September 19, 2011
In 2007, Melanie Jaggard went to the hospital for a punctured ear drum and was given the shock of her life. She had cancer; a very rare form that was located at the base of her brain.
Adenoid cystic carcinoma (ACC) is the second most common cause of salivary gland cancer but can affect other areas of the body. Melanie is one of only 20 to 25 people in the United Kingdom to have ACC and had a 2-inch tumor was removed from her head following a delicate 10-hour operation. She was single at the time, cancer free and one year later met the love of her life, Charlie Jaggard, on an online dating site. Charlie proposed three months after their first date and life was good, until she received the news that the cancer had returned, this time metastasizing to her lungs. Surgery was not an option because the tumors were too numerous and radiation was too risky to the lungs. However the couple was not discouraged. They married in January 2009 and Melanie decided to be a victor rather than a victim. Although 89 % of people with ACC survive after 5 years only 40% survive after 15. Melanie has a life-span of 15 years and she and Charlie have both decided to look at the glass as half full rather than half empty. After careful consideration regarding Melanie’s condition and prognosis, they decided to start a family.
Melanie is now pregnant with twins and is very optimistic about her future. While there may be people who will criticize her for starting a family, the Jaggards are convinced that 10 to 15 years will give them time to raise money for a cure or at least discover medicines that can shrink the tumor. Approximately 1 in 1500 pregnancies is affected by cancer. Melanie holds the distinction of being the only pregnant woman to have ACC in the medical annals thus far. She is treading in unchartered water but optimism will be her guide.
Lucius Annaeus Seneca once said: “Sometimes even to live is an act of courage.” Hopefully one day her twins will thank her.
May 9, 2011
There are two types of physicians who practice medicine: those who choose medicine as a career and those who medicine chooses to serve. When you are called to serve, your relationship with patients extends beyond a 15 minute boundary. Such was the case of my relationship with my patient, Adriana Echeverri Tucker.
Adriana was 38 years old when she first entered my office both happy and anxious about her first pregnancy. If Adriana had medical insurance, I might not have met her. She was married to a U.S. citizen but had to wait the prescriptive time period for her green card so she was not eligible for state-funded insurance and her husband was self-employed.
Adriana was a dog trainer by trade and originally from Colombia, South America. Her ambition and entrepreneurial spirit was contagious and admirable. She was also a perfectionist and because we shared the same birth month, I intuitively understood her fears and concerns about this first pregnancy. I would see Adriana even without an appointment on days when her anxiety got the best of her. She was an older woman who had conceived without the benefit of In Vitro Fertilization and I, who was childless at that time, knew her pregnancy was a precious gift. She ultimately delivered a beautiful baby boy, who she named Martin. When she brought Martin to Colombia to see her family, she brought me back a gift that remained on my desk for years.
I eventually lost contact with Adriana until this past Friday night when I flipped through my local newspaper and saw her name in the obituary section. At first I wasn’t sure if it was the same person until I read the part about her being a dog trainer. A was a memorial service scheduled for the next day.
The parking lot was completely filled and there must have been over 100 people in attendance. When the pastor asked if anyone else wanted to make a comment, I was given a microphone and tearfully stated how fitting that her memorial service was held on the day before Mother’s Day because she was such a proud mother. Through the testimonies I learned that Adriana was a volunteer COP in her community. She organized a movie night once a month in her church. She became a U.S. in 2009 and her 7-year-old son, Martin, was thriving. I also learned that Adriana had late-stage cancer that was only recently diagnosed 2 months prior to her untimely death that occurred in Colombia, one day after she returned to the country of her birth.
Her service ended by the release of purple balloons in the parking lot symbolically returning her spirit back to God. Her life was abbreviated but purposeful. I am proud to have been her physician and equally proud to call her my friend.
May 10, 2010
To look at Beth today, you would never know that she is a breast cancer survivor who had a battle with death and won.
My first encounter with Beth was via the telephone approximately 14 years ago, when I called the labor and delivery suite of our local hospital. In 2006, I was surprised to learn that Beth joined our health department as a supervisory nurse. After 18 years of working in the hospital, she had a calling to provide public service. However shortly after Beth started her new position, she was diagnosed with stage 2 breast cancer. One of her most difficult challenges was breaking the news to her three children and husband, who had been recuperating from recent back surgery.
Two days after Christmas in 2006, Beth underwent a double mastectomy with breast reconstruction. What was supposed to be a four-hour procedure took 12 hours instead. Beth awoke in the ICU on a ventilator and remained in the hospital for the next two weeks. Thirteen days after her procedure she encountered severe low back pain inhibiting her ability to walk. Three physicians diagnosed her with back strain as the result of her breast reconstruction. However, the pain persisted and she insisted on seeing her primary physician. During the car ride to his office, she screamed and writhed in pain. Upon her arrival, her primary care physician immediately called 911 and she was admitted to the hospital. A diagnostic MRI revealed possible metastasis to the bone and she was taken to the OR.
The neurosurgeon found a pocket of pus as he had prepared to operate on her spine. The “bone metastasis” was actually a MRSA (Methicillin Resistant Staph Aureus) infection that would have killed her, had it ruptured. Beth spent the next 12 weeks in and out of the hospital and self-administered IV antibiotics twice a day during that time period. Her breast implants were removed and her chemo therapy was postponed for six months.
Beth had economic setbacks as well. She lost her home and depleted her 401K retirement savings. However, despite insurmountable obstacles, her three children excelled in school and her husband remained by her side.
Fast-forward to the present: Beth’s daughter, Megan, is graduating from Oprah Winfrey’s alma mater, Tennessee State University at the age of 20 on an athletic full-scholarship and there has been a documentary highlighting her accomplishments (http://www.youtube.com/watch?v=UV8thlMSzW0). Her son, Matthew has also received a full-athletic scholarship to play football at West Virginia State and her youngest son is doing well in elementary school. Beth is cancer-free and is enrolled in a graduate program to become an advanced nurse practitioner.