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ttt ok raghu maama, viji leaving on 25 noon, anand coming on 25 morning and leaving 26 evening, so anytime after that date u can make schedule. pl inform arrival and departure dates asap From bottom of my heart, thanks to Viji Chikkamma and Chikkappa ( Pochamballi Bava) for visiting Bengaluru and being with Amma for almost 10 days ! Viji chikkamma, as usual – very active and full work – both inside house/kitchen and outside. Chikkappa did shopping and other help. Prema Amma was very happy with the visit. Due to happy, She has also now put on weight now – now she is 39 kg almost ( up from 35.5). Eating properly and sleeping somewhat ok. And no Hospital return after 27th October ! *So much thanks to Viji chikkamma/bava. Avangalukku ORU PERIYYA “OOOO Raghu maama family next has scheduled – i think 29th Nov or so ——- btw, I am taking Amma to Tirupathi on 26th December. We will go by car on 25th December. Darshan is at 10 am on 26th ( Srivani Trust special Darshan – Rs 10500 per person). Please pray for her health to make sure this Darshan happens without fail thanks to everyone for wishes🙏. first time in 3 months,prema amma walked out of house. we went to nearby pillayar temple by car. i am wearing new dress selected by viji chikkamma Myself, Prema, Saraswathi – we went to meet Dr Poonam Patil at Manipal Hospital today. Dr Poonam message – 1. “Prema weight has improved. It is now 42 kg ( it was 34 kg in Sept). So she she is eating a lot. Ok, no problem. but very fast weight gain also not good. So we will reduce the appetite medicine a little” 2. “No pain till now. But inside the cancer is still growing. No need to do any scan because there is no point. But to help for pain management ( in future), let us do “minor chemotherapy” every 3 weeks till her life. We will start this on Jan 11. This is a half-day procedure in Manipal hospital itself.” 3. “She is not having bladder control. So that is ok, minor problem. But if possible, do some physiotherapy exercise for her ( “Kegels method for bladder control”). It may help”. 4. “We will change 1-2 medicines for her because she is having breathing problem still”. 5. “otherwise, she is ok. we will keep praying for her comfort. I will anyway be meeting her every 3 weeks from now onwards for her chemo ( till end of her life we will give chemo) today 12th jan 2024 we are starting chemotherapy for prema. from today, every three weeks. till end of life. doctor gave choice – do we do chemo or no? i asked – “what advantage?” doctor reply – “maybe longer life, maybe less pain. but everything in god hands. not sure”. so i decided let us anyway go ahead. it is also costly procedure ( each time medicine 50k and treatment 20k). but if prema gets bad side-effect or after-effect, we will re-examine our decision 18/01/24, 7:10 pm – Sathish: at manipal hospital. admitted prema in emergency. rest details will follow prema inside emergency room. ecg being taken now. doc saying pet and other scans, examinations need to be done again to see how much more the cancer has spread icu-la admit pannindirikkom prema in icu room no 23. 1. in icu itself, there is special room where she is kept. reason being – high chance of infection from other patients 2. dr bharatesh and dr aparna icu doctors and thankam dedicated nurse – met me. she shud be in icu for 2 days max, then to normal ward. 3. lung is badly affected. neutropina something. there is small chance we will do ventilator tube, but we will call and inform u if we are doing ventilator at all 4. let us hope for best, she shud respond to treatment now. dr poonam will also visit her tomorow morning joint doctor icu counselling ( dr poonam of onco plus dr aparna of icu) at 1130am. will update after that to clarify – 1. any group is ok 2. need blood by 4pm, friday, 19 jan. so only local donors in blr pl 3. message was sent for wider distibution, so non-blr people – if any blr contacts pl pass on 4. generally speaking, >60 may hv bp, sugar etc. so not allowed we quickly got the other three donor confirmations. so myself, two of my personal friends, raghavendra ref abhinaya napad. so all arranged. txs again for ur offer. god bless guru maama visited. he also met amma inside icu. photo taken in icu waiting room, since no photo allowed inside icu 1. blood donation done and over for prema – 4 donors in all – myself, raghavendra ( reference abhinaya), vinod from my school and harish ( my friend) prema still in ICU. morning hemo count was 5.4 which is extremely low and worrying. so no shifting to ward as of now 3. full pnenumonia infection both lungs. another worry is that recovery is very slow due to existing immuno-compromised condition ( cancer). 