Jackie and Ted Cichocki
Ted Cichocki (pronounced "che-hockey"), a 67 year old former
pipefitter and 39-year employee at Inland Steel in East Chicago, Indiana,
was diagnosed with malignant mesothelioma of the pleura on November 20,
2000. Ted and his wife Jackie reside in Schererville, Indiana, in the
extreme northwest corner of the state.
Around December, 1999, Ted noticed that he was getting short of breath.
He consulted with his family physician, Dr. Willardo, in Hammond, Indiana.
A chest film showed the presence of fluid in the right chest cavity. Dr.
Willardo referred Ted to a cardiologist, Dr. Praksah N. Makam. Dr. Makam
performed a stress test which showed no cardiovascular abnormality. Dr.
Makam referred Ted to a pulmonologist, Dr. Thomas Papin, at the Munster
Medical Center in Munster, Indiana. Dr. Papin took a chest film which
revealed the presence of fluid on the right side.
At Dr. Papin's behest, Dr. John E. Jordan performed a thoracentesis
in January, 2000. The procedure produced 86 ounces of brownish-tinged
fluid. A chest film taken after the thoracentesis showed that there was
some fluid remaining. A week later, Ted returned for a needle biopsy and
repeat thoracentesis, which produced another seventeen ounces of fluid.
Both cytology on the fluid and pathology on the biopsy were negative.
Ted felt well enough after the second thoracentesis to vacation in Florida,
where he played golf. He remained asymptomatic until July, 2000, when
a persistent cough appeared. He returned to Dr. Papin, who took another
chest film, which was "clean;" Dr. Papin could not see any fluid
on the x-ray. Dr. Papin prescribed antibiotics.
Ted continued with no complaint until the middle of November, when he returned
to Dr. Papin, who this time referred him to Dr. Mateo V. Guanzon at the
Munster Community Hospital. Around November 17, 2000, Dr. Guanzon performed
a right-sided thoracotomy with thoracoscopy, biopsy and doxicyclin insufflation
at St. Margaret's Hospital in Hammond, Indiana. Ted recalls that Dr.
Guanzon immediately after the surgery expressed his opinion that this
was mesothelioma. Pathological testing performed at St. Margaret's
confirmed the diagnosis of malignant mesothelioma of the pleura on November
20. When Dr. Guanzon advised the Cichockis of the diagnosis, he kept repeating,
"It's inoperable, and you've got to get it treated."
Ted remained hospitalized until November 25.
While Ted was hospitalized at St. Margaret's, he was referred to a
Dr. M. Y. Ali, an oncologist in Munster. Dr. Ali's partner, Dr. Keralavarma,
would also talk to him. Dr. Ali and Dr. Keralavarma wanted to administer
chemotherapy through a port, but Ted wished to explore his treatment options.
He turned to the Internet, and found Dr. Nicholas Vogelzang of the University
of Chicago. It took two and one-half weeks before Dr. Vogelzang could
see Ted. Dr. Vogelzang told Ted that he was a good candidate for surgery,
and recommended Dr. Harvey Pass, Dr. David Sugarbaker, and Dr. Valerie Rusch.
Ted chose to try Dr. Pass first because of his proximity. To Ted's
surprise, Dr. Pass returned his phone call promptly and personally, but
was unable to schedule an appointment until January 4 because of a planned
vacation. Dr. Pass ordered a pulmonary function test, chest CT scan, and
a qualitative percussion scan.
On Monday, February 19, 2001, Dr. Pass began the pleurectomy. As he made
his initial incision, he discerned disease outside the chest in the subcutaneous
tissue which had not been revealed on prior tests. This was confirmed
on frozen section analysis and by intraoperative photographs. As the aim
of the EPP was to halt the advance of the tumor beyond the pleura, there
was no point in proceeding further. Dr. Pass aborted the procedure and
closed the chest. The next day, Dr. Pass told Ted that he should return
to Dr. Vogelzang for chemotherapy, to obliterate as much of the tumor
Ted scheduled an appointment with Dr. Vogelzang on Wednesday, March 7.
In the meantime, he got on the telephone with
Ray Wadas and
Rodney Steenbergen, who both praised the compassionate care at San Antonio's Cancer Therapy
and Research Center (CTRC), and its ALIMTA
(R) (pemetrexed disodium) trial. This trial is different from most, in that
it is not blind; rather, patients admitted to the trial are guaranteed
administration of the chemotherapy as long as the tumor shows no signs
of significant growth. Patients report good results with Alimta, which
does not have the troubling side effects of hair loss and severe nausea
associated with traditional chemotherapies.
Ray cannot say enough nice things about the staff at CTRC. He says that
the staff hugs him when he comes in; he says, "They treat you like
you're human in Texas." His tumor has shrunk, and he feels pretty good.
Ted's Surgical Scars
This office wrote Ted's doctors and Stephanie Hodges, the nurse coordinator
for CTRC's clinical trials, in order to help Ted obtain treatment
there. Stephanie first suggested that Ted seek admission to a closer,
similar trial ongoing at the University of Indiana. However, it turned
out that the Indiana trial had only one slot open, and they were looking
for a candidate with kidney problems, which Ted did not have. Ted contacted
Stephanie again, and scheduled a consultation in San Antonio. Ted reached
out to this office for help as he scrambled to gather together his most
recent medical records.
Ted and Jackie traveled to San Antonio full of hope. But when a CTRC physician
examined Ted, he found that Ted's oxygen level was too low; his lungs
were operating at 50% of capacity, and were possibly filled with fluid.
Ted's physical condition would have to improve before he could participate
in the Alimta trial, much less travel back and forth between Indiana and Texas.
Indeed, on the airplane ride home, Ted began experiencing severe shortness
of breath. He was gasping for air and the flight attendant had to bring
him oxygen. Ted says it was quite a scene.
On his return home, Ted scheduled an appointment at the University of Chicago
with Dr. Vogelzang for Wednesday, March 28. Because Ted's oxygen levels
were down so low (at 84), Dr. Vogelzang wanted to start Ted on traditional
chemotherapy right away, in order to try to reduce the size of the tumor,
with the plan of shifting to experimental chemotherapy if Ted responds
favorably. Dr. Vogelzang administered Gemczar and Adriamycin the same
day. Ted says he reacted "pretty good", although he did have
"the dry heaves" and nausea immediately after the chemo, and
heavy night sweats for a couple of nights. Ted also has noticeable swelling
in his legs.
The plan is for Ted to get his present chemotherapy every two weeks for
a total of three cycles, at which point he'll have a CT scan to see
if the tumor has been reduced. If Ted responds favorably to this chemo,
Dr. Vogelzang will then switch him into one of the trials.
Ted and Jackie have six children, all adult, and twelve grandchildren.
All of their children live nearby, except one who lives in Florida. Pictures
of their children and grandchildren adorn their home. In addition to enjoying
their family, the Cichockis loved golfing together. Now, they know that
their future together is filled with uncertainty.
Ted Cichocki is a fighter. He knows that the odds are against him, but
he is going to do everything he can to survive -- for Jackie, his children,
and his grandchildren. Our thoughts and prayers are with him on his journey for hope.
*** POSTED APRIL 9, 2001 ***
Mr. Ted Cichocki passed away on August 5, 2001