On Tuesday, April 22nd, my wife died. She hadn’t eaten anything in six days and was living on a few juice popsicles in the days prior to that. The last few days were a blur due to my lack of sleep, but I will recount what I can.
As always, this blog is more for me than for anyone else.
My father-in-law arrived in Idaho on the same date as my last update, Sunday April 13th so I will pick up the story from there.
He was here about an hour and then pulled me aside and said I don’t think she will make it to the end of the week. I told him that I would call the children. I sent out the “Bat signal.” Those who have seen the vintage 1960’s television show will get the reference. The eldest and her husband arrived the following day (Monday) and the middle child on Tuesday. Junior didn’t arrive until Sunday (Easter).
Monday, my wife (on oxygen at the time) got out of bed and refused offers of help to go from the bedroom to the couch in the living room. This was a distance of about 25 feet. As she neared the couch, she did a face-plant on the floor. The O2 line in her nose ripped open both nostrils. Blood was gushing from both sides of her nose. We stopped the bleeding by rolling up tissue and shoving it into both sides of her nose. Later she developed bruising around her right eye and nose. She looked like she had been in an MMA fight. Had she not quit taking blood thinners a week before, this would have been a disaster.
As I said, food consumption was about zero from this point forward. Once the daughter and spouse arrived, the son-in-law did make a food run. They bought mom sugar free popsicles! My wife took about one bite, and she was done. Yuck. That was the last solid food or food of any kind that she ever ate. Why in the hell anyone would think of buying sugar-free popsicles when you know these were the only calories she was getting is beyond stupid.
Anyway, the daughter and hubby did rent a car, so they went the next day to the airport to pick up the middle child.
After her fall, the wife was using a mask for oxygen. My wife has very labored breathing. She could say only a word or two and then would have to pause before trying to say another word. As the week went on, she began using hand signals to communicate.
Her SPO2 (blood oxygen saturation) began dropping. Normal readings are 95 to 99 percent. Hers was in the 80’s for a few days and then fell to the 70’s. Just for reference, a blood oxygen reading of 75 is the same as basecamp at Mt Everest (~17,500 ft above sea level). In her last few days, all readings without O2 were between 72 and 77.
Per the Internet, you should call 911 if you have a reading below 90. Readings like my wife’s begin to cause organ and brain failure after five minutes. On Friday or Saturday, she decided to refuse any more O2.
On Saturday, Sunday and Monday nights, I stayed up with her. Saturday night she was up from about 1 AM until just after 4. That night, I distinctly remember her saying, “Do all you do”
And me responding, “to the glory of God.”
This is something we said to our son every day before he went to school; up until we knew of his open rebellion against God in his last year of high school.
It was her heartfelt belief and one she tried to instill in our son. I know I cried when she said it. As it turned out, for the final time.
On Sunday night she was up from 1:30 AM until about 3. On Monday night I was up with her all night.
Her last night went something like this: She wanted to move from the hospital bed to the wheelchair about 11:30 PM. She said that she wanted to go outside. I wheeled her to the sliding glass door and then opened it. Per our weather station, it was 34 degrees outside. I told her it was too difficult for me to move the wheelchair outside. We looked out for a few minutes, and I remember closing the sliding door. Together we looked at the view. I said to her:
“There is our swing.”
“There is our deck.”
“There is our apple tree. “
“There is our yard.”
“There is our levee.”
“There is our town.”
“There are the stars.”
In her weak voice she said, “I am ready to die.”
I cried.
We then moved to the couch. I had to help her from the wheelchair to the couch. This was not too difficult since she had lost over 160 pounds during the course of this four-year cancer ordeal. I stayed with her. Sometimes I tried to give her medicine, sometimes I rubbed her back (the cancer in her bones and muscles caused her much pain; especially in her lower back), sometimes I was just her pillow. That was her favorite thing, just resting in my arms. Her breathing was labored. You could hear junk in her lungs that she was unable to cough it up. About 5:30 AM, her dad came into the house. I gave him a brief turnover and then went to bed.
