Round Seven: Turn On Your Stomach

“Turn on your stomach, madam and go to sleep. This might take about 45 minutes to an hour,” the soft-spoken radiologist said nonchalantly.

“We will tell you when to inhale and exhale. Follow our breathing instructions, closely and don’t move. I’ll leave you to change now,” he added, before discreetly stepping out of the spacious sterile room, outfitted with a spherical scanner. Earlier, they had one end sealed. These days, perhaps to make it less claustrophobic, you have both ends open.

I was all set for an magnetic resonance imaging (MRI) of my breasts. A nurse tip-toed her way into the imaging room to cover my naked midriff with a white sheet. Yet I continued to feel vulnerable and exposed as tears stung the corner of my eyes. Before leaving the room, the radiologist pressed a rubber horn in one of my outstretched hands. “Blow the horn if you feel any pain or discomfort. We’ll come to your aid”.

The thought escaped him to add, “If you feel lonely or scared.” To be sure, those are not biometrics that a radiologist can observe, measure or control in a patient.

I’d been given to understand that if my MRI report comes up with a cluster of atypical cells, as the earlier sonography had revealed, the oncologist on my liver transplant team would have to “gun down” the cluster of small lesions, assisted by ultrasound guidance. This would of course be followed by a biopsy that would reveal the true nature (benign or cancerous) of the tissues squeezed out from my left breast under local anesthesia.

I lay prone on the cold, magnetic plates, with my breasts cupped in silicon, and two pillows to prop me up and not a soul in sight. Not a whisper of a sound. It feels as if I have already crossed the ethereal boundary into the Ether land.

Mentally, I do my daimoku (A Buddhist practice of Soka Gakkai), fight my fears over the medical outcome and clutch on to the rubber horn as my one anchor in life.

On the other side of the glass partitioned procedure room, I can hear a gang of radiologists tittering and gossiping during a tea break. “Will they hear me?” I wonder.

“Okay madam, are we ready?” I hear a second baritone voice commanding me and my mobile stretcher rolls into the spherical scanner as I begin to feel my head spin from the claustrophobia. About an hour later I receive the breathing instructions, I’d been patiently waiting for and then was quickly slid out of the scanner.

“We are almost done,” the radiologist told me, except for a contrast study. He gives me a shot of a colored strain and I feel a shape, stinging sensation in my arm. “Don’t worry, we are done.” The stain begins to course through my capillaries and makes visible the tissues the radiologist wants to study visible, against normal ones. Then it was all over.

The MRI was however nothing compared to the apartheid I felt during PET (whole body) scan. Directed to a quarantined room of the nuclear medicine department, the doctor who had to administer the radioactive dosage to me on an empty stomach sat in the ante room with a syringe. I had to slide my arm for the shot through a narrow window.

If by merely being in the same room with me can endanger her life, what potentially damaging impact would the radioactive dosage have on my body, I wondered and felt a sliver of shock run down my spine. But did I have a choice?

My most traumatic experience is of an endoscopic procedure I had undergone eight years ago, where the surgeon kept slithering the camera down the oral route, into my throat; my stomach and liver, unmindful of my violent protests. After that I never got an endoscopic procedure done again, until now, when it’s a necessary part of the liver transplant procedure.

“That’s not how we do it, here. You won’t feel a pin prick,” said my endocrinologist Dr Gaurav Mehta at Kokilaben Hospital and true to his words, I didn’t know when it started and when it got over.

But my worst fears have come true. The MRI revealed pre cancerous cells in the non-operated left breast. Ordinarily, with this discovery they would have put me on drug therapy, but in my case, since this was a work up to my liver transplant, the clearance from the oncologist got held up for another round of medical discussions.

What if they decide to chop off my breast? What a sorry figure I’d cut with a cadaveric liver, one breast missing, thinning hairline, gaunt face and sagging skin. What can be a worse fate than that?

Thankfully, the transplant team opted for a gunshot procedure, wherein the radiologist applied local anesthesia to the left breast, the lesion got identified with an ultrasound, were shot at, and the specimens squeezed out and collected in a beaker for biopsy. They removed seven fixed lesions and three floating ones.

“Ordinarily we wouldn’t bother with such small lesions. But in your case we have to rule out all possibility of a flare up when you are on immunity suppressants, post transplant,” my oncologist Dr Mandar Nadkarni explained.

Because organ transplant is such a tedious, long-drawn surgery, the team has to work in sync with each other to save the patient’s life, and until I had clearances of medical fitness from each specialist, my medical case couldn’t proceed.

Also since a recipient’s body can reject the organ even from a matching donor and start producing antibodies against it, the transplant team has to administer a battery of immuno-suppressants to the patient. This deliberate lowering of a recipient’s immunity can be an open invitation to other opportunistic infections resulting in adverse reactions and unintended medical consequences that my team wanted to avoid else it would defeat the purpose of the transplant.

“Each cell of your body is like a foot soldier. It needs to be commandeered to defend you against all kinds of attacks. Doctors will assist. But you have to be your own healer,” my supporters at Soka Gakkai would advise me.