This page has no direct bearing on Cheryl’s chemo treatment and final days.  I feel it is important to include to illustrate her strength and ability to survive for us: her family and friends.  It also provides the basis for my view of how awful today’s medical experience can be.  As Cheryl came to repeat often: “It is what it is”.

The Cancer Discovery

Cheryl was diagnosed with advanced colon cancer (stage 2 or 3 depending on scale used) on 17 April, 2007. She’d had intestinal problems for several months and kept putting off the inevitable.

The doctor who performed the colonoscopy referred Cheryl immediately to a locally renowned colon surgeon, Dr. Raul Ramos. He apparently is an expert in a minimally invasive procedure: laproscopic sigmoid colon resection.

As the colonoscopy doctor was going over all the details with me, Cheryl was still loopy from the anesthesia.  Even though she couldn’t then grasp the seriousness of her illness, she went to great lengths to show good humor and comfort me.

We met with Dr. Ramos on 18 April. While we were not comfortable with his aloof demeanor, we agreed this was a serious issue and he had been recommended as the best around.

Hospitalization #1: The Colon Resection, 30 April-5 May 2007

We arrived at Methodist Specialty & Transplant Hospital (MSTH) on the morning of the surgery.  We were nervous but eager and hopeful of the outcome.

Her  surgery was delayed a few hours due to another surgery running late.  She was getting cold feet but managed to go ahead that day. While waiting, a nurse told us Doctor Ramos was “slow”.  I asked if that meant slow and methodical or slow and bumbling? She was a bit insulted and reassured me he was a very detailed and thorough surgeon. When her turn finally came, Cheryl started crying just as she was rolled into the operating room.  I look back on that moment as her realizing the outcome would not be good.

Cheryl went through post-op and  was placed into her room without anyone ever notifying my son or I.  She called us when she woke up. Her doctor did make a rushed visit to the waiting room and assured us all was well. We visited briefly and went home to call family and inform everyone Cheryl was doing good and the surgery went as expected.

The next morning and throughout the rest of her stay, severe and sudden pains hit her abdomen and lower back. 

She remembered the nurses commenting on her first night that her urine output was low in the catheter.

So, it went on: pains, profuse sweating, ”spikey” and short fevers and bloating. We complained and prodded the doctor and nurses that something was wrong. Their reply was the pain and discomfort was caused by the remaining gas used to inflate her abdomen during surgery. 

The recommended therapy was to walk. Cheryl managed to do as much walking as the pain would allow.

An X-ray was performed mid week to check for possible problems. It was negative.

Dr. Ramos commented late in the week that she looked about to give birth, she had become that bloated.  Again, no urgency to check for any possible complications.

Her urine output was low all week, she never had a true bowel movement and was barely able to walk. All of those were to be milestones to her release from the hospital.

Saturday morning, Dr. Ramos cleared her and her discharge was the most rapid we’d seen all week.  Just after he left her room, she again had the shooting pains and requested him to return.  The nurse adamantly told me he was with other patients, my wife had been discharged and he was not available to see us again.  He would see us again fairly soon...

Hospitalization #2 Damaged Ureter,  7-12 May, 2007

Returned to MSTH Emergency Room as Cheryl was so swollen, her thighs seemed ready to burst. ER did CT scan and discovered a large amount of fluid in her abdominal cavity.  Cheryl had her first bowel movement while in ER. She hoped she could return home after that but they had to locate the source of the fluid. Again, a bowel movement was supposed to be a prerequisite to release from surgery along w/ solid food diet.

A damned good urologist, Dr. Kurt Meissner was assigned to Cheryl. He scheduled a dye test and completed that on the morning of May 8. He informed me her right ureter had been severed by cauterization during the colon resection.

His wish was to send her home for a few weeks w/ Foley catheter and a pump to drain fluids. I expressed Cheryl’s desire to do repairs as soon as possible. He was concerned about possible infection but was able to complete relocation of her bladder and stint the ureter later in the afternoon, same day.

She was placed in a double occupancy room this visit-even though she was at the stated greater risk of infection.

