Saturday, December 30, 2017

The C word - Discovery

First - Friends, Thank You for the outpouring of love.  Sita and I have received numerous messages and phone calls over the past few weeks.  From Books to Ilaneer to second opinions, we are simply overwhelmed by the affection showered upon us.  Thank you, friends, from the bottom of our hearts.

It has been exactly a month since the C word entered our lives, changing our outlook and priorities.  In this post, I will talk about the sequence of procedures Sita went through to the C diagnosis and the next steps.

Annual Checkups - Though reluctantly, Sita does take her health seriously and goes for an annual checkup with a little bit of nudge.  But this year she procrastinated more than usual and went for her annual checkup only in November. 

She has been complaining of discomfort near left breast/shoulder area for a few months now.  First, she attributed it to her Friday strength training.   After the workout, discomfort used to last for a few days and subside.  But when it started lingering a little longer, Sita finally pushed herself to go for overdue annual physicals.

Annual Checkup at Apollo Spectra Clinic in Alwarpet - Sita went through the usual battery of tests (and more) during the third week of November.  While she got a clean chit, for the most part, Doctor did advise her to go for a Mamogram since the last one was done over two years back.  This advise combined with her discomfort made Sita head to Chennai Breast Center.

Chennai Breast Center - Sita has been seeing Dr. Selvi Radhakrishna for several years now (referred by Dr. Uma Ram) and decided to get a mammogram done with her.  Sita had gone through a mammogram procedure in 2015 and we were hoping this time also it would just be a routine affair.  But, after the mammogram, Sita was advised to go for a biopsy.

Looking back, I feel Doctor knew of the C even before the biopsy results came in.  Dr. Selvi had asked Sita few times if she had come alone to the clinic (which was the case).  I understand needle biopsies are generally painful and require the presence of an attendant, but Sita went through the procedure by herself with the next appointment on Nov 30 to collect the results.

On that fateful morning, Sita and I went out for our usual morning walk and discussed the impending Doctor visit.  Even then we assumed everything would be normal and collection of reports was just a formality.  So, Sita decided to go alone to see Dr. Selvi.

But, life changed by that afternoon.  Sita was told that the biopsy reports came positive for malignancy and was advised to undergo Petscan and ER-PR tests to determine conclusively the spread of C.

Pet Scan - We were told to go to one of the three places (Apollo Speciality, Bharat Scans and another place in Anna Nagar).  Our first preference was to get the procedure done at Apollo but there was no open slot for several days.  Our next best option was to go to Bharat Scans, Royapettah where a slot was available for the very next day (Dec 1, 2017).

Pet Scan uses a special dye with radioactive tracers and is injected into a vein in one of the arms.  Tracers help to understand how well organs and tissues are working. 

Sita was advised to fast the previous night and report for the scan at 7:00 AM in the morning.   As luck would have it, it rained cats and dogs overnight and a lot of places including the Scan Center was inundated with water.    We managed to get in on time but a lot of their employees couldn't.  After some wait and elaborate preparatory work, Sita went through dye injection and scan over the next 5 hours.

ER-PR - This is an extension of the earlier biopsy examination and will help determine the kind of cancer receptor that is active.  There are basically three possibilities Estrogen, Progesterone or HER2 (Human epidermal growth factor receptor 2). 

Globally, 80% of the breast cancers fall into ER- PR category and if ER-PR results are negative then the HER2 determination is done.  For Sita, it was ER positive with an intensity of 3.

Consultation with Dr. Selvi (Dec 1, 2017) - After the pets scan, we went and saw Dr. Selvi.  She gave us a patient hearing and took time to explain the whole thing again.  Though Doctor must have discussed the situation at length with Sita previous day, she perhaps zoned out and I wanted to see the Doctor myself to get a better reading on the entire situation.

As the next step, Dr. Selvi asked us to see Dr. Sankar Srinivasan, a reputed medical oncologist at Apollo Cancer Hospital at Nandanam.  He is a super busy guy and was tough to get a slot to see him.  But, after much persuasion, we got an appointment to see him on Monday, Dec 4, 2017.

The intervening two days was rather intense and busy for us.  On one side, we had a stream of wellwishers calling/visiting us and on the other side, there was this TWCM17 for which Sita had registered for 10K and was planning to run with Meera.  But Sita was in no mood to even get out, let alone run. 

Until that Thursday (Nov 30) morning, Sita was her usual, donning many roles she plays with elan, but after the C diagnosis, I could see her energy level going down dramatically.  Though she put a brave face, I could see the turbulence she was going through.  In fact, the entire family struggled to come to grips with the new situation in different ways.  More on that later.

Confirmation of C - Even before we saw Dr. Sankar on Dec 4, 2017,  we came to know of existence C from the pet scan report.  Though none in my family is even remotely related to the medical profession, we all became one by relying on Dr. Google.  Even then, we were hoping Dr. Sankar would tell us otherwise.  He didn't. 

Dr. Sankar confirmed the existence of C but comforted us saying this type of cancer is completely curable and suggested a clear but lengthy course of treatment.

  1. Chemotherapy - Undergo 8 sessions.  First four, every other week and the rest every 3rd week.
  2. Surgery - To be decided after the first four Chemo sessions.
  3. Radiation - Few sessions to be decided after Chemo
  4. Oral medication - For a prolonged period of time, duration to be decided after radiation.

Thus C entered our lives.  Now, Sita's journey to recovery has started with Chemotherapy and we are talking one day at a time.

Earlier Post
#1 - Coming to terms