Saturday, December 27, 2008

IN PLAY


IN PLAY

5am, Sunday, Dec. 28th
Yesterday was the first full day of chemo for Titi. The first of a six-day barrage to vanquish and purge his system of all the antibodies in preparation of the freeze in order for his body to accept the engraftment or acceptance of the stem cell transplants on day 0 and day +1.
On the 26th, he experienced an extreme heart palpitation (250bpm) for a couple of minutes and was back to normal with a morphine injection. This is the second time that it happened – the first time was when he was in the hospital in Bangkok. The doctors here said it was normal and that it could happen to anybody – not related to his condition !?
Yesterday, he experienced chills, a side effect from the chemo which was subsequently quelled with another morphine injection. May have to take him to a drug rehab center once he gets out of here ☺
From now on, there is nothing else that can be done except to wind down the days of the protocol and to ensure that he will not be rocked by any sepsis or external infections.
In the interim, it seems that everyone here is putting their lives on a holding pattern. The protocol has to be carried out in its exactness to maximize the probability of success.
Stem cells must be harvested on the very day it is transplanted and since I am a half-matched donor, an extra-ordinary amount of stem cells must be available. The neupogen shots (to elicit stem cells into the blood stream) will be lengthened to 9 shots instead of eight and Prof. Naparsteck said a rich harvest is expected within the 4 hours or so. I do not know how she can be so certain.
I am home-sick and also a bit concerned – last week when they took the initial blood samples from me, I suffered a haematoma (blood leaked into the subcutaneous level of the skin) and I can still see the red blotches on my right forearm which one of the nurses here confirmed the nature. I think I know the cause – when the nurse extracted the needle (after the samples were collected) the sweeping motion of taking the needle out plunged the needle deeper into my skin (and thereby puncturing the vein on the other side, I guess) before extracting it. Just a guess and never to be confirmed. The thought of a higher objective for being here compels me to be as diplomatic as possible but also to ensure that such things are minimized or rendered non-existence during the course of the protocol.
How far can I take this advocacy and how many willing ears? As far as I can tell, the doctors and nurses say they are overworked and does not show the level of care and attention we are used to in Bangkok. Are we spoilt or should we strive for TLC? How wide-ranging do they accept as responsibility for curing a patient?
Meanwhile, we still have been unable to find a coin-operated Laundromat. Websites revealed 5 of them in Tel Aviv – no addresses – just phone numbers. Today, after Mass, would be a good time to get the hotel front desk to help with the phone calls (only hotel and hospital staff know conversational English, cab drivers, for the most part understand but feign ignorance- St. Peter’s is one of the most well-known tourist landmarks in the area, but our cabbie took an extra 15 shekels finding it) to locate these sites of growing interest.
I did find some Thais working in a fast food joint in the hotel complex and they gave me the name and address of a local Thai restaurant that THEY themselves frequent. Another place of now extreme interest to visit for dinner.
My neupogen shots will start on New Year’s Eve and that should reroute my mind from thinking about home, laundromats and Thai food.
Until then,
Sabai, sabai

