Bob and Linda Treggett San Juan
Robert Treggett is a man of purpose with a zeal for learning and living.
In the fall of 2003 Bob was attending Northwest College in Kirkland, Washington
with plans to graduate with a degree in Ministry Leadership in October
of 2004. Due to his circumstances, that plan was put on hold during the
winter semester of 2004.
Bob's troubles began on Wednesday September 3, 2003 with a visit to
his family doctor for breathing difficulties. He was treated for possible
bronchitis. Following an inclusive chest x-ray, Bob was given an inhaler
with instructions to return when it was all used up and he was sent home.
By Sunday September 7, Bob's breathing was worse and he had a low-grade
fever, so he presented himself at the emergency room of Northwest Hospital
and Medical Center, fearing a case of pneumonia. It was determined at
this time that Bob had a considerable amount of fluid in his right chest
cavity. Bob was immediately admitted to the hospital and later that same
day a thoracentesis was performed, draining off 120 cc's of fluid
with the "biggest needle I've ever seen" from the right
pleural cavity. The cytological testing of the pleural fluid was interpreted
as malignant and consistent with adenocarcinoma. Immediately Bob consulted
a local oncologist, who after reviewing the medical records felt further
diagnostic testing was needed before mapping out a treatment plan. On
September 16, 2003, Bob returned to Northwest Hospital and Medical Center
where the surgeon performed a thoracoscopy, a diagnostic examination of
the pleural cavity followed by a pleurodesis. During these procedures
a few pieces of blood-stained, tan fibrous tissue were harvested and sent
to pathology. The pathology report issued on September 23, 2003, showed
an apparent atypical mesothelial proliferation in association with fibrotic
reaction and inflammation. The differential diagnosis included malignant
mesothelioma versus exuberant atypical but benign mesothelial reaction.
Because of the inconsistency of the diagnosis, the pathologist sent the
case to Dr. Samuel Hammar, an expert consultant pulmonary pathologist.
Dr. Samuel Hammar, a member of the U.S.-Canadian Mesothelioma Panel, diagnosed
epithelial malignant mesothelioma.
Bob in 2003
With the diagnosis now confirmed, Bob was faced with the grim realization
he was going to need the best medical care available along with his faith
to fight this horrible cancer. His surgeon referred him to Dr. Eric Vallieres,
a specialist in thoracic surgical oncology and the Surgical Director of
the Lung Cancer Program at the Swedish Cancer Institute. Dr. Vallieres
also serves on the Science Advisory Board of the Mesothelioma Applied
Research Foundationwww.marf.org.
Bob's first consultation with Dr. Vallieres resulted in positive news.
Dr. Vallieres felt Bob was a suitable candidate for surgery. Based on
his examination and review of the medical records, Dr. Vallieres suggested
immediate commencement of treatments which included chemotherapy followed
by a right-sided extra-pleural pneumonectomy (EPP) and adjuvant radiation
treatments. Dr. Vallieres insisted that Bob complete at least three rounds
of chemotherapy, utilizing Alimta in combination with Cisplatin, before
scheduling surgery.
On October 28, 2003, Bob began chemotherapy which was administered intravenously,
one day every three weeks, at the Puget Sound Cancer Center in Seattle,
Washington. The second and third days after treatment left him sick and
nauseous. On November 6th a port was inserted to help administer future
chemotherapy treatments. Bob weathered through the chemotherapy completing
the last one on January 20, 2004. It was now time to determine if he remained
a suitable candidate for the EPP.
Since a patient who undergoes an extra-pleural pneumectomy (EPP) is forced
to survive on one lung, the patient's cardiac and pulmonary capacity
must be fully evaluated prior to the surgery. Bob underwent all the necessary
preoperative tests and after looking at other treatment alternatives available,
Dr. Vallieres recommended that Bob go forward with the surgery. Dr. Vallieres
explained to Bob that he would face at least two weeks of postoperative
hospitalization and that the postoperative pain would be substantial.
Dr. Vallieres assured Bob that he would be given adequate pain medication.
But, Dr. Vallieres told Bob that he would also need to learn to cope with
some pain and discomfort as he was weaned off the pain medication.
