Chemotherapy: A carefully concocted cocktail of drugs

Monday, March 12, 2012 – Toronto.

Woke up this morning with a sense of cautious optimism. Today is chemo day.

Spent the next few minutes in bed with Nagib offering prayers to the four blood donors that have kept me alive.  Asked God to help us make it through today with courage and resilience and for the chemo to work.

Until last week, I naively thought chemo was all the same. In fact, each chemo treatment is a carefully concocted cocktail of drugs designed specifically for your type of cancer.  I observed some patients come in for 30 minutes of chemo, some receive a pill, some injections.  My chemo for lymphoma is called R-CHOP.  It requires me to go to the hospital every 3 weeks for a full day.  I am hooked on an IV machine for most of the day as one drug, then another, enters my body.  Every 20 minutes, a nurse comes to check my temperature and blood pressure.  I welcome the chemo and visualize it attacking the cancer in a battle inside me.

The start of the chemo experience is an interesting one. You check in to “Chemo Day Care” at the appointed time, and the receptionist gives you a buzzer.  If you’ve been to The Keg Steakhouse during rush hour, you know what I mean.  Then you wait (good thing I brought my iPad).  When your “table” is ready, the buzzer vibrates and chimes and the receptionist sends you to one of the colourful pods and a designated seat (Purple Pod, Chair # 12 in my case).   Volunteers come over to offer juices, lend a helping hand and stay to chat if you want.

In a surreal way, sitting for chemo is a relaxing affair. You sit in a comfortable leather chair, talk to family, have lunch.  I shared a pastrami sandwich and large salad with Nagib. It was like a date!

Chemo affects each person differently.  The common side effects are fatigue, mouth sores and nausea.  I have tolerated chemo remarkably well so far.  The only negative has been having a bitter metallic taste in my mouth so I am not enjoying most foods, except sweets.  So I am consuming ice cream and fruits and French toast and milkshakes to keep the calories high and my weight up.  Today, my taste buds have changed completely and I can’t handle any sweets.  This will be an interesting time of trial and error with food.

As the chemo drugs lower my immune system’s ability to fight off infections, viruses and other bugs, I’ve been advised to stay away from large gatherings of people :-(.  Next chemo April 2.

A SNAPSHOT OF CHEMO

Lunch from Druxy’s:  $12
Price of parking for the day at PMH: $20
Cost of chemo drugs: $000’s (thank you OHIP)
Surrounded by family while undergoing chemo (even though they were somewhat distracted):  PRICELESS !

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My Superheroes

Though they may not wear tights and a cape, nor have their initials plastered to their chest, there are four extraordinary superheroes who have come into my life.

Dr. Almas Adatia. Superpower: Persistence.

  • In December, I noticed I was tired and needed more sleep than usual.  I went to my Family Doctor, Dr. Adatia, who suggested I have my blood levels checked.  That was the very first time my hemoglobin level had plummeted to 70.  She took this very seriously and had me go to Emergency immediately for a blood transfusion.  With new blood in me, I felt alive again, but Dr. Adatia insisted on weekly blood tests which showed a continual decline.  If it were not for her persistence and follow-through, I would have likely continued living like this indefinitely without any resolution to the cause of the blood loss.

Dr. Jean Wang.  Hematologist, Princess Margaret Hospital. Superpower: The Connector.

  • I met Dr. Wang, my first hematologist, at the Emergency department at Toronto General Hospital.  I didn’t even know what a hematologist was!  I appreciated her thoroughness and how seriously she took her job.  Her focus was to get me to the right oncologist and get a treatment plan in place.  She knew that time was of the essence, and she ensured I was connected to the right oncologist.

Dr. Rodger Tiedemann.  Oncologist.  Princess Margaret Hospital.  Superpower: Superman.  

  • Dr. Tiedemann belongs in the extraordinary leagues of gentlemen.  A big New Zealander, he graces the hospital with professionalism, good looks, competence and an accent that makes even the worst news about cancer, seem like poetry.  Dr. Tiedemann’s expertise in both Lymphoma and Multiple Myeloma is a perfect fit for my complex case — it’s like he was made for me!  I really appreciate how he partners with us as he designs a treatment plan.
Dr. Christine Cserti-Gazdewich.  Transfusion Medicine Specialist/Clinical Hematologist.  Toronto General Hospital.  Superpower: Going above and beyond.  
  • Dr. Cserti is the kind of person everyone wants to have on their team.  She goes above and beyond the call of duty and places patient welfare at the heart of her work.  Last Thursday, when I was rushed to Emergency with a hemoglobin of 42 that was dropping every hour, she and her team worked tirelessly behind the scenes to find the right blood match.  A daunting task. Quite simply, without her, the game would be over before it even began.

