Quick update on Dad's surgery

We have just met Dr. Stephen and Dr. Kannan and they told us that Dad's surgery went very well.   It was a 4 hour surgery and Dad is currently in the ICU of Bethany Hospital.

Thank you for your prayers - and please keep praying for the post-op healing.

More details later this evening.

Dad's surgery posted

Late afternoon today - the Lord's day - we had a small conference in room 505 of Bethany Hospital.  Dr. Stephen Alfred was doing his evening rounds and reviewed Dad's condition with us.  He was happy that the bile drainage was taking place and that Dad has not shown any further sign of infection.  Dad's liver function test this morning showed that his direct bilirubin count has come down to 10.  So in consultation with Dr. Kannan, Dr. Stephen feels that we should use this window opportunity to do the surgery.



Sheba and I had talked with Dr. Stephen about this last night - and then I had a heart-to-heart with Mum and Dad this morning.  I told them that we are doing this procedure because we see it as the best opportunity to extend Dad's life given the reality of a pancreatic cancer.  The surgery is complicated but is being done by a a skilled surgeon who does this procedure regularly.  There is every possibility that once the opening is made, the tumor is discovered to be inoperable after all - but this is the time when doing a surgery will have a positive impact.  Later when the tumour spreads the day of surgery will have passed.  

I also talked to Dad and Mum that we really do not know what the post-operative challenges of healing will entail.    We expect a number of days in the ICU and then more days of healing in the wards of Bethany hospital and physiotherapy before Dad can be discharged home.   Our hope is that there will be no complications - that God will protect from infections and allow the newly stitched together organs to work with each other - and that healing of body will accompany the healing of soul and spirit that Dad continues to experience in this process.


Dad's response was that we are fully in the Lord's hands - and that He is absolutely good and totally in control.  And that over the past few years Dad has said hundreds of times that we are totally in His hands.  Mum and Dad expressed their confidence that God would see them through - and so we prayed together this morning - holding hands and committing ourselves to His hands.

Sheba and I had talked this morning that we want to trust God.  We know that there are many potential complications in store - but we want to express our hope and faith in the Lord to see Dad and Mum and all of us through with this.  When patients whom Sheba treats told her that they trusted God and asked her to do whatever was possible to help them, it gave her the confidence to move forward.  We sensed that God was asking us to do the same for Dad - to entrust him into God's hands and the hands of the surgeons that God has provided for us.

 
Dad expressed this thought in a communication to a very special person in His life earlier this evening: "As I go under the knife in the morning I know my life is in the Lord's hands.  My whole confidence is that the Lord is in total control." 

A few minutes ago Dad told someone "I feel like I am flying at 30,000 feet with all the prayers of God's people supporting us."

And so the countdown has begun. The bed in the ICU was already been booked for Dad this morning.  The lady from the blood bank has also come with the forms for the frozen blood plasma that Dad will get tomorrow.  Dad just got a body shave.  As I write this, Stefan will have landed from Delhi and is wending his way across the Mumbai traffic to be with us tonight.  Premi wrote a special letter to Dad which I was able to share with him and Mum this afternoon.  The prayer engines are revving up - I have just written a letter that we will be sending tonight to all the people on Dad's email list.  

We expect Dad's surgery to start at 9 AM Indian Standard Time.  How long will it last?  Perhaps 4-5 hours.  

Thanks for being along with us on this journey.




This lily bloomed at our house yesterday...  a sign perhaps?

Decision Day

Sheba and I had a late night discussion with Dr. Stephen Alfred last night.

Stephen is happy that yesterday's ultrasound shows that Dad's bile juices are being drained.  He is happy that Dad does not have a fever - other than a single episode of pain and rigors the day before.

At the same time Stephen laid out the realities of what the surgery can entail.  They may open Dad up only to find that the cancer has already spread - since the CT scan only picks up nodes larger than 1 cm in diameter.  In that case they would insert a permanent stent and close him up - and work on palliative care.  Even in a 'successful' operation - Dad may well face multiple challenges in the post-op recovery - and the cancer may well come back.