The next thing I knew, he was frantically calling for me. I went into the Livingroom, and he said she is dying now. She would take a breath and then nothing would happen for about twenty seconds and then she would gasp again, followed by another long pause. After a few minutes of this process being repeated. She was very still. Tears welled up in my eyes. I told her that I loved her. She gasped again and then was still. A huge tear came from the corner of her eye and dripped down the side of her nose. Upon seeing the tear, I knew two things with certainty, first, that she loved me, and second, that she was dead. As this was happening, I glanced at my watch. It was 6:46 AM on April 22nd.
Later I was looking through her phone and noticed that she had sung at Carnegie Hall in New York City on April 22nd 2024. Yep, one year to the day from singing at Carnegie Hall she had died. Her death was three weeks to the day from entering hospice. At the time it didn’t seem so, but her death was rather quick.
Sheryl in Carnegie Hall April 22, 2024
Below are quotes from things that Sheryl had written about her cancer journey.
The first is an excerpt from a text thread with ladies at our church that were praying for her.
“Reading through all this, it struck me that suffering can lead to contentment and grace. Bill will sometimes sit down beside me as I am coughing or “suffering.” He will rub my back and say, “Poor Sheryl! My poor wife…! I stop him and say, “Honey, I’m am NOT poor! I’m so blessed! I have God, You, and so much support. It is amazing to feel His love in my life.”
“Suffering brings us to an acknowledgment of the wonderful blessings of His grace.”
Sheryl and Bill Tolson celebrate Valentine’s Day 2025
The next is a dream that she had back in February. In our 21 years of marriage, she only wrote down two dreams. This was the second.
My Dream 02/25/25.
I was standing with Bill and Dad and several other family members under a wooden gazebo surrounded by huge oak trees. It reminded me of the area around the Orinda house. I had my Jeep keys in my hand, and I got in the car and drove away to go to a Women’s clothing store tucked up in a heavily wooded fern-filled garden canyon. I had to park in a strange spot that was up a large branch of a tree.
The store was filled with many dresses and I picked a pretty floral one easily and put it on. I walked out the other side of the store. The door opened up on to a huge grassy, wildflower speckled lawn. Across the lawn were spread many tables with people all sitting around visiting and talking together. Behind them was some sort of large one story building. My thought immediately went to Grammie and Grandad’s backyard.
I walked onto a clear area of lawn and heard music beginning to play. I realized it was the opening notes of Climb Every Mountain, and I began to sing. My voice was full and perfect. I could feel the notes floating up into a sparkling blue sky as I sang. I knew I was singing to His glory! I knew this was His garden, His house! I hit the high note at the end with such perfect brilliance that it seemed to shimmer. When I finished, I could hear murmurs from the crowd, “That’s Sheryl! She’s here! That’s Nancy’s daughter! She’s Amy and Alvin’s granddaughter!”
I turned and headed further across the lawn where I saw my mom. She gave me a huge hug and said, “That was beautiful! I love you!” I said, “Mom! I can sing again!” She laughed and said, “Of course you can!” We walked over together to a gazebo area similar to the one I left earlier. I could see Bill standing there. I walked up, handed him the keys to the Jeep and said, “You will have to go get the Jeep. I parked it in a strange tree. I love you!”
And I woke up crying happy tears!
In Bonners Ferry, Idaho, we had a public viewing of Sheryl on April 25th and a funeral on April 26th. She was transported to Sacramento California on April 29th and was buried on May 2nd next to her mother in Elk Grove.
At her funeral service, I read her dream just as it appears above and then read the following.
Sheryl Tolson public viewing April 25, 2025
Remembering Sheryl
By Bill
I used to tell my wife that I married the richest girl that I ever dated. Having all of you here is proof that I was right.
Whenever my wife would complain about something I would reply, “When I get to be your age honey, I’ll find out.” Since I was a year older, this often got her upset, but I really had fun saying it just to get a rise out of her.
Last night we had our final date night. It was called a “public viewing”, but it really wasn’t. It was my last time to see her in the flesh. I wanted to spend one last evening with my bride of almost 22 years. It was bittersweet but I wouldn’t trade it for anything.
She didn’t have much to say but that was OK. We remembered the excitement of meeting for the first time, our first kiss, the first time she let me meet her kids, of course this only happened after I had been vetted by a group of her most trusted friends. Then there was the night we went to dinner with Tommy and Kendall, and I proposed to her. It was December 7th, always a memorable date for us veterans of the US Navy.
