Bill Tice and Sandy Tice January, 1999
Bill Tice, an incomplete quadriplegic and writer, was previously diagnosed
with malignant mesothelioma at Alton-Ochsner Hospital in New Orleans in
the winter of 1992-93. He was diagnosed after an exploratory laporotomy,
which revealed the presence of a "huge" tumor in the omentum.
His doctors sewed him back up, sent him home to hospice care, and told
him he had ten days to live. The surgical wound was infected, and left
"a gaping hole." He was prescribed Cipro for the infection,
and, in defiance of his doctor's morbid prediction, he gradually got well.
Bill Tice knows adversity. He knows what's it like to be a statistic.
And he knows how to put himself in a position to beat the odds. He was
involved in a 1968 automobile accident in which the spinal cord was damaged,
but not completely severed. Bill has loss of muscle tone, balance, and
coordination, but he is not paralyzed. He can stand. Had the accident
occurred today, with prompt treatment he would have been left less disabled.
His disability has not embittered Bill; he faces his troubles with a sweet
nature. Besides, who has time for bitterness when you are busy being a
productive and decent citizen?
This is Bill Tice's incredible story.
In June 1999, because of his quadriplegia, Bill had to have a suprapubic
catheter inserted. About a month later, in July, 1999, he developed a
low grade fever, in the 99 to 100 degrees range. By August 25, 1999, he
had developed a non-productive, hacking cough. He only had a cough when
he had a fever, and the cough would go away if he laid down. The bouts
of fever started getting worse. He also had pain in the upper right quadrant
of his abdomen. He consulted with Dr. Armin, his family physician, who
prescribed antibiotics for a possible respiratory infection and took a
urine culture . The culture tested positive for a urinary tract infection,
which was treated with Cipro.
By September, Bill was becoming anemic; his hemoglobin count was dropping.
The fevers and cough persisted. He had no appetite, was starting to lose
weight and was lethargic. He returned to Dr. Armin on September 10. Dr.
Armin continued Bill on Cipro for ten more days, and started him on iron
for his anemia. On September 17, Bill returned to Dr. Armin for a chest
film, which was negative. Bill was also tested with negative result for
tuberculosis. He still had fever. Dr. Armin started Bill on another antibiotic,
Biaxin. On September 20, the fever broke only to resurface three days later.
On September 23, Bill was coughing, shaking, and having spasms. His nailbeds
turned blue, and his temperature soared to 103 degrees. He was taken to
the Emergency Room of Pershing Hospital in Brookfield, Missouri. A blood
test revealed that his anemia had worsened.
On September 27, Bill was referred to the University of Missouri Hospital
in Columbia for an infectious disease consult and CT scan. He was admitted
September 28. His anemia was worse. The CT scan showed a small amount
of ascites around the liver. Bill's doctors administered Prednisone,
among other medications, which his girlfriend Sandy Tate believes caused
the fever to temporarily abate. The attitude of the doctors was, "You
don't have a fever, there must not be anything wrong with you."
Bill was discharged on October 1 with a diagnosis of fever of unknown origin.
By the time of his discharge, his fever was already climbing back to 101.5.
Sandy continued calling doctors. Bill's fever continued, and his coughing
was growing worse. On October 6, he was readmitted to University Hospital.
He underwent a battery of tests, including a Gallium scan and bone marrow
biopsy. The Gallium scan was performed on October 15, and revealed inflammation
around the liver, which was diagnosed as a subphrenic abscess. Bill's
physicians attempted a CT-guided aspiration, but could not get any fluid.
He was discharged from the hospital on October 18 with intravenous antibiotics.
From October 18 through 30, Bill remained at home on the i.v. antibiotics.
His condition improved somewhat, but his fevers continued, although controlled
with ibuprofen. On November 4, Bill went off ibuprofen "to see what
would happen", and his fever shot back up.
On November 18, Bill was re-admitted to University Hospital for purposes
of a liver biopsy to test for granulomatous hepatitis. A liver biopsy
can cause blood loss, so he had a blood transfusion before the procedure.
He was running a temperature of 103 degrees. He had pain in the right
upper quadrant of his abdomen. The liver biopsy showed non-specific, reactive
hepatitis.
Dissatisfied with his treatment at University Hospital, Bill traveled to
Northwestern (University) Memorial Hospital in Chicago on December 13,
1999 and consulted with an infectious disease physician. On December 15,
Bill underwent a fine needle biopsy. The working diagnosis was a subphrenic
abscess. His doctors again attempted to drain fluid for a culture, but
were unable to get any fluid. Finally, his doctors used an eighteen-gauge
needle to perform a fine needle aspiration at the area around the liver.
