Good day / good night

"No news is good news" goes the old saying.  Well, we don't quite go along with that old saw.

But what may seem "small news" - may be some very good news, especially when we add up many, many evidences of grace.

A few glimpses from today:

Dad wearing a crisp, clean, new white kurta that Mum bought for him this morning.

A fridge stuffed with food - where it is hard to fit things in.  God has been so gracious to us.

Yohan's smile - that heart bursting flash of teeth which is so at odds with all that our son has experienced in the first 10 years of his life.

Sheba surprising her driving instructor by her proficiency at driving despite the 10 day 'break' in lessons (a number of days which she practiced using our Papaya - with me right beside her).

Seeing my beautiful daughter wake up after her afternoon nap.

Enoch's honest sweatiness after he had taken Yohan down for playing badminton.

Yohan's delight in getting '10 stars' for having written his three letter words right (Mummy-teacher deserves 10 stars too - make that 100 stars esp. as she is also coaching Asha and Enoch towards their year-ending exams at the end of this month).

Mum's chinese noodle dish for supper - prompting all and sundry to hail her as a 'genius' and make the G-sign with our fingers (with one person making it on the plate with a noodle).

Various calls during the day from people concerned and praying for Dad and Mum.   We see such a legacy of care that they have sown over the years...

Having colleages at JSK tell me about another HIV testing camp they have taken the initiative to organise.

An evening family devotion where we can travel back in time to be with Ezra and the Jewish exiles coming back to rebuild their lives - and see so many parallels with our lives today.

The great joy I have to see Sheba ministering with a patient at JSK - I don't need to hear what they are saying to know that she is helping and blessing them.

Walking outside in the golden evening sun with Dad.  A few rounds in the building complex, telling him things that I don't tell others.  Him wearing his crisp kurta and a black shoulder bag - which artfully concealed his bile bag and the tube that comes out of his side. 

Dishes washed, clean and ready for tomorrow.   The beginning of the sambhar that Sheba will be making for the Bible study tomorrow evening at Shanti's home.  Going out into the night to get drum-sticks and karrya-patta for it - talking to the banana-seller as the night cars drive by.

The list goes on.  In a world of where so much which is wrong is hailed as being right - it is very good to be able to feed on so many good things - all which flow from our loving Father.

And so a good day slips into a good night.

Rest Day (?)

Today was the first day of the week. 

We were blessed with a quick visit by Sarah - who had planned to stop by for 2 days to see her new nephew Yohan!  She had to change plans due to an unexpected assignment and so was only able to spend 6 hours with us - while transitting from her visit to the GM Priya Hospital in Latur and going back to Delhi for further work.

Daily update on Dad:  He is still as yellow as a carrot.  His first night back was a difficult one as he has to sleep on his back - but he is taking it well.  A good bath and a good appetite are blessings.   We are glad that Dad even took a little walk outside in the evening.

It was  a privilege to share about Dad at church today.  The dear saints at the house-fellowship who meet at Jolly and Suma's home have been so faithful in prayer and encouragement to us - and were to glad to hear about Dad's progress.

In the mean-time our guests have begun trickling in.   Drs. Samuel and Ruati Tonsing came mid-afternoon - meeting Mum and Dad after 9 years!   Pastor Chris Willams - transiting between Pune and Myanmar, breezed in early evening.

And in the meantime Mum got sobering news.  One of her cousins from Germany - Beate - had been trying to call Shanti Kunj - but did not know English and our dear Vicky knows no German.  He did have the presence of mind to note down the number and passed it on to us.   The news Beate gave when Mum finally got to talk with her was sad:  Mum's eldest cousin Georg has gone to be with the Lord.  At 84 he had lived a good life and was a firm believer in Jesus Christ.   Sadly, another cousin Manfred had passed away in December - but with his wife being estranged with the rest of the family - they only heard about it recently.

Oh God, our help in ages past,
Our hope for years to come,
Our shelter from the stormy blast,
And our eternal home.
Under the shadow of Thy throne
Still may we dwell secure;
Sufficient is Thine arm alone,
And our defence is sure.
Before the hills in order stood,
Or earth received her frame,
From everlasting Thou art God,
To endless years the same.