We were married on Friday the thirteenth in a little church in Vacaville California. It was a hot June night in two thousand three and everyone was sweating. We took our wedding vows using the Church of England’s 1662 Book of Common Prayer where Sheryl was glad to say that she would “honor and obey until death do us part”. It’s no surprise that Sheryl kept her word. In turn, I promised to love her as Christ loved His Church.
Early on, we had a few rough patches along the way, especially the two miscarriages which were balanced with the joy of her giving birth to our son, James.
It might surprise you to know that I rarely ever called Sheryl by name. She was called by her titles “wife of my youth”, “my bride”, “mommy”, “honey”, “bride of love”, and things like that. In fairness, James was often called “the boy of love” and Bob the dog was our “love dog”. Love was just part of what we did. Oh, behind her back, Sheryl did get called “management” on select occasions, but I think that is allowed by the description of the Proverbs 31 woman.
During our marriage, there were many road trips that we took. Some were just for fun, but many were to find a new place to live outside of California. Our road trips were sometimes over five thousand miles in two weeks. We saw lots of country, but in the end, it came down to Bonners Ferry where we bought two acres of land in 2020. This part of Sheryl’s story most of you know, at least in part.
Last April, Sheryl went with a group from Bonners Ferry and sang at New York’s Carnegie Hall. It was a dream for anyone that loved music as much as she did. A month later she lost her voice and knew something was very wrong. It was then that she learned that the cancer was back with a vengeance. In the next months, Sheryl experienced many rounds of radiation and chemotherapy, but treatment was unsuccessful. Sheryl was placed in hospice care on April first and died three weeks later, ironically her death was on the one-year anniversary of singing at Carnegie Hall.
At the end, just a few short days ago … or was it a lifetime …she was gasping for air. It was clear that each breath might be her last. Crying, I told her that I loved her. She then struggled for one last breath and then the biggest single tear, that I ever saw, came from the corner of her eye and dripped down the side of her nose. When I saw this, I immediately knew two things, she loved me, and she was most certainly gone. It was 6:46 AM.
So, there I was last night, mulling over these and other thoughts. Mostly, I was just missing her. Trust me, I kissed her several times when I thought no one was looking; after all, it was our last date.
In the last few days, everywhere I look and everywhere I go, I see her or some memory of her. In marriage two become one but in death, the opposite happens. The oneness is violently ripped apart.
Today we send my beloved Sheryl off on her final journey, a journey that ends with her body buried next to her mother where she will await the reunion of her soul and body at the end of history. Farewell my bride. It was my great privilege to be married to you and I’d gladly do it over again in a heartbeat.
Sheryl’s Grave in Elk Grove, CA
Only a memorial service remains as part of the farewell tour of my wife and our marriage. What is next is beyond my ability to see. Yes, I have ideas and aspirations of how I might move-on in my life but… I’m old enough to know that what I want and what God has in store for me might be different ideas. Other than organizing the house, I’m not sure what follows. God is good and has a plan. Funny how these words sound familiar. Kinda reminds me of someone I knew.
Sheryl Tolson passed away peacefully from cancer in Bonners Ferry on April 22, 2025, surrounded by her loving family. Viewing will be held from 5 to 6 p.m. Friday, April 25, at Bonners Ferry Funeral Home. Funeral Services will be held at 2 p.m. Saturday, April 26, at Providence Bible Presbyterian Church, 6530 Washington Street, Bonners Ferry.
She leaves behind her husband, Bill, of 21 years, her children Kendall Costello, Thomas Connolly, James Tolson, her sister Lori Douglass and her father Gordon Douglass.
Sheryl was born in San Francisco, and grew up in Orinda, California. After graduating from high school, she attended the University of California Davis and eventually graduated from Sacramento State with degrees in voice and business. Sheryl settled in Elk Grove, California, with her second husband Bill Tolson, where she taught elementary school for many years in the Elk Grove Unified School District. She loved singing and continued singing for various groups, including the popular Elk Grove Strauss Festival, Veteran’s and Memorial Day celebrations, and her local church choir. She was involved in the Chamber of Commerce, Old Town Merchants Association, and Rotary.
In 2020 Sheryl and Bill bought property in Bonners Ferry, where they retired in 2023. At their new home, Sheryl and Bill quickly made new friends. In retirement she used her artistic talents for singing and crafting gifts for fellow church members, family, and friends.
