62 year-old former boilermaker and retired engineer Allan Ostling lives
with his wife Jackie in Northern Indiana. The Ostlings live in a house
that any child would love to visit. One of the attractions is a porcelain
figurine of an "adult" rabbit reading to seven bunnies gathered
about. If a household can be said to have a spirit, this artwork would
seem to symbolize the highest and best spirit of the Ostling abode. The
Ostling enjoy collecting antique books and they have seven grandchildren
who love to come over to listen to Grandpa bring to life the fun and adventure
of a good storybook.
Most of the stories and the Ostlings' life experiences had been happy,
until May 14, 1999, when Jackie underwent surgery for breast cancer. But
the most profound, family and life altering blow came on June 9, 1999,
when the Ostlings' only son was killed at the age of 35 in a tragic
automobile accident. Allan Ostling, III left behind a wife and three children,
ages thirteen, twelve and one. With typical stoicism, the Ostlings began
planning to help support and raise their grandchildren, even as they dealt
with their own unspeakable grief.
Allan grew up tough. His father was an engineer, and the Ostlings moved
around a lot, from one boiler job to another, when Allan was a child.
He had been to 15 different schools by the time he went to college. Allan,
a strapping man known as "Big O", had no trouble making friends.
He laughs as he recalls, "I would just pick a fight with the biggest
kid in the class and whip him. No trouble at all . . . "
Allan chose the same line of work as his father, as a boilermaker and engineer.
His boilermaker work took him into powerhouses and other boiler sites
in Illinois and Michigan. After obtaining his engineering degree, he worked
at Inland Steel in East Chicago, Indiana for 28 years. Allan threw his
boundless energy into his work, often working 48 hours at a stretch. One
of Allan's co-workers at Inland Steel was David Johnson, whose wife
was diagnosed with peritoneal mesothelioma on July 12, 1999.
After his retirement from Inland Steel in December, 1993, Allan remained
very active. He continued to work on his house, in his shop and on his
his favorite pasttime, his boat, where he and his wife Jackie spent time
with his children and grandchildren. He lifted weights five days a week,
and ran an average of three miles, three times a week.
In late July of this year, just a month after the death of his son, Allan
began to feel unusually run down and short of breath. He found that he
was no longer able to run two miles without stopping. He made an appointment
with his family physician in Valparaiso. His doctor detected diminished
sounds in his lung and admitted him to Porter Memorial Hospital in Valparaiso,
where doctors removed 500 cc's of fluid from the right side of his
chest. Two days later, they removed an additional 1600 cc's. When
the cytology proved inconclusive, the doctors did a 'punch' biopsy,
which also proved inconclusive.
On August 6, Dr. Joseph Venditti performed a lung biopsy of the right pleura.
The differential diagnosis included mesothelioma. The specimens were sent
to pathologist Dr. John Goeliner at the Mayo Clinic in Rochester, Minnesota.
On August 23, the Ostlings learned that Dr. Goeliner had diagnosed malignant
mesothelioma of the pleura. The next day, Jackie Ostling, as bright and
energetic as her husband, contacted this website.
Their oncologist, Dr. Klein, had suggested a chemotherapy and radiation
regimen, but he did not discuss surgery as an option. The Ostlings wanted
to do as much research as possible before committing to a treatment. We
helped the Ostlings contact Dr. Harvey Pass in Detroit, Michigan, Dr.
Scott Swanson in Boston, Dr. Perez-Solar in New York City and Dr. Valerie
Rusch in New York City. By September 1, Dr. Pass had e-mailed the Ostlings
three times with questions and advice. The Ostlings were pleasantly surprised
at Dr. Pass' attention and compassion.
The Ostlings' oncologist, Dr. Mary Klein, told them that they would
have a 30 day "window" within which to complete consultations
and commence treatment; otherwise, all of the tests Allan had undergone
would be outdated, and would have to be repeated. The Ostlings set off
on a whirlwind consultation tour, meeting with Dr. Pass in Detroit, Dr.
