Before the Fall of 2001, Navy veteran Lee Brackett spoke quickly, crisply,
and forcefully, with an unmistakable Yankee accent and attitude, opinionated,
to the point, his humor often as biting as the weather.
You always know where you stand with Lee, and he thought he knew where
he stood, too. At the age of 60, he was still working fast and hard, 10-hour
straight shifts as an auto mechanic. He did it to support himself and
his wife of 37 years, Ginny, but he likes working hard. Sitting around,
Lee says, "Bores me outta my skull."
If you knew Lee Brackett's voice before, and you spoke to him on the
telephone now, you wouldn't believe it's the same man. Lee can
hardly believe the change himself. After the extra-pleural pneumonectomy,
his voice is higher, and both the bark and the bite are weaker. For the
first time in his life, Lee Brackett doesn't really know where he stands.
TROUBLING SIGNS IN NOVEMBER LEAD TO DIAGNOSIS IN JANUARY
His troubles began in November 2001, when he had a cold but could not seem
to get rid of a dry cough. He consulted with his primary physician in
Fitchburg, Massachusetts. Lee's physician could not hear any lung
sounds. He ordered chest films, which were taken on December 1. The chest
films revealed the presence of pleural effusions on the right side. Lee's
physician referred him to a pulmonologist in Leominster.
On December 13, 2001, Lee's pulmonologist performed a right-sided thoracentesis,
withdrawing approximately one-and-one-half quarts of fluid that were the
color of apple juice. Cytological tests upon the fluid were negative for
a malignant process.
Lee was then referred to a thoracic surgeon at the University of Massachusetts
Memorial Medical Center in Worcester. He met with the surgeon on December
27. The next day, Lee's surgeon performed a CT-guided thoracoscopy
with biopsy and talc pleurodesis. During the procedure, 1400 ccs of straw-colored
fluid were removed from his chest. Immediately after the surgery, the
thoracic surgeon advised Lee's family that he had observed tumor studding
the pleural wall, "removed a tumor" and forwarded the biopsied
tissue to the pathology laboratory for analysis. Lee was discharged from
the hospital around January 2, 2002, and given Percocet and Motrin for
A pathologist at Massachusetts Memorial signed the report diagnosing Lee
with malignant mesothelioma on January 8, and on January 9, Lee again
met with his thoracic surgeon, who gave him the bad news. He referred
Lee to an oncologist associated with Burbank Hospital in Fitchburg. On
January 14, Lee met with the oncologist, who, in turn, referred him to
Dr. Michael Jaklitsch at Dana Farber Cancer Institute in Boston.
On January 28, Lee met with Dr. Jaklitsch and Dr. Pasi Janne, a thoracic
oncologist. Two treatment paths were discussed: pleurectomy with intra-operative,
heated perfusion chemotherapy, or extra-pleural pneumonectomy, followed
by radiation therapy sandwiched between chemotherapy regimens. Lee met
again with Dr. Jaklitsch on February 25 and then March 18 for final review
of the pre-surgical tests. The tests confirmed Lee's suitability for
surgery, and he was scheduled to undergo an extra-pleural pneumonectomy
on March 22, 2002.
A SERIES OF UNPLEASANT DEVELOPMENTS DURING AND AFTER SURGERY
Lee checked into the hospital early in the morning on March 22, and the
surgery went ahead as planned that day. During the EPP, his doctors discovered
that the tumor was more extensive than had been thought. The surgeon,
Dr. Michael Jaklitsch, removed the right lung, pleura, pericardium and
diaphragm, replacing the pericardium and diaphragm with patches made of
Gore-Tex. The thoracic cavity was then flushed with "hot" chemotherapy.
Following surgery, Lee was moved to intensive care, remaining there until
he was transferred to a step-down unit on Friday, March 28. Ginny states
that he was hooked up to more tubes than she has ever seen in her life
-- "every which way but Sunday," as she puts it. One of those,
a chest tube, was used for drainage of excess fluid and air that built
up in the chest as Lee's body tried to heal itself following the excruciating
removal of the lung. Another was a breathing tube to facilitate respiration
as Lee's body adjusted to taking in only half of the air that it once
did. Ginny says that the breathing tube gave Lee "quite a bit of
On the night of Sunday, March 30, Lee fell out of his bed and onto the
floor. Lee does not know what happened; he thinks he probably "just
bailed out" in his sleep. He does not even like to think about this
and the other pain he has suffered since the first surgery, simply stating,
"It's worse than you can possibly imagine."
Several days after the surgery and before his traumatic fall, Lee developed
gross distension of the abdomen. His doctors discovered the cause: Lee's
heart had pushed the pericardial Gore-Tex patch away and into the abdominal
cavity. Ginny states that the patch was pressing against his remaining
lung and aggravating his breathing to the point of hyperventilation.
Dr. Jaklitsch performed a second surgery on April 1 to remove the pericardial
patch. Dr. Jaklitsch explained that the purpose of the pericardial patch
is simply to hold the heart in place for two days, and that it was unnecessary
to replace the patch, as after that two-day period the heart would remain
in position. During the surgery, part of the original incision was used
to access the patch. Following this surgery, Lee spent three more days
in intensive care before being transferred to a step-down unit. Lee was
finally released from the hospital and sent home 21 days after his initial
surgery. Lee was in a hospital bed on the 37th anniversary of his marriage to Ginny.