As a member of a choral group in Bonners Ferry, Sheryl was able to sing at Carnegie Hall in 2024. A month later she was stricken with a recurrence of cancer and lost her ability to sing. Her struggle with disease ended on April 22. When asked, Sheryl would often reply that, “I know God has a plan, I may not like it, but I trust Him.”
Halfway through April my wife’s health is continuing to decline. She is in pain much of the time. In addition, breathing is becoming more difficult. Morphine and oxygen are now regular parts of her care. She grows weaker by the day. Food consumption continues to decline. When you vomit part of whatever you eat, you decide to eat less just to avoid the futility of a meal. While she liked the promise of what the esophageal stint would do, the truth is it has had the opposite effect that was promised; namely, she is eating less than before. Meals are poached eggs, popsicles, oatmeal, and an occasional yogurt.
Cancer continues to spread. She is developing lumps of cancer just under her skin on her back and chest. One area that bothers her a lot is a lump of bone sticking out of her right side near where she had an incision to open her chest cavity and pull her stomach into her chest. This surgery was done 3 ½ years ago.
While she likes the relief that comes from taking a bath, her days of climbing the stairs to get to the tub are over. Last time she took a bath she had to rest multiple times to get up the stairs. She then had to rest before getting in the tub. The handrail that I installed is helpful but presupposes that a person has the strength to hold on while traversing the stairs.
Her dad is arriving in a few short days to help. Sadly, he knows how this will end but chooses to be here anyway. I’m glad he is coming.
I was hoping that she would make it until mid-June, our 22nd anniversary, but at this point I think it’s all over before then. I generally know her last wishes, but we have yet to work out the details of the memorial service that she wants in Elk Grove. We are doing three activities/services: Funeral in Bonners Ferry, Graveside service in Elk Grove, and a memorial service.
My parents are flabbergasted that my wife wants a proper Christian burial and then a memorial service. They think the body is trash to be burned and tossed away (or scattered). It’s just one of many disconnects that modern Christians believe even though the Bible teaches the opposite. My problem with them is that they don’t care what the Bible says on the issue and no amount of contrary evidence is allowed into their world. Oh, then they start hitting me with the cost angle. I’m like, so what. Even if nobody helps pay for this, I can use the insurance money to cover the expenses.
When the kids do make it here one last time, I hope she divides or distributes the bulk of her possessions. After things are settled, I would like to load the pickup and start delivering mom’s stuff to the kids. I don’t want to have all that stuff warehoused here until I too am planted in the grave. It’s not fair to put that on someone else later.
The truth is that much of what my wife has collected isn’t worth a plug nickel. For her everything is about sentimental value and nobody shares her sentiment. Today’s generation doesn’t care about real silverware, or fine China dish sets, or Depression era glassware, or mass marketed children’s books from the 1960’s. The Bible says that you should leave an inheritance to your children’s children but how can you when they aren’t getting married and making babies. The oldest is trying to check this box but the two boys are stuck in Andrew Isker’s Trashworld as happy as pigs in slop, just playing video games and passing the time away.
People keep trying to relate to me and say they are praying for me. I’m just the passenger on this trip through the valley of the shadow of death. The big blank for me is what happens after all the above is over? Frankly, I don’t need much help until that time at which I’ll be a lost puppy.
Minor update: given the trajectory of my wife’s condition, I think the end is much nearer than I had supposed, barring some intervention, I think she has days remaining and not weeks. I’m curious what my father-in-law will think once he gets to see the situation firsthand.
The best thing about March was a four-day visit by the stepdaughter and her husband. The next best thing was the baby show that was supposed to happen months ago. It was put on hold because the mom decided to have her baby a week before the shower. What nerve!
The rest of the cancer story for March was one of decline.
My wife is no longer cooking. The meal tasks have fallen on me. I’m getting really proficient doing poached eggs, but please don’t ask me to eat one. Yuck!
Bathing is another task which has become more complicated. My wife has been experiencing pain in her body; especially, her back. The best temporary relief she can get is from taking a bath. The tub is upstairs. For the last two weeks, she has had to climb up the stairs on her hands and knees. She claims that she is unsure of her balance going up the steps. Afterwards I must help her down the stairs.
She sleeps for much each day and her energy is very low.