Time, like an ever rolling stream,

Bears all its sons away;
They fly, forgotten, as a dream
Dies at the opening day.

Oh God, our help in ages past,

Our hope for years to come,
Be Thou our guard while troubles last,
And our eternal home.

- Isaac Watts

Dad is home... for now at least

We brought Dad home at 12 PM today. 

He was only in the hospital for 4 nights - but a small stretch of eternity has passed us by.

A week ago tonight, we were sitting with Dr. Stephen Alfred as he spelled out the possibilities that a tumour like the one which the Dehra Dun MRI scan had picked up.

A week later we have Dad out of immediate critical danger from a totally blocked common bile duct.  We have found out that the growth seems confined to a 2.5 cm mass in the upper pancreas.  We have had Stefan come down and already leave for Delhi (and today for Spain).  We have had a flood of emails and calls and comments and above all prayers.  And we have made a decision to move ahead with the major surgery for the 23rd of March.

Dad is still not 'better' - and we now have the challenge of managing the many who want to come and see him and pray with him.  It is of course a great blessing to have so much love - but it also costs.  Every visit made means effort on Dad's part.  Effort to engage, to talk, to share, to narrate his story.  Pray for us as we seek to strike the right balance in these days.

For all of us - we need a recharge - after the pressure of the last few days - we need to shift gears to get back into synch with each other, with others around us.

As I write this, Dad is sleeping in his favourite pyjamas behind me.  What a blessing to have him home.

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Meanwhile, could you please direct your prayers to Delhi, where Neeru's father was admitted in an ICU last night.  We understand that he has suffered a minor stroke.  Please pray for complete healing and wisdom and care by the medical team there.   Please lift up Neeru and the kids at this crucial time.

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Praise the Lord, you his servants;
    praise the name of the Lord.

Let the name of the Lord be praised,
    both now and forevermore. 

From the rising of the sun to the place where it sets,
    the name of the Lord is to be praised.

- Psalm 113.1-3

The end of a day

It's 10 PM as I write this at the end of today - Yohan is asleep in the front room where he sleeps with Enoch.  Asha is in her room studying for her Geography finals.  Enoch is behind me learning a Marathi poem...  with coaching from Sheba.

And Mum is with Dad at Bethany hospital in room 512.

Dad had a good day.  After last night's successful procedure, he has been on antibiotic drip all day - and now has a tube from his side which has been draining bile fluid into a bag.   He is glad to be able to be drinking fluids again - and seems to be itching to get back to his 3 bottles of water start to each day which he and Mum have religiously followed for the past number of years.

Dad continues to be in good spirits, but is tired.  We hoped that he may be discharged this evening, but now understand it will be tomorrow.  Tomorrow he will be back on semi-solid food too.

Stefan flew back to Delhi this afternoon - to be with his dear wife Neeru and Ashish, Anjali, and Anita before he wings out of India for a week-long set of teaching that he is giving to Kingdom-seeking artists in Spain.

We had an important visit this afternoon.   Two weeks ago we had gone to the welfare authorities at Bhiwandi and applied for custody of Yohan.   They said they would send a social worker to us to do a 'home visit' and assess our capacity to foster him.  This lady came this afternoon - along with two colleages.  We are so grateful that Dad's condition has stabilised enough to have a thoroughly normal visit by these three ladies.  We understand that we need to take Yohan with us to the authorities on Monday afternoon for a decision on our case.  This body is set up to determine what is in the best interest for a child and find a supportive environment to make this happen.  It has legal authority and the chairperson has the rank and powers of a judicial magistrate.   We trust and hope that they will authorise us to be Yohan's guardians - as we strongly feel that we are the right place for him.  The social workers said something that was music to our ears: "he has really found a family."

And then they asked us a heart-breaking question - they know of at least 2 HIV positive boys who no one and no institution wants to take... could we find families for them?  Please join us in prayer as we seek to legal custody of our precious boy - and ask God to open up foster families for those other boys who do not have homes?

