Marguerite and Bob Dyer in Mexico
Bob Dyer is a 60-year-old retired Navy and civilian marine machinist who
lives on 2 ½ acres in Poulsbo, Washington. Bob spends most of his
days working in his workshop or riding his lawn mower. When not tending
to his land, Bob can be found in his shop, sipping a beer, visiting with
his buddies and neighbors as they often come by to sit with him.
Bob and Marguerite have been married since 1972. Their Home-away-from-home
is a cabin located on Haven Lake near the North Shore of the Hood Canal
off Ephendal Pass. A beautiful natural spring feed lake, great for swimming,
fishing and skiing. The Olympic Mountains can be captured in the background
with eagles and osprey competing for the rainbow trout in the lake.
Toward the end of 2003, Bob Dyer felt like he was battling allergies or
a mild case of pneumonia. In approximately February of 2004, he developed
a persistent, nonproductive cough. He treated himself with over-the-counter
medications.
In the spring of 2004, he started feeling unusually run down. He noticed
a decline in his energy level and had shortness of breath. This now became
a concern for him, because Bob is normally a very active man who tends
to his acres daily. Bob stated that, "I was out in my workshop where
I love to go out and do woodcarving or work on the boat or whatever. And
I got up one day and tried to walk out there and I just couldn't breathe.
I went back in the house and was talking to my wife and she says, "Well,
you're going to have to go to the doctor.""
In April, he consulted with a pulmonologist at the Doctors Clinic in Bremerton,
Washington. A chest film and CT scan were taken which revealed a moderate
size pleural effusion on the right side. The CT scan also reported that
the lung parenchyma demonstrated some ground glass appearance involving
the mid and upper lung field.
Bob Dyer aboard his trusty tractor
The doctor performed a thoracentesis and removed a milky-white fluid. Cytological
testing of the fluid confirmed the presence of mesothelioma, epithelial
cell type. According to Bob, two days later, the doctors bluntly told
him, "We just took 20 years of your damn life away, buddy."
The Dyers were informed that there appeared to be no mass or tumor present.
A follow-up CT scan revealed a persistent pleural effusion. Upon first
learning of his diagnosis and prognosis, Bob stated it is like "getting
hit right between the eyes. You soon realize that you need to slow down
a bit in life and reflect."
Bob was then referred to an oncologist at the Olympic Hematology &
Oncology in Bremerton, Washington. The doctors discussed several treatment
options, including surgical intervention and the use of Alimta. They suggested
to Bob that he consult with Dr. Eric Vallieres of the Swedish Cancer Institute
in Seattle, Washington. Dr. Vallieres is a surgical oncologist well-versed
in the treatment of mesothelioma. He is a member of the Science Advisory
Board of the Mesothelioma Applied Research Foundation. (www.marf.org)
On May 20, the Dyers met with Dr. Vallieres. After reviewing his medical
records, Dr. Vallieres wanted Bob to undergo three treatments every three
weeks of Alimta with Cisplatin and then return to be evaluated for an
extra-pleural pneumonectomy (EPP). Bob and Marguerite felt comfortable
with Dr. Vallieres and wanted to pursue an aggressive treatment program.
With the help of Dr. Vallieres' office, they coordinated his treatments
with an oncologist close to their home.
Upon returning from Seattle, Bob underwent a second thoracentesis. Nearly
every two weeks, Bob had to have his lung drained.
On June 2, Bob underwent his first Alimta treatment. He did not suffer
any side effects other than a loss of appetite. On June 9, he went in
for some blood work, of which everything looked good. He had a thoracentesis
on June 22 and his second Alimta treatment on June 23. His last Alimta
treatment was on July 12 and a fourth thoracentesis was performed on July 26.
At the end of July, Bob underwent a PET scan and CAT scan. Dr. Vallieres
reviewed the films and was pleased with what he saw. He felt Bob was ready
for the extra-pleural pneumonectomy (EPP).
On August 30, Bob underwent the EPP. The procedure lasted nearly four hours.
Three hours after the surgery, Marguerite walked into the recovery room
to see Bob sitting up in bed - fully alert. Bob felt fine and ready to
ride his mower! He was transferred form intensive care to his room.
Bob's cabin on the Hood Canal
On the fourth day post surgery, Bob's oxygen level dropped significantly.
He was transferred back to intensive care. CT scans revealed some shadowing,
like streaks near the lower part of the left lung. The capillaries on
his left lung had begun to close. Bob was then intubated and placed on
a ventilator. After two days, Bob was weaned off the ventilator and extubated.
For the next five days, he slowly regained strength and respiratory function
with the help of steroids. On September 14, Bob returned home to Poulsbo
Bob was pleased to finally be able to look at his yard, something other
than the stale walls of a hospital room. After just a short time at home,
Bob's blood pressure dropped. He also began to experience profound
weakness and dizziness. He met with his family physician in the local
emergency room. Several tests showed his white blood count was too high.
He was put on a fluid drip and was sent home with an appointment to come
back the next day. Unfortunately, his condition worsened.
On September 17, Bob returned to Seattle. The doctors at the Swedish Medical
Center started an aggressive treatment of increased steroids and treated
him for the possibility of 20 surgical infections with antibiotics. A
CAT Scan revealed a ground class appearance of the left lung.