Eating is from a limited menu. The last few days have been poached eggs for breakfast and dinner. Juice popsicles, cheese sticks, and yogurt are occasionally consumed as well. Contrary to what we hoped, the esophageal stint has not increased her menu options, only her ability to vomit has improved.
Last Friday, was the PET Scan that would show if her chemotherapy and immunotherapy was working. The results arrived yesterday. The results were even more dire than I could imagine.
Despite treatment, the cancer has spread significantly. My wife has cancer in her saliva glands, her neck, chest cavity, spine and lower back, and pelvic region. She also has cancer in both the left and right lobes of her liver. There are so many places with cancer that they are not listed by occurrence any longer.
I’m not a doctor, I just play one on this blog, but it seems that she has little time left. I think she has two to four months remaining.
Between the cancer and the starving game that she is enduring, it seems just a matter of time before something breaks. I’m trying to persevere and not dwell too much on what’s happening. I can mourn later or at least that is what I’m telling myself. How long until we have to rent a hospital bed and park that in the bedroom?
Update just prior to publishing: Physician’s Assistant says that the doctor told her that treatment is ineffective and is therefore ended. Chemotherapy was cancelled today and forevermore. Also, my wife’s white cell count was too low, and she couldn’t get treatment with that kind of result anyway. We are now on hospice. Clearly a new chapter in this cancer saga.
Also, I contacted the middle child and told him that it’s time for FMLA. He needs to make arrangements to see his mom towards the end of April or first of May.
Knowing that my wife’s mortality is staring both of us in the face, we knew that this year would be the last Valentine’s Day that we would ever share. About two weeks prior, we had tried to find a nice place for a Valentine’s meal but came up dry. In 22 years of marriage, we had never gone to a nice restaurant for dinner on February 14th. As often happened in the past, I had decided to buy a nice steak and the trimmings and hope for dinner on another night. It was disappointing.
However, two days prior, we received a call saying that the best place in town, Tavern at the Lodge, had a cancellation. We were grateful and really excited for this unexpected gift. Tavern was offering a seven-course meal for the evening.
We arrived shortly after 5 PM. Meal service was scheduled to begin at 5:30. We got the table next to the fireplace. I tried all the dishes as they came out. Many I have never had before and likely would never order again. The meal also came with two glasses of wine. One was a very dry white and the other a dry red. I didn’t like either one. Below are a few photos of the meal.
Valentine’s Table Setting
Salad
Appetizer
One of three beverages served
Veal Wellington (sorry but we missed the duck photo)
Wellington showing heart design detail
Dessert
I think we only got pictures for five of the seven items. I don’t claim to be as thorough as Johnnie Does.
After the meal, we stared across the table at each other. We both knew this was the last Valentine’s dinner that we would share together. We both started crying; something I did off and on for about the next 20 minutes. Finally, it was my turn to pay the bill. Once that was done, we went home.
Also in February were more medical procedures including additional chemo and immunotherapy.
The cyst that regrew was removed from my wife’s back. This time the doctor thinks he got it all.
Toward the end of the month was the placement of an esophageal stint. What a horrible thing to do to someone. My wife is suffering terribly as a result of the stint. Her body aches all over and she has constant nausea. The stint is supposed to force her esophagus open to 18 millimeters (50 percent more than it can be stretched any other way.) Oh, and it’s about 5 inches long. How would you like that object surgically placed in your throat? She is experiencing lots of coughing fits as a result. It also doesn’t help that she has more fluid in the plenum cavity in her chest. You know my wife is sick when she is skipping church and shunning visitors.
CT and PET scans in March will likely direct what future treatment that she receives.
Oh, lastly, in my previous post, the news that I posted seemed rather dire. At our last meeting with the Oncologist, I asked about the write-up from the other doctor that I had previously posted about. The Oncologist was dismissive of the conclusions in that report. In short, his comments were thus, one conclusion would require surgery to confirm, and the other is premature but might be supported once the next PET scan was done. He didn’t really say “no” to what was in the report, more that it was just too early to go there yet.
These last few weeks have been horrible, informative, and whatever the heck is the opposite of fun. I’m frankly a little depressed and discouraged as I hope to explain below.
The fluid in the lungs is back. It is not as bad as it was before it was drained in the hospital, but it is definitely returning. Even a dumb guy like me could clearly see the horizontal line showing the liquid level on the X-ray a few days ago. The pathology on the liquid came back as positive for cancer which was no surprise.