She had great trouble controlling her bowel function.  I kept her as clean as possible while staying with her. She told me one of the overnight nurses left her for nearly two hours in her soiled bed/robes. I asked the staff to help bathe her and they told me I could help her stand in the shower to wash off.

On the morning of her release, I noticed three of the staples on the left side of her incision were pink at the puncture marks. Dr Obeng, the staff physician said all was OK. Her first surgery was laproscopic and even at this time, those incisions looked good. Due to the second surgery, she was cut all the way across her stomach.

Again, on a tired and dreary Saturday morning, we headed home.

Hospitalization #3: We Discover MRSA,  13-18 May, 2007

On Mother’s Day, Cheryl got up, and seemed very tired. Before heading to work, Sean made her a nice French Toast breakfast.

About 11 am, she decided to lay on the couch for a nap.  At noon, I checked her temp and it was over 101. Her blood pressure was low and pulse was over 120. By the time we arrived once again at MSTH ER, her blood pressure was dropping even more, pulse had gone over 150 and her temp was over 103.

The ER staff spent much time trying to contact doctors Meissner & Ramos and little time actually treating her. Cheryl finally started slipping into unconsciousness. I had my first experience with the possibility of losing her to modern medicine that night. While waiting and fretting in the hallway, Dr. Obeng passed and recognized me. I commented on the MRSA and reminded him of those irritated staple wounds.  He gave me the medical version of “Shit Happens”.

I finally got one nurse to check her. He managed to get a doctor to administer Vancomycin which almost immediately started improving her vitals. It did cause Red Man Syndrome: swollen eyes, ears, etc..

Dr. Ramos arrived, removed several staples on each side and drained the wound. The left side appeared to have been the worst infected.

After we got her into a room around 2 AM, I came home and planned to return before Ramos made his rounds on the morning of the 14^th.

Monday morning, Cheryl called me at home crying. Ramos had came to the room around 6:30 am and without sedative, removed the remaining staples and used his hands to open the rest of the now healing incision. He had nurses pack the wound. Her morning nurse felt terrible at her treatment and apologized to Cheryl for not having an opportunity to prepare her for the pain he caused. 

Now, the larger incision had to heal naturally without staples or sutures. She was eventually placed on a KCI Wound-Vac and was administered Vancomycin. A Dr. Berkowicz was assigned as infectious disease specialist. He determined she had contracted that dirty little hospital secret: Hospital Acquired Methicillin-Resistant Staphylococcus Aureus (HA-MRSA).

She recovered fairly well during this stay.

In less than three weeks, Cheryl went from a reasonably healthy cancer patient to a scared, worn out,  and nearly killed product of modern medicine gone wrong.  BUT, she never stopped laughing and finding hope.

We asked for her release on a Friday this time as Saturdays had proven to be a bad day for home comings.  Doctor Meissner was able to release her.

While driving home on that warm and sunny day, she ironically stated if she were to have to be readmitted that they’d kill her...

I had to share her concern as our experiences with Methodist Specialty and Transplant Hospital and their staff had been horrendous. A few nurses and orderlies, one X-ray tech and good old Dr. Meissner were all we could speak positively about.

Our Long, Long Summer

Ongoing home treatment for MRSA using Bactrim/Septra and KCI Wound-Vac. The surgical wound healed completely three times, and then, after 8-10 days, the left side would reopen and be infected. The entire right side of the wound healed in maybe three weeks, the left side was always the problem. Remember the irritated staples?  After expressing our frustration several times, Dr. Meissner referred Cheryl to Warm Springs Treatment Center approx. mid September. Warm Springs cleaned the wound, and had us flushing it daily with a boric acid solution/repacking daily. Finally, they simply allowed the small wound to heal closed and kept her on Septra through 31 December as a precaution.

That’s the short version of the remainder of 2007. Most of this time revolved around Cheryl’s home nurse’s visits. They became her social network beyond Sean, myself and the pets. We both missed weeks of work. I, too afraid to leave her alone when she did become a bit more self sufficient and she had problems with her part-time employer not allowing her to use the Wound-Vac when she did feel well enough to work.

Looking back, this was a special time in my life.  We were able to relive 24 years of happy memories, share our fears, plan our future and make up for every disagreement we ever had.

Fate had different plans for us however...

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