It was fast.
Being tired is perhaps the most elementary of health issue. Rachana started complaining about being tired around first week of March 2016. Like any other sane person, we didn’t rush to a doctor. On Mar 15th, Rashi’s birthday, we went to Dallas Arboretum and she was very tired and just could not walk. Her heart was racing and she had difficulty breathing. She sat in one place and I took the kids around. We finally took an appt with Dr. Tasneem, my physician. Rachana did not even have a physician; after Rashi was born she didn’t see a doctor in 4 years. She met Dr. Tasneem on Monday Mar 21st who did some blood tests and set up another appointment for Thursday.
On Tuesday Mar 22nd Dr.Tasneem called back around noon and asked Rachana to go to ER immediately. She said her red blood was 5.6 instead of 12, white blood was very low and platelets was 30k instead of around 150k. The Dr. asked her to be careful and not get a cut before we reach the ER. Rachana remembers her sounding pretty serious. We were still not particularly worried. We thought we just ignored the situation for a few weeks, probably not having a balanced diet, we’ll probably get a unit of blood and be back home in a day. Rachana was making some of her cake toppers and took about 30 mins to finish that, then got ready. I googled for the nearest ER and found the directions to North Hills Hospital.
North Hills ER was smooth. With hardly anyone there we got a ER bed in maybe 30 mins. They did some blood tests and admitted her into the main hospital. By 4-5 pm she started getting the first unit of blood, followed by another in the night. At 11 pm Dr. John Higginbotham came in and spoke to her about her condition. He explained, like Dr. Tasneem, that all 3 components (RBC, WBC and platelets) of the blood are down. It was a condition known as Pancytopenia. They are concerned because usually its because of a bad viral fever, bleeding (typically during a heavy menstrual cycle) and other relatively common issues that Rachana is not showing any sign of. He said that in the morning a Heamatologist will see us.
The next day (Wed, Mar 23) was frustrating as no doctor showed up till 3 pm. We were still under the impression that its some disorder that the specialist will talk to us about, write up a prescription and send is home. We got annoyed at a nurse who relayed it further and Dr. Higginbotham showed up again around 4 and told us that they are still doing some tests and that an Ongologist will see us in a few hours. The first alarm bell rang. I googled Oncologist just to be sure and the word cancer entered our lives. Dr. James Turner arrived around 7 and told us that they can see some ‘extra’ cells in her blood stream and those are preventing the normal production of blood. He explained this could be in the leukemia or lymphoma category but they have to do a bone marrow biopsy to confirm. We both were pretty shaken up after the dr. left. I had to go home and get some clothes and broke down while driving home. Family was updated and everyone was shocked and were praying for the bone marrow results to come negative. Rajeev and Alaap drove down in the night to talk to us.
The next day (Thurs, Mar 24) didi skipped work and came to the hospital. Rachana was given a unit of Platelets to prepare her for the biopsy. She has a reaction to the platelets which included shivering, rising temp, clattering jaws and body aches. They called in the Rapid Response Team and we were all pretty scared. But thankfully, she went back to normal in about 20 mins, but it shook her up pretty bad. The bone marrow biopsy was done in the afternoon. The procedure involved poking a large needed in the lower back and pulling out some bone marrow. This was sent to pathology for testing. After the biopsy the Dr. explained that the radiologist tried 4 times but just could not get any marrow. He explained that they will do another blood test called flow cytometry and the results will give them a good indication if this is Leukemia or Lymphoma. They gave her another unit of blood for the night.
Next morning (Fri, Mar 25) they took her for a CT scan and while there they also tried to get a bone marrow sample again. They also operated to put a port in her chest which will be used in give chemo. Dr. Turner saw us again after the procedure and said they did get some bone marrow but not a lot. He said the Flow Cytometry definitely points to Leukemia and he said its B Type Acute Lymphoblastic Leukemia. The bone marrow results would not come in for a few days but he said he had enough data to start the chemo. The doctor said he’ll put in the order for a bed at Texas Health Methodist HEB to start the treatment on Monday in their oncology unit. Rachana had a bunch of questions about why thus happened and the Dr. explained that this disease has nothing to do with the health of the individual – it’s just bad luck. The stem cells in the bone marrow go through a maturing process to produce red cells, white cells and platelets; but sometime they end up pushing out immature blast cells into the blood stream rather than waiting for full maturity. These immature cells take up space and energy and the body procedures less of the good cells. With less of the good stuff the body is weak, tired and its immunity is very low. The dr. said that this mutation probably started in the last 2-4 months and there was a chance that we could have been doing our annual physicals and still not catch this. He did say that being young and not having any other medical condition is our our side. He said today cancer is a curable disease and said the prognosis is cure for about 80% of the cases. They gave her another unit of blood and started the paper work to discharge from North Hills.
We came home Friday evening with our lives taking a pretty big left turn. We went from tired to leukemia in 4 days.