Tissue was biopsied and submitted for pathological testing.
Bill Tice - May, 2000
On December 17, Bill was diagnosed with inoperable hepatocellular carcinoma
(liver cancer). On December 20, Bill's doctors advised him that there
was a misdiagnosis, and they weren't sure what the proper diagnosis
was. Northwestern sent for the slides from Ochsner for comparison purposes.
The slides looked the same under the microscope. However, the doctors
at Northwestern expressed skepticism that he was previously correctly
diagnosed with mesothelioma, given his prior complete recovery with antibiotics
and disease-free state for seven years. He was discharged on Christmas
Eve and told to get a second opinion.
Bill consulted with Ellis Fischel Hospital in Columbia, Missouri on February
23, 2000. Columbia, Missouri. He was admitted to the hospital on March
1. On March 9, Dr. Boris Kuvshinoff performed an exploratory laparoscopy
with tissue biopsy. Pathological testing on the biopsied material resulted
in a diagnosis of malignant mesothelioma of the peritoneum, epitheliod
type. The tumor sits beneath the right diaphragm, covering the top and
back of the liver, and extends into the area below the left diaphragm,
in the left upper abdomen.
Dr. Kuvshinoff consulted with Dr. Paul Sugarbaker in Washington, D.C regarding
cytoreduction with perfusion chemotherapy. Even though Dr. Kuvshinoff
had never performed this procedure before, he told Bill that he would
obtain the necessary equipment for the cytoreduction and perfusion. However,
Bill was aware that there was a possibility that the tumor had invaded
the diaphragm, and that all or a portion of the diaphragm might have to
be removed. Because of his quadriplegia, Bill especially needs his diaphragm
to breathe. Bill declined surgery with Dr. Kuvshinoff.
Bill forwarded his records to Dr. Paul Sugarbaker, who declined. His girlfriend
Sandy writes of the agony they experienced with the decision to decline
surgery by Dr. Kuvshinoff, and with Dr. Sugarbaker's refusal to treat Bill:
Bill is not a candidate for the surgical procedure developed by Dr. Paul
Sugarbaker, as Bill is an incomplete quadriplegic and uses his diaphragm
to breathe. However, we had a surgeon here in Missouri who wanted to do
the procedure on Bill, and planned to include a thoracoscopy to determine
the extent of tumor above the diaphragm. He had never done the procedure
before. After the consult with the thoracic surgeon who would also be
involved, it was clear that Bill might come out of the surgery without
most of his liver and part of his lungs and diaphragm. We were told it
was our only hope.
We agonized over the decision to proceed. We prayed for guidance. We asked
every doctor we knew and respected, as well as the anesthesiologist present
during Bill's laparoscopy on March 9. We feared Bill would not survive
the procedure. We knew if he did, he would probably be ventilator dependent
the rest of his life. As things are now, we are also dealing with the
illness of my mother, which began as pneumonia in December. She is in
a hospital in Kansas City now attempting to wean from an ventilator. She
has severe lung disease. She lived for years with my dad, a builder using
products containing asbestos. Connection? Maybe. Bill sees her struggle
on that ventilator. He does not want to live that way. We sent the CT
scans to Dr. Sugarbaker himself. He refused to do the procedure on Bill.
He is the expert. We decided not to let the Missouri surgeon learn on
Bill. We were devastated, knowing he might have been our last hope.
It was March 29 when we learned Dr. Sugarbaker would not do the procedure.
I helped Bill to bed for a nap. I sat at the kitchen table. I was furious,
heartbroken, confused, my faith was shaken to the core. I try to do the
worrying, the research. Bill is too weak, too emotionally and physically
fragile. When I can get nothing done, I feel I have let Bill down. I told
God that day, there at the table, to please, PLEASE, let me know what
to do. I opened my eyes. There on the table was a web page I had printed
with a list of mesothelioma specialists. I checked
U.S. News and World Report for the ratings. M. D. Anderson was #2 for cancer centers. I called Dr.
Verschraegen. Again by the grace of God, I got through and told her Bill's
story. We were sitting in her office less than a week later.
Dr. Verschraegen, a member of the Science Advisory Board of the Mesothelioma
Applied Research Foundation (MARF), was able to meet with Bill on April
4. She has prescribed Megace, megestrol acetate, which is normally used
to treat cachexia. According to Sandy, in a 1985 study of 23 patients,
one with mesothelioma had a complete response, survived 96 months and
was disease free after taking high doses of megestrol acetate. Megace
is not considered to be a cancer cure. Bill is doing a two month trial.