Thursday, December 25, 2008

PROTOCOL


THE HOLY CITY
CHRISTMAS EVE saw winds and storms over Israel beginning at 3am. By 9:30am when Ellie, our designated driver and tour guide, picked us up the temperature was in the low teens (decC), extremely stormy and windy. Lek took a respite from the hospital and joined us on the trek.
Ellie was aware that we were here because of Titi and that he was in the Medical Center. Instead of heading straight for Jerusalem, he offered to make a side trip to Old Jaffe – a 2000+ year old town adjoining Tel Aviv. The church that we had gone to previously with Titi, St. Anthony, was in this town. Today he was taking us to St. Peter’s and we soon found out why.
This ten-century plus old Catholic church stood on a bluff overlooking the Mediterranean south of Tel Aviv and therefore the views were quite scenic especially on that day, with the rainy haze and white-capped 3 feet waves.
There is a suspension bridge that spanned across a butte to the Church named the Wishing Bridge with astrological symbols affixed on the railings spaced along the length of the bridge.. The sign says that those who cross it and pray with their hands placed upon their signs would get their prayers answered. I think Ellie had done this before with similar visitors. After prayers were offered and pictures taken from every angle and nook and crevice, we finally set off eastbound for Jerusalem.
The hour+ trip was uneventful but as we approached Jerusalem, on the roadside of Hwy.1 leading into the City, we saw burned-out wrecks of army tanks and jeeps strewn along n long stretch. Remnants of the days, only twenty odd years ago, when the Israeli troops traveled from Tel Aviv to take control of the Holy City.
Jerusalem is a city that evolved and grew around the Old City and the surrounding numerous mosques and churches and sites of historical interest. The roads meander and snuggle, up and down the hilly city with relatively little or no street signs to help the tourist venturing on their own.
We chose the Garden of Gethsemane as our first stop and Ellie had a hard time finding it. But timing is everything…as the gates into the garden and church opened just as we reached.
The eight olive trees in the garden was majestic and certainly held its credibility as to its existence when Jesus once strolled and prayed in it during the Passion and before His crucifixion. We also found the rock where He supposedly knelt and prayed before the soldiers came for Him. This rock was half outside and half inside the Church of the Nations (locally called Church of the Agony).
NOTE: All the pictures will be posted on a website in the very near future.
It was a very emotional and stirring visit only to be shocked back into reality when we stepped outside the gates. There were vendors selling religious trinkets and olive branches (!) outside the gates. We stopped and selected about 7 items which we had bargained down to about 70 shekels. We were unable to come up with the exact change so I pulled out a hundred shekel note and waited for the change. Instead, I was offered some more additional items which I adamantly refused and demanded my change. All of a sudden, I found his whole armful load of chains with crucifixes deposited on mine and my 100 shekel note disappearing with the holder into the side streets.
We then went t the Old City through the Jewish side. Entrance into the Western Wall (Wailing Wall) is separate for men and women and the Wall correspondingly had men and women sections. While we were there, scores of young uniformed Jewish students (high school age) were emptying by the busloads and queuing to gain access to the Wall and almost all of them were carrying semi-automatic weapons. Not a very comforting sight for the average tourist from Bangkok but I am sure a way of life otherwise.
We then meandered along the small side streets that led us into the Armenian and Christian quarters totally lined with trinket shops and eateries. It was getting dusky and really chilly and the ‘shop till you drop’ attitude posted a new low. We headed back to the car and Tel Aviv.
On the way to the car, I received a phone call from the Hospital. Titi’s Protocol had been decided.

THE PROTOCOL
The countdown with the daily treatments leading to the transplant is in black and white.
Today, Christmas eve, was day -11 > mapping day.
25th: Titi to be given the lymphocytes and plasma previously harvested from me. This step is given in order for his body to build up (create) the antibodies that would counter the donor’s good cells. These newly-formed antibodies would then be killed off on subsequent days with chemotherapeutic drugs.
26th: day of rest and antibody formation
27th: Chemo begins
1st: New Year’s day marks the last day of chemo
2nd: DDay minus 2: Titi gets a dose of radiation to complete the preparatory process
3rd: rest day
4th: Titi will receive the transplant of stem cells that will be freshly harvested from me that same day.
5th: Titi will receive bone marrow cells also harvested the same day from me.
6th: and onwards – recuperative process begins and all the prayers previously harvested take effect.

