Biopsy, A liverly experience.

Day 2 of anxiety. Now the surgeon is thoroughly pissed of with me (I ask too many questions) and thinks that my operation would be more of a liability than success that he can show around. Compounded with multiple queries from various other doctors, he thinks that a biopsy would be more fruitful. So here we are, at Raheja romancing with another doctor with attitude willing to insert needles in my liver. I must say that having serious illness does has its advantage. For example I have visited all major hospitals in Mumbai by now, Jaslok, Lilavati, Raheja, you name it.

Getting on with biopsy the doctor is trying to humour me.
"what do you do for living Srinivas?"
"umm.. it is difficult to explain, you sure you want the answer?"
"sure, I have time"
"I am IT architect"
"oh there is such a thing?"
"see I told you.."
Doctor by this time looses the interest and takes out real long needle and stabs in my abdomen. It hurts like hell, even with local anaesthetic. I was going to ask him what he did for living, I think he guessed it and wanted me to shut-up. These livewire procedures are not for the people with weak heart, l mean if you look at the size of needle there are good chances that you'd faint.
I endure it, old military training comes handy. After the needle is in the liver, doctor has free hand to take out as much tissue he likes. There is this chuga-chug sound when he is taking out the stuff. Once the sound stops you are ready to kiss your wife good-bye, they declare, its over. He asked me to sleep on my stomach and after half hour there's a small blood spot on the cover. Now I know why they call biopsy as 'traumatic' procedure. One more scan to confirm that my liver is functioning (or not..) and we are out. Coming out I warned everyone about cracking jokes on my posture (I was sleeping on my stomach in hunched position). Outside an old man told me that I should not worry, he had his biopsy done just now & it didn't hurt. I was going to tell him that this was my first baby so I am little inexperienced. Good sense prevailed. I said nothing.
The doctor walks in, "is the pain better ?" I told him it was a trick question, he did not get the joke. One particular thing I noticed is that medical professionals do not have much sense of humour as we would like. Or maybe they see life in bare form everyday, so find nothing funny in sarcastic jokes of a cancer patient. The nurse called me, 'madam' by mistake and I told her that I am still a man, they are yet to perform the surgery. She, of course, didn't get it. My wife did, so it was very difficult for her to conceal the laughter. They ask you to drink something and attendant is watching to see if something oozes out of the body puncture. I almost felt like the cat in cartoons. Well nothing interesting happened, the water & tea went straight in stomach. I even had lunch after that.
On journey back home, we were discussing next action plan and my eldest brother told me that I have a long life barring few inconveniences later this year, which may include some surgeries. I told him, that meant two things, I need a long term pension plan and 'inconvenience' is good choice of word for an operation which involves removal of two thirds of the liver and subsequent chemotherapy.

Journey of No Return

Today I start my personal journey of no return. A day in my life when I can make grand statements like this. I was talking to my son today, and I realized that my outlook of the world might be changing soon. Today the doctor would decide to operate upon me, on the other hand he might open up and declare that cancer is spread so much that it is impossible to operate and chemotherapy is the only option. watching lot of strangers decide whether you should leave or not is wierdest experience of all. I also realized that I may not survive this ordeal as much I would like to. I had, what is known as, deathbed experience. There are high chances that I may have malfunctioning liver and go in coma and die naturally. Once the death is accepted as inevitable rest of decision making is rather easy. As I think about it, I am kind of short circuiting the pains part. I am told that surgical procedures of any kind are extremely dangerous and could be fatal. On the other hand chemotherapy is
seen as equally dangerous, e.g. Loss of desire for sex.. I mean what is the point in living life after that? Death might be easier option in that case. Don't think I am sex maniac but let us be serious, I will not be drinking for rest of my life, no smoking and now you take out sex what remains behind? So what is life?
That is a good question to ponder over at such an artificial Sunset of my life. I would have still liked to run that marathon with my Nike shoes you know! But all my material aspirations seem very distant now. Now the only aspiration i have is to live my life. Fight for my life, be a cancer survivor. I want my son to remember me as person who fought hard.(And of course write a book about it,with photographs of before and after, no less! :-))
With all these grand thoghts i start my journey of survival today, with abundant hope and a gratitude towards life lived. 'Right ho!' as bertie wooster might have said...

I have cancer!