Tomorrow is a new day.  We will be running the fourth and final session of our Church Volunteers training in HIV care at Jeevan Sahara Kendra (one session every alternate Saturday).  We will also hopefully be bringing Dad home.  And trying to deal with the flood of messages which have come our way. 

We are tired.  It's only been a week since we waited for the confirmatory MRI test to be done on last Saturday in Dehra Dun.  And since that clearly showed the tumorous growth completely blocking Dad's biliary duct, we have seen Mum and Dad come down to Thane, been admitted at Bethany Hospital, discuss surgery, had Stefan fly down from Delhi, have one attempt at introducing a stent fail, saw another succeed last night, been overwhelmed with prayers and messages from all over...    Dad is currently stable and continues to be in best spirits despite his discomforts.

And so we look forward to a time of Dad resting and regrouping for the next big step.  We hope that his bilirubin levels will fall over the next few days ... and then to surgery.  We know that the tumorous growth seems to be compact and linked to the top of the pancreas - and since it has apparently not spread further, we want it removed.  The road ahead is not easy - as the surgery suggested is not a routine snip snip and sew back together - it is a major removal of vital parts of Dad - and a melding back in radical new ways - which we hope and pray Dad's body will respond well to.

Please pray for Dad and for each member of the family - near and far - as we all prepare for this big step.

We will be talking with Dr. Stephen Alfred about this, but at present it looks likely that Dad will go under the knife on Friday March 20th or Sat March 21st.   Your prayers carry us forward in all of this!

Stefan and Dad on Wednesday evening

Sweet dreams are made of these...

At 5 PM Sheba, Mum and I went over to Bethany hospital to pray with Stefan and Dad. 

We had been praying all day, ever since the morning when we heard that Dad's procedure was posted for 6 PM this evening.  And thanks to our networked friends - so had so many others all over our country, and all over the world.

Yesterday's valiant attempt by Dr. Stephen Alfred to put in a stent using an endoscope did not work - since the tumour was so solid.  Would this evening's procedure work?  Dr. Stephen had requested his colleague Dr. Girish to come up from Mumbai to do this. 

Dr. Girish is an interventional radiologist - and decided to try and insert and external/internal stent.   His plan was to make a small opening on Dad's side, and moving through the liver, enter the common biliary duct and attempt to put in the stent besides the tumour - but also keep a pipe out to Dad's side.

If the attempt and putting the stent in did not work, then the pipe would be used to drain the bile juices and hopefully lower Dad's jaundice.  If Dr. Girish succeeded in inserting the stent, then the pipe would be used to drain off the excess fluid, and after some hours, the outer opening would be closed and the rest of the bile juices would drain into the small intestine using the newly opened stent.

So the four of us in the room prayed with Dad - and deeply sensed that we should not be afraid.  That was a message that many had sent us.

Dr. Girish did not arrive at 6 PM.   Mumbai traffic at rush hour is something else - and he had already had a full day of procedures.   He arrived at 7.15 - just 10 minutes after one of the two main operating theatres at Bethany finished a major case - allowing Dad's operation to be done in that theatre instead of in the casualty theatre.  Even traffic jams seem to have cosmic purposes at times.

After praying, Mum and Sheba went back home to be with the kids, while Stefan and I stayed with Dad.  When the time came for Dad to be shifted to theatre, we went down with him to the big swinging doors that mark entrance of the two operating theatres at Bethany Hospital's third floor.  Dad was being pushed in a wheelchair - and his two sons walking along side.   You always wonder when the doors close at the theatre and your loved one is being given anaesthesia - whether they will come out of it.  Whether they will be wheeled out with breath in their lungs or not.  Faith is tested most when the stakes are high.

An hour and a half later, Stefan and I were called back down to the theatre.

We took off our shoes and were ushered into a small room where the surgeons unwind.  Dr. Stephen and Dr. Girish were there in their green scrubs, drinking tea.

"It all went very well" Dr. Stephen told us.  The stent had gone in with the first attempt.  The actual PTBD procedure had taken all of 20 minutes to do - and had gone completely according to plan.  What a huge relief for Stefan and myself. 

