The last 10 days were a mixed bag.  A key element of the transplant was going to be the interplay between the graft (donor) and the host cells.  The worst case is of course when the donor cells are rejected.  Thankfully, that has not happened by a long shot.  The best case is when the graft cells fight enough to kill all remaining cancer cells but do not go overboard and attack organs like liver, gut, skin in its over eagerness.

There were signs that my graft cells were getting a little overeager (the liver counts were a little off).  This meant that I needed to go on steroids to calm the process down.    Nothing is free in life, so the steroids come with side effects.  The standard ones of sleeplessness, moodiness, hyper activity, over eating did not manifest.  For me it was gastritis.  So, spent 4-5 days in discomfort.  But it seems to be getting better and the liver counts improving.  My medication will be brought down, which will alleviate most of the discomfort.    It is important that a balance be reached.  Please pray for us.

Am keeping well and positive.  Most days better than the rest.  Lots of good folks looking out for me.  No fever. Good appetite.  Eyebrows coming out.  Some fuzz on my head.  Almost to normal skin colour.  Eyelashes peeking out.  Muscles slowly shaping up.  Nisha is drowning in Chicago academic rigour and enjoying.  Ash is working on his SATs and fretting about Arsenal – his football team.  They cannot get a shot on goal and he is ready to show them how to do it.  Amita is strong and encouraging me to think about engaging with life a little more.  The time will come with all your prayers and best wishes.

Distancing from pain/pleasure and increasing awareness

“Apperception” (the ability of the mind to introspect and/or reflect on itself) is probably one of the most intriguing ability of the brain.   There is a schizophrenic ability of the mind to view a thought created by it as an independent entity.  What makes it fascinating is that the two processes behave completely independent of each other; almost like different people, leading to second guessing, critiquing, non acceptance, strengthening conflict  etc…  For example, I buy something with some reasoning and then another thought kicks in and starts wondering if it was the right time to buy, or was too much paid, or should I have shopped online etc..   Lots of people have called the first thought “observed” and the later as an “observer”.  The two processes can become “critic” and the “critiqued”;  an “analyzer” and the “analyzed”, a “learner” and “learnt”, a  “planner” and “planned” a judge and judged etc..  While there is a lot to be gained from observing and understanding this process; as it relates to happiness, energy, improvement, planning, and learning. It encompasses so much of life’s mental processes;

The ability to view all of these mental processes “at once” “as a whole” and not get sidetracked into one of them, is quite extra-ordinary.  Seeing both as a single entity, from the same source; not as separate and competing allows us to sink into the vastness of pure observation, awareness of the whole instead of limiting life to one isolated schizophrenic thought.  To do so when there is body discomfort like a searing stomach reflux is what practice and meditation can give us.

Sharing

A beautiful paragraph from my friend Gopinath … “There is joy, beauty, power, and courage in life when you lean into the chaos that the randomness of life, the suchness of life places in front of you. When you don’t resist or fight it but receive it with grace. We then lead a full life that we may not have asked for but one that we have been blessed with. ”

A fantastic funny article at WSJ

http://online.wsj.com/article/SB10000872396390444868204578064483923017090.html

sO Positive

It is official.  The bone marrows sleight of hand is real.  O –ve is history.  The future is bright and it is O +ve.

This could mean that;

              Amita and I will have to get married again.

              I will have to go back to NIT for my Bachelors and actually study this time around.

             Amita will try to explain all of this to District of Motor Vehicles in Bangalore and get my driver’s license to reflect this change.

According to the doctor, this means the “engraftment” is official.  And the esh brothers have more than a few things in common.  The doctor, when he broke the news, told Amita that he is going to call me Suresh.

Shivers

The week started and ended with a shiver.  I experienced some shivers evening of Oct 4^th with a 99 degree fever.  The previous infection, that happened a few weeks ago, made us endure one of the toughest nights in the hospital, started with a similar shiver and a 99 degree temperature that rapidly climbed to 104 degrees.  This time, thankfully, the fever stayed within the 99/100 range.  We did not have to get admitted into the hospital.

