Amrita- Daily Progress Report

26.11.07
Monday
Admitted in CMRI, all tests including X-ray completd and blood donation organized

27.11.07
Tuesday
Operation start
Operation completed - Difficult equivalent almost to an open heart surgery according to Surgeon who was astonished how she could move around with such a condition.
Shifted to ICU. Saw the pieces of lesion kept in a jar, yellowish white, cleaned up to maximum extent

28.11.07
Wednesday
Conscious, less restless than before
Fully conscious, stable condition
Sleeping on sedation
Same condition, Dressing completed, under sedation
Fluctuating B.P., Heavy sedation, No bleeding
Seen by visitors under sedation, Functions normal
According to Saikat nothing to worry, Functions are in order
Ventilator to support lungs function, which is now apparently cleared of fluid. He has noticed slight wriggling of body. Solid food through stomach may start. No possibilty of further deterioration of condition. Blood transfusion has stopped. Heart having been pressed by the tumor is a little compromised.

29.11.07
Thursday
Vital signs are in order, Conscious, Condition better than before
Condition unchanged with sedaion
Condition unchanged with sedaion
Visited Mamun. She is fully conscious, but in lot of pain both from operation and ventilator. She was staring at the ceilng with a bit of dilated eyes. Efforts to withdraw ventilator gave rise to some respiratory distress.

30.11.07
Friday
Conscious and under sedation, Sleeping
Apparent clearing of lungs in the month of September is due to steroids, which had not helped the treatment leading to wrong diagnosis. Body is not yet strong to do natural breathing and hence ventilator helps in aiding. Everyday off ventilator will be attempted.
At 10.30 a.m., ventilator was taken out till 12.40 a.m. Later, it was taken out again for some time.
Visited Mamun. She is fully conscious and alert and was able to communicate. Her face was normal and appeared much better than before. Albumin was added to increase protein level in blood.

01.12.07
Saturday
Same condition, Ventilator on
Lungs had lost of fluid, particularly left lungs, hence will take a little longer time to be cleared. Saw her yesterday at 10 p.m. Mamun gave her a smile, which is very assuring.
She is fully conscious and alert and was able to communicate. Her face was normal and appeared much better than before.
Accrding to Doctor, it was an extremely difficult operation and it is a miracle that she has survived and he has taken a chance. She should not leave hospital, till she is fully fit. Many tubes are out and lungs is functioning almost 80 percent.

02.12.07
Sunday
Visited Mamun. Ventilator taken out from 2 P.M. and put on an oxygen mask. Able to talk with a bit of hoarse voice. Able to sit up and no discomfort exists. Breathing still shallow.


03.12.07
ICU
No ventilator for last 15 hours.
Mask replaced by oxygen tube. Diet given by mouth.
Had solid diet, comprising of fish, rice, dal etc. also tea and biscuits. All outside life support removed. May be shifted in a day so to room.
Bimanda had a telephonic talk with Zahir. Preliminary reports of slides show malignancy. Should be reconfirmed by another laboratory. Treatment should be with a combination of chemotherapy and radiation.
Amrita had a little disturbed sleep. Presently sleeping.
She is fine and normal and may be shifted to general ward in a day or so.
She has walked on her own. Only discomfort is cough and removal of phlegm. Report of the removed tissue mass shows Nodular sclerosis - Hodgkin's lymphoma.
She is fine. CMRI biopsy report along with slides handed over to Quadra for immunochemistry histology.

Shifted to room and called from room and appeared her original self.
In the room, with Zahir as attendant. Drainage from the bandages and coughing and breathlessness are the only constraints.

06.12.07
In the room, with Zahir as attendant. Drainage from the bandages and coughing are under control. According to Dr.Roy of Quadra, it is a very much treatable form of lymphoma. Report will be submitted after 7 days.

07.12.07
Self taken over as attendant. Continuous cough persists. Raised the bed for comfort.
Self taken over as attendant. Cough under control. Antibiotic, steam inhalation, nebulizer etc. continues.
Fever 99.4 degree. Given combiflame. Fever subsides.
Dr.Biswas visited. May be released in two or three days.

08.12.07
Had a good night's sleep. Well rested.
Dr.Rupak Bhattachayra visited and he checked the color of discharge, pain, stool, fever,walking, breathing, stitch removal, whether burning sensation in urine.
Situation continuously improving. Slight fever subsides.

09.12.07
Bimanda visits. Dr.R.N.Ghosh recommended for chemotherapy, who suggests 6 dosage in 6 months. Very much treatable. Before release suggests one dosage, depending on Dr.Biswas's recommendation.

