Of Celebrations!

It was World Cancer Day yesterday. And I celebrated it in true style. By partying all weekend with a gang of new friends. By packing for a long overdue vacation. By boogieing at a fitness class. And by showing my special brand of finger to cancer.

A friend posted yesterday that cancer is not a celebration of life. I humbly beg to differ. It's definitely a celebration. Of multiple things. It's a party of your body being strong enough. It's a gathering of your mind being resilient. And it's coming together of all your priorities to the top of your bucket list.

It's also a win of all the things you took for granted - eating food, combing hair, raising your arm over your head (all my pink sisters who have had lymph nodes removed will relate to this). Anybody fighting to recover from any ailment will tell you - recovery is cause enough for celebration. For an amputee becoming a blade runner, for a cardiac patient running a 5 km and for a survivor their next clear scan - each milestone however big or small is enough to party. After all it gives hope to others taking their first steps to recovery. And hope is what makes us human.

This is not to take away from the pain, the horror and the depression while treatment is on. It is unfortunately all too real. And everyone deals with it differently. But if a Parrikar giving the Budget speech with a nasal pipe, a Tahira rocking the bald look and a Yuvraj dominating the cricket pitch all help the next fighter face cancer with courage - I say bring on the champagne! It's time to celebrate.

Happy Cancer Day to me folks. And I pray I never wish any of you or yours the same. Gonna be selfish this time and keep it all to me. Cheers!

Courage

Courage comes in many forms. There are no degrees of courage (mera courage tere courage se better kyun) even though given the level of discourse on paid (unpaid) media (my nationalism is better than yours) it may well soon be a topic of discussion. But I digress... Courage cant be compared simply because we dont know the demons that are being conquered inside a person.

Courage for me in the last few months was appearance. I have always been conscious of not being pretty enough, not being slim enough (not that I do anything about it), not being groomed enough (not that I do anything about it either- innate laziness and preference to spending time reading wins out - every single time). Being blessed (?) with frizzy curly hair the only option of not looking like a lions mane was to tie it up too. In order to look better after Manasvi was born I learnt a few different hairstyles that used to make me look and feel good about myself apart from standing out in a crowd. And then I lost my hair...

As a cancer patient losing hair was always expected. What I didn't predict was the amount of hair I had or the rapidity with which I would lose it - I sat combing my hair one entire afternoon for 4 hours with every brush stroke filling my hand with a fistful of hair and I still had a head of hair and another bag full of hair. Every time I touched my hair I came away with a literal fistful. And it didnt even make my baldness prominent - my hair just looked thinner. This slow stripping away was depressing! Plus Manasvi was curious. So I stuck to my promise to her and explained that I'm losing hair coz I'm taking medicine. I remember out of nowhere she walking up to me one day saying 'mum I'm also losing my hair'. At my credulous expression her reply was 'arre that cough medicine you gave me yest is making me lose my hair' as she showed me the imaginary hairstrands on her brush. Medicine = hair loss - chemo side effects simplified by a 2.5 yr old. She was even curious about how easy it was for my hair to come away and we spent a few fun hours where she pulled out my hair for me (go ahead judge me but it was our coping mechanism so what the heck) and put them in a bag... After the patches became prominent I chose the Mocambo look and got it shaved. And went about life like that.

But then had a dear friends wedding and a nephews birthday party, neither to be missed but my first public functions. I had multiple options - first being missing them altogether (cancer actually gives you good reasons to skip events you never want a part of anyway - everyone sympathizes), second being fashioning a turban or wearing a wig and lastly turning up the way I was. The first 2 options were quickly discarded by what was rapidly becoming my cancer coping mantra - this will not affect my life or how I lead it. What was left was option no 3 and looking for a whole lot of courage to go with it...

Coz even though I would be with people who love me and care for me for both functions there would be even more who didnt know me but would def notice the only bald lady in the hall. So I armed myself with my rudimentary makeup skills, dressed myself in the brightest colors I could find and took up the widest smile I could summon and walked in with my head held high on my husbands arm. Stared back at every person who looked at me daring them to comment (people surprisingly prefer averting gazes to coming out and asking what is foremost in their mind - a distinctly helpful attitude), didnt hold back from participating in every thing and ended up having a whole lot of fun! What a revelation! As long as I was not making a big deal of my baldness (was well prepared with a few Shakaal, Kaancha Cheena, Mocambo jokes), no one else that mattered really cared and those that didnt matter, well who cares!

And that gave me courage. To attend my daughter's first annual function, to celebrate her birthday in a playzone, to join festivities, to join my husband at sports events, to go to restaurants and generally to live life as I wanted to. But in todays day and age, so many girls choose to go bald or have really short hair (remember Barkha Dutt) and they lead normal lives; so why all the fuss you may ask... the key word here ladies and gentlemen is choose. Unlike those people, cancer patients are not given a choice in our hairy matters. What we have are coping mechanisms. And each of those - hiding away, flaunting, wigging it out - need their own form of courage. Like I said courage - it comes in many forms!