Today was yet another CT scan of the chest. I think this is the third one in two weeks. It is clear to me that the doctors are expecting to find cancer in the tissue surrounding the chest cavity. The write-up of the CT scan seemed to confirm that without coming right out and saying it.
Below are some of the medical terms used in the write-up
Ill defined/irregular pulmonary nodules
Nodules in the lungs are not necessarily cancer but could be. Given everything else happening, nobody is even suggesting that they be tested. It’s pointless.
Multiple enlarged mediastinal lymph nodes
When the lymph nodes in the mediastinum become enlarged, it is called mediastinal lymphadenopathy. Mediastinal lymph node enlargement can occur from a wide range of diseases, either on its own or in association with other lung conditions. It usually stays less than 10 mm in diameter.
Mediastinal lymph nodes are typically the first ones that cancer cells from the lungs will trap, providing doctors have the means to know if cancer is spreading.
Under the heading Impressions
Recurrent pleural collection
Pleural effusion, which some people call “water on the lungs,” is the buildup of excess fluid between the layers of the pleura outside your lungs. The pleura are thin membranes that line your lungs and the inside of your chest cavity.
Interlobular septal thickening and may be due to edema or lymphangitic carcinomatosis
Interlobular septal thickening is commonly seen in patients with interstitial lung disease. On HRCT, numerous clearly visible septal lines usually indicates the presence of some interstitial abnormality. Septal thickening can be definied as being either smooth, nodular or irregular and each likely represents a different pathologic process.
(The above URL links to an example of Interlobular septal thickening.)
Lymphangitis carcinomatosis is the malignant infiltration and inflammation of lymphatic vessels secondary to the metastatic spread of malignancy from a primary site. The carcinomatous infiltration of the lymphatic vessels almost always occurs in the pulmonary interstitial lymphatics
Bruce et al. observed death within three months of presentation of respiratory symptoms in half of the patients, and Zhang et al. noted that almost 72% of the patients died within seven months of presentation.
Folks, this diagnosis is eerily similar to the cancer that took out my wife’s mother about ten years ago. My wife’s disease is above the diaphragm while her mother’s cancer was below. Both are lethal.
However, this is not all the cancer news for the week.
As stated in a previous post, the cancerous cyst that was removed in November grew back in short order and is now larger than its predecessor. It was supposed to be removed this week via an outpatient procedure but after taking one look at it, the doctor said it was too big and would need to be removed in the hospital operating room. This is scheduled for next week.
Also, it has been agreed that my wife will be getting a stint in her esophagus at the end of the month. This is intended to hold her esophagus open to the max that it currently opens which is about 12 millimeters. Hopefully this will allow her to eat more solid types of food. Poached eggs are a rather boring breakfast every day.
The thought that my wife could have as little as three months is very disturbing. I thought we would have more time together. What is happening to her respiratory system looks to be the beginning of a cascading failure of bodily systems.
I feel especially sad for the children. They kind of know what’s going to happen to their mother but…
Yesterday (Tuesday Jan 21st), my wife had another PET Scan. It is the first one in 2025. Her last was back in November. The results were even more dismal than either of us expected.
This PET scan was using a newer machine, and the results were written by a different doctor. The scan report didn’t give the size of tumors but only the SUV intensity. (Only three measurements were given. They will appear later in this post.)
Before proceeding, I will recap what an SUV reading is.
A higher SUV may indicate increased metabolic activity, which could be due to various factors, including inflammation, infection, or cancerous growths. Conversely, a lower SUV could indicate less metabolic activity. Generally speaking, metabolic activity is considered:
Going into this we knew there were five tumors. The four originals that were on my wife’s neck and upper chest plus the one on her back which had been removed and had promptly grown back in a matter of weeks. If the PET scan had stopped here, I would not be blogging on this today; however…
The physician’s assistant showed us the scan as a whole body, front-to-back, but did not zoom in on any areas. By viewing the new scan, we knew there was at least one new tumor visible, but we were advised to wait for the results.
I will now go through the results of the scan. The report generally goes from head to toe.
