Munira Premji

Friday, March 11, 2016, North York General Hospital.

Today, I started chemo treatment for Breast Cancer.  And while I’ve had chemo twice in the past four years for Non-Hodgkin Lymphoma and Multiple Myeloma, this feels like a familiar but different experience.  It’s like taking the same journey, but to a different location.

North York General Hospital does a fantastic job of preparing patients for chemotherapy.  I went to a chemo class a few weeks ago where patients, regardless of type of cancer, are invited to participate if their treatment requires chemo.  At this class, held every Friday, we heard from a pharmacist who talked about the different types of chemo (neo-adjuvant, adjuvant and palliative), how it works to kill both good and bad cells (so it’s effective but not targeted), and who pays for most of the chemo (Government of Ontario, Cancer Care Ontario).

I loved the calendar she shared with us on what to expect for a 3 week chemo cycle:

– Fatigue for the entire 3 weeks
– Nausea for the first 5 days of chemo
– Mouth Sores around Day 10
– Expected Hair Loss between Days 15 and 25

It seems like the toughest point is 7 – 10 days after chemo; that’s when your immunity is at its lowest.  And, although each individual will react differently to chemo, this calendar helps to give the patient some semblance of control over what to expect.

I also found it so helpful to have a pharmacist sit with me on Day 1 of chemo to give me specific personalized information about my cancer, to ensure that any current medication I am taking will not interfere with the chemo regimen, and to discuss how best to manage the side-effects.  I told her about the multi-vitamins and other supplements I’ve been taking. Then, I mentioned that my cousin in Mombasa had sent some herbal medicine but she probably didn’t need to worry about it.  She was way too smart for me – she did some research and came back with detailed instructions on when I can eat Moringa (not during the chemo, but ok for the anti-body treatment after), and how long I’m allowed to eat Terminalia Arjuna (maximum three months).

At the training class, we  met a dietician who talked generally about the do’s and don’ts of food to take while undergoing chemo.  This was followed by a Social Worker who talked about the kind of support she could provide (counselling for self and family, financial assistance, transportation, etc).  We also met with an advocate of Wellsprings, a place that offers support and programs for patients and their caregivers.  The session concluded with instructions from a nurse on the blood work regimen, the length of the chemo treatment (generally 4 – 8 hours) and a tour of the Chemo Clinic.  I was beyond impressed with the quality of the session — it was just the right content, delivered by the right people, to get me comfortable with what I can expect over the next few months.

What I am learning from my experience with cancer is that, while the cost of the in-hospital drugs are covered, drugs required out-of-hospital are not covered at all.  You have to rely on your group insurance plan (if you have one) and that, too, has annual maximums, which you will likely blow through very quickly.  For instance, I need to be injected with a drug called Neulasta after each chemo treatment, to increase the white cells in my body.  Neulasta costs approximately $3,000 per needle and I need 6 of these injections for the 6 cycles of chemo, totalling $18,000, well above the maximum annual limit of our group insurance plan.  So part of the process is to work with our insurance company, the Victory Program (funded by the drug companies) as well as the Government of Ontario’s Trillium Drug Plan (which is income-tested) to figure out how best to get the drugs I need without being too much out of pocket.  And while this is a time-consuming process that requires several phone calls with all the stakeholders and completion of forms requiring extensive details, I am thankful we live in Canada where these medication and resources are available.

Chemo Day 1

My first day of Chemo was quite memorable.  I ended up with an allergic reaction to one of the chemo drugs – Taxotere (aka Docetaxel)- that caused me to have sudden severe back spasms, neck pain and difficulty in breathing.  All the nurses in the Chemo Centre calmly gathered around me, and immediately stopped the chemo treatment.  Then they proceeded to give me an antidote that controlled the side effects.  Once everything was under control, with Dr. Robson’s approval, they administered Taxotere again, slowly. It was a bit scary in the moment but it all worked out in the end.