Control

We always strive to control our surroundings - right from political aspirations to the daily fight over remote, every decision or action is to exert our control over the existing situation. So faced with a situation where things as I knew them were spiralling out of control I focused on the mundane to keep my sanity.

Even as my parents walked in earlier than expected and I stood in front of dad asking him about the report. Even as I saw his sad nod and mums tears. Even as I cried against Ashvek's chest - the mind was working furiously to control this situation too. And it came upon how to lists as the perfect solution... How to inform my office? How to share this with family and friends? Which family and friends? How to share this with Manasvi? How do I want to fight this?

Coz fight it I did. I didn't have any options. I had a lovely 3 yr old who was literally my world (side note - when I tell her tu majha jag ahes her ever curious self asks me - kuthlya jug ahe milk ki juice? - side side note - this is what I mean about horrible jokes when stressed) and for whose happiness I would literally fight the world. This was just my body after all. And if I couldn't handle this the alternate was not something acceptable to me.

The quest for this control helped me quickly set up a few ground rules with the husband. Poor stressed thing that he was, he quickly agreed probably relieved that I appeared to be handling the news maturedly

A. My daughter will know all about the disease. It's a tough fight and I need to see my motivation with me daily

B. I will never wear a wig - this was a god given opportunity for me to walk the talk of 'you are who you are not what you look like' with my daughter. If I hide my eventual baldness Manasvi would grow up with the misconception that looks affect how you feel about yourself

C. I will share my story with as many people as possible. Any misfortune is unreal until it happens to you and if even 1 person diagnoses themselves early coz they were cautious on hearing my story - that would be one less victim for cancer

My father had similar ways of coping. His list involved deciding and embarking on immediate course of treatment, financial support and my well being. My mil did what she does best and threw me a lovely party with my parents invited too. No other gesture could have conveyed to me better that in this fight as in life - we were in it together.

In accordance with my father's plan, we visited Tata the very next day and met Dr Badwe (Padma Shri, Director of TMH, best breast oncosurgeon in the world and a friends father - in ascending order of importance for me and possibly his shortest introduction ever) His calm demeanour and Santa Claus smile made my last and toughest decision a breeze for me - Where do I get treated? At the place where he could be my primary surgeon even if it meant 3 hours travel to and fro - Tata Memorial Hospital

Introduction

To be fair, I wasn't totally honest when I said end Dec was my introduction to Cancer. A very dear friends dad has been the world's authority in breast cancer ever since i knew him but given the arrogance and naivety of youth I hadn't realised how much a difference uncle made to thousands of lives every year until I was one of those fortunates to be treated by him. The friend himself had pursued a masters at John Hopkins - the Mecca of onco research world wide.

Closer to date in Aug 2017 I had also gotten my hands on an amazing Pulitzer prize winner 'Emperor of All Maladies' by Siddhartha Mukherjee. The non-fiction was scarier than a psychological thriller and left me with a slight sense of unease. For the uninitiated and those who may not want to plough through its 600 odd pages I would like to touch upon the key pointers he makes. The interpretations or possible mistakes are all mine and I request any reproduction of below should be taken directly from the book itself:

A. Cancer cells are effectively human cells that grow at super fast rates. Sounds simple? That's coz it is. They are part of our body which means our normal immune system (the bahubali of our body) cannot distinguish between a cancer cell and a normal friendly cell (effectively making a cancer cell the first Katappa - with nonaltruistic motives of course). So the body NEVER fights a cancer cell. 

As we evolve over the years and become stronger thanks to the multiple inventions in medicines - cancer evolves too (still a part of our body remember?) So they are still stronger than normal cells even after evolution. In fact cancer has been prevalent from ancient times and mummified remains of Cancer patients have been found at multiple locations. The one and only disease to have survived the centuries.

Scared already? There's more. Because cancer cells are part of body and body can't distinguish between them and normal cells - nor can external medicines. Most medicines act on the principal of attacking a foreign substance - a virus, a bacteria, a fungus etc. Only cancer medicines attack actual existing functioning and healthy body cells along with cancer cells! In fact the blood brain barrier; which evolved specifically to keep harmful cells away from the brain; lets in cancer cells happily while stopping chemo drugs from entering (in football analogy the worst kind of self goal there could be)

B. Now since cancer cells evolve they also learn to evade tactics of getting rid of them. So a single treatment methodology almost always has lesser effect in long term than a multi treatment one - hence the deadly triumvirate of chemo, surgery and radiation is prescribed for most cancers. (Think Ravan and his heart being crushed by Hanuman at the same time as Lord Ram let loose an arrow at his body. If both are not killed together one just regenerates the other and starts killing again. In fact Siddhartha mentions this Ravan story in his book as a possible analogy for cancer used by an ancient Aryan society which had made tremendous progress in medicine due to partly Sushrut and other greats)

C. And lastly the irony of it all - since the only way to distinguish these two cells is rate of growth, medicines target ALL growth cells in body which leads to normal side effects of hair loss, fertility loss, menopause in women etc...

