Update on dad's condition.

Over the last weekend, several things happened. First, the doctors have determined that dad's ascites is a case of pancreatic ascites - a rare complication of pancreatitis. What this means is that the pseudocyst the doctors have been hoping would mature, has erupted and pancreatic fluid is now leaked into the peritoneal cavity. Hence the swelling. The second Coop loop placed beneath his umbilicus has been draining very little water but whatever is coming out looks dark brown - muddy water. In contrast, the other Coop loop in his side is draining clear yellow fluid - normal ascites.

A test of the muddy waters show high levels of pancreatic enzymes - hence the conclusion that this is pancreatic ascites. To rest the gut and avoid stimulating further release of the pancreatic enzymes, dad is now put on TPN - Total Parenteral Nutrition. Basically this means he does not get to eat or drink anything orally. A special team of nurses and doctors will put together a unique formulation of nutrients (amino acids, lipids, vitamins, minerals etc) that will be tailored to his daily requirements and this will go in via the PICC line. Meanwhile, he will continue with strong antibiotics which we hope will prevent infection from setting in. He will also be watched for any signs of a fever.

If there are signs of infection, surgery will look very likely. The hope is that the TPN will bulk dad up and give him the reserves he needs to come out of surgery strongly.

With the TPN in place over the past two days, we have noted that dad looks stronger these days and he is trying very hard to co-operate eg sitting out in the chair for long periods etc. In the past dad was so frail that four people were needed to get him off the bed and settled into the chair. Now, he only needs the help of one nurse since he is strong enough to stand momentarily by himself. So we are happy that the TPN seems to be working.

We get good days and we get bad days. On Sat when I was with him, he threw up a copious amount of brown/yellow fluid - water very likely, since I was giving him ice cubes before that. Looked very much like the Merlion to me! Okay, very ugh factor but it went all over my hand, his pjs, the bed etc. Very icky. The nurse had to change everything. Hopefully the vomiting would be an isolated one-off incident. We were worried that it was a sign that his gut was not doing well.

Gillian went to see him on Thurs after her exams and mom said he had such a big broad grin on his face when he saw her that mom went all teary. Gill thanked him for the handphone he bought her. He had bought it for her the day before he was first admitted and so never had the chance to give it to her. So mum thought it best to give the phone to her so that she could still thank dad while he was lucid. Gill was always his favourite and he really spoils her rotten sometimes, so it was understandable that he was so happy to see her.

With Gillian eliciting such a good response from dad, I am toying with the idea of bringing Trin to see him. My only worry is that Trin may jump on his bed, play with his tubes etc!

We take each day as it comes. I am still half-hearted about Japan. But I know KH wants to go. I think my sister has also pretty much pulled out already. Which in a way, frees me to go because I know she will be there for mom and mom will not be alone. But at the same time, I feel bad about not pulling my weight. It was the same the last time we went to Japan. I guess I will have to continue to sleep on it and keep praying for a direction.

Incidentally, I no longer see porridge, Milo and milkshakes in the same way. After taking care of some of dad's meals - blending porridge, mixing the Propass with Milo, giving the Resource etc, I think I can swear off fish porridge and milk shakes for a long long time. I used to like porridge - one of my favourite foods - but these days, ugh... no. It just reminds me too much of dad's diet before the TPN...