With all the facts in front of him, Bob agreed to the surgery. On February
23, 2004, Dr. Vallieres made the usual incision extending from beneath
the scapula to below the nipple. He removed the 6th rib and opened up
the chest cavity. After rolling the pleural sac away from the diaphragm,
Dr. Vallieres removed Bob's entire right lung and diaphragm, a portion
of the adherent pericardium and pleurae. The diaphragmatic and pericardial
defects were closed with patches. Further pathological analysis of the
tissue removed during the surgery confirmed the previous diagnosis of
malignant epithelial mesothelioma and the presence of a tumor on the pericardium.
Postsurgically, Bob was troubled with atrial fibrillation. His recovery
was guarded and difficult.
Bob in ICU with Dr. Eric Vallieres and one of his excellent nurses
Since the surgery, Bob has only praises for the surgical skills of Dr.
Vallieres. According to Bob, the surgical precision of Dr. Vallieres left
only a few small areas of cancer cell activity. These areas were so obscure
and minuscule that his radiology treatment plan had to be redesigned by
his doctor. Bob completed his radiation treatments on June 18.
Bob states that he still has some residual pain from the surgery. Although,
he had to take 60 mgs of morphine 24/7 for a whole month longer than expected
and then 30 mgs at night for another month, he is now morphine-free and
manages the low grade residual pain with doses of Percocet as needed.
Prior to radiation treatment he was even able to regain enough strength
to help his wife Linda with some work in the front yard, but only in a
supervisory capacity.
With the past few months behind him, Bob is looking forward to his future.
He anxiously awaits for his follow-up visit with Dr. Vallieres scheduled
for late July. Bob is hopeful that Dr. Vallieres will provide the medical
release necessary for him to return to work as a building maintenance
supervisor. Bob desperately wants to return to work. The financial burden
of his illness has been shouldered by Linda. Living on only one income
has been difficult. Bob is also anxious to return to college and complete
his degree. He hopes to return in February of 2005 and graduate the following October.
If you were to ask Bob about life before his diagnosis and life since,
he would relate how he and Linda have been avid sailors and skiers since
they met. When circumstances forced them to sell the sailboat and give
up skiing they became golfers to fill the void. Now, even that has not
been possible since Bob began his cancer treatments. Bob feels life will
become pretty dull if he can no longer play golf or use his right arm
for any kind of strenuous activity, as is presently the case. A fitting
activity will have to be found to keep him and his wife of 15 years as
active as they have been since their beginning.
*** POSTED JUNE 22, 2004 ***
The above pictures show the skin reaction (grade I) standard for medical
radiation exposure on Bob's back June 29, 2004
An Update 6/2/06 (from the Treggetts)
The latest news for Bob's health:
This week he had a CT scan then met with his Pulmonist (lung doctor).
The CT scan showed some renewed tumor activity. The last time we met with
the surgeon, he noticed something suspicious on a CT scan Bob needed for
another health issue not related to the cancer. With both scans it enabled
the pulmonologist to compare, which showed that the spot originally noticed
by the surgeon has now increased in size. The pulmonologist said it is
probably inoperable because of the location, on the bottom of the remaining
lung (left side).
On the good news side, Bob has been doing really well with his strength
and stamina, being able to start working with a Physical Trainer at our
athletic club to gain back some muscle tone that was lost during his recuperation.
He is not required to use oxygen except at high altitudes which enables
him to sleep.
He will be scheduled for a PET scan then will see the surgeon and possibly
a conference with all doctors involved (will know more later). It is not
yet known how we will proceed.
News on Bob's Education:
He graduated in May from Northwest University with a Bachelor's in
Ministry Leadership. He graduated Magna Cum Laude and was nominated by
the faculty to the Sigma Chi Pi Honor Society. He has started volunteering
at our church, Overlake Christian Church, to help in the area of leadership
training at OCC, around the corner, and around the world.(If you want
to know more about our church, visit: www.occ.org).
Prayer Requests:
Wisdom for the doctors while diagnosing & treating.
For strength and stamina so Bob can be effective in his efforts.
An Update 6/14/06 (from the Treggetts)
Well the verdict from Science is in. I have a tumor on my left pleura.
It is about the size of a large green pea. The doctors will be conferencing,
as soon as the MRI I had today is available, and presenting my case to
the tumor board. When I get home from vacation in July they will present
me with my options which will pretty much be site-specific radiation (latest
in difficult tumor treatment technology). Needless to say it is in-operable.
Not the news we were all hoping for, but God is still on the throne and
in control. For phase one treatment He used expert Doctors at all stages,
for phase two treatment He will have to personally intervene if I'm
to survive much beyond Jan., 1,2007.
