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.