4. so constant monitoring. doctor also repeating – possibility of ventilator tube if required, so we will alert u if so. ——— since prema in icu, not interacting much with her and we are outside in waiting room only. guru maama, my friends etc all visited her during day in icu 20th Jan* Just finished meeting with ICU Doctors ( Dr Indira). Prema still NOT getting better. Oxygen being pumped at 10 litres/minute ( today afternoon it was 8L/minute). Even one minute if removed, she is not able to bear. “So we will not move her to ward now. We have to keep her in ICU only. Sorry”. So, already 3rd day in ICU, and will continue to be here. Doctors will again review at 9am tomorrow ( Sunday) – they have asked me to come and meet them at that time, for further course of action. Also, she is very weak with so many medicines having gone inside. Will update by tomorow afternoon. Another problem is that since tomorrow is Sunday, many specialist doctors will not come. So it is possible that she remains in ICU even till Monday 21 jan discussed with icu doctors, convinced them and *shifted to ward at 1pm*. room 516C. dr shashank came. wheezing problem, mouth ulcers, weakness = main problems as of now. hourly checking of saturation levels. now at 94. if it goes below 92, then we will do oxygen. otherwise regular nebulisation is enough prema update, 9am, monday, 22 jan very weak, hemoglobin count still very low, heavy chest congestion so not able to breathe properly, ecg has been taken and waiting for specialisit advice pulmo team came. 1. platelets very low, we will put her on steroids again 2. for breathing, we will put her on oxygen here in ward itself. let us see if her condition improves. if not, we need to decide on going back to icu 3. no more palbocyclib or chemo for her lifetime. she is not able to bear 4. hemo now at 7+. we hope it will improve. 5. heavy infection is still there in chest 1. platelet count worrying – 27k. if it dips below 20k, we need to give platelet transfusion 2. bone marrow issue perhaps. so some bone tests needed 3. we are starting her on 5L/litre oxygen immediately. let us see after 24 hours, bcos severe chest congestion still there 4. infection will take 6 weeks to heal. infact, she may be in hospital for another 4-5 days atleast. so pl, no travel. cancel her proposed trip to coimbatore on feb 10. no chance. —- we are doing our best. but patient body has to now fight and get ok. it is upto her body now. 22/01/24, 12:00 pm – Sathish: prema on oxygen plus drips 22/01/24, 9:31 pm – Sathish: prema update, 9pm, monday, 22 jan 2024 1. heavy wheezing still there. so on oxygen most of the time. remaining time of nebuliser 2. she is not able to eat food properly bcos of mouth ulcer, somehow managing 3. steroids given. so sometimes she is talking nonsense. she said “i am in udupi now for mutt function, guru promised to take me so i hv come” 4. tomorow mornng we will do platelet test again. if same level, then infusion. —- chief doctors will visit 10am tomorow. will update then *prema update, 9am, tue, 23 jan* 1. no sleep, constipation, not having food, uncomfortable in hospital. also bed sores have come. 2. wheezing better but still on oxgen at 3L/min. unable to talk properly. 3. *platelets very low as per 8am blood test. it has come down to 16k. so we will do platelet transfusion at around 11am* 4. pulmo doctor anisha came ( chief pulmo dr guru will come later). she said – “her platelet and potassium v low. so we can manage best only in hospital. what if platelet again comes low tomorow? u know what will happen? there will be severe internal bleeding immediately. so pl let her be in hospital” 5. prema version – “no, i know my body best. i will give instruction to make my food in correct way. i will put papaya leaf etc to increase my platelet count. at home, i can monitor myself better at home. so let us go home!!!” ——- so i put prema on conference call with both guru maama and raghu. guru maama will also come to manipal today by 1 pm or 2pm *prema update, 10am, wednesday, 24 jan* prema still not ok. needs 24-hour oxygen support. she is now being taken to basement for some procedure – platelet transfusion plus bone marrow biopsy. will update in evening. 7th day of hospitalisation, and she will continue to be in hospital 1. at 9am, pulmo came. dr guru said “if u promise to take care of her at home with iv, oxygen, then i will agree to discharge her in evening”. so we started the process. 