I can tell you about the Hickman line too... :)

When I was first diagnosed last year, I had 3 rounds of chemotherapy and all the treatment was done using whats called a Hickman line (name after one of its inventors). The #Hickman line is a central venous catheter, that is inserted on one side of your chest most, and it goes into your main vein leading to the heart. The peripherally inserted central catheter (#PICC or PIC line), on the other hand is inserted in a peripheral vein in the arm, and then advanced to a larger vein close to the heart. 
Hickman line
PIC line
Both the Hickman line and the PIC line are used for long term treatment like chemotherapy. They also serve as a means of giving #intravenous medication (like antibiotics or fluids), giving blood transfusions and they are also used for drawing blood for analysis/tests. Inserting the hickman line is a more complicated and more painful procedure, but it has a larger tube and hence has less chances of clotting and giving trouble. So there are pros and cons.

This time when I relapsed, for the first course of chemo, they did put a hickman line in. But towards the end of the treatment, it got infected and was leading to high fevers, so they decided to remove the line. This lead to the insertion of the PIC line for the first time. #God works in strange ways... You see, having the hickman line on the chest is more disturbing and uncomfortable - compared to having the line on your arm. Especially, for me it was not possible to sleep on my front! Anyways, I had to go through severe high fevers (apparently called rigors), for the Hickman line to be pulled out and then get the new PIC line in from the 2nd course of chemotherapy. It was a great relief and much easier to manage and do day to day things. I did end up getting rashes and the skin getting sore, but that might be my skin reaction to the plastic dressing which has been on for the last 3 months. I had similar reactions with the Hickman line too.

In most cases, removal of a PICC is a much simpler procedure as compared to the hickman line. And for me, it was just that. As compared to the pulling/cutting/pushing of getting the hickman line out (which I have gone through twice already), it was so much easier to get the PIC line out. The nurse simply pulled the whole line out with great ease. When the line was out there was slight bleeding, so she applied some pressure for a couple of minutes and then a sterile dressing. Hardly any pain...!

If you're faced with the need to use any of the above methods, do speak to your Doctor, don't take my experience as the only basis for your decision. Although the hickman line is more painful while inserting and removing, and it does require more care - there can be good medical reasons why they might want to use the hickman line. For me, it was an admin reason. The hospital closer to my home, where I was treated last year and had the first course of chemo this year - they only did hickman lines! Guess I should start a petition to get them to insert PIC lines too. It doesn't require an operation theatre - just a sterile room with a properly trained and qualified nurse... :)

I'll take off the dressing soon now, and be able to wash the whole left arm properly. And maybe do some exercises to strengthen the arm. They will insert a new PIC line when needed, but for now, I'm a free man...

#Psalms 107:1 - Give thanks to the Lord, for he is good; his love endures forever...

Wednesday, 4 December 2013

Another day spent in Hospital

Don't worry, was just routine stuff... Today's Agenda was:
- Blood tests
- Bone marrow test (If platelets were above 100)
- Clinic appointment at 11:20am to meet my Consultant

Ancy took the day off to be with me. Got there around 9:30 in the morning and was there till about 4pm, so almost spent the whole day there... :) Now, the blood tests were to check is all the counts (Hb, platelets and neutrophils) were recovering well. And they also needed to make sure the platelets were above 100 to do a Bone marrow test.

Ok, quick Bio lesson (Thanks Wikipedia):
- Hb: #Haemoglobin in the blood carries oxygen from the respiratory organs to the rest of the body (i.e. the tissues) where it releases the oxygen to burn nutrients to provide energy to power the functions of the organism, and collects the resultant carbon dioxide to bring it back to the respiratory organs to be dispensed from the organism.
- Platelets: #Platelets are a natural source of growth factors. They circulate in the blood and are involved in haemostasis, basically helps in blood clotting.
- Neutrophils: #Neutrophils form most of the WBCs in the body and are responsible for our immunity.

Now, a Bone marrow test is done under local anaesthesia, and they poke into the back of your pelvic bone, where the most bone marrow is produced. I know it sounds painful... and at times it can be. I have had it done around 10 times now (they do it after every chemo cycle, to test that the bone marrow is functioning well, and is in remission). Remission means being free of blasts or cancerous cells. Of the 10 times, 2 were really bad. The best time it was over in 10mins, the worst took around an hour...

