Back in Sept 2016 Rachana’s chemo was going on schedule and she was feeling good most days of the week. Then in the first week of Oct she had sepsis, and as you all know, spent 100 days in ICU and fought back from what most doctors thought was a pretty bleak prognosis. The visible signs of that struggle left her with partial bilateral foot amputations and damaged lungs with a chronic cough. A CT scan of her lungs, in April, showed massive cavities especially in her right lung. The doctors could not predict how, if ever, it might resolve. They explained that like our kidneys, the lungs don’t need to function at their full capacity; a person can survive with one lung. Given the physical damage and cavities the infection left, the bigger issue was susceptibility to further infections, which unfortunately didn’t take long. After fighting two infections in June, we didn’t have high hopes for two important tests that happened in the last few weeks weeks.
On June 20th she had a repeat CT scan on her lungs. We and the doctor were surprised at the remarkable improvement we saw in the images. One of the doctors commented that he had to double check if these were really Rachana’s lungs! The last infection, I believe, ended up helping Rachana. Because the doctors had to place a chest tube to drain out the infection from the cavity, I believe the negative pressure helped pull the recovering lungs up filling the cavity and perhaps the scarring from the infection resulted in the lungs getting ‘stuck’ to the walls, giving them some leverage. It seems the space between the lungs and the chest cavity, which is filled with fluid, helps lubricate, cushion and protect the lungs. After the 7+ chest tubes that Rachana had since the ICU days, that space is compromised but not harmfull. The scarring is maybe working as anchors helping hold recovering lungs. Anyways, today the lungs look in their best shape since Oct 2016
On July 10th, Rachana had another excruciating bone marrow biopsy. I was in the room for all her biopsies till date and it does not get better. They give her local numbing injection to make the cutting and poking into her muscles a little easy, but there is nothing stopping the pain of drilling, I repeat, actual drilling, into the hip bone to extract a sample of the marrow. The last biopsy in March 2017 showed Minimal Residual Disease, i.e. sign of some leukemia cells in her blood. This last one showed no sign of leukemia! This was a huge welcome surprise! Because of the infections in June we had to stop her chemo for about 4-5 weeks and I was hoping for status quo i.e. MRD and nothing worse. Yet again she defied the odds.
So, now the doctors have resumed her chemo to continue as per the treatment plan. The doses have been reduced to protect her bloods counts from dropping significantly, which is a precursor to infections. She is currently in the third of five maintenance phases. If she remains healthy and all her chemos can continue without any interruptions, the last chemo will be in June 2018. After that, if she remains cancer free for 5 years, she’ll most probably be cancer free for the rest of her life.
We are celebrating her healthier lungs, leukemia free status and the fact that her treatment plan is back on track! Except for leg pain, on most days she is now feeling good too. Once the prosthetics are available (hopefully in the next 1-2 weeks) we hope the leg pain will also reduce.