2. but at 1215pm, platelet result came. it is 13k now ( inspite of transfusion given yesterday). so no discharge today. really very dangerous. again giving another round of transfusion. chief oncology doctor will come in afternoon and decide further course of treatment. *but no discharge today, please. patient platelet is at dangerous level* also, prema full olarifying since morning ( delirious). talking nonsense stuff sure, maama. will inform. prema first sudha ( hosur) and anu paakkanumnu sonnaanga. so i will discuss with them first and then give napad schedule proposal🙏 26/01/24, 9:45 pm – Sathish: its 945pm, friday, 26 jan 2024. still at manipal. have asked for ambulance. we are leaving hospital by 1015 pm, taking prema home. many arrangement to be done at home blood and oreferous transfusion prema at hospital. has to be done twice daily for 5 days yesterday prema hemoglobin count at 6.1, so decided to skip coimbatore. prema romba sogamaa irukkaanga for missing shilpa function small request to everyone in napad. pl send all the photos/videos of the function that u have in ur mobile. u can send either on group or on DM. prema wants to see all of them her last hospitalisation was till 27th jan. So for last 33 days, she is better with no hospitalisation. during last one month – sometimes weakness. 1-2 occasions very bad loose motion ( once 10 times in 24 hours). haemoglobin low count was controlled with transfusion ( 3 times). so, we are managing at home with all medication, injections, downstairs doctor etc. next step – we will take full blood count and also do her pet scan at manipal and the meet onco as well as pulmo, next 10 days. will keep you informed. prema phone no is 9742766951 and 9916128085, in case u want to call to wish her for her birthday super chikkamma – thanks chikkamma for taking care of amma one full week 🙏🙏 many temple visits by latha chikkamma with prema ( nearby shiva temple, Ulsoor sathyanarayana temple etc), some outings etc. prema very happy. thanks also to Sowmya and sukumar chikkappa for permitting chikkamma prema health problem – today visit to dr poonam patil manipal hospital – *severe fungal infection of mouth and throat* – so mouth and cheeks fully swollen – “candiasis” – so medicines have been given a light post for a change – prema at ashwamedha ghaat ( or assi ghat. not sure Manikarnika ghat) at varanasi – aug 10, 2023 – at that time cancer was already in full status ( but we did not know)😀 – three times water immersion – pidivaatham ! walking in knee-deep water about 100 m inside – to boat, then dipping ! thanks gv aunty for video taken Premakka wanted to have bath only in Manikarnika ghat. At Ashwamedha ghat we had dharshan of Ganga arathi sriram/anu ( also aradhana), romba thanks for visiting prema yesterday, coming all the way from chennai mouth ulcer mostly poyiduchu. but after mouth problem ( 45 days back), main cancer tablet has been stopped. she refusing to have that medicine because of side-effects 2.5 months have passed after last hospital stay.saraswathi helper set aayiduchu, i think. if all goes well and her health same status, then i will bring her to srirangam on may 11th prema is doing ok, no complaints. she is taking all medicines. but not taking cancer tablets ( because of side-effects). also no chemotherapy at all, because first chemo in jan 2024 result was 10 days of hospitalisation. anyway, she is fine as of now. but she also not coming for onco doctor checkup or PET Scan etc, because she is saying – “no point, no use” every 2 weeks, we do her blood test so we did her latest test yesterday. hemoglobin is less at 8.4 and platelets is 90K, but other readings are ok. Anyway, her hemo is usually less for last 1 year. i am taking amma with saraswathi ( helper) by car to srirangam this weekend ( 11th and 12th May 2024) – for family function ( 70th bheemaratha shanthi for sukumar chikkappa/latha chikkamma ( my mom younger sister). i need your best wishes for her safe travel. thanks, have a good day. amma sends her best wishes to everyone. warm regards, 04/06/24, 12:16 pm – Sathish: You deleted this message 19/06/24, 8:19 pm – Sathish: after long time, posting about prema health. prema not ok for last one week. very heavy breathing, cannot breathe properly. so first we tried oxygen support for 2 hours a day. but not much help. since prema refusing to go to manipal, we met local doctor yesterday. many tests done – chest xray, hemogram, ecg etc. main point from reports – hemoglobin count very low – 6.2. total count 1.5 ( also v low). chest xray shows left lung in bad form ( but since pulmo doctor not seen report, we cannot say more). —— so as of wednesday, 19 june 2024, evening, we are putting prema on hemoglobin tranfusion. this is 2 hour procedure done in local hospital. we will repeat this 3 times weekly for 3 weeks. then we will see. last time ( nov 2023), we tried this method. but after one week she became even more weak so we admitted to manipal. let us see this time again, and hope for best

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