The penalty kicks continued – and I was not the one doing the kicking!  Oct 12^thsaw a repeat of the same event, excepting that the fever did not stop at 99 but climbed to 103.5 with the shivers.    Together with the doctor, we were able to piece together the events of Oct 4^th and 12^th.  Both times, the shivers happened within hours of a visit to the doctor and the hospital. I have something called the “Hickman Line” inserted into my right chest, into a main vein, for easy IV administration of medicines and drawing of blood for blood tests.  A “stopsign” in every outing to the hospital is the cleaning of the Hickman line, which includes injecting some anti-coagulating agents into the tubes.  There was something happening there that was triggering the shivering and subsequent infection.  So, we came in for a day admission on Oct 11^th and got the Hickman line removed.  Am back at home 11^th evening with no fever and feeling good.

There is a little GvHD (graft versus host disease) that the doctors desire.  But like a good garlic dish, we want just enough and not too much.  The doctor says I am doing great.  I seem to be walking that thin high line

Sometimes we feel like we are in the middle of the ocean with waves coming in at us.  We just need to roll with it and trust that these waves will get us to shore.  We met a fantastic lady called Abla, from Oman.  She exuded a enthusiasm that was so infectious (the only thing that is worth being infected by in the hospital).

Shivering into Awareness

It is revealing to see how the body and mind reacted to the shivers.

I froze when the first shivers started.  The “past” flooded my present.  And my mind projected into the future.  JK (Krishnamurthi not Rowling!) says it beautifully when he says the “future is the past”.  The mind feared a repeat of the past experience.  It seemed so important to be aware of the process and not descend into this virtual abyss of fear.

I will try to trace the events that coursed through the body and mind.

The shiver was strong enough to register in my mind.  All our experiences triggered by the external world seem to enter our internal world through our senses.  Our senses need to be stimulated enough to register an experience.  Some other examples in real life;

• Phone rings in a bar that is playing loud music.  The ring does not even register in the mind because it is drowned in the louder music.
• Pain that was below a certain threshold did not even register when a strong pain killer was taken.
• Sometimes the phone rings, but it did does not register because my attention was somewhere else.

We can extend our imagination to:

• A match stick catching fire in a larger fire is not even noticed.
• The smell from a perfume stick gets lost in the stink from a nearby garbage dump or the excess fragrance from a stronger perfume stick.

The entry of an experience into our body seems to start with the registration process by our senses of external stimuli.  The manifestation of this registered experience passes through multiple steps;

step 1.    Our senses registers stimulus that has the strongest sensory impact and the attention of the mind.  Clearly my shivers were strong enough to register.

step 2.    The senses, upon registering the event, triggered a series of psychosomatic reactions that are worth tracing.

In general, once the stimulus is registered, mind with its multiple belief systems kicks in by comparing, opining, judging, critically evaluating, regretting, celebrating etc.. Usain Bolting into the future – a future that is either a desirable future or a fearful one.

In this particular experience, my mind compared the current “shiver” to past experiences – creating psychological time – a future based on the past.  A future was formed, where my mind created an inevitability of an exact replay of the past infection, with the same intensity.

step 3.    The result of the sensory assimilation are emotions such as; anger, fear, happiness, pride, jealousy etc.. Clearly, in my case, for this experience, the predominant emotion was fear that occurred due to the projection of a past unpleasant experience into the future.  There was also anger at being dished out this stuff.   I threw the thermometer away when i saw the mercury defying gravity.

step 4.    Finally the above emotions register in the body as feelings; such as, sweating, butterflies in the stomach, low energy because of reduced blood flow, high blood pressure, cry, laughter, endorphins,  T cells, adrenaline, etc.. In my case, for this experience, the feeling was decreased blood flow etc..

This “ladder of experience” starts with the body through sensory input and ends with feelings in the body; with its steps traced by the mind and its belief systems and emotions.  The ladder of experience can turn into a “spaghetti of experience” when associative memory, triggered by any of the steps, cascade several past experiences into one another.

Windows into Peace

The good news is that every one of the above steps in the ladder offers us a window into the “creative space” that can stop the vicious reactive patterned cycle.

For starters (garlic bread before the spaghetti !) , my mind disputed the thoughts that were cycling through.  The disputations of reactive “step 2” thoughts went like this;

“it does not have to get as bad as last time”, “just because it happened once does not mean it has to repeat itself’, “what is the worst scenario in case it does happen – one week in the hospital’, “What is the use of all this worrying; it will only make it worse’ etc… 

These “disputations” opened up a window that reduced the velocity of reactivity. They lessened the speed of thoughts and also changed the direction of thinking by stopping the relentless flow of the past to the future.   Of course, solving the problems of the mind with the same tools (mind/thought/memory) that caused the problem is hazardous.  There is a danger that, through associative memory, the mind will wander back into the past or conjuring some imagination.

