Monday, 01 August 2022 | Krishan Kalra
Early in 2007, every two weeks or so, I noticed a tiny spot of blood on my night shirt. Dismissing it as a mosquito bite, I paid no attention. Then, in June, it started appearing every day and it was happening at the same location – close to the right nipple. My family suggested I must consult our family physician. So, I sought an appointment the same day. Apparently he was leaving the clinic and suggested we meet in the evening, “but do tell me what the problem is,” he added. The moment I explained the ‘tiny blood spot’, he seemed alarmed asked me to reach his clinic as soon as possible. Being close to the office, I was there within a few minutes and by then Dr Tandon had made an appointment for me at a diagnostic lab nearby. His prescription mentioned ultrasound, mammography and FNAC! Crazy, as I thought it was – mammography for a man – I complied. Anyway the doc at the lab, after the ultrasound and mammography didn’t seem worried; he mentioned that it looked like a small harmless cyst but I should get it removed anyway. On my way back to the office, I called another doctor and requested for an appointment for next day with the general surgeon at his hospital. Dr Thakur – a leading gastroenterologist and a dear friend who is often our first point of reference for any health issues – too was quite cool and said, “come tomorrow morning, it will be a day job and you can go home in the evening”. Everything seemed fine and I got back to the hectic day- normal routine for a chamber CEO.
Couple of hours later, our friend called and told me that “this did not look like the job for a general surgeon” and he had instead arranged for an FNAC test next day at a senior radiologist Dr Pant’s lab where another doctor from yet another lab will extract sample from the tumour under ultrasound guidance and test the same in their lab. It was now beginning to dawn that something was indeed wrong so I called and told my wife. Next day at the radiologist’s place, surprisingly, Dr Thakur was also present. As soon as the fluid sample was extracted Dr Pant looked at a tiny bit under his microscope and mentioned, “Krishan Ji I’m afraid it doesn’t look good,” of course, we will wait for the investigation. Being a Saturday, the doctor mentioned that they will give the report on Monday afternoon. Dr Thakur wouldn’t accept that and requested him, “No way Sir, I want it this evening”.
Later that evening, as I was in the midst of a meeting at the chamber president’s office, my son called and whispered, “Sorry dad, it is malignant; I’m coming to pick you up”. I don’t know how god gave me the strength but I was quite unruffled and told him there was no need and I will be home in an hour or two.
Next morning we started discussions about the oncologist we would meet on Monday. After several calls to friends it was settled that our first call would be on a young surgeon (Dr A) – who had recently come back from UK and joined a local hospital in Gurugram. Later in the day, a family friend – founder member of the Rajiv Gandhi Cancer Hospital (RGCI) – closed the issue. “You can meet any doctor but your surgery will be done by Dr Harit Chaturvedi at RGCI,” he said assertively. So on Monday morning, we met Dr Harit; one look at the FNAC report and he said he could schedule the surgery on Friday morning – exactly six days after the FNAC test. We were asked to get a few more tests done and get admitted on Thursday evening. “We will send you home on Saturday,” he added. Since we had already made an appointment to meet Dr A, we headed back to Gurugram. Surprisingly, he wanted to do a core biopsy before deciding about the surgery. Hoping that surgery may be avoidable we agreed and the procedure was set up for next morning. My next visit that day was to Dr Pant for a test prescribed at RGCI. I also mentioned about Dr A’s advice for the core biopsy. Our good man almost shouted, “How can he prescribe a core biopsy at a location where there is literally no fat? This can actually injure you seriously. In any case, with the FNAC confirming malignancy where is the need to do this?” He was so convincing, I cancelled the biopsy appointment and decided for RGCI.
On Thursday evening, after an almost full maddening day at the office I went to Rohini and got admitted. After a light meal, there were the usual preparations for the surgery, mandatory visit by the surgeon and early next morning I was wheeled into the OT. Fortunately, I wasn’t at all nervous. Despite being the ‘worrying kind’ I don’t know how I remained absolutely cool, chatting with my son late into the night before turning in for a sound sleep. I remember being given the anesthesia, then faint images of the surgeons and nurses, all kinds of tubes and sensors being hooked in…. and the next thing I know is waking up in the recovery room at about 4 in the evening. A little later they moved me to my room. Usual dinner, follow up visits by the doctors and – true to their word – I was allowed to leave the hospital by noon next day. There was a tube attached to where the stitches ended on the 4-5 inches cut on my right breast and this ended in a calibrated container which would be with me all the time. I was told to check the amount of waste fluid collected in it every morning and the day it came to less than 50 ml I could go back to get the sutures removed. Other than that minor annoyance, I was free to lead pretty much normal activity, walk gently, go for work etc., bath time the container had to be held aloft and I was to make sure no water fell on the stitched up area and of course I was not to sleep on the right side. There were also some antibiotics, antacid tablets and painkillers. I stayed home for a week and then went back to office. My wife got me a shoulder sling bag – good old jhola used by pseudo intellectuals – so the container sat in that and didn’t hinder my movements. Stitches were removed on day 13. Few days later the ‘tumor board’ reviewed the case and concluded that (thankfully) I won’t need any chemotherapy or radiation and only oral medicine – 20mg a day of Tamoxifen was prescribed for five years. As a precautionary measure, I was asked to wear a ‘pressure sleeve’ on the right arm during flights or when at high altitudes.
We went back to the Gurugram hospital for a second opinion. Whereas the oncologist generally agreed with the RGCI recommendations, his radiologist colleague suggested 21 sittings of radiation! This got us in a fix-whom to believe- and so we managed to meet yet another highly experienced specialist – a professor Julkaat AIIMS. He was quite emphatic that there was no need for radiation and I only needed the oral medication, quarterly reviews and six monthly blood tests, u/s and a chest X-ray. Since RGCI I requested the good doc if he could do the quarterly reviews and he very kindly agreed. I followed the routine religiously (X-ray was dropped after 2-3 years) and at the end of the five-year period, I was told that the reviews could now be annual. With the almighty’s grace, I am in good shape so far and there have never been any hindrances on food or travel or any other activity. Of course the insurance companies refused to increase my health cover which I would have liked in my old age.
Now the Lessons Learnt
· Watch out for any unusual symptoms / changes in your body.
· Do have a good GP – a dying breed but some good senior doctors still provide this service even though they don’t call themselves GPs; instead they are mostly known as ‘consultant family medicine’.
· If ever the GP raises a red flag, do not ignore his advice; quickly get all the tests done prescribed by him/her at a good laboratory.
· In case a malignancy is diagnosed get to the experts ASAP. Preferably choose a good dedicated cancer hospital.
· Do not panic; cancer is easily curable if detected early. In any case, panic and worry will only multiply your misery many times. Have faith in god; and your doctors – they know best.
· If surgery or/and hormonal treatment is advised, seek the earliest date to get started.
· Religiously follow the doctors’ advice about follow up medication/treatment/diagnostic tests as well as diet, exercise and any other precautions.
· Unless you are working for the government – where you enjoy life time medical care facilities – try to buy a good health insurance policy at personal cost. It might sound superfluous because most employers cover you under a group policy but remember this coverage ceases – except in case of some very good companies – the day you retire.
(A veteran of the corporate world, the author now does only voluntary work in various spheres. Views expressed are personal)