So the choice is up to us - to go ahead while Dad is still operable - or not to. 

As a family we are at peace that Dad is fully in God's hands.  We know that our Lord Jesus is the author of life - and our eternal sustainer.  We also know that besides adding "days to life" - He also adds "life to days."

As it stands, Dad's operation is booke for 8 AM tomorrow morning - the 23rd of March.  The ICU bed is booked for post-op care.  The surgeon - Dr. Kannan - as well as Dr. Stephen have committed themselves to be there.   Stefan has booked his flight ticked down from Delhi and should be here in Thane at 8 PM tonight.

The one decision point left hinges on Dad's bilirubin level (Dad tells me that Billy is fighting with Reuben).  Dad gave blood for a liver function test this morning - and we expect the results in the early afternoon with a final decision to go ahead with surgery being made at 5 PM.

It's a decision day.  One choice will be made this evening at 5 PM.  Whether to go ahead with surgery tomorrow - or whether to postpone and wait till Dad's liver function improves more will be made at that time.  But in the bigger pictgure we can rest assured that all of our times continue to be in the loving hands of our Lord Jesus.

Thanks for walking along with us on this journey.

Fragile

I am in Room 505 and a nurse is checking Dad's blood pressure.  He was taking a nap greeted her happily. 

"Is it ok?" he asked after she finished the reading.  "Yes, it is normal" the nurse said, "and so is your temperature."

Looking at Dad - you sometimes wonder if anything is wrong with him after all.  He remains cheery - even though he is mainly horizontal these days.

But he has not been admitted at Bethany Hospital for a rest time.  He is actually quite sick.   Having said that, Dad commented the other day that the 'rest' he is getting now is something that he is at least in one way enjoying - not having to answer the tyranny of the hundreds of emails that he normally feels he has to catch up with.

Lets be straight here: Dad is here at Bethany Hospital because he is quite sick.  His bilirubin level when measured this morning was less than the collosal '31' that he his Wednesday sample was (the report of which we saw on Thursday) - today's sample weighed in at 27.   We are hoping tomorrow's will be a lot better.  Our goal is to get the bilirubin level below 10.  If we don't see progress to this by Sunday, the surgery planned for Monday the 23rd will be postponed.  With the surgery itself fraught with various risks - we don't want to have Dad's kidneys shut down in the post-op period because of high levels of bilirubin.

 

Just how fragile we are came to us very starkly today.  Dad was chatting happily (as is his wont of course) with sister Jancy - the nursing superintendent - when he felt a pain near his liver.  The pain then travelled in a straight line up to his shoulder - and then spread across the front of his abdomen.  Then the chills came - uncontrollable shivering.  Blankets were put on but it didn't help.  The nurses called the Doctors - with Dr. Stephen and Dr. Kelkar (Bethany's most senior physician) also coming to the bedside.   Mercifully it subsided after abotu 15 minutes - but those were terrible minutes for Dad.  This is something he has never experienced - having been healthy for most of his life.   We think it shows an infection - and a high-level antibiotic is now being pumped into Dad at regular intervals.  And it shows us just how serious Dad's condition actually is - and how quickly something can cascade out of control.   Mercifully, the rest of the day passed without any incident and I can now hear Dad snoring softly in the bed as I bash the keyboard (and am about to make a quick run to JSK to get this off into cyberspace).