One of the funniest things was, I was in Chemo Chair #2 and behind me was some soothing artwork.  When I needed oxygen after the bad reaction, the head nurse slid the picture frame off the wall, to reveal emergency equipment hidden behind the picture.


Another funny thing was that, while I was getting one of my chemo drugs, I had to keep my fingernails cold so that they would not be affected by the harsh drugs.  Here’s a picture of me with my hands in bags of ice:

IMG_1551I am counting my blessings yet again today.  In spite of what I am going through, I am just so grateful for the support, prayers and encouragement I have received so wholeheartedly from so many people.  It bolsters my spirits and gives me the strength to keep fighting.

I take my hats off to the caregivers who are the true heroes in this journey.  Nagib and Sabrina sat with me the whole time in the hospital completely focused on making things better for me (we managed to get through a lot of wedding planning stuff in the process!).

The caregivers at the hospital do such a fine job to ensure patient comfort, education and safety.  There is really no price you can put on love, friendship and community.  It is what the world needs more of to be kinder and happier place.

In the meantime, I’m on Dexamethasone and I can’t stop running around and driving everyone crazy!  See my previous experience with Dexa here:  The Dark Side of Chemotherapy



  • Alisha Bhanji , March 27, 2016

    Munira aunty,
    My thoughts and prayers are with you.
    Love, Alisha

  • Shanaz , March 17, 2016

    Dear Munira,
    I admire your positive attitude, courage and unwavering faith – keep it up. You are certainly an inspiration to many! Praying for your good health and success in your treatment, may Allah always keep you in his love and protection.

  • Anonymous , March 15, 2016

    Hi Munira, I lost the blog for some time-happy to be reconnected-but have kept you close to my mind-your resilience i admire and will keep you close in prayer and thoughts. You will finish victorious!

  • Rashida Tejani , March 15, 2016

    You are an inspiration to many…I admire your courage. Loving thoughts and prayers for speedy recovery.

  • Anonymous , March 14, 2016

    You continue to be such an inspiration. My thoughts and prayers are with you always.

  • Anonymous , March 14, 2016

    Munira you are in my prayers always .. you are truly very special

  • Dave and Erika McMullen , March 14, 2016

    Dear Munira — we are inspired by your positivity and courage in embarking upon this long and onerous treatment process. We will be thinking of you and your dear family over the coming weeks and months, and wishing you full success in your treatment and recovery!

    The very best to you,
    Dave and Erika

  • Anonymous , March 14, 2016

    Prayers for you Munira. May the Good Lord give you strength to deal with yet another series of treatments and keep fighting and beating this disease. I admire your courage, your spirit and or absolute determination to face whatever is thrown at you with such positivity. You are a truly an inspiration! God Bless!

  • Lyndsy Evenden , March 14, 2016

    Keep fighting Munira!!! Thinking of you x

    • Munira Premji , March 19, 2016

      Hi Lyndsy! We are the fighting machine!

  • Bob Boulton , March 14, 2016

    Munira, once you complete all of this (see “Job”, Old Testament, you know, that other book) you have two extra things to do.
    1. Publish these posts as a book
    2. Get an agent to arrange high-paid speaking gigs where you will also do book signings.

    Regards, to say the least, Bob.

    • Munira Premji , March 19, 2016

      I smiled so hard when I saw your note Bob. Yes I know the other book. Working on a book. Perhaps you can be my agent! I miss you!

  • Anonymous , March 14, 2016

    We have watched your journey, and your resilience and ability to rise and inspire others, from afar, with nothing but respect and admiration. Stay strong, we are all with you.

  • K.Amersi , March 14, 2016

    Dear Munira,

    Thanks for the thoughtful and eloquent update of your brave journey.

    Sending much love and prayers and healing energy your way and to family and your amazing medical team. May all be guided by the highest of divine powers…

  • Noor , March 14, 2016

    Thxs for sharing your journey. Loads of prayers and positive vibes coming your way. You are an inspiration to so many.

  • karimahabib2012 , March 13, 2016

    A successful first day of chemo with some minor hickups!
    May all your chemo sessions be positively blissfull!!!

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