And so a few minutes later we walked out in a happy daze.

It took a little longer for Dad to be brought up to room No. 512 - but after we shared a grateful prayer, Stefan and I had the pleasure of making the first happy phone-calls and winging a small raft of SMSes with big smiles of relief on our faces.

And then with a welcome rumble, Dad was wheeled around the corner.   He was awake!  Turns out they gave local anaesthesia after all!

Before they even got him on his bed - he was already talking.  Dr. Stephen had told him the good news too - that the stent had been successfully implanted.  Big smiles all around!

I then had the happy task of going back to and picking up Mum.  I drove our little Papaya through the dark streets of Thane with a song in my heart.

Mum came over with food for Stefan and fresh get-well-soon cards for Dad from Enoch and Yohan.

We walked in to find Dad asleep - Stefan had turned off the lights.  But 30 seconds later that changed - a nurse walked in briskly and cranked up the bed so that Dad's head was up.  "You need to sleep this way" she said and clop, clop, clop she was off again to do another task in another room.

Dad realised groggily that Mum and I had returned and insisted the lights be put on.  Once again he was back in form, chatting happily about his time in the theatre.

"It was so crowded in the operating theatre" Dad said, "crowded with so many angels!"

Amazingly, we just received an email with a shot of Dad while the operation was going on - courtesy of Dr. Stephen Alfred!  The picture he took in the theatre shows Dr. Girish conducting the PTBD procedure!

 

We are all going to sleep very well tonight.  Well that's our thought - we sincerely hope Dad will get good sleep post-operation.  But we know that he is being well cared for by Stefan (an expert at short nights) and a small army of nurses (and a larger deployment of angelic beings perhaps).   We have all along felt a ground-swell of prayer - and this evening all of us - near and far - experienced the happy thrill of cresting this wave when we got the news of the successful procedure.

We are of course not even close to the end of this story.  But like Winston Churchill said: "This is not the end, this is not even the beginning of the end, this is perhaps the end of the beginning."  We are very happy that this complicated procedure went well - and we look forward to Dad's jaundice dissappearing soon.  But the issue of the tissue remains.  There is a big 2.5 cm growth, which the CT Scan says appears to be on the head of the pancreas that is not just there for fun.  We know that it has to go.   We would be very glad if in the next instant the tumour dissolves... and we know that people have prayed this prayer - as have we as little children to their loving Father in heaven.  But we also know that if it doesn't dissappear, it will need to be cut out.  Currently the Whipple procedure seems the best bet - and that entails removing significant portions of a number of Dad's important inner organs in order to leave nothing cancerous behind.

So we certainly continue to need your prayers... for quick recovery from today's PTBD procedure, for Dad's jaundice to subside, for wisdom about how and when to go ahead with the next big steps.

As a family - both those in Thane as well as those far away - we are so grateful for each and every prayer said on our behalf - and the many signs of love and affection that we continue to receive.  Dad has an ocean of emails waiting for him - but we are going to wait for some time before we allow him to start answering them! 

So we sign off with this shot of Mum and Stefan giving Dad a hand massage.  His jaundice has made him very itchy all over - and so gets wonderful relief when we do some therapeutic scratching (a.k.a. massage).  With the stent in place, the desire to itch should fade away soon!

Sweet dreams everyone!  Thanks for praying and being part of the team!

Dad's next procedure

Dear Friends,

Just a short note to say that Dad is due for his next procedure in 4 hours from now - another attempt to introduce a 'stent' (small tube) in his common biliary duct so that the bile juices can flow into the intestines and reduce Dad's jaundice.

Dr. Stephen will be manning the endoscope and Dr. Girish (an interventional radiologist) will be performing a PTBD procedure where they are attempting to get by the mass blocking the common biliary duct through the liver...  Dad will be under complete anaesthesia of course.

We appreciate all your on-going prayers - and humbly request that you continue to bring Dad before our loving Lord Jesus during these crucial times.

Love from all of us - both here in Thane and far away too!

“I have told you these things, so that in me you may have peace. 
  In this world you will have trouble. But take heart! I have overcome the world.”  - John 16.33 NIV

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!