Cancer in the family

Dad and Mum arrived in Thane this morning.

We are glad to see them.  And we are sad to see them. 

24 hours earlier - at 6 AM on Sunday morning they were woken up in their peaceful bedroom at Shanti Kunj in Mussoorie by Stefan and Neeru who were visiting for the weekend.

"Dad, Mum, we have to talk" Stefan told them.  "You need to leave for Mumbai in two hours."

Stefan then told Mum and Dad what Sheba and I had discussed with Dr. Stephen Alfred here in Mumbai.

Dad's bile duct - the central duct between his liver and intestine is blocked.  We had hoped it might be blocked by a stone - but the MRI report that Dr. Stephen had asked him to do on Saturday showed clearly that it was not a stone, but a growth.  And the bile duct was not narrowed but completely blocked, leading Dad to become more and more jaundiced.

The blockage of Dad's common bile duct is a 'growth.'  What is almost certainly a cancerous growth.  A piece of rogue tissue that has grown out of control and is now impeding the normal function of Dad's body.

Last week Dad called us and told us that he had hepatitis A - and that he had been put on a strict diet to rest his liver.  We are grateful to God that Dr. Alem from Landour Community Hospital asked Dad to go down to Dehra Dun to get an ultrasound.   That ultrasound report - which Dad did on Tuesday showed us the blockage.  When we got the report by email, Sheba told me "this looks like a cancerous growth."  We showed it to Dr. Stephen who concurred.

And so on Saturday night, when Sheba and I met with Dr. Stephen, he laid it out for us.

We need to bring Dad down to Thane immediately.  The common bile duct needs to be opened surgically and a 'stent' - a small tube inserted so that the bile juice can empty into the intestine as it was meant to.  This stent will allow Dad's jaundice to recede and give him relief.  The technique to do this is called ECRP and uses an endoscope to look at the tumor and insert the stent.

But the stent does not address the cancerous growth.  Dr. Stephen told us that we need to do a CT scan to see whether there are other nodes present.  Nodes means that the cancer is disseminated.  It means that it will not be possible to 'cut it all out' - and that even if surgery is done, the average life span post surgery is the same as those who do not go for surgery.  Zero sum game.

If no nodes - then we have to find out exactly how far the mass is spread.  The name of the game is whether the tumour in Dad is 'operable.'  Stephen felt that there would a 50% chance of operability.  If not?  We would have to look at options ranging from chemo and radiation to palliation.   But we will cross that bridge when we get there.

Even if Dad is considered 'operable' - we are not talking about a small tonsillectomy here.  Stephen said any surgery would be major.  Most likely doing a  Whipple Procedure where the top of the pancreas, the common bile duct and a portion of the intestine are removed.  And then the intestine is reconnected with the liver and the stomach.   The operation can take as long as 5 hours.  Stephen said that mortality in this operation may be as high as 20%. 

Stephen prayed with us, earnestly for Dad.  "Our times are in your hands" he reminded our loving Lord - on behalf of His servant Ray Eicher.

So the take home message was: situation serious.  Any extra delay can mean more damage from the jaundice.  So we had to get Dad here to Thane as soon as possible.   Dr. Stephen assured us of the full support of Bethany in this, and we walked out into the night to take the next steps.

When Sheba and I we got back at 9.30 we prayed.  Then we called up Stefan who along with Neeru and the kids are in Mussoorie.  Dad and Mum were already in bed and so we walked through the possibilities.  Then we acted. Flight tickets were booked (with a little help from our friends).  Stefan and Neeru were to give Mum and Dad some rest, but wake them latest by 6 AM so they could hear the prognosis and have some time to pack.

After a short night Stefan and Neeru woke Mum and Dad up with the news.

As we expected, they took the news with grace and grit.  "God is in control" said Dad.  They prayed.  And then they got to work.  Mum packing for who knows how long.  Dad in the office setting things right.  By 9 AM a few of their friends gathered to pray them off at the top of the hill.

Stefan and Neeru and kids went down to Dehra Dun and out to the 'Jolly Grant' airport to see them off on the flight to Delhi - and then on to Mumbai.




They got to the airport in time, prayed and said good-bye and saw Mum and Dad go through checkin and security. 

But while driving back to Dehra Dun, Stefan's phone rang.  The flight was cancelled.  Freakishly strong winds meant the incoming planes were sent back to Delhi.  No more flights that day out of Jolly Grant.