We all have superheroes in our lives.  People who did little and big things to make our world a better place.  Who are your superheroes and how will you recognize them today?

– Munira

The Magical Hat

There are two types of people in this world – one who can wear hats, and the other who can’t.  Unfortunately, my Mum fits into the latter.  For years, we have tried to find a hat that likes her –from baseball caps at Jays games, to visors on beach vacations, to Santa hats at Christmas parties, to beanies, to berets, to bowlers. If it’s been invented, we’ve tried it – and trust me, we’ve tried them all.  On Monday, while sitting in the chemotherapy daycare unit of Princess Margaret Hospital, a hat found its way to Mum.  Not just any hat – the hat.  A bright pink and white, hand-made toque that was a perfect fit atop her head.  Like Cinderella’s glass slipper.  Mum had found a hat that agreed with her, and the hat had found a new home.

But this particular hat was more than just a hat; it was an act of kindness.  It was made by a past cancer survivor who wanted to ‘pay forward’ the generosity given to her during her experience with cancer.  It is unfortunate that too often we pay our pockets, without paying it forward.  In today’s society, kindness has taken a backseat to unsubstantiated greed; generosity has been demoted to something we can do, rather than something we should do; and the giving of time to a worthy cause is a calculated act that must be booked in our calendars weeks in advance.  Never have I been more attuned to our values as a society and how they seem to stray year after year from our core human instincts.  And then a hat comes our way – and flowers, phone calls, emails and chocolates – from both strangers and friends alike, demonstrating the power of a simple act of kindness in driving my Mum towards a place of positivity and promise.  A place where she feels she has an army of support behind her to get her through this journey.  A place where she feels she has something worth fighting for – and more and more, that reason seems to be to give back and ‘pay forward’ all the support that she has received during this time.

The hat has been a reminder of the fragility of life – the idea that we can be at the peak of our careers one day, and the next, be bed-ridden in the Intensive Care Unit.  It is a reminder that life is too short, moments are too precious to be living a life we do not particularly want to live.  Engaging in habits we don’t want to be involved in.  Doing things we are not absolutely passionate about.  But most of all, the hat has been a symbol of hope – a silent gift from a complete stranger telling us that everything will be okay.  If the hat-maker could survive cancer, my Mum can too.  And when going through an experience like this, you hang onto every ounce of hope you can get.  Every stable hemoglobin level, every normal temperature, every bit of energy is something to be hopeful about.

The hat will become an essential accessory item when my Mum begins to lose her hair in the coming weeks.  But the little fellow has played an even greater role already  – to remind us to live each day in gratitude, to be kind to others, to embrace the fragility of life and to remain hopeful.  A magical hat, indeed.

– Sabrina

The last 5 weeks.


When I heard the word cancer, my first thought was that I had limited time and needed to get everything organized right away in case I ran out of time.

Within two days of my diagnoses, I got hardwood floors put in the entrance, kitchen and family room.  They look stunningly beautiful by the way!

Ordered and installed new curtains for the living room.

Went on many dates with my husband.  Watched a poignant show called “In the Heights” about a story of a group of immigrants in New York with hopes and dreams about their future.

Saw PottedPotter on Valentines’s Day as a surprise present from Nagib.  Front-row streets and we ended up being part of the act.  It was a terrible show but wonderful company!

Had many people come home to visit and say prayers.

Friends have been dropping by constantly in the evenings and weekends with carrot cakes and to have chai.

Went out with friends and tried new restaurants and exotic food.  My new favourite haunts are Canadian Thai and 168 Sushi at Dufferin and Steeles.

And am regularly going for massages, acupressure and reiki.

Hosted a party for my colleagues from Sanofi this week to celebrate how much I love working with them.  Indian food and Karaoke night.

Oh and I have been working everyday, except when I’ve had tests at the hospital.

The first miracle I have experienced is that I have two stage 3 and 4 cancers and am experiencing no pain – – just a bit of tiredness.  How is this even possible?  God is so looking after me!  I feel his hand on my shoulder.

I will survive.

Dear Cancers:

“Go on now go, walk out the door, just turn around now ’cause you’re not welcome anymore…Weren’t you the one who tried to hurt me with goodbye, you think I’d crumble, you think I’d lay down and die. Oh no, not I, I will survive, as long as i know how to love I know I will stay alive. I’ve got all my life to live. I’ve got all my love to give and I’ll survive. I will survive.”

Sincerely,

Munira Premji