Swanson in Boston and Dr. Rusch in New York City -- all within a three-week
span. The Ostlings wanted to make sure that their final decision was based
on accurate and reliable information. They also wanted to make sure that
the surgeon they chose truly cared about the patient's long term care.
The Ostlings ultimately chose Dr. Pass, who told them that he would try
to spare the lung by peeling the tumor off the pleura. Dr. Pass' approach
appealed to Allan's sensibilities as an engineer. Why remove the entire
lung when the tumor was located around the lung, not inside of it? Allan
was concerned that if the entire lung was removed, but the tumor eventually
spread to the other lung, he would have no backup, no fallback plan. Allan
approached the ultimate question with the serenity of an experienced engineer.
If I had a tractor that was not functioning because it was covered with
a corrosive rust, yet the engine worked fine, he mused, why would I want
to pull out the motor? Just remove the rust . . .
On September 29, 1999, less than a week after the Ostlings informed Dr.
Pass of their decision to proceed with him, Dr. Pass began surgery. On
inspection of the chest cavity, Dr. Pass saw that the tumor was more advanced
than indicated by the CT scans: the tumor had invaded the right lung,
and the lymph nodes tested positive for tumor activity. Dr. Pass had no
choice but to remove the lung. Additionally, Dr. Pass repaired the diaphragm
and a portion of the pericardium. He classified Allan as late stage III.
The Ostlings naturally had hoped for the best. In an intellectual sense,
they were prepared for the worse, but the reality proved to be far more
unpleasant than they imagined. For a complete narrative of Jackie Ostling's story,
please click here . Jackie describes her husband's course after the extra-pleural pneumonectomy below:
The next seven days were the most pain I had ever seen my husband experience.
The Dilaudid pain medication caused him to "go crazy"; his eyes
were rolling, his feet twitching. The Toradol constipated him severely;
his abdomen was grossly swollen. He had a lot of pain from lying on the
incision on his back. He was finally released from the hospital in a state
of exhaustion on October 6, 1999. Before Allan's release, Dr. Pass
advised us that the lymph nodes were "all positive" for tumor
activity. Both Allan and I understood at the time that this worsened his
Allan was back in the hospital on October 13 and 14, 1999. His hematocrit
and hemoglobin counts were low. He required transfusion of four pints
of blood. He continued to suffer excruciating back pain, probably from
the surgical incision by Dr. Pass. Allan found no relief from this pain
until last week, after consultation with a pain management specialist.
He has had several nerve blockin an attempt to control his pain.
Last Tuesday, November 2, 1999, Allan started to experience discomfort
and bloating in the area of his abdomen. Two days later, Allan underwent
an ultrasound ordered by Dr. Pass. The ultrasound detected the presence
of fluid in the abdomen. That same day, doctors removed approximately
three liters of fluid from Allan's abdomen via paracentesis. The results
of cytological testing confirmed that Allan's mesothelioma has moved
to the peritoneum (his stomach lining).
On Friday, November 5th, we consulted with Karmanos Cancer Institute oncologist
Dr. Michael Kraut, who counselled us on our chemotherapy options. He asked
that we return November 10th for a CT scan of the chest, abdomen and pelvic
area to attempt to find anything that would qualify Allan for the gemcytabine/cisplatin
protocol. At this point, radiation cannot be used, as the cancer is apparently
"travelling." As Dr. Kraut said, "Where do we radiate?"
Dr. Kraut's plan is to do three cycles of chemotherapy, three weeks
on, one week off. If all goes well, it should take eleven weeks. This
does not include any week where his blood counts would be too low to do
chemotherapy. Dr. Kraut felt that we should have future chemotherapy done locally.
Allan looks terrible. He has lost thirty-one (31) pounds, his color is
gray, and he has no appetite. His stomach bothers him and he has nausea
most of the time.
Because the tumor had invaded his abdominal lining, with the consequent
pain, swelling and weight loss, in early November Allan was in no condition
to give testimony in his lawsuit against the asbestos manufacturers, and
his deposition had to be cancelled. Each day was a trial in itself --
hospital visits, long waits in doctor waiting rooms, searching for pain
doctors, faxing medical records, consulting with specialists.