Well finally my day in glory. As noted before I do not have great achievements and I used to brood over that. The fate however was in my favour. It decided to give me a glamorous disease instead. Finally I have my golden oppty to write the book, whether I survive or not!
I passed the first stages of yes/no dilemma fairly quickly and now am choosing between surgery or chemotherapy. Life is just another Starbucks.
Every doctor I meet is at first surprised, then resigned, and finally consultative. I have been dignosed to have HCC (hepato cellular carcinoma). This was based on FNAC of the large tumor in my liver, accidentally discovered during CT scan of my abdomen. However I have no other commonly observed symptoms of hcc, such as AFP markers, hepatitis (b or C). I do not have alcohol abuse history and I do not stay in sub-saharan africa to eat something carcinogenic. In short I have rather unusual case of HCC. This puzzled many doctors as the signs do not follow textbooks. Funniest part is almost all doctors agree that I would be treated well, if I go to US. Doctors are also divided on the treatment. One school proposes that first the size of the tumor should be reduced and then operated, while other school of thought is more aggressive in cutting first and treating later. However both schools are certain that if I do not treat it I will die. No brainer there... I mean, who needs highly trained doctors to tell you, you are going to die, once you have cancer? One certain Einsteine predicted long time back that life is accident!
Well it gets better, couple of doctors I met today almost wrote me off. They said the 'd' word too frequently while looking at my reports.
Now I am waiting for my chemotherapy, first ever! I read on internet that chemotherapy affects the desire to have sex, I wonder whether that is true (this will be quite a disappointment with my all new georgous look, 'see no hair', another side effect of chemo!)
Well I will find out soon enough...

Prisoner of Hospitals

It is now a week that I have been out of my prison (Hospital !). I had little breathlessness on couple of weeks ago and that started a string of tests and subsequent hospitalization. I was diagnosed to have a cardiac problem, a cancer and pulmonary complications (at the same time!). The hospitalization itself was not that bad.. well there were lot of young nurses to begin with, but the being-instructed-where-to-pee is not a state one would want to be. Especially if you are used to sufficiently democratic house (now don't get me wrong, we do have bathrooms, but we also have balconeys with potted-plants). The worse part is most of the young nurses did not know their trade, thus they would insert the needles everywhere in my body without lot of professional skill and cause all kinds of IV fluids to get in my body, where least expected. I consider this to be very dirty game on the part of nurses. After all one is expected to be warned about the punishment before treating to full effect of it. The good part is I learnt how to manage the IVs and a great deal about 'Hepatoma' (hepato-cellular carcinoma or HCC. We, in medical trade, like to use the shortforms you see..), but none about what caused the 'breathlessness'. My doctor has a hypothesis that tumour in liver causes pressure on diaphragm and causes breathlessness. I think if proven true, he would probably publish a paper on it. In other words we have a rare condition. I wonder how useful this case would be for generations of medical students. There would be discussions about whether alpha-phetoprotein level should have indicated it or it was just another form of FLC (Fibrolamellar Carcinoma). Professors would have pop-quizzes on symptoms and the right answer would be 'breathlessness'.. :-). I am looking for quite a bit of photographs taken of my tumour in liver and become famous posthumously.
My wife (who wanted to be doctor but became engineer and assumes that she has the knowledge of medicine), on the other hand, thinks that I have a problem of overgrown nose bone which is causing all this 'breathlessness'. According to her I have sinuses problem compounded with pollution. My mother thinks I do not have problem and I need lot of rest.
However all of them agree on putting me through the experiences of hospital. I do not hate hospitals in general, but what gets you, is sleeping on rexine beds and staring at the white ceilings (well.. er and also the fact that you can not really flirt with the nurses, however young - it is like being in strip clubs, you can watch but can't touch!). Hospitals are almost like a prison, you have to drink tea at time they give it to you, lunch on time, dinner on time, even sleep on time (if you decline they force a pill down your throat to make you sleep) and absolutely no sex..not even thoughts (in case it increases your blood pressure). I am sure in even in real prison they treat prisoners better and nobody is drawing their blood 2 times a day. I have got so many pricks on my hands that it is difficult to find the contiguous part of the skin. I have radioactive isotopes in my body, lungs, liver. I have been treated through multiple magnetic scans. The tests ensured that if I do not have cancer, I would have one eventually.
I have few more tests planned this week, I am assured that the new prison is in different place and has better nurses, however punishment would be little severe... this time they plan to cut me open. It is true that prisoners don't have choice, only change of wardens...