Once I got some space, Step 1 and 4 offered a critical window; my mind was able to observe the sensations of the body, in this case shivering, and just stay with it.  No mental commentary.  The simple process of observation of the sensations in my body was so cooling to everything. I slowly slipped into an integrated body and mind that stayed in the present moment and arrested the flow of the psychological time – the flow from the past to the future.  This avoided so much suffering.

My journey, over the last 10 years, to integrate my mind and body has been pivotal to attaining this rest during these mind-storms.     I recall the many “body scan” meditations that I have done that acutely observes body sensations and just lets it be.  I have done 1 minute to 1 hour meditations; Vipassana to Jon Kabat-Zinn. They have all been amazing to me.  Vipassana is the PhD of this technique; i share a video by Jon Kabat-Zinn.

http://www.youtube.com/watch?v=SHVwkoQPPKc body scan meditation by Jon Kabat-Zinn

Sharing

I read this beautifully written article about West Indies T20 cricket by David Hopps, it is adorned with marvellous use of punctuations.  I took me back to my days in Boston and Boston Globe, when I used to devour the sports writing by Bob Ryan and Dan Shaughnessy.  Those were the days when the Red Sox and Patriots were the eternal bridesmaids to New York teams.  I used David’s article to explore with Ashwin and Amita about use of punctuations etc..

http://www.espncricinfo.com/icc-world-twenty20-2012/content/story/585733.html

For the intellectually inclined, there is a lovely site you can visit;

http://www.aldaily.com/

The above recommendation came from Satya “Becker” Prabhakar.  And the following insight about the site from Gopi Kallayil;

For 14 years now Evan Goldstein and Tran Huu Dung have been producing this daily labor of love dedicated to some very high quality and erudite thinking. They are both based in NZ, update it 6 days a week, and draw from great literary sources around the world. Their human curation is excellent. A recent example being Life after TED from FT by April Dembosky.

Today is my 49^th birthday!  As I received the first wishes of the morning; I felt compelled to reach out with this note.  My Pranams and heartfelt thanks to all of you who have shown us your love, given us energy through your actions, best wishes and prayers.  It has been the boat I have needed to cross my oceans of uncertainty.  This day looked a little distant when I was doubled over in pain during my Chemos or lying listless at the bone marrow transplant unit.   A special request to include my doctors, nurses and para medical staff in your prayers today.  We are strong and optimistic and hope to double over in laughter when we meet you in the future.

May all be well and be happy!

Nisha left for her 2^nd year to University of Chicago.  Tough kid who knows what she wants.  It was terrific to undertake my first two trips in 4 months that was not a drive from home to hospital and back.  I went to the airport to bid bon voyage to Nisha and also attended Ashwin’s parent teacher meeting.

I have had a good week.  I got better every day by a few percentage points. Have been eating well and getting stronger.  Slight fatigue still prevails.  We visited the Dr Sharat on Thursday and he was comfortable with what is going on. My haemoglobin levels are low; which might be contributing to my fatigue.  But the RBCs are the last to proliferate after a stem cell transplant.  I might need some transfusion next week if it gets any lower.  There is also a mild persistent fungal infection that is demanding some strong anti-fungal medicine.  The counts are ok.  The brevity of this medical update is heartening; please continue your prayers.  It has been the cornerstone to my recovery.

Had a marvellous visit from Satya Prabhakar, alias “Becker”.  Becker, nicknamed by his friends because he considered himself an up and coming tennis player when he was studying in Gainseville, FL, is an old friend of mine having travelled 20+ years of our lives together.  Becker founded Suleka, a leading website for Indians.  Let us say he has turned out to be a far better business guy than a tennis player!  Also was blessed to have a visit from Sharanya.  I do not know anyone who prays harder for me!  Anand Anandkumar’s visit was terrific; he is an inspiration to me, having recovered from thyroid cancer and other issues to start a thriving bio-tech company.  Real hero with his attitude and heart!  Lovely phone call from Mr Viswanathan! And a visit from Thamar.