And in the midst of all of this - life does go on.  Our JSK team completed a good HIV testing camp yesterday afternoon and saw 48 people getting voluntary and confidential HIV testing done.    Vikas talked about Joseph in our morning prayers.  Our staff then fanned out for their home-visits. A friend of ours who had lost both parents to HIV and has been bringing up his sister and brother (thankfully all three siblings are negative) brought his sister to the JSK centre see Sheba as his sister has been suffering from epileptic fits.   We have known this young woman for years - but today something seems to have happened, and amidst tears she was able to let Sheba have a glimpse into her heart.   Earlier Sheba had made a small step forward herself in a different sphere - she passed her drivers licence test!  The early morning rides we have made have paid off - and the official liscence is in mail.  Asha and Enoch went to their school - and their final exams are looming just around the corner so Asha took her violin to class today to commemorate her last music class (at least at this school - classes 9 and 10 are sadly music-less).  On coming back in the evening, Enoch did his maths studies - and then Enoch, Yohan and I had a quick game of Risk.   Asha will be burning the midnight oil - so she went down to meet a friend for some time. While Mum was with Dad at Bethany, our dinner table had the five of us polish off hot chappatis and Sheba's delicious channa sabji - with shreekhand to top it off.    Just as I was about to come over to take the night shift, the phone buzzed with Stefan's number on it - he has come back safely from his assignment in Spain.  

The miracle of communication allows us to talk on the phone - even though we be many, many kilometers apart.  So many dear ones call up to find out about Dad - and assure us of their urgent and earnest prayers.   The miracle of the net allows this small reflection on today to spread to various corner of our blue planet.   Locally, one of our church members starts the day by switching on the computer and finding out the latest about Dad by looking up the blog (I believe this is after she reads her Bible etc. of course).   But the bigger miracle is the amazing fact of prayer allowing us to speak directly as children to their parents - to the very Maker and Creator the universe - and the One who loves our souls!

Today taught us again just how slender this gift of life really is.  How slippery the things we so often take for granted can me.  The remarkable way that our organ systems are doing their work, day after day, night after night 24 x 7 x 52 x as many years our loving Lord has in this life for us.  Dad's body suddenly seems so fragile.  How quickly we forget that we are made of dust.  And yet how amazing to know that our lives are so wonderfully structured and purposed.  Despite our fragility, we also have so much robustness wired into us.   When Appa called up today, he inquired about Dad and then said in a wonderfully matter-of-fact way "Sab teek hojayega" - it's all going to become ok - "we have prayed about it!"

My Lord knows the way through the wilderness....

I am writing this from room no. 505 of Bethany hospital.  Dad is sitting up in bed no. "A" of this twin share room, reading his bible and occasionally looking at the IV line to see if the drip is flowing as it should.   The room is a corner room with windows on both sides - and both look out on greenery. 

It's 9 PM and we are back in the hospital.   In the adjoining bed, Sister Vandana Shinde is getting ready to leave.  She is the wife of Pastor Pravin Shinde of Airoli - and the older sister of our dear and faithful JSK co-worker Daniel Kautikkar.   All three are waiting for her discharge to come through - some snag in the mediclaim means that they are still here.   Daniel showed us the latest picture of his one and a half month old son.  Mother and son are far away in Daund - where Yerusha will be till the baby is 3 months old.

We don't really want to be back in this beautiful hospital room - but sometimes you have to do things that are not quite what you want to do...

The trigger for Dad's readmission was his liver function test that we had done yesterday.  Picking up the results this afternoon was a shock.  Instead of going down from the already high over all level of 19 last week, the reading for yesterday's liver function test was a chart-popping billirubin level of 31!   Could it be a clerical error? 

Dad has been pretty well over the past few days.  He read the paper and went for a small walk each evening.  We met guests and he ate with us at every meal.  We are so grateful for the blessings he has received.  His itching is far less and he has had a good appetite for most of the time.   

But his urine had remained pretty brown and his stool was pretty pale.  And his eyes remained the shocking yellow that we see when he opens them wide...

So when we called up Dr. Stephen to tell him about the results he asked us to immediately have Dad admitted again.

Dad of course used the opportunity to make new friends.  Here he is waiting for me to process his registration to Room 505 - and he has already made another new friend.