CHRISTMAS DAY
With the protocol set, it is game on! We realize that temporary setbacks, sepsis, fever etc. might still occur in addition to his extremely sore throat and butt.
Titi has a hard time swallowing so his diet has to be altered in order for him to be able to intake his nutrients with more liquids.
After breakfast, Nicky decided to stay with his dad while Mimi, Lek and I set off for Mass at St. Peter’s. Our cab ride got ‘lost’ so he says – a common trick to load up the meter, we understand, - and arrived just right after the sermon.
Unlike St. Anthony’s, where the parish was predominantly Africans, St. Peter’s is almost all Filipinos. The mass we attended was a guitar mass punctuated by Filipino songs and thus lent a distinctly Asian atmosphere.
While we were visiting Titi at the hospital late afternoon, we were invited to join the lighting of the 5th candle celebrating Hanukah. Prof. Naparsteck, the chairlady of the HematoOncology Department, explained to me that this celebration is the only non-religious one in Jewish rites…it is about how in ancient times, a person found a small cruet of oil and managed to light up the temple for eight days with that cruet of oil – ergo the nine branched candlestand –the middle one being the official ‘light’ used to spread the flame. She went on to say that the celebration here was sponsored by a couple whose son was a patient at the transplant center but unfortunately, died.
There was singing and tears of joy and sorrow flowing from the doctors, nurses and patients…each lost in their own emotions but all were assembled at the nurses’ station in the bone marrow transplant department.
Starting tomorrow, when the protocol begins and chemo begins to tackle a new phase of this odyssey, we need your prayers now more that ever. Thank you.

Tuesday, December 23, 2008

THE QUEST CONTINUES



Wednesday, DEC. 24TH; 3am
Christmas eve – we are planning on going to Jerusalem, the Holy City today. After ‘interviewing’ several taxis that we took previously, we chose a friendly ‘wife loving or is it fearing’ elderly gentleman who has visited Bangkok, of course staying at Khao Sarn Road for several weeks. During the cab ride and during the course of the conersation (interview) he made several calls to his wife to ask questions re their Bangkok trip (she remembers everything…he says with resigned admiration). This odyssey will begin later on today.
Monday saw Titi settling from his high fever again with a high flurry of activity centering around his ever-volatile condition…attempting to amass a large-enough data-base to find a window of stability in the near future to perform the transplant.
Because he had a stubborn pain in the buttocks, a visit to the proctologist was scheduled and the subsequent reports were maddeningly alarming. After the check-up and q and a with the proctologist, the following was evident – the attending doctor in Bangkok slept on her watch in this instance.
Titi had laser surgery several days before his departure from Bangkok. The surgery was performed with the intention of making the trip less painful – all good so far except we now realized that a proctologist was NOT consulted prior to the surgery. It was just between the hemato-oncologist and a surgeon.
The resultant effect was that layers of protective skin (there is a very large amount and cluster of nerve-endings and nodes collected near the scrotal area) where the laser tried to clean up was peeled away – the excruciating pain was the apparent result along with his apparent lack of neutrophils (an immunizing agent) in his blood. An ointment was ordered and delivered that afternoon and according to Titi, seemed to help.
The negative take away is that the protocol cannot begin until this condition stabilizes i.e. no fever and infection on the near horizon. The proctologist said that if it does not clear up within several days, another operation may be necessary!!! Prof. Slavin just had one comment on that – ‘just get well’ – he ordered Titi.
Brushing aside all the negative recriminations of ‘what might have been if the laser surgery had not been performed etc. etc.’ , the overall consensus in our group was to forge ahead with positive thoughts and concentrate on getting well soon.
In the meantime, on Tuesday, the preparation for the transplant had begun.
I was summoned to be at the hospital at 8am for registration and blood tests.
At nine am, the paperwork was complete and at 11:30 the bloodwork started.
( In the pix..blood flows out from the left and back into the system via right)
About 50 ccs were collected in vials and I was told to come back in 15 mins. for them to harvest about 100+ ccs of lymphocytes and 150 ccs of plasma. The preparation for the ‘killer cells’ combo of Titi’s and mine to overcome the blast cells had begun.
The process/procedure in theory is quite simple but Prof. Slavin warned, ‘the devil is in the details’.
Theory of the Procedure (Haploidentical Stem Cell Transplant – HSCT)
Prof. Slavin started off with a question:
“What if some 50 ccs of the blast (read bad) cells were taken from his body (Titi’s) and put into mine?”
Answer: My immune system would overcome and kill these baddies in no time.
On the other hand, 50 ccs of the good guys would not do the trick if similarly transplanted into the midst of the blast cells.
To drain the body of all white blood cells and then to find an identical (never 100% matching) donor would always be subject to 80% probability of system rejection of the donor’s cells – especially at Titi’s age and severity in the blast stages of this type of leukemia (CML). The ideal thing to do would be to have Titi’s existing immune system accept the good donor cells (half his and half donor – haplo), forge an alliance and kill the blast cells together. This is the theory – in a nutshell).
In order for that to happen, the procedure would have to temporarily freeze Titi’s immunity process in order for his body to adjust to the invasion of the good cells. This will be accomplished with a combination of drugs to suppress the existing lymphocytes and antibodies.
The good professor then goes on to describe a method of separating the killer cells (the immunity defenders) resident in the system. Separation of the good killer cells and the bad ones means nullifying the potential of the bad ones so that the good guys can have the time to join forces and kill off the baddies.
Concept is clear but the process is apparently fraught with risks of infections and sepsis. Prof. Slavin is an immunologist first among his many areas of expertise so he is very well suited to help Titi in this case.
The schedule is as follows: Respites for the patient (to continue the healing ‘down under’ ) and for the donor . Tomorrow– neupogen shots will start at 8am/8pm Christmas day for four days to culminate in the harvesting process on Monday the 29th. Hopefully, Titi can then be ready to start the protocol by then.