My journey to understand two differing approaches to daily life continues.  It manifested in past weeks with the noodling on “The Secret” and a “Meditation”.  The first is the classic “self help”, “pranayama” approach and the second is the “zen”, “mindfulness”, “vipassana” approach.  Slight tension exists in their respective literature, practices and courses. We were advised during the first hour of the vipassana course to cease all other practices (like pranayama, mantra recitation, visualization) that alter reality by forcing breath or thinking in a certain way to attain goals; such as, better health or more stable mind.

The first approach encourages goals and actively tries to achieve them by “replacing negative thoughts with positive ones”, “healing the body with visualization, prayers” etc…  The second approach, trusting of what happens in life, does not actively seek to change; subscribes to “being-ness”, “Is just mindful of life processes” and “impersonally lets all to just be”.

The first approach, when confronted with a mind that goes into a spin of self-doubt, feeling sorry for itself, fearful about the future or angry about something, replaces the negativity in the mind with positive thoughts.  The second approach when confronted with the same circumstances eschews the advantage of altering the thoughts; instead enters a space of mindful awareness, stillness, and watchful acceptance; allowing wisdom to manifest.

They often have seemed to me, in the past, to be at odds with each other.  The first has the practicality of providing succour and answers to the “problems” of daily life.  It also has the comfort of honouring the reality of emotions that are happening and providing some immediate relief.   The second has the aura of common sense; it seems to reveal the “questions” and the “context” for which the first approach already has answers!

I had an interesting experience that seemed to provide me some insight.   I have always had a pattern that has been quick to state its opinion on food.     For example, in the past, a “bad” cup coffee would have gotten me irritated and upset at Amita about the seeming lack of attention to details, not putting in the effort or even exploding my judgement to “not caring enough”. This of course, will trigger Amita’s patterns, which were mostly withdrawal; that will in turn trigger my patterns of anger and withdrawal.   These contagious emotions and patterns would cascade into one other, offering little respite.

Recently Amita made some food that I did not like.  My patterns of critiquing reared up.  I was then able to observe my patterns of critiquing without any need or agenda to changing it, or to be a person who is above critiquing; no guilt for critiquing or desire to alter my negative thoughts into positive ones.  This allowed me to be easy on myself (by honoring my thoughts and feelings) and gave me a creative pause to observe:

• That Amita had observed my body language and got worried that she had not done the right thing.
• The fact that my taste buds are ever changing and it must be impossible to cook for someone whose tastes are ephemeral.
• Amita’s infinite other contributions to me and the utter insignificance of likes/dislikes over a single dish.

The pause allowed a creative response without the patterned domino effect responses of anger and withdrawal.  The creative pause gave me the clarity to talk to Amita about my understanding of what happened and the collective dynamics of our combined processes.  It was lovely to see the second approach of mindfulness giving me the creative pause to creatively execute the first approach.

Einstein said it best – “you cannot solve a problem with the same level of thinking that created it”.   The first approach suffers from that limitation!  It tries to solve a problem created by a pattern in the mind through another pattern (positive thinking) from the same mind.  We end up in a place where we have clear answers to unclear questions!  On the contrary, pure observation or “being-ness” changes the level of thinking and manifests sensible interactions by seeing the whole, and turning away from thoughtless and reactive responses; allowing for intelligent pro-active engagement with the world.

There seems to be a lot of ways to get to this “creative pause” before actively engaging with the world.  “Pause and Act” seems to be a better version of the old adage – “think and act”.  Just thinking before action can fall into the dark canyons of action driven by reactive thoughts.

Pausing is the result of awareness and observation without an agenda.  This begs a few the questions: How do we set ourselves up to be more aware?  How do we observe without a goal?  Will noodle on this and pen a few lines next week!

Keep us in your prayers!  Thanks for all your best wishes.  And have a wonderful Gandhi Jayanthi.

Sharing

Talking about integrating different point of views and cultures; Ashwin’s friend sent us this lovely rap song

https://www.youtube.com/watch?v=Xduo8E_ERbY

I was touched with the lyrics; it seemed to beautifully depict the pressures and journey of a talented young Indian living in the modern world and finding some meaning in prayer that connects him to a larger context.  The young generation is just awesome!

I am also midway through a lovely book

“Thinking fast and slow” by Daniel Kahneman, who after winning the Nobel prize in economics and has turned his attention into some game changing insights in Psychology.  He is widely tipped to win a Nobel prize in psychology..