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Contractor Frames His Treatment Plan

Randy Evens is a 66 year-old recently retired general contractor who lives in Carson City, Nevada with his wife Virginia.

In July of 2011, Randy first began to notice a lack of energy coupled with some shortness of breath. He chalked it up to getting older and continued to work at his normal pace.

Randy has always been a hard worker. In the late 1950s, Randy first walked onto a construction site and began working as a laborer. A strapping lad who stood over six feet two inches tall, he was quickly assigned to carry material to the framers and carpenters. Every day he would carry large pieces of lumber, including wall studs. With his long arms, Randy challenged himself to see how many studs he could carry at one time – four turned into six which turned into eight and then nine! If he had longer arms, there was no telling how many he could carry. His strength was not an issue.

It was not long before Randy learned the carpentry trade. So now, not only did he carry the lumber up on the slab but he also constructed and raised the walls. Soon he was walking the top plate and rolling trusts.

Running a roof? “no problem.”
Framing in a chimney on a multi-story home, “no problem.”
Carrying four by eight sheets of plywood up top? “no problem.”
Climb a ladder lugging wood and nails? “no problem.”
Work in the wind? “no problem.”
Work in the cold, rain? “no problem.”

Working construction was what Randy did and he enjoyed it. Even when he got older in life, he expected his workers to perform up to the same standards that he had set for himself. He continued to carry and haul the same amount of material he did when he was younger. “I always took pride in my strength and fitness level. It was something I knew I could count on.”

Dirt biking in the 1970s

When the symptoms continued, he met with his allergist, thinking maybe it was his allergies. His doctors modified his current prescription but the new medication did not help. His allergist felt Randy may have been suffering from pneumonia and asked him to come in for a chest x-ray. As soon as the doctor reviewed the films, he called Randy immediately and told him he needed to see a pulmonologist as soon as possible.

In August of 2011, Randy met with a pulmonologist associated with Mountain Medical Center in Carson City. When the doctor listened to Randy’s lungs he told him he heard “lots of water”. A CT scan was taken of his chest and the films revealed a concern for primary left pleural malignancy or metastatic disease into the left pleural space.

Randy then underwent a thoracentesis. During the procedure he told Randy he had to re-insert the needle three times because he was bumping into “large amounts of gristle.”

Immediately Randy felt better and went back to the job site. On August 23, a PET scan showed a malignant neoplasm of the pleura which was consistent with malignancy.

Randy underwent three more drainages over the next month. Were the needles painful? “no problem.”

Randy's surgical scar

Randy then traveled to Reno, Nevada and met with a general surgeon. After reviewing Randy’s records, it was the doctor’s and his staff’s recommendations to present Randy’s case to the tumor board at the University of California Davis in San Francisco. On September 1, the tumor board agreed that Randy would benefit from a tissue biopsy before any treatments were discussed

In the meantime, Randy met with an oncologist in Reno. The oncologist told Randy that extensive surgery may not benefit him, feeling that surgery would take more of a palliative role. The doctor went on to state that being over sixty-six years old his risk was much higher in the sense of mortality from the surgeries. When Randy asked him about any side effects of chemotherapy, he was told that he would be “sick as a dog, weak as a kitten and all his hair would fall out.” Randy quickly decided that chemotherapy was not for him. BIG problem. “My strength has always gotten me through any hardship and I will not allow chemotherapy to drain me.”

On September 19, Randy underwent a talc pleurodesis with a tissue biopsy at the Renown South Meadows Medical Center in Reno, Nevada. The diagnosis confirmed malignant mesothelioma with a stage 1.

Randy’s daughters immediately jumped on the Internet and located Dr. Robert Cameron. Randy and his family met with Dr. Cameron on October 3. After reviewing his medical records, Dr. Cameron felt Randy was an ideal candidate for the pluerectomy with decortication (P/D).

On October 27, Randy underwent the surgery. Over the next 12 hours, Dr. Cameron performed a bronchoscopy, left exploratory posterolateral thoracotomy, radical left pleurectomy, complete pulmonary decortication, partial resection of the diaphragm with reconstruction using bovine pericardium, partial resection of the pericardium as well as lymph node dissection.

Evens Family

Wow! It takes 12 hours just to pronounce all those medical terms!

After eight days in the hospital, Randy was discharged and sent home to recover. Due to the unusual nature of the pathological findings, Dr. Cameron decided to forgo radiation therapy at this point and recommended that the best course of action be a combination of chemotherapy with Alimta, Cisplatin and Avastin. Beginning in December of 2011, Randy completed six sessions over the next eighteen weeks.

In March, Randy began his radiation treatments at UCLA. He was radiated every day during the week (Monday thru Friday) and completed the treatments in early May. On May 19, Randy headed back home to Carson City where he is resting and gaining more strength every day. More importantly, he is enjoying every day!

When he was working, Randy’s weekends were always something he looked forward to. He enjoyed working on old cars and going to car shows. In his garage is a 1929 Model A Touring car. “My weekends were special to me. It was the two days I thought about all week long. Those were the days I could do MY stuff, things I love. Since I stopped working, those days were no longer special. My days were ordinary, long and boring.” But, now that his four grandchildren are out of school for the summer, he has longs, exciting days ahead with them.

*** Posted on May 22, 2012 ***

*** Randy Evens passed away on August 2, 2012 ***