For the faint-hearted, be strong. I drove back after most of these procedures, and today also I took the tube back home (an hour journey). There is discomfort for a day or two, but nothing we cannot handle. I am sitting at my desk, blogging now, without any pain-killers, so rest assured it is bearing pain. It’s just that the last time was the time it took an hour and I was sincerely praying that the same doctor doesn't do the procedure. Sadly, she was there today! lol... I told the nurses to get me another doctor as I didn't want to go through the hour long pain again. But God plans everything... It just made me pray more the whole morning... ;)

Finally, when my turn came, guess what, the same doctor! I'm sure the nurses might have told her that I didn't want her doing the procedure. But she was still nice to me and tried to convince me that it’s a blind procedure, and at times can take time to find the right spot. It might be because my marrow is reluctant to come out, etc etc. I kept listening, but in my mind was thinking about how the procedure would be and that it all depends on her skills and she is covering that part up... hehe...

Anyways, it started at around 3:15pm and I was praying really hard. Kept mumbling over and over again "thank you Jesus, thank you Jesus for a fast test, thank you that there is no pain, thank you Jesus...!" Guess what... It was over by 3:30pm... :) She didn't get the spot the first time, and I was anticipating another hour of torture, but by God’s grace she got it right the second attempt and everything was done in about 15mins. Awesome right…!

Points to take away:
- Fear not, it's something that has to be done. Be strong.
- It doesn't only depend on the doctor's skill, but various other factors.
- While the #BoneMarrow test is being done, taking long slow breathes helps with the pain.

To potential Stem cell donors:
Please don't think this is going to be done to you. This procedure is for the privileged few, the brave who are battling cancer. :) If you are ever found to be a match, in 80% of cases the Stem cells are extracted from your peripheral blood. And this percentage is ever increasing as they perfect the #PBSC procedure. Even if for some reason they need to do a bone marrow harvest, it's done under general anaesthesia, so you feel no pain during the procedure and just some soreness later (like I'm feeling now). Each one has their own views, but think about that little soreness, that little time you need to sacrifice - against the joy and greatness you will feel for saving a LIFE...!!! And become a real true life HERO...!

Our faith gets tested like this at times, but no matter what happens, cling onto our #Creator, because he has the best laid out for you...

Tuesday, 3 December 2013

About the Blog title... B+


My friends and family have been pushing me to start blogging about my fight with cancer. To let my feelings known and to put information out there about what I'm going through, in the hope that it benefits others going through similar trials. And also to increase awareness about #StemCell donation... I am a very private person, so I really don't know how much personal feelings I'll share, but I'm hoping to do something good with the blog. Time will tell how it turns out...

Now, the aim of this post is to introduce the title. I'll go back in time and definitely share more details on the initial diagnosis and whats happened so far. But to introduce the title, I need to say that at the present point in time, the next course of action is a stem cell transplant... Popularly called a #BoneMarrow transplant.

When people hear about this, they feel pain and fear due to the various myths out there about Bone marrow donation. And another thing some ask is this:

"Whats your blood group? Can I help if we belong to the same blood group?"

I'll get into the details of Stem cell donation later. But for now, know that its got NOTHING to do with a persons blood group...

Anyways, a few days back a close friend (Liju Thomas) got asked the same question. Someone was asking him about me, and suggested the same - about helping if we had the same blood group. Liju knew that it is not related to the blood group, so explained it to that the person who asked. Later, Liju told me about this episode and while talking about blogging, he did ask about my blood group. And when I said B+, that's when he suggested this title.

For those who know Liju Thomas, he is great at marketing... And sells his ideas well. On most occasions, I don't succumb (lol), but this time, he was absolutely right. By the amazing grace of God, I have been positive throughout these turbulent times. My wife, our parents and all friends have been amazing support too, which further helped being #positive and in fighting #cancer.

I couldn't think of a better blog title. And finally after months of procrastination, I got the much needed push to start this blog. I couldn't get "B+" as the URL, and "BePositive" was already taken, hence I chose "cancer-bepositive". So the blog URL is:
http://www.cancer-bepositive.blogspot.co.uk/

So special thanks to +Liju Thomas for the idea of the blog title...

There are loads of people who have been by my side, and I'm indebted to them for life. As I write more, I hope to mention each and everything on of them. These are the webpages that my family and friends have created to help raise awareness:
www.facebook.com/HelpJeson
www.sahita.co.uk
www.twitter.com/HelpJeson


You can follow me on my personal links for Facebook, on Blogger and on Twitter too...


With love and prayers,
Jeson Chelleth
#Cancer Warrior