Carlo Sales’ wife listened to the doctor carefully.
“Sorry,” he told her “you’re going to have to put up with him for another 30 to 40 years.”
Months before his wife’s September meeting with the doctor, Carlo was working out in the gym when his primary care physician called.
“She said she had good news and bad news,” Carlo, a diabetic says.
The good news was his A1C or monthly average sugar was down.
The bad news: his white blood cell count was up.
The “normal” range of white blood cells (also called leukocytes, those micro soldiers that fight infection) in human blood is between 4,500 to 11,000 per microliter.
Carlo had 143,000.
“She said she will refer me to a hematologist,” Carlo recalls. As a nurse, he knew he had leukemia.
Rambunctious and a prankster as a teen growing up at the then La Salle-Bacolod, Carlo acted like a health professional.
“I told my doctor I wanted a differential.”
A blood differential test can confirm leukemia. “If I still had blood left,” Carlo tells DNX in an email interview from the United States where he has lived since 1992.
“I acted like a nurse,” he recalls. But as soon as “I took off the cap and gown, I thought I had very little life left.”
A differential or a blood differential test is used to detect abnormal or immature cells and can also be used to diagnose an infection, inflammation or leukemia, an article on healthline.com said.
Carlo was thinking about the worst.
Eventually, he found out that he had chronic myelogenous leukemia (CML) defined as an “uncommon type of cancer of the bone marrow” that causes an “increased number of white blood cells in the blood.”
The Mayo Clinic reports on its website that “chronic” means “the cancer tends to progress more slowly than acute forms of leukemia” while the term myelogenous “refers to the type of cells affected by this cancer.”
The description of the disease, though frightening already, does not come close to the horrors it can wreak on one’s mind, on that of the sufferer.
“I thought of anything bad one can think of,” Carlo recounts, “on the first month, I was thinking about what would happen to my wife and daughters if I die young.”
Carlo, usually sunny in high school, admits: “Depression got me good; I detached myself from everyone.”
“I tried to spend more time with my wife and my two daughters; real friends were there to support me and my family.”
These friends even had a cancer haircut deal to show their love and support for Carlo.
But depression still crept in.
“There are times that I’d just break down by myself but didn’t show it to my wife and daughters. I blocked my emotions and just devoted it to God, gave it all to him,” Carlo said.
He also kept himself busy to cope.
The battle had just begun. Carlo was fighting on two fronts: trying to heal from cancer, and battling depression.
But he had help.
One of them was his boss, who he described as “very private” and who, a day after he was diagnosed, told him to take time off “as long as I can in the course of my treatment.” This boss even helped Carlo with the cost of his treatments and loss of income.
“That made a lot of a difference,” Carlo said.
While the foreigner boss helped Carlo, some Filipinos, ironically, stabbed him in the back.
“They tried to grab the opportunity that I am sick,” and could have thought “they could take over what I was doing.”
Unfortunately for them, they “failed and got fired,” he said.
Then the treatments.
Back-stabbing friends were already bad. The medicines that were supposed to help also left a bad taste.
Carlo said the hardest part of the treatment was in the beginning when he took hydroxyurea for a month before the bone marrow biopsy.
It was the hardest part.
“Everything I ate and drank, I threw it all up,” he said.
He lost 30 pounds.
That was the crazy part.
Life from then on for Carlo was a series of drinking seven different medicines, including a “strong ass” anti-allergy medication, laboratory tests and seeing his doctor on Mondays for the first three months, like a lab rat.
But Carlo had not yet lucked out.
He had considered himself extremely lucky since he was diagnosed, a mindset that seemed to have served him in good stead.
Six weeks after he was diagnosed, he had not yet seen a hematologist.
That changed with only one phone call.
His wife, who is the nurse manager for a retirement community, called a friend who owns a pharmacy and asked for referrals.
After an hour, Carlo got a phone call from a doctor, “which was uncommon” in America, he said.
Correction pre. In lest than 24 hours I had an appointment with Janbay. Most of the hematologists that was referred to me can’t and won’t be able to see me for the next 6 weeks but he called me personally 30 minutes after Angelie talked to his wife.
And it was not just any doctor who called Carlo.
It was Nasser Janbay, a renowned oncologist or cancer specialist at Integris Cancer Institute at Southwest Medical Center in Oklahoma City.
Nasset told Carlo and his wife he has CML. “He told us 10 to 20 years ago there were very little options.”
Then Nasser told Carlo to quit smoking before seeing him.
“I will cure you,” Nasser assured him “but told me the only thing he wanted me to do is not to read the side effects of the medication he was about to give me.”
“If you feel like shit, call me or go to the emergency room,” Carlo recalled Nasser as saying.
That Nasser became his doctor was one of two strokes of luck for the beleaguered Carlo. First, had he not been a diabetic, he would not have known he had CML. “I would have been dead by now.” It was discovered during a routine check up for his diabetes, he says.
Second, in less than 24 hours, he had an appointment with Nasser when most of the oncologists referred to him was not available for the next six weeks.
But Nasser “called me personally,” he says.
Carlo went to the City of Hope in California to get a second opinion, the hospital being reputed as the best with the best specialists for any kind of blood disorder.
The doctors there, however, told him to go back home.
“They said I had the best doctor in the United States.”
The new treatment started and by April 2019, Nasser told him he was “doing well” and wanted to see him only once a month.
The FISH test or Flourescent In Situ Hybridization that WebMD defines as a test that “maps the genetic material in human cells” showed by April that Carlo only had 57 percent leukemia cells “and all my blood works were back to normal.”
Last September 2019, another FISH test showed only 12 percent leukemia cells left. The doctor told Carlo “the medicine is working the way it should be.”
Since then, “the labs are perfect,” he says and the doctor even stopped his medication for high blood pressure.
And he also got off his anti-depressants.
The treatments were all paid by Carlo’s health insurance, a good thing, he said because the expenses added up to quite an amount.
Carlo’s next visit to the doctor is December 23, just two days before Christmas.
Grateful is how Carlo describes himself now. Grateful to a lot of people, his wife and children, especially, his parish priest to whom he exclusively confesses, and a retired priest friend, all of whom did a lot of handholding when he went through his darkest moments.
Carlo has gone back to doing charitable missions for his church, endeavors that he had supported for years. “The poor folks we feed still remember me, they told me they prayed for me,” he recalls.
“Sometimes, when strangers tell you that you just want to cry,” he admits.
For now, the boy from Bacolod who has gone through rough patches in America, episodes that will never be printed, is content to have just survived.
And being with his wife, Angelie Lorena and daughters, Charlize Margaret and Veronika Gwen, a bit more longer is to him the best Christmas present he ever had.