Thankfully, his condition slowly improved and he began a physical therapy
program. All total, Bob spent nearly 33 days in the hospital.
On October 6, Bob once again returned home to Poulsbo. He feels that the
problems were not a result of the surgery but more due to the medication
he had taken. Bob's body, having never seen anything stronger than
aspirin, was not used to all the chemicals pumped into him. He and Marguerite
have nothing but good things to say about Dr. Vallieres and his staff.
Marguerite says, "everyone was exceptionally nice and concerned.
When Dr. Vallieres first saw Bob on the ventilator, he became very, very
concerned and angry! Taking it so personal!"
It was very difficult for Bob's two children, Kellie and Mike, to see
their dad on the ventilator. Kellie took two weeks off from her job in
San Diego to be with her dad at the hospital during the day while Marguerite
commuted to Silverdale to teach each day. Marguerite's commutes ended
the day Bob was put on the ventilator. During Bob's second visit to
ICU, Mike spent two nights with him, talking to him and keeping him calm.
Bob, Marguerite and their two children, Kellie and Mike
Since the surgery, Bob has lost over 30 pounds. Before he can begin his
radiation treatments, Dr. Vallieres has given him strict orders to eat
and regain his strength. Soon, he will begin to enjoy his breakfasts -
his favorite meal of the day.
Since returning home, Bob has begun walking and stretching. He does not
have the appetite he once loved, but is forcing himself to eat. The radiation
treatments will be given four times a week for five weeks.
Bob is not taking any pain medication. He states that apart from the stress
of not knowing what to expect next, he feels good. His main concern is
for Marguerite.
Marguerite is a teacher at Central Kitsap School District in Silverdale,
Washington. She took Family Medical Leave on April 29th, the day Bob was
diagnosed with mesothelioma cancer. Marguerite and Bob never expected
a long stay in the hospital so, Marguerite started the school year. However,
she found herself back on Family Medical Leave when Bob's left lung
started to have problems. Marguerite believes her place is by Bob's
side. It was Marguerite's wish to retire in three years but that has
been put on hold due to the unexpected medical expenses.
Bob was born and raised until the age of 18 in Huntsville, Tennessee. His
father, a coal miner, made Bob promise that once he was old enough, he
would move out of that part of the country and never go underneath the
ground "since it's not safe."
Bob remembers his promise and states "Well, I come out here, and I
don't guess it's too darn safe here either." Bob goes on
to reflect, "I'll tell you, you live a good life and you're
happy and you're getting ready to enjoy retirement and you let somebody
look at you and say, 'You're going to die.' You tell me how
it'd feel when you was healthy six months earlier. I don't know
how to explain it, but I don't know how much time I've got left.
I'd love to enjoy it but we have got everything on hold right now
because there's no life out there for me."
We know that before long, Bob will be back on his mower, hiding from Marguerite
in his shop, regaling his hospital experiences with his buddies and neighbors
over a cold beer.
*** POSTED OCTOBER 18, 2004 ***
An Update -- 2/10/05
Bob continues to get stronger. He and Marge power walk every day in the
local mall. Bob no longer relies on oxygen.
The latest CAT scan looked very good. On February 10, Bob will meet with
his pulmonary specialist and on the 11th he will have his body 'mapped'
(tattos and markings) in preparation for his radiation treatments which
will begin on February 14. The treatments will take place five days a
week for six weeks. After the treatments...it is off to Mexico for a long
anticipated vacation!
An Update -- 5/4/05
It has been over a year since Bob's initial diagnosis. On May 3rd,
Bob saw Dr. Vallieres for a follow-up. Bob's CT scan from January,
according to Dr. Vallieres, was good. Dr. Vallieres reminded Bob and Marge
that the hardest part of his treatment [the radiation] was over. He completed
his radiation therapy on March 29th. The regimen consisted of treatments
five days a week for six weeks. He is truly glad to be done with that.
According to Marge, Bob experienced only two bad bouts of vomiting but
they were spaced out enough that he was able to recover between each episode.
The last treatment "stirred up things" a little. So, once his
system has had a chance to balance itself out he can again begin to feel
a little better and they are hoping to get out a little more once that happens.
For nausea, they are alternating between Zofran and Metoclopramide to off-set
their side effects. As far as "discomfort," Bob has basically
been forced to take Ibuprofin in the morning and at night to ensure his
"discomfort" level is kept to a minimum. [Bob does not like
the word pain so, we won't use it.]
Marge excitedly reports that Bob is gaining weight again. She states they
try to get food down and keep it there. His blood pressure medication
has been lowered. Bob has been out to his work shop a couple of times
- a dear friend of the Dyers has dubbed the work shop by way of a hand-carved
sign "Bob's Doghouse." And this coming Friday, May 6th,
2005, Bob will get to cut his 2½-acre lawn for the first time in
a while. Soon, they will again be able to make the trek to their cabin
for some serious R&R. Oftentimes the caregiver will neglect their
own physical well-being so, we can happily report that Marge takes time
for herself by exercising and taking leisurely walks with friends.
Mr. Bob Dyer passed away on May 25, 2005