Olga's Story
Cancer: Discovery, Treatment, Life and Death
You never think about it happening to yourself or to those you love. You really never think it could ever happen to your companion, your one true friend, that one person in the world you truly love, with whom you always knew you would spend your complete life. But, it can. And it did.

Olga is my spouse. But more importantly, Olga is my best friend, my companion, and the love of my life. I can only hope she feels the same about me. Olga is also a mother. She believes this to be the more important of the two relationships. She has always considered being a mother the most important part of her life.

She loves being a mother, and deeply loves her two sons, Sef and Patrick,more than anything or anyone else. I accept this and love Olga all the more for it. I am telling you all this because it is true, and because it is important to know as I tell you about my small family's journey into and through the darkness that comes with cancer.
Discovery & Diagnosis

We started April 2000, much the same as every April, much as everyone does, with cleaning and planning. Olga and I had already begun talking about remodeling our home. The weather is more than pleasant, it's almost perfect. Olga continues with the long hours and hard work that come with running your own successful business. We have just received happy news, Sef, our older son, and his wife Christi, are expecting! Our first grandchild will be born in late November. I have already completed preparations for running in the Capital 10,000 run. I hope to beat my best time, even though I've stopped the almost daily 3.5 mile runs at the YMCA. I've asked Olga if she wants to join me in the run this year. "No," she says. We both feel, suspect, or maybe know something is wrong. I ran in the Capital 10,000 on April 2, 2000, the first Sunday in April. Soon after that, everything changed.

Olga has not been feeling her usual active and healthy self for almost two months now. She has not been eating well. She's unable to complete a meal and has stopped trying. She's been complaining about her stomach being constantly upset. Even though she's not eating full meals, she always feels full, like she's just eaten a huge dinner. She also suffers from what feels like acid reflux. She's begun taking antacids for the first time in her life, starting out with Maalox and Mylanta. They help, at first. When they cease helping, she turns to Tagamet. Which helped even more, at first.

Now, Olga tires easily, very easily. Before, she rarely tired. Olga is a hard worker, both at home and at her business. But now, she needs to sleep for long periods in the middle of the day, and still needs to go to bed early. She is beginning to look pale. Much of the time her lips lose all color, and her face appears drawn. Patrick and I know something is wrong. We urge Olga to go to the doctor for attention. Then, the trouble begins.

Olga tries to make an appointment with her primary care physician, Ann Black, M.D. But, when she calls the doctor's office she is told that Doctor Black has begun to shut down her practice, without even informing her patients. The only reason we learned the practice was closing was because Olga called to make an appointment and was told the doctor had stopped seeing patients. At about the same time, Olga and I have already decided to change health plans from an HMO to a PPO because we have had difficulty with the very limited number of doctors on the HMO plan. Without a primary care physician, Olga was unable to get a referral to a specialist. Luckily, the change to a PPO was imminent. Olga tries to make an emergency appointment with a gastroenterologist. Unfortunately, they have no available appointments for at least a month. Olga is now forced to see a new gynecologist for a well-woman check, even though we all know she is not well. Her long-time gynecologist died recently and Olga was forced to pick a new one. This new one was useless. She did not want to do anything more that the basic checks. Because Olga has been so tired and pale lately, she demands that the gynecologist perform an anemia test, which, of course, is not part of the normal well woman checkup. The doctor is in no rush to get the results, and doesn't even want Olga to bother her at the office. They will call Olga with the results.
April 10, 2000

Before the results come back, Olga is getting much worse. She begins to see blood in her stool, and is unable to eat virtually any solid food. She appears as a ghost much of the time. Her beautiful olive-colored skin now almost without color. She can barely stand for any length of time. Frustrated with the situation with her personal physicians, Olga speaks with one of her doctor clients about her symptoms. The doctor orders Olga to the emergency room. We leave Patrick at home and Olga and I arrive at the hospital emergency room that evening, at about 7:00 p.m. The doctor rushes Olga in and takes a series of blood tests. Blood is found in Olga's urine and stool. She is also dangerously anemic. The doctor and Olga suspect a bleeding ulcer. Olga is immediately admitted to the hospital.

Olga is so anemic, the doctor orders immediate blood transfusions. Olga takes a total of 4 units of blood overnight and the next day.
The day after, Olga is sent to surgery for an EGD scope of her digestive tract. Her gastroenterologist is one of the most respected in Austin. I sit in the waiting room for a couple of hours.