So by the time it was necessary for me to research on cancer I knew the disease dispassionately. What was new was the jolt that even while I was reading up on cancer, it was growing inside me (remember the lump was discovered in Aug) - insidious lil thing that it is! And that introduced me to the most difficult part of Cancer - denial. Denial in all forms and I will touch upon the ones I experienced. But at the time that our story last digressed, Ashvek and I had just spent a sleepless night reading up on cancer.

Morning had us bundling up Manasvi to school and heading for a biopsy. Mum joined in with a glum face and dad just hugged me hard before I went in. I have a horrible habit of cracking wisecracks when I'm nervous - and I remember doing the same during the 10 min procedure. I have a very low threshold to pain (ask my gynaec - Even with just a 4 hour labour ending in normal delivery I was fighting half the time for an epi and begging for a csec which thankfully he refused) and so local anaesthesia was welcomed. A needle was inserted via guided sonography and tissue samples were pulled out for a typical FNAC procedure. Multiple slides were created immediately and handed over (did I mention I'm a doctors daughter and hence the radiologist went really out of her way?) And before dad and Ashvek ran off to literally opposite ends of Mumbai to get the sample processed, I got my mammo report. A typical mammo report has a scale with the lowest for benign tumours and highest for a 95 % probability for malignancy (doctor speak for cancer) and guess where was I on the scale? The highest possible rating! As we were to find out in the next few days - we were no longer interested in the statistic of 0.01 % women at 30 with no history of cancer get breast cancer but whether i was a 100% part of that 0.01%. There were no longer any probabilities of multiple dice throws - just a simple binary coin toss - yes or no!

And after the two longest days of our life (the mum and the mum in law kept in the dark to spare them the uncertainty) the coin dropped to show Cancer rearing its ugly head!

Refresh

Exactly 8 months 2 days after I got back the worst test results of my life, I celebrate my birthday today with family and friends who are family... it's a birthday in the real sense of the word - it's a rebirth after fighting one of the toughest fights of my life with Ashvek always by my side. It's the beginning of a new life with Manasvi guiding the path ahead - same as she illuminated the dark days gone by. It's also a day to be thankful for my 2 sets of parents - who together underwent the angst of my being reborn these last months. And finally to celebrate with amazing people who always have our back - just because I can celebrate another birthday! What happened those days you ask? Let me tell you a story...

End of Dec 2017 was a flurry of activities for me - a busy job, out of station trainings, holidays with friends and family, party planning (because well Dec you know). In the middle of all this normal craziness that personifies a typical working 30 yr old mum I had a gynaec appointment as a follow-up. Way back (or that's how it seems in hindsight) in Aug I had discovered a lump in my right breast; small, hard but hard to pin down too. In the all-knowing cynical mind of mine it was a normal milk clot, bane of all feeding mothers. And while at 28 months Manasvi was no baby, I was emotionally unable to completely wean her off. With days passing, as they seem to do, very quickly, the lump grew in size. A quick look by mum when we were dressing for a function and she began pestering me to see the family gynaec. Prescient in a way only mums can be maybe... Mostly to get her off my back I scheduled a visit only to be told in clear terms that Manasvi had to be weaned off so the lump could get time to dissolve. We had a long chat - my daughter and I - where we composed long tearful tributes to the 'boo' (as she called her feed), sang paeans to it's glory and ended our last connection to her babyhood. 10 days of medically drying up my feed and 10 nights of managing a restless toddler who was used to feeding like a baby in sleep - it struck me that the lump stuck around. It didn't dissolve nor did it go away. A colleague asked me to go for a mammo but I preferred waiting to see what my doctor advised. Being a doctors daughter I knew how medicos hate self diagnosis and rightly so. Another visit and another set of medicines followed - this time to settle any infection in the lump. And this end Dec visit was to see the effect of the last rounds of meds if any on the lump (nada), to get reports of a scan prescribed at the last visit (boy oh boy did I underrate that) and plan future course of action.

I went in after office and since I knew that the lump persisted, wasn't surprised when was advised a stat mammo. I am a doctors kid so I'm used to pretty much all tests being categorised urgent and important - this was on par past experience. The first inkling I had of something worrying was when the radiologist (highly respected, very well known and hugely experienced) kept her clinic open late for me. (Even though she was my father's friend, in my experience, this enables you to get to head of the line not keep the entire clinic open. That last bit is reserved for strictly family and I def was not related to her). I rushed to her all apologetic to have ruined her Tue evening (ok post 9 pm counts as night) plans and was made to undergo a scan and a mammo. For the uninitiated a scan is where they run a scope over your body and is used for quick checks inside the body (think kidney stones, baby photos and gas clouds) whereas in a mammo the breast is sandwiched between two plates and an X-ray is taken. (Since X-ray exposure is harmful most good doctors don't prescribe mammos until something is suspected). Post mammo was my second inkling of things not being right - I was asked to come back immediately in the morning for a biopsy. Wow! What's that? All notions of no self diagnosis flew out the window and what followed was a night of frantic Googling. And that ladies and gentlemen was our introduction to the world of Cancer...