We could hardly believe it when we heard the news.  But Mum and Dad wrangled a taxi with two other travellers, got their baggage back double quick - and then drove to Delhi.... Or tried to.  It took 2 hours just to get through Haridwar due to the neck to neck traffic caused by a large religious function.  Then outside Delhi the same.  Net result - 9 long hours in a taxi.  Not what any one of us wanted at all.  This was supposed to be a quick dash to Mumbai for a sick man.

But at each phone call along that excruciating trip - all I heard from Dad was cheeriness.  The amazing optimism \ practical full-on-trust-in-Jesus that has been the hallmark of Dad is very much intact - blocked common bile duct or not.

We had realised that Mum and Dad would certainly not get to Delhi for their 6.30 PM flight to Mumbai - so we cancelled and booked the first one the next day.   Our dear friends David and Stephanie Rendall picked them up at 11.30 PM and took them home - gave them 2 hours of sleep and then ferried them to the airport again.

With such an epic journey, we were half expecting 2 figures to totter off the airplane in Mumbai and have to be carted away in wheel chairs.  Nothing of the kind.   I got a phone call at 5.20 AM from Dad, telling me that they were in the airplane at Delhi airport, and that I was not to come to pick them up at the airport - that they would come by taxi themselves.

And then as if in a dream they were here at our doorstep at 9 AM this morning.

Dad cheerful - but with very yellow eyes.  How yellow? 

Well, this yellow!



It was surreal to have Mum and Dad with us - and to be drinking coffee on a beautiful morning and hearing them share how much they sensed the prayers of so many people for them.   They were just so cheerful.  Amazing grace in action of course.

After some coffee and a bath, we headed over to Bethany Hospital to see Dr. Stephen Alfred.

Stephen walked Dad through the same path he had with Sheba and myself.  With the additional benefit of actually seeing the films from the MRCP that Dad had done in Dehra Dun and showing where the edge of the growth dramatically blocked the common bile duct - and telling us that it looked like the pancreas has not been affected by the tumor so far.

Stephen stressed that we needed to get Dad fit for the procedure to insert the stent - and so we had a raft of tests to do - which we finished off by 2 PM.   Dad was pleased as punch to get off his boiled vegetable diet and wolfed down 2 idlis and sambhar and a tomatoe soup in the hospital canteen.   His normal outgoing personality meant that through out the waits he would make friends with the persons next to him - and inevitably, Dad would share a tract or Christian booklet with his newfound friend too.

An afternoon nap and then the results came in.  Dad's bilirubin levels high.  May need 2 more days before the ERCP can be done.  Dad's serum creatin levels good.  Can do the CT scan tomorrow.  Decision made -we are to get Dad into the Bethany Hospital at 8.30 AM tomorrow and then get the CT done at 9 AM. 


We have cancer in the family now.  An unwelcome guest - but one that will bring out what really is in us.  May we allow the holy scalpel of our loving Lord Jesus to cut out that which is displeasing to Him in all of us - not just in Dad.   When we told Yohan why Opa was coming back, he cried.
 
We normally get a phone call from Mussoorie on Monday evenings.  Today Mum and Dad were with us - but we still got one.  Stefan and Neeru, calling up to find out what happened during the day.

Who would have thought even late last week that we would have Mum and Dad with us for family prayers...? 

But here they were with us!

Enoch chose an appropriate song for us to sing together tonight:  Forever God is Faithful 

Give thanks to the Lord, Our God and King
His love endures forever
For He is good, He is above all things
His love endures forever
Sing praise, sing praise

With a mighty hand and outstretched arm
His love endures forever
For the life that's been reborn
His love endures forever
Sing praise, sing praise
Sing praise, sing praise

Forever God is faithful
Forever God is strong
Forever God is with us
Forever and ever, forever

From the rising to the setting sun
His love endures forever
By the grace of God we will carry on
His love endures forever
Sing praise, sing praise
Sing praise, sing praise

Forever God is faithful
Forever God is strong
Forever God is with us
Forever and ever

Please do pray for Dad - and for all of us at this time.

Dad is clearly sick - but rejoicing.  We are all unsure of the roles that we will be playing in the coming days and weeks - and what the eventual outcome will be.

Someone said that 'cancer is a word, not a sentence.'    Well, its a word that we are just beginning to understand, just beginning to unravel in our family.

This evening Jolly and Suma and Anil came over to pray for Dad.  We annointed him with oil and all prayed fervently.  Your prayers are very welcome too.

If you want to write to Dad, you can write at: ray.eicher@gmail.com 

We don't know how long he will be at Bethany Hospital - and the mobile reception is poor there.  But do feel free to call me at (+91) 9321112065 for updates on Dad's condition - or call our home number at (+91) 22-25899747.