Olga's doctor came over to me. I watched his face as he approached, and without his saying anything, I knew something was wrong. He walked over, patted me on the shoulder and back. He then held me around my shoulder and said, "I found a growth in Olga's stomach, a very large growth." He called it a "tumor." I couldn't believe what he was saying. He only spoke for a few moments. He would not make a diagnosis. He had taken a biopsy of the tumor and would not get the results for at least a day. He told me he was sorry, asked if I needed anything, and then left me alone after I said, "No."
I saw Olga in her hospital room a couple of hours later. She asked what the doctor had said. I told her the truth. We remained hopeful. But, we could only wait for the biopsy results. The doctor came by the next day. He told us it was stomach cancer. Olga would need to see a surgeon and an oncologist as soon as she was released from the hospital.

We cried together later that day. Why do any of us cry when this happens? Because we fear we are about to lose someone dear? Because we hate it that someone we love so dearly is forced to suffer? Because it hurts. We told our children about the diagnosis later that day and night. What can you tell them? It hurts deeply even as I write this later. It hurts deeply to tell your children their mother has cancer. Patrick is still 17, and has just completed his application to attend the University of Texas. He has not yet graduated from high school. It simply hurt deeply that night, as it continues to hurt.

Olga stays in the hospital for another night and day, as we begin to make plans to see the surgeon and the oncologist. I haven't been back to work full-time since that day.
April 12, 2000
Olga came back home today. She remains on a clear liquid diet. The tumor is so large that it prevents Olga from eating anything more than clear vegetable broth, water, and Gatorade. Almost immediately after getting home Olga looks up her condition on the internet. The internet is a wonderful thing. You can find information on any topic. This time, I wish she hadn't looked; I wished the answer wouldn't be there. We discover that Olga's cancer is relatively rare in the United States. There are currently no known treatments for it. Because it is rare, it one of those cancers for which little research has been done. The general prognosis for Olga's condition is very bad. We both are scared. We have an appointment to see the surgeon on April 17, 2000. Our health plan conversion to the PPO has finally come through, after several days of arguing with the insurance company. The surgeon's name is F. Ames Smith, Jr., one of the most respected surgeons in Austin.

April 17, 2000
We have an emergency appointment with Doctor Smith today. We wait in his office for over an hour before we are called in. It is freezing in the waiting room. Olga asks me to remain in the waiting room while she speaks with the surgeon. She wants to face this alone at first. My wait is interminable. I watch and listen as other women in the waiting room speak of their cancers. Most talk about breast cancer. Breast cancer is one of those cancers that has been thoroughly researched. The treatment protocols are well-established, the outlook for most who suffer appear good. I am there in the waiting room literally for hours. Finally, Olga comes out to get me and we retreat to the Doctor's private office. He is not there when I arrive. He doesn't need to be there because I see the trouble and the pain in Olga's eyes, on her face. Olga takes my hand as we sit down together on the doctor's leather sofa. It is as cold as the news I know I am about to hear. We sit close together, holding on to each other. She looks me in the eyes, and tells me "it is bad, real bad." All I can do at that point is hold on to her tightly, trying to give what little comfort I can give at the moment, waiting for the truth from the doctor.
Doctor Smith comes back in in a few minutes and talks to us. From how he describes it, the tumor is the size of a baseball, or larger. It blocks almost the entire stomach tract. He tells us it is very bad. Olga asks for a prognosis, but he won't give one. He never gives one he says because he believes it only takes away hope. From what he tells us, though, it is so bad that he is uncertain on how to treat it. He believes radical surgery is the only real alternative because of the tumor's size. He worries the tumor has spread to other vital organs like the pancreas and intestines. He wants to schedule surgery as quickly as possible, and he wants a second surgeon, one of his partners, in the operating room with him. He asks Olga for permission to pray for her at the start of the operation. Olga tells him yes. She likes him very much and appreciates his support. Unfortunately, the earliest available date for the operating room is not until May 3rd. We go home after making the surgery appointment for a total gastrectomy.
The drive home is quiet. There isn't much you can say at that point. You're in shock. Your mind is going 100 miles per hour. When we get home we make plans to tell our children about the extent of the cancer and the plans for surgery.

