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

A Day of Miracles

Thursday March 8th, 8pm, Toronto General Hospital. My Dad, my brother Shayne, and I were crouched around my Mum’s hospital bed in the Emergency Room, reciting our evening prayers together. The mood behind curtain #15 was sombre and still – a change from our normal Premji positivity – interrupted only by muffled cries of sadness.  The doctors had said there was a nearly 50% chance that my Mum would not make it through the night.  And for the first time since hearing about the cancer diagnosis, I realized that this may be the day I would lose my Mommy.

Rewind 7 hours.

We arrived at Princess Margaret Hospital for an appointment with our oncologist, Dr. Tiedemann, and a pre-chemotherapy class.  And just because my Mum had been feeling weak for the past few days, she insisted she get her blood levels checked.  Dr. Tiedemann confirmed the diagnosis of Multiple Myeloma and Lymphoma based on results from a second bone marrow test and a PET scan and suggested chemotherapy start the next morning.  But ironically, in that moment, cancer took a backseat and the focus became her hemoglobin of 42.

To put this into context, the average person on the street operates at a hemoglobin level of 120-140, and anything under 50 is considered life-threatening. Given the urgency of the situation, she was taken by ambulance across the street to Toronto General Hospital but upon preparation for a blood transfusion, test results showed her red blood cells were ‘bursting’ due to what was believed to be an army of antibodies she had built up in response to the initial 2 blood transfusions in January and February.  And her normal red blood cells were getting killed in the crossfire.

Mum’s an antibody-maker – her body makes antibodies to fight off any foreign substance that comes in contact with her.  It’s probably why she has never been significantly sick before, but these antibodies were proving to be detrimental to this situation.

She needed blood and needed it fast – but an imperfect blood match would have caused her immune system to attack the new blood, turning her own red blood cells into innocent casualties of this war.  But if we waited the 6-8 hours needed to find a perfect blood match, Mum’s hemoglobin could have dropped even further, putting her at a significant risk of organ failure.  We were balancing between the needs of Emergency Medicine to transfuse blood immediately, and Hematology to transfuse the right blood.  At 8:00pm her hemoglobin had dropped to 36.  They rushed her to the Intensive Care Unit (ICU) – pale-faced, oxygen mask, machines beeping.

Just as we were beginning to lose hope, we received word that four units of a well-matched blood had been found.  A miracle beyond measure.  While our faith was being tested, a team of Hematologists led by Dr. Christine Cserti, were working hard in the blood bank to find the perfect blood match. It’s almost like while we were questioning God’s plans, God was busy in the blood bank saying “Guys, it’s okay, I got this”.

The four bags of blood were our last hope – we asked the ICU doctors what the plan was if the blood didn’t work, and were told “steroids until we figure out what to do.” With a risky Plan A and no Plan B, we focused our energy on befriending the blood, giving them the names of Mr. Bean, Dexter, Edward Cullen and Popat, respectively.   We sat beside her, hearts racing, tears rolling, prayers abounding as we watched those first drops of blood make their way into her body. Drip, drip, drip.  If her body was going to reject the blood, we would know within the first few minutes.  A nurse was by her side monitoring every vital sign.  I have never been more scared.  And we have never prayed harder.  I am not entirely certain whether it was the steroids or a dose of romance in Mr. Bean’s blood, but as the new blood seeped through her veins, Mum began to serenade my Dad with the love song, “Perhaps, perhaps, perhaps”.

4 hours later, Mr. Bean went through successfully – but we were not out of the woods yet.  Since each of the four units were given by four different people, it was possible Mum’s body could reject any one of those four bags.  We watched  Dexter, then Edward Cullen, go through — next blood reading:  a 51!  Great sign.  It was the Popat Power of the last bag of blood that pushed her hemoglobin to 91 by 1pm on Friday afternoon.  Let it be known that Shayne has decided to name his first-born son Popat in honour of this miracle. Mum was released from ICU into the General Ward the following day and was released on Sunday afternoon when her hemoglobin levels had remained stable.

Thursday March 8th was one of the scariest days of my life.  But it was also a day where I have never been more grateful.  Miracle #1 – Mum could have collapsed at any point that week and would have had to be rushed to our closest hospital, North York General, and infused with unmatched blood.  Given her status as an “antibody-maker”, her body would have rejected the blood and she would not have survived.   But instead, her low hemoglobin was caught by an unplanned blood test and acute hyper hemolytic anemia was detected before it was too late to do something about it.  Miracle #2 – When the test results came back on Thursday confirming an aggressive, late stage Lymphoma, the oncologist wrote up a prescription to start chemotherapy the following day.  But by the time the nurse called the chemo daycare unit, it was 5 minutes after it closed, and instead had to schedule the first chemo session for Monday.  If Mum had started chemo with a hemoglobin of 42 (because a week prior it was 90 and she was cleared for chemo), her body would not have been strong enough to take the toxic drugs and she would not have survived. Miracle #3 – 4 different blood donors with the exact antibodies to combat Mum’s Y and C-antibodies found within 30 minutes.  Generally, this takes 6-8 hours as the blood bank has to screen for 20 different variables.  We owe our gratitude to Dr. Cserti and her team for working non-stop until they found the right blood.

That night, I began to lose faith. But it was in those moments of despair, that I witnessed firsthand the power of prayer, the power of holding on, the power of giving it everything you’ve got.  I have a renewed sense of faith that someone pretty powerful is on my Mum’s side and that these cancers stand absolutely no chance against the strength and courage of Munira Premji.

– 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.”


Munira Premji