All of us have spent most of our time in the ICU and the hospital. Sameer’s condition remains serious. His status as of this morning is as follows:
- His temperature was back up to around 100F after being normal for 3-4 days. No bacteria have shown up in his blood culture for the last 3-4 days. We do not have results yet from this morning’s blood cultures. The temperature has come down now to around 99F by now.
- His blood pressure and heart rate are stable. Both are somewhat higher this morning than they have been for the last few days - probably related to his higher temperature. This is not a cause for concern. In fact a slightly higher blood pressure helps during dialysis.
- He has been on dialysis for the last 3 days and his kidney-related vitals have been holding steady, although elevated. However he has a lot of fluid retention and they will try to remove some of the excess fluid through dialysis today.
- His blood oxygen level has been fluctuating in a narrow range since yesterday. Therefore they are giving him some extra oxygen through a small mask over his nose and mouth. They think that the lungs tend to collapse a bit due to a lack of motion. This also is not a cause for concern right now.
- He has been comfortable and does not seem to be in pain. Prior to today, he was responding a bit by opening his eyes when we were talking to him. This morning he does not seem as responsive.
- They did a chest x-ray yesterday and his lungs were OK.
- His bilirubin level has gone up to around 7 (it indicates liver function) from 3 yesterday. This could be indicative of the stress his liver is experiencing due to the chemo he has received. The doctors are reviewing his medicines to see if they need to make any adjustments.
- His bone marrow biopsy results have shown that there is absolutely no blood cell production in his marrow. This is called aplastic anemia. It is most likely that this was caused by the tremendous amount of chemotherapy he has received to date. Therefore it is not possible to judge the status of the leukemia. We will have a clearer picture when his marrow recovers in two to three weeks.
His attending physician is pessimistic about his recovery. He says that no one has seen as much chemo at the Seattle Cancer Care Alliance as Sameer. Even though Sameer is strong, the body can only take so much. We have told him that Sameer is a fighter and we expect him to pull through this one. We also had a meeting with all the specialists in addition to the attending hematologist-oncologist on Friday and requested them to treat Sameer in a multidisciplinary approach by coordinating very closely with each other. They said they are doing that already and will make sure that they continue to do it.
My friend Douglas Adkins, Reena and Reena’s brother Deepesh were present for the meeting. Prashant has been sick with a cold and he cannot come to Sameer’s hospital floor. He has been in constant contact to follow Sameer’s progress. Sunita (Sameer’s mother) visited Sameer last night and was able to spend a few hours with him. She has not been well herself and has not been able to visit frequently. I was concerned about how she would react seeing Sameer in this unconscious state. I have tried to describe to her Sameer’s condition but it is always hard to see your son or loved one in Sameer’s condition. She did well considering everything, and tried to engage Sameer. She also had good help from Andrea (Sameer’s nurse) who answered her questions clearly and with empathy. Andrea reassured Sunita that they are doing everything possible to take good care of him.
Swami Bhaskaranand of the Vedanta Society of Western Washington (Vedanta Center) visited Sameer yesterday. He prayed at his bedside and blessed him. Swamiji has known Sameer since he was 3 years or so old. Swamiji has been praying for him everyday as have several other devotees at the Vedanta Center who have known Sameer for a long time and are extremely fond of him. I know that all his friends in addition to our relatives and even others whom we do not know have been praying for his recovery. We appreciate all of their prayers.
Robert, Brady and Veer were here since Wednesday arriving at different times and leaving at different times. Brady was the last one to leave (early this morning). Brady has collected videos and sound clips from many of Sameer and Reena’s friends. Sameer was able to respond somewhat to them since they were loud and demanding! Deepesh also came on Wednesday and plans to stay through the coming Wednesday. Reena’s mother and Deepesh moved to a smaller (1BR) apartment from the 2 BR apartment they were renting since most of the time the second bedroom was not being used. Anamika has come last night and saw Sameer briefly. Samit is here as well since late last night, and Melindah is coming this afternoon. I look forward to seeing them all.
For any of you who want to visit Sameer, you are welcome to do so. However the infection control makes it necessary that if you have had any cold, flu or other symptoms in the previous week or have been in close contact with someone who has been sick, you cannot come in Sameer’s room. This is important for Sameer’s safety since he has no immune system at this time, and an infection can be fatal. Also, he cannot have any flowers or plants in his room, and is being fed by an IV. Please do not bring any gifts for Sameer, we appreciate your blessings.
The best scenario for Sameer is to avoid any infections or additional complications for the next 2-3 weeks until his blood counts start to recover from the chemo. The nurses here are wonderful. The analogy I have in my mind is that doctors are like gods - powerful (smart) but slightly distant and afraid of raising expectations- while the nurses are like angels. They are positive and very supportive. They bathe him, turn him, keep him from getting infections while administering all the medications, drawing blood, taking vital signs, recording everything, and constantly hovering around him all day. He has a dedicated nurse for each 12 hour period of the day. They rotate and all of them are transplant ICU nurses, which means that they are very senior and experienced. They tell us that they have seen people recover almost miraculously. While the doctors tend to explain all the potential complications and are pessimistic, the nurses deal with each case on its own without presuming the outcome while working optimistically. It is such a nice example of karma yoga in every day life.
Some of you have wondered how we are doing emotionally. Reena has been strong and has been spending all her time at the hospital. Reena’s mother has been there to support her and has been spending most of the day at the hospital. I have spent most of the days at the hospital since Sameer has been in the ICU. Before that, I would return from work a little after 4 PM and spend the evening with Sameer and Reena before going home to sleep. As you can imagine it has been very hard for all of us. I have been praying to the best of my abilities to Lord Shrinathji (Shri Krishna - our family deity) to heal Sameer.
When I go to Vendanta Center, I pray in the shrine of Sri Ramakrishna who to me is another avatar of Shri Krishna. I have been continuing to work professionally even traveling to conferences and meetings. This keeps me from worrying all the time about Sameer with unproductive thoughts. I have suggested to Prashant to do the same and spend as much time with Sameer as he can (when he is healthy) but continue his work. I encouraged Prashant to accept responsibility for a new project with very tight deadlines which now is taking all his time.
My priorities are Sameer, my family, our friends and my work. I have been thinking about the teachings of Bhagvata Gita which has been helpful to me in my life. However, my mind is unwilling to accept any separation from Sameer. I pray to God for Sameer’s recovery since it is hard for me to imagine a satisfying life without Sameer. Therefore, I am going to continue to focus on the right and intelligent action, and on praying or even demanding from God to bring our healthy Sameer back to us.
Please pardon me if I have not returned your calls. I take calls when I can but I find it harder to return calls especially the calls which require some additional work of finding and punching a lot of numbers.
Thanks for your continued prayers for Sameer’s recovery. Take care.
Kumar Bhatia