Final Goodbye to My Sister-In -Law, A Christian Example for my Kids

Hi, Helen,
Thanks to be a good Christian example for my 4 kids. Even though you could not speak,the 2 tiny drops of tears from your left eye after my daughter’s prayer at your hospital beside shown that you were with us during the prayer, and I knew you truly felt and heard that your good effort to teach my kids to know God for the past 20 years was not in vain.As I saw the stream of Church members who came to visit you, I realized they were also came to say the final goodbye for the same reason as you had taught their kids to become good Christians too.

Thanks for letting me into your life as one of your brother-in-Law;thanks for trusting in me as the medical person that have the privilege to serve you and thanks for letting my wife and kids to have opportunities to share their individual, personal and final thoughts and prayers with you before your departed.

No words from me can express the deep sorrow and understanding I felt about your CCA journey except I know you just went before me earlier on the same journey.

May your soul now at peace and join your parents to sit on the right side of God and enjoy heavenly peace.

God bless.

HX: 58 yrs. young female, mother of two sons;love to cook and eat ;felt ill at Thansgiving dinner on Nov. 2010 ;dark brown urine;later jaundice.

Diagnosed on Jan.2011 as Stage IV extrahepetic cholangiocarcinoma with mets to omentum.

Start treatment at OSU by Dr. SAAB with Gemzar+Xeloda+Avastin with good results especially on the abdominal omentum carcinomatosis which almost completely disappear after the first CAT scan; Unfortunately the regimen had to change due to the side effect of “colon perfolation” of Avastin.

MK2206 clinical trial was suggested after several months of Gemzar and Xeloda regimen which did not help that much on the cholangiocarcinoma and ovarian and liver mets started to develop.Stents had to put in every 2 months to relieve the bile blockage. I suggested to her at this point to try the standard regimen of Gemzar+Cisplatin first before the MK2206 since it is so new(phase 1 clinical trial and only 3 patients in the study)and the GEM/CIS may help to control other mets like ovarian cancer.
She did talk to the doctorfor further advice,but he said to her”you can always come back for the other chemo”; Well , then she decided not to miss this chance and started the clinical trial on MK2206 ( cell pathway targeted therapy agent); CA19-9 improved substantially but hyperglycemia(side effect of MK2206)developed and therefore MK2206 had to be stopped after 2 month.
I did at this point ask them to get 2nd opinions for radiation and medical oncology from Mayo,but she is too weak and lost the fighting spirit.
By this time , the other metastasis of the liver,ovary and the peritoneal carcinomatosis continued to grow aggressively without other form of treatment; The last proposed chemotherapy by the doctor was FOLFOX .
But she was to weak to do the whole regimen;she did only the 5FU 48hour pump once and she could not tolerated it .
She did not havethat much pain at the last stage of her journey;she developed sepsis,DVT and swelling of both legs and had to be admitted to the hospital 3 weeks ago.She could still talk to people and the doctors in the first part of the hospital stay;to receive 2 stents for the failing kidneys.
Due to the growth of the 2 ovarian cancers pressed against her intestine.she could not absorbed anything thru nutritional tube feeding;DNR is requested by her and her family;comfort care like oxygen and iv fluids were provided.
Our family is fortunate enough to communicate with her for the last 5 days;the last word my wife heard from her was “coffee” and my wife got some and use the little sponge to put some warm to touch coffee on her lips.
Three days later;most of her organs stopped working except her heart and her mind;she finally transferred to the Kobacker hospice care.(I highly recommended this facility if you are in Ohio.)
During the hospice stay;her eyes were closed most of the times; her blood pressure continued dropping until it could not be measured even by hand held BP measuring device;the heart rate continued to go higher trying to keep to maintain the blood pressure;the lower parts of the body was cold and the forehead as well.
Finally this morning, she passed away at the age of 58. she endured this horrible ,inhumane,brutal and cruel disease courageously for 15 months.
May she rest in peace.