Four tumors that already had chemo and radiation:
1 Right supraclavicular nodal SUV 3.8
2 Right superior paraesophageal SUV 4.6
3 Right posterior chest wall/pleural SUV 8.2
4 Focal uptake right lateral seventh and eighth ribs SUV 5.8
Cyst that regrew on her back after removal:
5 Posterior superficial subcutaneous nodule at level of eleventh rib SUV 8.6
(The cyst on her back was measured at 2 cm traverse (horizontal))
Next, the scan found an additional six tumors.
All six tumors were in what I would describe as the pelvic area.
6 Small deep subcutaneous module overlaying right superior gluteal region SUV 8.3
7 Deep aspect right inferior gluteal muscles SUV 12.0
8 Soft tissue just medial to superior left acetabulum SUV 6.6
9 Focal left gluteal muscle SUV 4.2
10 Focal uptake left greater trochanter SUV 5.4
11 Focal uptake proximal right femur just below the less trochanter SUV 11.0
As the infomercial says, “And that’s not all” because, sadly, there was more.
In my wife’s chest the scan found loculated pleural fluid collection in her posterior right chest measuring 7.4 v 5.5 cm
Loculated pleural effusion refers to the accumulation of fluid in the pleural space, the thin space between the lung and the chest wall. Unlike simple pleural effusion, where fluid accumulates uniformly, loculated effusion involves the formation of pockets or compartments within the pleural space.
The nodule right superior gluteal region was 9 mm.
Anatomy Terms
Superior = above
Inferior = below
Traverse = horizontal
Subcutaneous = deepest skin layer
gluteal region = external (outside) pelvic cavity
nodule = abnormal group of cells (think lump)
In two months, we went from five to eleven tumors. The cancer has spread to skin, muscle, and bone tissues. The fluid in the lungs is likely the result of the cancer being in the lymphatic system of my wife’s neck and chest. A web search seems to indicate that if a certain quantity of fluid accumulates that it will need to be drained. Given her history, the fluid is likely full of bad stuff.
Following the PET scan, we were called in on Friday (Jan 24th), for a CT scan. This scan was combined with a swallow test to see if fluid was leaking from the esophagus into the chest cavity. Thankfully, this result was negative.
However, the next morning, my wife began to cough up blood. This continued all weekend and on Monday morning, the office of her oncologist was contacted. We were instructed to go to the local emergency room for treatment.
My wife was admitted to the hospital. After poking and prodding her, the doctors decided to put a drain into her chest cavity and remove the pocket of fluid in her chest. They put a hole about 1/8 inch into the right side of her back. The hose went between her ribs. The portion of the hose inside of her was about six inches long. It was covered with a sizable dressing. This hose was connected to a much larger one that emptied into a rectangular box. The holding box had cascading sections which went from right to left. Each section was marked with lines to measure the amount of fluid discharged from the drain. The unit of measurement was cubic centimeters. In addition to the collection device, there was about another 160 CC’s that went to the lab for examination.
Once the fluid was removed, she could breathe easier, and she stopped coughing up blood. After two days, the chest tube was removed, and she was sent home. It was never determined why she was coughing up blood. There is a waiting list to test her for possible reasons. We are waiting to schedule an outpatient exam to learn more.
Meanwhile next week is removal of the cancerous cyst on her back (again) and more chemo.
Sometimes, when your reality and expectations align, it’s not a good thing. Yes, I know that is contrary to what our culture teaches, but do you still believe the Disney lie that following your heart is a good thing? 2025 looks to be the long slow plodding walk thru the valley of the shadow of death.
Let me explain.
The meeting that my wife and I had with her oncologist a few days ago was depressing. She finally asked the “big question;” namely, “What is my prognosis?”
The doctor’s response was that she had a fifty percent chance of living ten … to twelve months. He initially stopped after saying ten and then added the “to twelve months” after a brief pause. I felt that the subtext of his answer was buckle up buttercup, the water is about to get really rough.
This reply was followed by a discussion of chemotherapy, immunotherapy, or doing nothing. I thought these were the three choices, but they managed to decide on a fourth option. My wife will begin to do both chemo and immunotherapies simultaneously starting next Tuesday. The chemo will be a slightly different cocktail of drugs than last time, the major side effect of this round will be diarrhea. Why she thinks that side effect is better than cold sensitivity is a mystery to me. I’m picturing her having to be within line-of-sight of the nearest toilet and potential dehydration as a horrible way to live.
