Monday, March 23, 2009

Venturing Near Death's Edge

~~ Life is not measured by the number of breaths we take, but by the moments that take our breath away ~~

One never knows the path life will take or the blessings to be found in the journey. This is a story of hope and the friendship made while standing near death’s edge.

Beverly, or B, as her friends call her, has always been a walking ad for fitness. She exercises regularly, plays a mean game of golf, and her youthful, strong and vibrant personality reflects a woman in excellent health--the last person you’d expect to have a devastating illness.

My brother Derris was 22 when he married 20 year old Beverly. I've always envied their passion, the way they look at each other as if they’d just tumbled into love. B has been a friend since their marriage, but not a close friend. Spending thirty-one years in the same family circle hadn’t brought us together in that sense. This would soon change.

In November, 2003, B was diagnosed with Hepatocellular Carcinoma, a primary malignancy of the liver typically found in people with hepatitis or cirrhosis, and is more prevalent in older Asian men. B fit none of these profiles.

The day I got word about her cancer, a voice within me said, Show up, in whatever form that might take. First I brought their dinner then made an offer to do whatever I could to help. To my astonishment, B asked me to be with her and Derris when they met with the Oncologist.

I joined them the next day at the doctor’s office, along with my sister, Gari. With notepads, pens and questions, we entered the small room with only a compact desk and a few chairs. Our positive attitudes intact, we were optimistic about B’s next step and made small talk while we waited.

The Oncologist's soon opened the door, no hint of compassion in her brown eyes. She sat down and focused intently on the file she held. Friendly formalities were skipped as she slapped us with statistics. Beverly had a 30% chance of living three years, if she took drastic steps, which she had yet to determine. We staggered from the room and dropped to chairs in the empty lobby. Nothing made sense. I looked into my brother’s face, raw with pain as he held B in his lap, his arms wrapped tightly around her, tears rolling down their faces. Whispers of disbelief and racking sobs echoed in the room for what seemed like eternity.

Thus began a five-year cycle of darkness and light.

Two months after our visit to the oncologist, B entered the hospital to have a portion of her liver removed, medically referred to as a resection. After a 6-hour operation, the surgeon told us the resection had gone better than expected. The cancer had been easy to remove, dangling as it was from her liver. He compared it to an ornament hanging on a Christmas tree. B’s case was an anomaly, which he believed would increase her chance for survival.

Merely a few months later, B was going on boat rides with Derris, playing golf, and taking walks with friends and her dog, Snickers. As if she’d never been ill a day, she lived life for all it was worth. For the next three years, she thrived. With each passing month our hopes increased. Perhaps she had indeed beaten the odds.

The horror returned on her third cancer-free anniversary. This time, the disease made its home inside B’s liver and could not be lopped off as in the first resection. B’s medical team collaborated for the next couple of months before deciding, on March 2007, to remove the entire right lobe of her liver. Again, the surgery went well and so did her recovery. Her friends, family and doctors shook their heads in wonder at her fast recuperation.

There were days, however, when the dread of the cancer’s return hovered over B like a threatening cloud, although this was not the visage she showed to the world. On the bad days, B tumbled into solitude. Friends and family learned to give her space, but if the despair or avoidance stretched into days, helpers appeared to pull her through in creative and loving ways. A small group of golfing buddies decided to create an emergency happy hour, friends would drop by and coax her into coming along for a walk, others would bring food and gifts to cheer her or her two boys would take her to lunch. But more often than not, she would curl up in Derris’ lap and cry while he held her. In view of all she went through, her morale remained mostly upbeat, her face bright with happiness, her attitude reminding all of us how blessed we were to have our health and how fleeting is life.

Sadly, B's fears were not unfounded. The cancer returned six months later. After many consultations and tests, the doctors concluded B’s only chance for survival would be a liver transplant. The path this took is a book in itself, but I will share this with you who are faced with a similar situation: the patient and advocates must be diligent. Do not leave the homework and research only to the doctors or the medical team. Thankfully, many of B’s friends, family, and even a few who had never met her rose to the challenge, two of them being men who had survived liver transplants.