10.12.07
Pain and fever in the evening persist.

11.12.07
No fever and slept well

12.12.07
Almost normal

13.12.07
Amrita - Deluxe room
Discharged from CMRI and returned home

14.12.07
Normal and had a good sleep. Self left for Dubai.

15.12.07
Slight fever and pain persist

16.12.07
Slight fever and pain persist. Vomitting tendency. Doctor recommended CT scan of abdominal and pelvic region. Spoke with mamun. Breathlessness persists. CT scan over. Zoya needed some medical attention.

17.12.07
Had a restful night and vomitting tendency is less.

18.12.07
Slightly disturbed sleep. All medicines will be gradually stopped. No vomitting tendency. To make appointment with Oncologist Dr.R.N.Ghosh
Amrita much better now. No fever and restful night. She is doing light office work. Quadra report says Lymphoma - B Cell. Nothing detected in CT scan of abdomen. After chemotherapy, should be extremely careful about infection from outsiders. Good drugs are available in tackling side effects.

19.12.07
All reports collected. No abnormality in the abdomen. Dr.Roy suggested another opinion from U.S.A. Very good medicine available of this type of cancer. Dr.Ghosh is a very good Doctor. Bulbuli coming on 15th January.
CT showed no remnants of tumor, but some fluid still in the lungs. Amrita cheerful and some fever subsides on its own. Diagnosis is Diffused B-Cell non-Hodgkins lymphoma.

20.12.07
Sounded o.k. with a little breathlessness. Appointment fixed on 22.12.07, Saturday morning with Dr.R.N.Ghosh at Jatin Baghchi Road. Bulbuli coming on 10th January to stay till 2nd April.

21.12.07
Zahir in Kolkata. Everything is ok.

22.12.07
Had a meeting with Dr.Ghosh, who suggested immediate start of chemotherapy, comprising of 3 months or 6 months cycle. Chemo to start as early as on 24.12.07 or 25.12.07 in Thakurpukur Cancer Hospital, with 2 days' stay each time. Chemo to be admistered every 3 weeks. Cost of each cycle will be approximately Rs.1.00 lakh.
Talked with Mamun, who is having constant bouts of cough and also breathlessness. According to Doctor, this is due to fluid in lungs and will go after Chemo. 6 cycles to be administered. Pain and fever still exist. Attending to light office work also.

23.12.07
CMRI finding different than that of Quadra. Difficult to start Chemo without proper diagnosis.
Roy and Tribedi ruled, as they outsource investigation and it will mean delay of 15 days. Decided to give slides and stock to Thakurpukur Cancer Hospital, who will confirm the findings, so that Chemo can start by the week end. Intermittent coughs persist.
Talked with Mamun. Voice is much clearer than before, though breathlessness exists. Cough is less and expectorant coming out. Continuous visitors in the house. Must be restricted after Chemo. Food normal. Zahir gone with Zoya to Calcutta Club for a children's party.

24.12.07
Mail from Viji Venkatesh (MAx fundation head, India of Novartis) shows that Dr.Ghosh is a good Doctor.

25.12.07
Going for Hepatitis B vaccination.
Voice ok. No fever or cough. Doing light office work. Still getting salary.

26.12.07
Chemo to be administered every 21 days, to complete all 6 cycles in 3 and half months
Date not finalized about start of Chemo, to be decided after receipt of report. Munu has offered financial assistance, if needed.

27.12.07
Spoke on phone. Sending mail to office for transfer to Kolkata. Zahir in Delhi since yesterday and will return for further attention.
CMRI - Hodgkins, Quadra - Non-Hodgkins. Medicines are different. Chemo to start possibly 1st or 2nd January.

28.12.07
Working on laptop. Outside food gives acidity.
Thakurpukur is not able to conclude findings. Zahir decides to send slide to USA and also to TIFR, Mumbai on Monday for confirmation.

29.12.07
O.K. otherwise
Thakurpukur is not able to conclude findings. Things in a mess there. Technicians avoiding responsibilty.
According to Dr.Ghosh, review shows that it is borderline case. Patient to be admitted on

03.01.08,
Chemo to start on 04.01.08. Conference held between Dr.Gupta, Dr.Ghosh, Bimanda etc. Zahir to go to Mumbai in Tata Memorial and also send slide to USA.

30.12.07
Amrita is ok and Zahir visiting Mumbai and Chennai.

31.12.07
Slight breathlessness exists. Heart was 70 percent effective just after operation, improvement from 40 percent before operation. No medicines except thyroid and vitamins. Planning to take one year break from work.

01.01.08
Acidity and nausea exist.