My wife wants to go out swinging, which is a good trait and one I expect from an upbeat and optimistic person. I kind of think the quantity versus quality-of-life question should have been asked but it wasn’t. I can’t help but wonder if the cure is worse than the disease. The die is now cast and our course plotted for the next few months.
Oh, lastly my mom is down to 88 pounds and not doing well. I may be trekking to the once golden state more times than I want is year to say farewell to family members.
Christmas is over. The children have returned from whence they came. This was likely the last Christmas with their mom. In a sense it might be hard to grasp because mom cooked for them and was her usual bubbly self, but lacking the energy to go at full speed all the time.
To me their visit seemed like a pause in the progress of her cancer and its treatment. Tomorrow, we end the year with yet another visit to the oncologist. In December we have had biopsies with more cancer and findings of malignant cells. Mom now admits that she is experiencing stage 4 cancer. The cancerous cyst removed from her back appears to be growing back and feels larger than the one removed just a few short weeks ago.
2025 will begin with one of three possibilities; immunotherapy, chemotherapy, or no further treatment because it won’t matter. Due to chemotherapy being ineffective, I think that is not the most likely option. Immunotherapy ended last time in hospitalization and the beginnings of several organs starting to fail. I think my wife is hoping for this option but with better monitoring. The option that further treatment is futile is one that polite conversations don’t discuss.
Jimmy Carter died yesterday. He was arguably the worst president of the 20th Century. Carter’s biggest claim to fame was making it to 100 years old. Joe Biden makes Jimmy look good by comparison; however, Biden has been functionally braindead for most of his term in office. Who was running the country is not known yet. The “tell” as they say in magic and gambling is whether Democrats will fight over credit for Biden’s Administration or just ignore his failure and look to the future (2028).
Trump is casting a large shadow over the political landscape and Biden becomes more irrelevant every day. As I said last time Trump was in office, I don’t care what he says. The only thing that matters is what he does. To have any lasting legacy, he needs to get legislation approved by the Congress and signed into law. At a minimum he has two years to do that. I hope Trump will unleash hell on the swamp from day one.
As for the Elon Musk committee to cut waste, I have doubts that much will really happen. I think it’s doomed just as the Grace Commission was under Ronald Reagan. Look for Republicans to campaign on the Committee’s findings but fail to implement the suggestions into law.
As for church stuff, I’m really getting excited about the Bible thanks to Brian Godawa and his writings. I also have been going through a podcast that he participates in called Iron and Myth. I have added what they describe as a supernatural view of the Bible to my other beliefs about God.
I also have benefitted from some sermons that I downloaded from Doug Wilson. Both Wilson and David Chilton have teachings that touch on the supernatural view of the Bible, but they don’t elaborate on it much.
Lastly, I have been going through training to be a Deacon at my church. Mostly, it has consisted of going through the Westminster Larger Catechism, although we will eventually get into another book as well.
The church which we attend has been very generous to us. Frankly, Christmas wouldn’t have happened without their support and caring. I wanted to give them a “shout out” without going into details.
Another batch of procedures, another post. The main event this week was a probe being sent down my wife’s throat to check out her esophagus. The opening at the top of her esophagus is now a whopping 5 millimeters in diameter. The doctor was able to dilate the opening slightly, but this measurement is much smaller than last time when it was able to dilate to 20 mm (2 cm). As a result, he had to use a pediatric sized camera to see what was going on in there. The active tissue on the PET scan appears to be an ulcer at the bottom of the esophagus. No tissue was biopsied in this exam. That is good news; however, it sounded to me like the pediatric scope was not really capable of doing any tissue samples if they were needed. We will have a follow-up exam in about 3 weeks—assuming scheduling allows for this since it’s right in the middle of the holidays.
Also, this week a cyst was removed from her back. This is likely not a big deal, but it did appear during the early phases of chemo and radiation. Pathology is likely a week away.
My wife is capable of about two hours of activity a day before crashing. This is enough to put on a good show at the grocery store or church. Overall, her energy level is low. She is down to 155 pounds. This is the least amount she has weighed since beginning college. She is getting more calories but most of them are “junk calories” like pie filling and cheesecake. After some trial and error, she is now comfortable eating cold things like ice cream. Her daily calory goal is up to 1,400 per day, but like I said it’s quantity not quality nutrition.