The wait was a long and continual heartbreak. Making the transplant list alone was a struggle. When her name was finally added, we again waited. As days went by, B's life was rapidly slipping away and we questioned if a liver would become available in time to save her. Several cancers had formed by this time and the doctors led us to believe there was a possibility the cancer would metastasize, their main concern being her lungs. If this were to happen, she would be removed as a liver transplant candidate. We cried knowing what this meant. Our only option was to pray.

Three months into the transplant wait, the doctors tried chemoembolization and radiofrequency ablation. When successful, the process ceases the growth of tumors long enough to buy time until a donor is found. Following the treatments, B had extreme bouts of nausea and became so dehydrated, she was raced to the ER. After the surgeries and pain she had suffered, I was shocked to hear her say it was the first time she truly believed she would die.

On March, 2008, during one of the overnight chemoembolization procedures at Methodist Hospital in Houston, a liver became available. After being prepped and meeting with the surgeons and anesthesiologists, B heard the disheartening news. The liver was too large for her body. Disappointed beyond words, she and Derris made the trip back to Austin.

During the entire wait for the liver transplant, B and her cell phone became a team. Night and day it stayed by her side. Every time she heard the familiar ring tone, she quickly checked the cellular screen, eager to see the hospital number. On May 15, 2008, at 4:40 in the morning, the ring came. Another liver was available, although again she was second in line. Back to the hospital they went, trying to stomp down their hopes. Hours later, the surgeons determined the first person was no longer a viable candidate. Within an hour, B’s transplant would begin and she would finally receive her liver. Our prayers were for a successful surgery, but also for the selfless family who donated the organ of their loved one.

Six and a half years have passed since we first learned about B’s cancer. She is cancer free, doing great, feels wonderful and loves every day of her life. We are blessed by what we feel is nothing short of a miracle.

From the beginning of her illness, B’s surgeons expressed bewilderment at how a woman so healthy could have Hepatocellular Carcinoma. Her case was so extraordinary, transplant surgeons wanted to be part of her operating team so they might later write about her in medical journals. The head surgeon claimed B’s liver transplant was the most successful in history.

Over the past years, I have been continually bowled over by B’s tenacity, overwhelmed with pride by every agonizing yet valiant step she took, astounded by her ability to face yet one more procedure or one more trip to the hospital with strength. She persevered when I would have faltered. I grew to respect and love her more and more as a sister and one of my best friends.

Like many who have faced death, B often remarks how much her life has changed. She is blessed with more true friends than anyone I know and the extent of their love is beautiful and unwavering. I am blessed and proud to be called one of her close friends. She and I have an abiding camaraderie, grounded in the days we shared in the war against cancer.


My husband and I attempted to recreate the dish we love to order from Romeos in Austin. I think we got pretty close. Hope you enjoy.


Serves 4

2 or 3 chicken breasts, grilled (optional)

2 tablespoons butter
1 tablespoon olive oil
¼ cup chopped red onions (or 2 small shallots, chopped)
2 cloves garlic, minced
6 oz mushroom, sliced (optional—sometimes I substitute the mushrooms for the black beans & corn or vice versa)
¼ cup roasted bell pepper, diced
1 canned chipotle pepper (packed in adobe sauce), seed & chop
¼ cup corn (roast when grilling the chicken)
¼ cup black beans, drained
½ teaspoon salt
Black pepper to taste
4 tablespoons fresh cilantro, coarsely chopped

2 teaspoons adobe sauce
½ pint heavy cream
¼ cup milk
¼ cup white wine
favorite pasta (enough for 4 servings). I like fettucini or linguini.
¼ cup Parmesano Reggianno cheese, grated (fresh is best!)

In a saucepan, melt butter over medium heat and add olive oil. Sauté onions and garlic until golden, taking care not to burn garlic. Add mushrooms and cook for 2 minutes or until tender, but not limp. Add roasted bell pepper, chopped chipotle pepper, corn and black beans and heat on low for 3 minutes. Stir in salt, pepper and cilantro.

In small saucepan, stir together heavy cream, milk, white wine and adobe sauce. Cook on low until heated then stir into corn and black bean mixture. Add grated cheese and stir. Keep warm on low heat.

Slice grilled chicken breasts into strips.

Cook pasta according to directions on package.

Arrange pasta on plate. Spoon Chipotle mixture atop. Sprinkle with cheese.

This is wonderful with a leafy green salad and hot crusty Italian bread.

Expert Ezine Author

Expert Ezine Author
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