Hi All,

Good news regarding my mother - she was shifted out of the ICU yesterday evening and doctors say she is doing fine now...

I took her out of the room for a walk and she is able to tolerate soft diet as well..

Thankful to god that she is improving. The fight will continue!

Best Regards,
Sushant

Thanks Marion - this will be valuable as I explore all the available options..

Dear Lainy - Yes, my research shows that the top Onco surgeons in India are world class. They are well connected with the renowned centres in the US with some having worked there for long before relocating to India. Tata Memorial hospital (Public Pvt Partnership, non profit, economy thus crowded hospital)  in Mumbai is the Hub of treatment in India and is the learning ground of surgeons who get to see a vast variety of cases and complications. From there the famous Oncos move out to Private hospitals (Lilavati is one of them where my mom is admitted).

Also, there are a few CyberKnife centres in India with one called HCG - across different cities in India. Will do a detailed research later..

They have sent samples for a culture, apparantly the report takes a few days.. The doctor will do a CT today to look for any "collection" of fluid that may be a source of infection..  Will ask about Levaquin.

Thanks everyone for your kind words.

@Lainy - the surgeon has removed the head of the pancreas during the surgery like they do in Whipple's I guess. as for my mom's condition today, it has not improved with high WBCs and fever (which is down after medication).. the intensivists are exploring the cause of infection and changing the antibiotics etc.. praying my mom can feel better soon

@Gavin - thanks. I will look at the surgery board for more on this..

@Randi - your story is very inspiring and thanks for being a source of hope. Pray, I will explore every possible option  to make sure my mom beats all the stats. Thanks for your offer for help, I guess post recovery, I will have questions related to  adjuvant chemotherapy.

@PCL1029 - I live in London and will try and find out doctors to reach out to once I am back there.. Although I am planning to relocate back to India in a couple of months to be around my mom..

My brother lives in California (Cupertino), he will be able to reach out to Oncos in the US with my moms case history and scans etc once we have a complete file (post op scans etc)

My plan is to take opinions from the US and the UK and India and get the therapy in India based on the decision (will work out quicker and affordable I think as she will not have insurance etc abroad)

Please let me know what you guys think about my plan of action..much appreciate

Best,
Sushant

Thanks again Lainy. As I wait outside the ICU for the next opportunity to see my mom, your kind words are comforting.

My mom's tumour was 2.7 cm in the distal bile duct and had started to move into the head of the pancreas. I will find out more about whether cyberknife can be useful for her post whipples..

quick one: I am my mom's son (though she tells me she wanted a daughter when I arrived and that I havent disappointed after.. )

Thanks Lainey.

There have been quite a few complications:

1. She probably had an oozer in the area joined up after surgery so Ryle's tube showed some bleeding till the last 3 days. Blood transfusion was given, and endoscopy done to clip the bleeding source. Slowly it seems it has stopped. fingers crossed.
2. The drain was high due to hypoalbuminemia. It seems to be getting better
3. Today, I am told there may be some infection (WBCs are high) so they will continue to keep her in ICU. There is no fever and PCT was normal (so no sepsis)

Have not discussed the post op plan with the onco surgeon. He insisted that the first milestone is recovery from Whipples. His other patient next to my mom is already home by gods grace, she took 8 days to recover.. I guess it depends on how well the body responds as well..

Also, dont know about the cyber knife ... havent discussed, read on it.. what is this for and how should I find out more..

Regards,
Sushant

Hello,

I live and work in London and currently in India to see through my moms treatment.

My mother is still in the ICU battling some post operative complications from Whipple's surgery.

She went to the doctor on 20th Feb with painless jaundice (probably after a week of minor symptoms appearing). Even though it was a doctor in a small town in India (not Mumbai), they immediately asked for an ultrasound be done. Based on that the doc recommended further testing (MRCP). We then moved to Mumbai and MRCP, CT, Endoscopic Ultrasound and PET/CT Scan showed Distal Bile duct Cholangiocarcinoma. (FNAC was negative during surgery)

Dr. Jagannath is a well known surgeon (probably the best) in India in Hepato billiary  oncology. He figured it was resectable and  conducted the Whipple's surgery on 18th March 2013.

Because she had bilirubin levels around 6 during operation, as no stenting was done, the recovery is taking time.

I saw the biopsy report yesterday. It says stage is PT3N1 - 9/20 peripancreatic lymph nodes are metastatic. The tumor had started spreading to pancreas with mild differentiation seen. Although the margins are free of tumor with closest margin on pancreas 1 mm.

We are just hoping and praying for her recovery from the surgery and then think about the next steps. Not sure what the prognosis is at this stage (statistically very depressing I think) but we will fight till the last option available!

I guess the next steps for me are:

1. Take second/third opinions on all reports
2. Plan for chemotherapy etc..
3. Prepare for the expenses and plan relocation as per 1 and 2..

Will appreciate any comments / information on the above.

Thanks everyone for being so amazing and for the people who put this site up.. it is a relief that I can find knowledgeable opinion from around the world here..

Sushant