He takes Megace in liquid form, once a day. Bill currently weighs 159
pounds. He weighed 206 pounds last summer. Bill and Sandy had planned
to get married this summer, but have had to put those plans on hold.
We wish these two special people all the best in their struggle with mesothelioma.
*** POSTED MAY 21, 2000 ***
On May 22, Bill married in long-time love Sandy while admitted to the Boone
Hospital Center in Columbia, Missouri. On the morning of May 25, 2000,
Bill died of mesothelioma.
Following is a tribute Sandy Tice wrote which was read at his funeral:
Thank you all for coming. I got to know Bill through his writings and through
verbal communication in its purest form unhindered by body language, eye
contact, and subtle nuances that define our relationships with others.
Over time I learned that a relationship with Bill involved much more than
simply "knowing" him - Bill was a man to be experienced.
As I experienced Bill, I encountered a man with strength of spirit and
depth of character unlike anyone I had ever known. He brought out and
nurtured the sensitive, loving aspects of my own personality that had
long been stifled. I felt safe and protected, and always wrapped in a
cocoon of his love. Bill said, "Wiggle your toes," and I learned
to relax and savor the moment, and to appreciate the simple pleasures
of life. I was the happiest I have ever been.
Bill was a teacher. He considered Christ the greatest teacher of all time,
and sought to emulate him. He taught strength in the face of overwhelming
adversity, and humility. Bill said, "Stay humble and don't stumble."
He taught kindness and graceful acceptance of circumstances beyond our
control. When my faith was shaken to the core, he gently reminded me,
"God loves us," and helped me believe it. He helped me continue
to pray, and he continued to pray his frequent one-liner, "Jesus
Christ give me faith." When I grappled with issues of guilt imposed
by criticism from the community, Bill told me, "Don't hold yourself
bound up." His belief was that Christ came to teach us forgiveness
and abundant life free from guilt and self-condemnation. Bill possessed
wisdom beyond my understanding. When I questioned how a man could possibly
attain his level of wisdom, he said simply, "A fool is a man who
doesn't know, but doesn't know he doesn't know. A wise man
is a man who doesn't know, but he knows he doesn't know. But when
he knows, he knows he knows."
Bill was selfless. As his health failed and we met obstacles at every turn
in seeking a doctor who would help him, he worried about me. And he worried
about my mother and her own life and death struggle, and he prayed for
us. He worried about his children, as all fathers do, and continued to
reach out to them, and to teach them. In his selflessness, he taught me
perseverance and helped me recognize and build on my own strengths as
we pulled together and became our own support system, even as our hearts
were breaking.
Despite enormous physical challenges, Bill never complained. He endured
the indignities imposed by his disability, and always, always said, "Thank
you" for any help received. Caring for Bill became a joy with reward
far exceeding the effort expended. As he grew weaker and we had even less
contact with people and the world around us, we strived to maintain normalcy
and draw strength from the people who remained in our lives, especially
Bill's sisters and two very special women, Joy Wade and Nora Rhodes.
With their help, Bill was able to maintain his daily routine and his dignity,
and and to continue to hope for the future. Bill was a man who appreciated.
When I commended him for his bravery as he faced his illness of the past
ten months and strived to maintain his health, Bill said, "The gem
cannot be polished without friction nor the man perfected without trials."
As he lay dying, he said, "I want to do this right," and he
did. He left this earth polished to perfection. Bill is my hero.
Bill was my soulmate, the great love of my life. He brought out the best
in me, and said I did the same for him. When speaking of our relationship
even until the very end Bill told me, "I'm the luckiest man alive."
I knew I had been paid the highest compliment I will ever receive. His
last words to me, summoned with every ounce of effort and breath available,
were, "I love you." As I held him as he took his final breaths,
the room became brighter and clearer and outside sounds faded, and I knew
we were surrounded by holiness. Bill has gone on to abundant reward beyond
our limited imaginations. I have been privileged to live the love of which
poets write and songs are sung. My heart is filled to overflowing with
love for and precious memories of this exquisite man.
On this beautiful day of celebration of the life of my beloved sweetheart,
Bill Tice, please remember his mottos: "No killing, no stealing,
no lying," and "Please, say please and thank you. Thank you."
Mrs. William A. Tice, Jr.
*** POSTED JUNE 6, 2000 ***