Two steps forward...

Dad had the first major procedure done on him this morning - an endoscopy under full anaesthesia which tried to put a 'stent' (a small tube) in to allow the common bile duct to start draining back into his intestine.

Dr. Stephen Alfred started at 7 AM and at just before 8 came out to meet us.  He had bad news - the mass was unexpectedly dense and though he had tried for 40 minutes, the guide wire just did not move around it - and he did not want to risk a rupture of the intestine or inflaming the pancreas - and so he stopped.

Stefan had arrived from Delhi during the procedure, and Stephen took us in to see the pictures of the mass - a smooth, round, egg shaped object that if left unattended will shut down Dad's vital organs as the unused bile grows more and more in his body.

So we had Dad wheeled back out of the operating theatre and back to his room No. 512 at Bethany Hospital.  Within a short time he was conscious again and spent the rest of the day in cheery conversation (and some naps).

In this picture - Dad is not looking at an ECG report.  Rather, he has an Anjali Eicher original - a drawing of the ridge of Mussoorie - at the bottom of the picture - with further ridges that she had added above it.

Stefan gives an explanation of the art-work - which was done just before Stefan left for Mumbai - so fresh that there was not even time for the artist to sign her work!

It was grand to have Stefan with us today - and to get a call from Premi in the evening too.  Neeru was also constantly in touch - as were so many others.

One thing that has come out over and over in the last few days is the ground-swell of love and prayer that is washing over us.  We are weak and tired and wonder what next, but God has an army of loving souls who are thinking and praying and fasting on our behalf.  What a privilege...

Here is a picture of the artist working on her master-piece in cold Mussoorie:

Dad remains in a steady stream of cheerfulness.

He does not answer the phone a lot - but everyone who walks into the room gets a cheery chat.  Today he talked with everyone from the ward boy to the vice chancellor of a university who had stopped in to see him in mid-afternoon.  All got the same joyful tone of voice (though he was a bit hoarse after having had an endoscope down his throat first thing in the morning).

We wonder sometimes who is the patient - Dad or us?

But then we also can see his tiredness - and his jaundice is still high.  So we must do something... but what?

At 5 in the evening Mum, Stefan, Sheba and I had a conference with Dr. Stephen Alfred about the next course of action.  Stephen is positive that the growth can be operated out - but the operation is a massive one - and with Dad's jaundiced condition continuing and the ERCP not working (something that happens very rarely for him) he suggested that it would be better to try again in a different way.

Stephen suggested having a colleague of his who is an interventional radiologist come and do a procedure called a percutaneous transhepatic billiary drainage (PTBD).   The idea is to make a hole in Dad's side and enter the billiary duct through the liver - and then pass a wire down and try and push past the growth from the other side -  and have an endoscope waiting on the intestinal side to slip a stent onto the guide wire...  if this doesn't work - then to have a tube from the common billiary duct to the outside to drain the bile and allow Dad to become less jaundiced... before the big surgery.

It's very hard to make decisions when there are many unknowns and possible outcomes.  But as a family we decided that whatever the decision on the surgery (and we do need that lump to come out a.s.a.p.) we do want to try again to have a way for Dad's bile juices to drain - and so we have asked Dr. Stephen to ask his friend to do the procedure together with him tomorrow.

Please pray for us as we move forward with this step tomorrow.  And for great favour in all of this.  We are so aware of the fragility of life.  Thanks for the waterfall of prayer and calls and support we are getting for Dad...

Our times are in His hands!