Because Olga cannot eat, the doctor orders the placement of a feeding catheter in Olga's chest. That is accomplished the same week. A home nurse comes on a daily basis to offer instruction and assistance with the feeding catheter. The feeding tube is the only thing allowing Olga to keep up her strength before the operation.

We also select an oncologist this week, Dr. Thomas Tucker. He practices at the Southwest Regional Cancer Center here in Austin. We are able to get an immediate appointment the same week. The visit goes as well as can be expected under the circumstances. He also is a kind doctor. But, we hear what he says. He puts it very gently, but it is as horrific as it is gently put.
"There is no protocol for treating" Olga's cancer, especially at the stage it appears in Olga. He doesn't need to say it twice. The is no accepted treatment. He does offer some hope, though. The national annual convention for oncologists is meeting in New Orleans the next week; he is going and maybe a new paper will be published and presented on stomach cancer treatment. The doctor is not even certain that chemotherapy is an option at this stage. He will meet with us when he returns from the meeting next week. When we see him again, he has "good" news. A paper was published at the meeting. He had a copy sent to him by overnight mail and showed it to us. A new protocol for treating stomach cancer was presented. With the doctor, Olga makes the decision to proceed with the "new" treatment. It is a very difficult protocol. While many types of cancer are treated with one or two days of chemotherapy a month, Olga's will begin with seven days of treatment, with varying types and strengths of chemicals infused into her body, for seven days. The seven day treatment will be repeated one more time, three weeks apart. Radiation will then start in conjunction with continued chemotherapy until just after Thanksgiving.

Olga also continues to work with the doctor's office to get an earlier surgery date. One week later we find out that there has been a surgery cancellation at the hospital. Olga and I contact the doctor's office and work to make sure that the doctor signs up for the time and schedules Olga. After several false starts and heated discussions, we are able to grab the spot and Olga is scheduled for the total gastrectomy on April 26, 2000.

By April 25, 2000, Olga's condition is at its worst. She is able to swallow only small amounts of liquids, and only then with great pain. She is forced to swallow large amounts of cleansing liquid in preparation for the surgery the next day. She makes every attempt to comply with the doctor's orders to drink close to a gallon of the liquid the day before. I see the intense pain she suffers. It's in her eyes each time she takes the liquid. After a few attempts it becomes more than unbearable. She has begun to vomit violently each time she takes the liquid. Then, she begins to vomit large amounts of fresh blood. She simply must stop taking the liquid. I call the doctor and urge him to stop the treatment. He agrees even though it is very important to her surgery to allow him to make the clean cuts he needs to tomorrow. We go to bed that night exhausted and worried, anxious and afraid.

April 26, 2000

We are fortunate that our families care deeply. Three of my brothers who can make it arrived in Austin from California, Nebraska and Dallas to offer support and comfort. One of Olga's best friends came from California to help the weeks before the surgery was scheduled. Olga's family arrives in Austin from San Antonio the day of the surgery. Her brother visited from Nebraska earlier in the week.

We arrive at the hospital mid-morning and Olga is prepared for surgery. Doctor Smith expects the surgery to last over four hours depending upon what he finds. He tells us that if he finds the worst, if he is unable to remove the tumor, he will close up quickly. The anesthesiologist comes out after two hours with good news. They are able to remove the tumor. Two hours later, the surgeon comes to the waiting room and tells us that everything went as well or better than he had expected. He was able to remove all of the gross visible tumor. He also removed Olga's entire stomach and part of her transverse colon. He was able to save her pancreas. He also attached a feeding tube directly into Olga's lower intestine. Olga is in the recovery room for another three hours. She does not arrive in her hospital room until about 7:30 p.m. She is awake and everyone is given a short visit. My brothers and Olga's family leave. Patrick and I stay with her. I spend the night.

April 27, 2000

The day after starts with a great deal of hope and relief. Olga appears fine. Because of the anesthesiologist's fine work, Olga is in very little pain. She is allowed no food or liquid. But her spirits are high. She looks better that she has in many days. But, we know the road ahead of us is not only long, it is dark and arduous, physically, mentally and emotionally. We know we will learn just how painful and difficult it will be in the next few weeks after surgery. The surgeon had taken biopsies of around 20 of Olga's lymph nodes during the surgery for testing.


Next Page - After Surgery

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