HOME TO A HARD REHABILITATION AND RECOVERY
As April turned to May, Lee was still recovering from surgery. Home was
preferable to the hospital, but no picnic, either.
He can't sleep straight through an entire night, nor can he sleep lying
down. Following surgery, Lee began sleeping on a wedge pillow because
he could not breathe if lying down.
Prior to his surgery, Lee was a "mouth breather", someone who
took air in through his mouth. Now, he must concentrate on breathing in
through his nose, and then out through his mouth slowly, so that inhalation
takes about half the time of exhalation, in order to properly circulate
the air in his remaining lung. He says, "All my life, I could never
get enough air in through my nose. Now, not only do I have to get all
my air through my nose, but I have to literally think every time I breathe
in, and every time I breath out. Sometimes I think it's driving me
During the surgery, Lee's doctors had to slice through a wide swath
of several layers of muscles that aid in arm movements. He began his recovery
therapy with a visiting nurse and an occupational therapist helping him
to regain his mobility, particularly in his arms. Simple tasks were now
being relearned, and he struggled to perform more than five repetitions
with any exercise.
May finally brought warm weather to northern Massachusetts, and Lee began
to walk outside, a watchful Ginny at his side. Lee tries to walk for 30
minutes, and it is all he can bear. He has hyperventilated during these
walks, and catching his breath can take several minutes. The fatigue is
like nothing he has ever experienced.
Lee returned to Dr. Jaklitsch on May 8, and Dr. Jaklitsch was happy to
see that most of Lee's swelling had gone down. When asked why there
was one other lump in his chest, Dr. Jaklitsch explained that it was an
effect of the EPP procedure. When the lung is removed, a rib must be removed
to allow proper access and removal. The rib cannot be replaced; consequently,
all the remaining contents, including the rib cage, shift downward in
the chest cavity. Lee has an appointment on May 16 with his oncologist,
Dr. Janne, as well as a radiation oncologist. They will determine the
next step in his therapy.
HARD AS NAILS YANKEE STEELS HIMSELF FOR THE FIGHT AHEAD
Lee does not like to think about the chemotherapy that lies ahead. He is
uncertain about what the regimen will consist of, but he is aware of the
trying nature of chemotherapy. He is doing everything within his power
to conserve what little strength he has, steeling himself for the punishing
rounds of treatment to come.
Lee hates sitting around the house. He not only wants to get back to work, he
to get back to work, to support his wife and himself. Prior to his illness,
nothing stopped Lee from working his shift -- ten hours, no break. He
had even given up a 20-year, award-winning photography hobby to make sure
that he could work enough hours to pay the bills. Lee Brackett literally
finds himself between a rock and hardship, like many other brake mechanics:
he needs to work to survive, but his job exposed him to a deadly mineral
which is killing him.
Lee is determined to find a way out, to live and to work again, to continue
to pay the mortgage and support his wife of 37 years. Like most married
men, he does not like to talk about his own suffering, or possible death.
He worries about what will happen to
, and she has motivated him to have his lung surgically removed and to
wean himself off medication. Now, moment by moment, Ginny motivates him
to concentrate on every breath he takes. Lee Brackett might call this
tedium; we call it heroism.
*** POSTED MAY 31, 2002 ***
An Update --
Lee has come a long way in the two years since his surgery (March 22, 2002).
He still experiences some pain in his chest where the rib was removed
and he has to be careful how he bends or twists -- as Gore-Tex diaphragms
do not work like the original but basically he is able to function quite
normally. Looking at him, you would have no idea what he has been through.
One of his main issues is some weight gain from two years of inactivity
but he is hoping the warmer weather coming will allow him to get outside
and do some walking. Breathing is also still an issue at times. Cold New
England winters require use of a face mask if outside for any length of
time while hot, humid summer days require sitting in front of an air conditioner.
Last May we sold our house as it was very old and needed the type of repair
and upkeep that we could no longer do. We bought a small, two-family with
our daughter. It doesn't require much work other than yard work and
she is around to help out and to "cat sit" if we want to take off.
He has progressed well enough that his "every three to four month"
check-ups in Boston were changed to every six months. Also, he was able
to drive us to Maine last fall for a vacation in Bar Harbor/Acadia National
Park and shortly we are going on our first ever cruise. It is time to
get the old Navy man back to the sea. We also have a family vacation scheduled
the first of May (Disney World - where else?!) and a long awaited trip
through some western National Parks on the American Orient Express (train)
at the end of May.
We always wanted to do some traveling in the past but between working,
raising children, and life in general we just could never do much of it.
We have learned now not to put things off. If there is some place you want
to go - - now - life is much shorter than any of us realize. (Life is
also much longer than it would have been had he not had the EPP!)
Ginny and Lee Brackett
An Update --
After enjoying "relatively" good health for two years following
his EPP, we found out several weeks ago that his mesothelioma has returned.
This time it is in his abdomen. He has had fluid drained three times already
and is currently undergoing chemotherapy (Alimta and Carboplatin) on a
twenty-one day cycle. He has had one treatment and is due for his second
on the twenty-ninth of July.
We know the prognosis is not very good the second time around but he will
continue to fight for as long as he can.
We are thankful we were able to do some of the traveling we wanted to do
before this returned. We always knew it would come back but thought we
would have a couple of more years before it did.
This insidious disease has go to be stopped from ruining the lives of so
many people who have done nothing but work hard all of their lives. They
do not deserve this.
Mr. Lee Brackett passed away on December 2, 2004