God bless us all with a Merry Christmas.

Sunday, December 21, 2008

Letters from Israel II


HAPPY 33rd ANNYVERSARY, Hon!!!!! First one celebrated apart and hopefully never again (apart, I mean ;-) )
MONDAY Dec. 22nd, 3AM – WHERE DID THE WEEKEND GO?

One of the highlights of the trip to-date was breakfast.
The breakfast buffet in the hotel is a welcome experience. A copious array of salads and cheeses along with freshly-scrambled eggs, scones and small cakes stuffed with herbs and chicken greeted us. Apples, oranges, grapes and persimmons along with about 5 different types of cereals flanked by jars of different teas graced another serving table. We are told this is a typical Jewish/Mediterranean breakfast and a definite treat for all guests. A great way to gather momentum through the day and did we ever need the pick-up and energy boosts.

One take-away for the ages from these past three days is to understand the meaning of patience – in terms of Titi’s illness as well as the modus operandi of the hospital staff with a healthy side-helping of Murphy’s Law thrown in for good measure.

We did not trek to Jerusalem on Friday as planned. Titi’s external pain centered on his buttocks returned and he’d rather take it easy and rest, staying put in room 23 and get adjusted to his surroundings. It turned out to be a beautiful day, about 23degC and sunny so the rest of us decided to walk the half-hour or so to the sea shore where the Mediterranean awaits.
( see picture)
The azure waters that greeted us on arrival was as calm as the panorama was wide. Sailboats dotted the horizon like fluffs of cotton and grew bigger as we hurried on down through the park to the shore.
Mimi and Nicky and I opted to walk along the shore in the cool water while Lek decided to stroll ahead on the pavement and wait for us at the pier rest stop. After a respite of water and sodas, Nicky wanted to go one more round to collect the remainder of the seashells he might have missed and to select the best one for his Papa.
We stopped for lunch at a corner restaurant where bottles of ketchup and mustard were sighted – sure sign of hamburgers and other familiar food. Servings of salads and burgers turned out to be huge to assuage the price of each order. The pasta given to us for tasting turned out good so we ordered one to go for Titi. The excuse to take a cab was there to get the food back to the hospital while still hot and indeed we arrived in good time and Titi was in good spirits although the nagging ‘pain in the ass’ was persistent. Jet lag finally caught up on Friday afternoon.