On admission they flushed the external stent to make sure it had not been blocked.  The ICU doctor found that fluid went in easily, and came out without trouble, so it does not seem to be clogged up.   But what has happened to the internal stent we just don't know.  It doesn't seem to be working. 

And so we are here on the next twist and turn of this journey.

Earlier this evening I asked Dad what he wanted to say to those who are reading this blog.  These are his words:  "I want to give the same message:  God is in total control.  There is no worry, no anxiety, no fear.  He knows everything that is going to happen, and what ever does happen is for our good."

Dad is currently hooked back up with an IV line - which is delivering his antibiotics efficiently into his veins.   And the external stent is now fully open - instead of the every four-hourly 15 minutes that we were doing at home.  His kidneys seem to be working fine - the blood test shows a normal serum creatinine level.  We will repeat a liver function tomorrow and see.   

He is able to drink water and enjoyed a snack of idlis and coffee that I brought up from the hospital canteen just after admission.

Once again we just sense the great tide of prayer that is going up on our behalf.

Life has some interesting twists and turns.  Tomorrow Sheba has her driving test (soon we should have 2 legal drivers for the Papaya).  We were expecting to meet the authorities in Bhiwandi to get the legal papers for Yohan - but that seems to be postponed too as they said that they would be having a seminar and so we should come on Monday.   

We realise again just how fragile everything is - and also just how much the love of God is present for us.  It's no accident that Jesus is called the Good Shepherd.  He knows the way ahead, and walks before us, besides us, caring for us, leading and guiding, protecting and correcting.

What is the road ahead?  Well, like sheep following our shepherd up a mountain path, we really don't know.  It may seem that the next bend is the last one - but He really knows - and our work is to follow him. 

Currently Dad is scheduled to meet with Dr. Stephen on Saturday morning.  Our plan last week was for Dad's bilirubin levels to come down and then to proceed for his major surgery on Monday 23rd of March.   Now?  Let's see.    We know that every day is a day of experiencing grace.

As Dad lies in bed - ready for another hospital night - we remember the song he used to sing to us when we were small:

My Lord knows the way through the wilderness,

All I have to do is to follow

My Lord knows the way through the wilderness,

All I have to do is to follow

Strength for today, is mine all the way

And all that I need for tomorrow

My Lord knows the way through the wilderness,

All I have to do is to follow

That has been the story of Dad's life.  From his very beginnings - all through till today.  God's grace lived large.  God's mercies, received and given on.  As our Lord so clearly told us: "Freely you have received, freely give."   We have seen this lived out over and over again by Mum and Dad.  

Sometimes it has been messy (make that many times) but as we look back, we are overwhelmed with the clear note of love that shines through it all.

Mum brought Dad and myself some supper - Weiner Schnitzel!  
Dad could only have some mashed potatoes and gravy, but I tucked in for both of us!

How much more time does Dad have?   He tells all and sundry that he is 75 - in which he counts his 9 months after conception and the current 'running year.'   By conventional standards he is 73 years old.  Will Dad live another 10 years?  Five?  One?  Is His time to meet the Lord even sooner?   We really don't know - but we do know something:  Dad lives very much in the present - his cheery greeting of all and sundry continue to bring light to all his care-givers.   And whenever he is called to meet his Maker - Dad will take that last bit of his current journey with great joy and peace.

And so we come to the end of this day.  Dad resting.  The family - Oma, Sheba and our 3 kids at home.  I am on night duty with Dad (and slipping out for a few minutes to upload this on the blog from the computer at JSK).   

The world is spinning.  

A new day is coming.  

Fresh opportunities for grace are close at hand.

All in God's hands

We just got Dad's liver function reports today - and instead of going 'down' they have actually gone 'up.'

We talked with Dr. Stephen and he has asked Dad to be admitted back at Bethany.  And so off to Bethany we are going in a few minutes.

Dad was talking to Vicky on the phone and told him that it is 'all in God's hands.'

In deed!

Thanks for your prayers and support as we take the next steps needed.

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.