Praises:
Prayer requests:
-
Please pray for Linda's back the disc problem is not getting any better
and her discomfort comes and goes very randomly.
-
Pray for peace and stamina while we are on vacation.
-
Pray for strength and courage as I come home to do battle yet again with
this cancer.
An Update 7/23/06 (from the Treggetts)
On 6/13/06 the pulmonologist had Bob undergo an MRI to find out how much
tumor involvement there is. That night we left for a three-week family
vacation to the East Coast. While we were out of town, the pulmonologist
called Bob's cellphone and let us know the results of the MRI. The
tumor on the lung was a definite, and there was also a new tumor on the spine.
On 7/10/06 we had an appointment with the Radiologist, Dr. Mehta, who was
responsible for Bob's radiation treatment a couple of years ago. Dr
Mehta stated that because Bob is not experiencing any pain he doesn't
see any reason to treat the tumors with radiation at this time, which
should only be considered when there is an onset of pain.
Upon Bob's inquiry as to whether the doctor knew of any studies underway
for second-phase treatment, he referred us to an oncologist not previously
seen by Bob since this doctor is involved in a clinical trial with a promising
new drug for treatment of Mesothelioma. We found out from the Symposium
we attended last year for MARF (Mesothelioma Applied Research Foundation)
that once a patient has chemo with a certain drug cocktail that the same
drugs should not be used again in the second round of treatment
On 7/19/06 we met with Bob's pulmonologist, Dr. Pappas, who confirmed
that the oncologist we were referred to, is an excellent doctor and he
has worked with him before. During the appointment, I mentioned that Bob
had come down with a rash on his mid-section both front and back on the
right side. After the doc looked at it, he said it was shingles which
is a virus that lies dormant (from the chicken pox) and can occur at any
time later in life. He was given medication to combat that.
On 7/21/06 we met with the new oncologist, Dr. Howard (Jack) West, and
his research assistant, Shirley Raltz, RN. They covered with us the guidelines,
side-effects, and paperwork connected with the chemo drug for this second-phase
treatment called AZD2171. Since we were there and had no pressing appointments,
they had Bob undergo some tests to provide a baseline for later comparison.
He had a CT scan, EKG, blood work, checking also for kidney function.
If Bob is approved (which we don't see any reason why he should be
rejected) he will be registered into the study and given chemo which is
three 15mg pills taken orally. He will be required to document his pill
intake, and document his blood pressure taken twice a day since one of
the drug's side-effects can be high blood pressure. To monitor the
effectiveness of the chemo on the tumors, for the first two months the
same tests as those taken for the baseline will be done once each week,
then thereafter, once a month.
Praises:
-
No pain from the tumors.
-
The shingles were caught early for treatment and now show signs of clearing up.
-
No IV chemo, so no extended clinic visits!
Prayer requests:
We would like to take this opportunity to make you aware of the MARF non-profit
organization that funds research grants to find a cure for this deadly
asbestos-caused disease. You can visit their website at: http://www.marf.org
to read stories of people affected by this disease and presentations of
medical professionals at last year's Symposium. If you choose to make
a financial donation to fund research into finding a cure for this life-ending
disease, it is tax-deductible
An Update 10/10/06 (from the Treggetts)
Even though Bob is feeling as good now as he did three years ago, he is
still grappling with the loss of the ability to do basic things. Lately,
he has learned about the natural grieving process that comes with the
loss of a body part (Bob's right lung was amputated). Originally,
Bob was told he had a 39 month prognosis; that date is fast approaching
- December 2006. But Bob is "not dead yet and has no intention of
rolling over either." In mid-October 2006 he will begin missionary
work, traveling first to South Africa then to Kenya in November where
he will be joined by Linda. In February 2007 Bob plans to go to India
and in May, to the Philippines. He plans to enjoy this time traveling
and being with family.
While Bob doesn't have a lot of stamina, he says he can sit and talk
for hours. His doctors will be monitoring the new spot on his left lung
with CAT scans taken every four months. He still has some residual discomfort
from the initial surgery where a rib was broken to remove his right lung.
But even though Bob finds it difficult to put his carry-on bag overhead,
he will continue to minister abroad, "God has trained me to travel
overseas to train pastors and church leaders." Bob will not waste
any time meanwhile, he says "it was hard enough just trying to sit
around for three years recuperating."
*** Mr. Bob Treggett passed away on August 23, 2008 ***