Saturday morning, we made plans to attend mass. It was the anniversary of Malika’s death as well as Shabat here in Israel. Titi was dressed and determined to come along – it was his first outing in more than 3 months. The church, St. Anthony’s, was in Jaffe- a ten minute cab ride away. There are no Catholic churches in Tel Aviv – a relatively new city some two hundred years young while Jaffe, also a port, existed a couple thousand years ago, an Arabic cab driver residing in Jaffe told us.
The exterior of the church seemed imposing but friendly while the interior retained the traditional gothic structure with high-domed ceilings and tall stained glass windows. The parish was ninety percent African, Asians comprised the rest of the church goers that day. During the offertory, accompanying the cruet of wine and chalice being walked up to the altar was a long possession of people carrying baskets of fruits amidst a joyous and raucous African hymn accompanied by bongo drums and cymbals. A truly moving and thoroughly in the mood experience.
The church gradually became packed and the some people started coughing in the pew in front of Titi so we decided to leave after receiving Holy Communion. The host was dipped in wine and offered directly to the mouth. I tried to initially receive it in my palm first but was denied the acknowledgement. Hopefully Titi did not catch any extra germs when he received the host, I thought.
After mass, we started walking back to the center of Jaffe and stopped at a bakery where bread of all sizes and types and pizza slices streamed endlessly out of three ovens and efficiently passed onto waiting patrons. We got a smattering of everything that looked and smelled good and ducked into a cab back to the hotel where lunch was summarily served by Lek and Mimi. I taught Nicky ‘kitchen patrol’ (I washed and he dried) the night before and he good-naturedly resumed his initiated role.
Ti developed a sore throat in the afternoon to accompany the insistent nagging pain. He mentioned it to the attending doctor/intern.
At about 3am Sunday, the pains in the throat and butt was so severe that he could not sleep. The hospital could not do anything about it because his protocol had not been drawn up and no drugs could be prescribed as such. Patience in this case was accompanied by extreme discomfort.
Sunday morning saw Titi’s extreme discomfort continue amidst the start of the work week for the hospital – government run and consequently a mad-house of activity with a shortage of doctors and nurses overwhelmed by the onslaught of patients post-weekend medical needs. He was sent downstairs in a wheelchair to the ground floor to see an ENT specialist for his nagging throat pains.
The patience here was evident as he was made to wait for his turn amidst scores of patients with coughing and sniffling fits.
He had developed a fever of 38degC accompanied with chills (the teeth chattering kind) which precipitated a flurry of blood checks and pain-reducing drugs. His protocol will start in the planning stages when his condition is stable and fever-free. The main things to accomplish for the next few days is to check from his blood and bone-marrow that he is free from sepsis and internal infection (one and the same, I think), a ‘hickson’ (central line) be installed and protocol method selected among the attending staff. Accordingly, the road map outlining and explaining his protocol would have to wait.
However, my donor protocol would begin on Christmas day- would be four days of Neupogen shots (2/day – 12 hours apart) and 2 days of apheresis (external harvesting) PLUS a bone marrow harvest for good measure (not looking forward to that last one).
In the pm, after his bone marrow biopsy, he remained blurry and out of touch for a while and even though hungry, could not bring himself to swallow because of the pain in the throat. He was given additional and new external gel appliques and drugs to try to counter the growing pains. After dinner, about 8pm, Lek called me to say that Titi’s fever had returned and the attending doctors seemed nonchalant on hearing about Titi’s developing condition.
( I was previously ‘advised’ by Prof. Slavin that afternoon for being too strident in my advocacy of Titi’s treatment and that he had every confidence in his team as well as their experience in dealing with such critical cases and that we were ‘on the same team’.)
Nevertheless, I went over to his room after the phone call and found him shaking and shivering and wanting to know what his temperature was. I walked back out into the nurses’ station and found all of them sitting around, some seemingly busy, others obviously relaxing. One of them, Ashraf, got up after I told them of Titi’s condition, went inside and asked whether Titi can take solids. Very difficult was the answer, so Ashraf said he would come back with a liquid drug and stuck a thermometer under his left armpit and said that he would be back in TEN minutes to look at it. In the meantime, Titi had draped and kicked off layers of blankets, went to the bathroom (with the thermometer in tow) and layered and kicked off some more blankets. About twenty minutes in total, I estimated.
I walked outside. There was only one nurse around, Ashraf was no where – presumably to get the drugs, I told myself. I walked inside and took out the thermometer and glanced at it. 40.5degC was what I saw.
In a daze, I walked outside with the thermometer and told the nurse the reading. Oh, was the calm reply and for the next endless 3-5 minutes, I watched her try to find Ashraf, dialed a few numbers and hung up on all of them. NO interest in answering whatever the condition, I thought. Just then, Ashraf came through the doors with another intern, break over, ten minutes (or was it over twenty) up and back to work. He grunted when I showed him the thermometer and proceeded to go inside to administer the pain killer he had . Titi had requested to take Tylenol but he had to take what was prescribed.
After a while, Titi was peacefully resting and I left, all numbed from the extremely high temperature reading and the seemingly non-chalance of the hospital staff. They have seen and experienced so much more of this than I, so I thought and that is why things seemed under control to them while all hell was breaking loose in my mind.
Lek was supposed to call re new developments, if any, later on tonight.
It is now 4:30 am. Think I will draw down that second cup of coffee and walk over to see how he rested.
Does patience have any limits?
Sabai, sabai