On November 12, Allan had to have another paracentesis, with another three
liters of fluid removed from his abdomen.
On November 17, Allan Ostling rallied. He overcame the pain and delirium
to testify clearly and powerfully about his exposure to asbestos over
the past few decades. He testified to his concerns about whether his medical
bills would be covered by his health insurance; he worried about who was
going to provide for his grandchildren. He answered the questions as an
engineer would, striving for accuracy. He testified patiently. After the
deposition, Allan's exhaustion was certainly apparent. He slept for
44 hours straight!
Parenthetically, we hope that the defense lawyers read this. It is the
defense lawyer's modus operandi to first file motions to delay or
cancel a deposition because they "are not ready." If that doesn't
work, and they actually have to meet the patient face to face, they will
prolong the deposition, so that the patient will tire to the point that
they can then move to strike the deposition on the ground that they did
not get a "fair chance" to cross-examine the plaintiff. In this
case, Dr. Pass provided a letter asking that the deposition be limited
to three hours because of Mr. Ostling's weight loss, constant pain
and metastatic disease. Most courts understand that the human rights of
the patient-plaintiff must override the patently technocratic objections
of asbestos perpetrator's defense lawyers.
The "Big O" is a remarkable blend of strength and gentility,
a man who can bend steelworkers to his will and lead them, and enthrall
his grandchildren with bedtime stories. He will tell you that the loss
of his son hurt far worse than his mesothelioma. We wish him and Jackie
the best as they continue their fight with this insidious disease.
*** POSTED NOVEMBER 24, 1999 ***
An Update -- 3/8/00
When this story was posted on November 24, 1999, the outlook for Allan
Ostling was grim. His mesothelioma had apparently moved into his abdomen,
as evidenced by the build-up of serous abdominal fluid known as ascites.
Dark shadows had developed under his eyes and in the hollows of his cheeks.
His testimony at his deposition represented a triumph of a steely will.
Allan confided beforehand that if it were not for his scheduled testimony,
he might have "given up" to the horrible pain.
But Allan Ostling did not give up -- and neither did his doctor, Dr. Harvey
Pass of the Karmanos Cancer Institute of Detroit, Michigan. In an eleventh
hour bid to stop the cancer's relentless advance, Dr. Pass counseled
the Ostlings to try a promising Gemcytabine and Cisplatin chemotherapy
protocol pioneered in Australia.
The results were astonishing, and dramatic. The chemotherapy caused the
effusions in Allan's abdomen to recede, then disappear (as interpreted
from a CT scan). The swelling in Allan's abdomen went away. Within
two months, Allan's color had improved, and he regained some of the
weight he lost. He recently felt good enough to go to dinner with his
wife Jackie, and even had a couple of beers. Yes!
This is not to say that the chemotherapy has been easy for Allan, as a
February 25, 2000 note from his wife Jackie attests:
"Well, we reached another milestone. He made it through another cycle
of chemo. Next week is an off week where hopefully, he will be able to
rebuild some stamina and then one last cycle.
The end is in sight and that's a good feeling!
However, as of this morning he was physically exhausted, cold, dizzy spells
and we knew something was wrong. Off for a blood test that showed Hemoglobin
8.9, Hematocrit 27, Platelets 52 and low magnesium. So as of tomorrow
he is back to the hospital for 2 units of blood. Maybe that will pick
him up so in a week he can finish the last cycle. (It's only been
5 weeks since his last 3 units of blood).
In any case, with an end in sight, he is fairly tolerant of these side
issues. Mostly sick and tired of being sick from chemo and tired all the
Finally, on March 7, Jackie writes:
"Today started the 1st treatment of the last cycle of chemo. They
already warned Allan he may not be able to make it because his white count
is so low. Even after transfusions and a week off, it still went down
from 4.4 to 3.3. I went over to the health food store and told them I
wanted a jar of everything they had that would build up the immune system.
Poor Allan - if he sees one more pill, he may give me the boot."
We wish the Ostlings the best in their continued journey for healing, and hope.
Mr. Allan Ostling passed away on April 30, 2000.