Thursday, December 18, 2008

TelAviv1..chronicles of a quest


TODAY IS FRIDAY....which along with Saturday constitutes the weekend here in Israel. Sunday will start the workweek. It is presently 3am and having crashed since 8pm last night and fueled with a hot cup of hotel room coffee already and angling towards the second cup in a minute, I start.

We arrived in Tel Aviv yesterday morning at 6:40 am from Bangkok, a flight of about 11+ hours. The flight was happily uneventful except for the ElAl toilet police – more on that later. Titi had a very restful flight unaided by any drugs and also experienced very little pain. All precautions had been taken – Titi and Lek sat in business class while Mimi, Nicky and I were in economy – separated by only a few rows.
We actually had 4 seats in business class – the last two being a condition from the airline as being mandatory that Titi had to have oxygen throughout the flight and as a consequence of that, we had to have an attending physician that knew how to work the equipment. The oxygen tank had to have a seat all for itself.
The hospital in Bangkok had arranged for all the logistics moving Titi from Samitivej Srinakharin by ambulance directly onto the plane, ElAl…the highest security-oriented airline in the world.
We then arrived at the airport in three cars…one van actually was filled with luggage – Lek, Titi’s wife was very well prepared for an extended stay. all the comforts of home (meaning kitchen to us Thais) including the rice cooker were packed into one dedicated hard-shelled suitcase severely challenging the weight limits that the airline had imposed on well-prepared travellers.
Titi stayed in the ambulance while the rest of us went inside to check in. Lek and the doctor went to the business class check-in while Mimi, Nicky and I lingered at the tail end of a long sssss of a waiting line for eco. BUT ELAl had wanted to get the whole group together so we were happily summoned to the ‘front row’ for check-in.
An ElAl official walked over after we were all assembled and questioned us in detail, all the while looked at us straight in the face to catch any signs or hints of abnormal behaviour. We passed with flying colors and was rewarded with green security clearance stickers on our papers.
It was done with such efficiency and professional courtesy yet with intensity and awareness that I jokingly asked them whether they were trained by the Mossad.
“Good question,” he answered thoughtfully, “but no, we were not trained by them but we have contact with them.” With that, we were quickly whisked inside…the doctor went to rejoin the ambulance and the four of us lingered in the Thai passenger lounge until boarding time where we rejoined Titi and Doctor Achariya on board.
Seated so close to where they sat in the business class seats, we made frequent visits to see how Titi was doing – the hourly visits often saw the three of them fast asleep with a lonely empty seat between Ti and Dr. Achariya. purchased by us to store the oxygen UNDER the seat. I had contemplated requesting the food for that seat be sent to seat 25C in the eco section.
On one of my visits to see them, I ducked into the restroom between the biz and eco sections. It was when I came out that I cam in contact with the ElAl toilet police (TP) who told me in chiding terms that eco bladders cannot be relieved in the biz section. Some time later on, Nicky and I walked up the aisle to visit and we slowed down as we neared where his parents were seating, it happened to be right in front of the biz section toilet with the TP walking by. She stopped in mid-stride, turned to face us and proceeded to point to the eco facilities – hate being caught red-handed!
Ben-Gurion Airport was busy and crowded when we landed.
The precautionary measure of ordering an ambulance and limo to carry us to the hospital turned out to be a good move although the patient was in fine shape. Again, we were whisked through long lines of immigration and avoided the customs area. In no time, we were at the curb waiting for our ride where we were soon slammed into Bangkok-like traffic jams going into Tel Aviv.
Ti, Lek and Nicky went with the ambulance while Mimi and I went to the hotel to check in. The hotel is right across a small street from the Tel Aviv Medical Center where the Center for Transplants and Cancer Research (CTCI) resides on the 9th floor.
On the way to the Center, visitors had to go through a metal detector - the first time I went through it, it beeped so I proceeded to reenter the detector. Just then, another beep showed a man, similar in age to me, passing through the detector. BUT he just kept right on walking with the guards showing no concern over stopping him for a recheck. Upon asking the guards why he sailed right through, 'he is too old (to do anything dangerous)' came the response. I instantly felt a lot younger but decided I should condition myself to look older under such situations..

We all assembled at the hospital around 9am and met Orit, our international coordinator,around 9:30.
Prof. Shimon Slavin, the renowned CML immunologist (if you think I am lavishing praise, google him) eventually joined us and chatted a bit informally, mentioning that he would be going through Ti’s medical history along with a blood test at the CTCI. He would be seeing Ti later on in the afternoon. (that's him in the pix going over Titi's case file)
We then received a tour of the facilities – very warm and friendly atmosphere. We dropped into the donor room where the stem cells would be harvested (my OR in a few days). There were two donors on individual beds in the external harvesting process – warm and friendly atmosphere and not at all tense or scary.
We were then led into room 23 where it will be Ti’s home away from home for at least 2-3 months. There is a small fold-out bed where Lek will be sleeping – everything was there except for COOKING facilities ☹
We then went back to our one hotel room (the second one will be ready whenever it will be ready…no promises) where Lek hastily unpacked the essentials (rice cooker/rice/canned curry) and proceeded to start cooking. She already had their favourite fried pork and Chinese sausages precooked and packaged from Bangkok. I think future occupants of this room will have an unexplainable urge to make Thailand their next destination.
After lunch, Dr. Achariya went touristing in Jerusalem; Lek, Nicky and Mimi went shopping and I stayed with Titi to talk to Prof. Slavin.
He came in after a while and proceeded to explain the theory side of the procedure which was extremely revealing and logical (the details will be blogged on Sunday when there ill be a staff meeting regarding Ti’s case and the road map clarified). He then did a check-up of Titi and said that he is in no need for emergency consideration and even espoused the idea of him going outside the room and hospital for the next couple of days as nothing will happen until after the staff meeting (hopefully on Sunday).
SO, this morning, after I post this blog, I will be making arrangements for a 1-day trip to Jerusalem and as far as the day can take us in this Holy Land – even may try to venture into Bethlehem if the Palestinians will let us in.
Sabai, Sabai