"This Is So Unfair" -- Complications Post Lung Removal Steal Life of Robust 63 Year Old Nelson Lachapelle. Worcester, MA

Towards the end of 1999, sixty-two year old Nelson "Nellie" Lachapelle made an appointment with his doctor in Worcester, Massachusetts. He was feeling unusually tired and was experiencing shortness of breath, pain in the lower back and occasional chest pains. Otherwise, Nelson may have been close to taking advantage of his senior citizen benefits, but mentally he was far from it.

Nelson regularly participated in exercise. He has always had a gym in his house, possessing such exercise equipment as "Bowflex", "Solorflex", stomach machines, Roman chair, etc. He was a long time body builder, from late teens on, representing his local YMCA in competitions, winning such titles as: Mr. Boston, Mr. Worcester, Mr. Springfield, etc., and he took great pride in cultivating an athletic physique. He and his wife enjoyed dancing, taking trips, and doing Community Bible Educational Work.

Thinking it was Pneumonia, Nelson's physician took several chest films, which did not show any fluid in the lung linings. Nelson occasionally suffered from high blood pressure and was taking a prescription to treat it. His doctor gave him a stronger prescription as well as prescribed antibiotics.

About a year later, around January, 2000, Nelson again felt short of breath. He returned to his doctor who thought he again was suffering from pneumonia. A chest film revealed his right lung lining was filled with about three liters of fluid. He was then referred to a pulmonologist located at the University of Massachusetts (UMass) Memorial Medical Center.

The pulmonologist performed a thoracentesis via the back on the right side at UMass Memorial. He was unable to remove all of the fluid. He explained to Nelson that there would be an adverse side effect if he tried to remove all of the fluid. The fluid was submitted for cytological testing, which was inconclusive for the presence of cancerous cells. Nelson was counseled to wait for two weeks to see if the fluid would return or if his body could absorb it.

When the fluid did (unfortunately) return in February, his doctors performed another thoracentesis with a needle biopsy. The doctors also harvested biopsy material from five locations within the right chest cavity. A CT scan was also performed. The specimens were submitted to the pathology laboratory at UMass.

A few weeks later, Nelson was advised over the telephone of the diagnosis - malignant mesothelioma. His doctor referred him to second surgeon to confirm the diagnosis. On March 13, Nelson underwent a video-assisted thoracic surgery (VATS) at UMass. Nelson remained in the hospital for four days, and went home on Friday, March 17. The pathology department at Umass again confirmed that he was suffering from malignant pleural mesothelioma. Nelson was offered two treatment options: surgery to remove the tumor and/or lung, or "watchful waiting" that is, to do nothing but monitor his health and postpone treatment " (but not too long because then it may be inoperable). The first offer suggested a better quality of life, and that is what Nelson was looking for - life without mesothelioma, and life without pain, so he decided on the surgery.

Mr. and Mrs. Lachapelle were, of course, devastated by this grim news, and began intensively researching the Internet with their daughter's help, looking for information on mesothelioma. He investigated a radiation, non-surgical treatment in New York but was told that the tumor was too extensive.

The Lachapelle's daughter read with great interest, on the Internet, articles written by Dr. David Sugarbaker, who is considered to be a pioneer in the multi-modal approach to eradicating the mesothelioma tumors. The Lachapelles met with Dr. Sugarbaker on April 4. Dr. Sugarbaker said that Nelson was a suitable candidate for a right-sided extra-pleural pneumonectomy (EPP) with removal of the diaphragm, the pericardium (same diagnosis as was given by a well respected UMASS Cardiothoracic Surgeon, who had many years of experience with Mesothelioma in South Africa). Dr. Sugarbaker explained that a blood transfusion would be necessary during the operation. Nelson, however, was a devout Jehovah's Witness and he according to his belief could not receive another's blood. Unfortunately, Dr. Sugarbaker was unable to honor this request. They asked Dr. Sugarbaker if he knew Dr. Conlan, from UMass Memorial and he said "Yes" and he felt confident that Dr. Conlan was a great surgeon and if he could perform the surgery without blood to go with him. This they did and on Monday, April 10th, Dr. Conlan performed the bloodless EPP on Nelson at UMass Memorial Medical Center in Worcester, Massachusetts.

UMass Memorial Medical Center hooked up Nelson with the "Bloodless Medicine and Surgery" Center where he consulted with several Oncologists who helped him "build up" his blood cells in preparation for the surgery.

Prior to the surgery, Nelson experienced constant pain and severe fatigue. He slept most of the day and ran a low grade fever, under 100 degrees, "up and down." His weight dipped to approximately 172 pounds, from a "playing weight" of 205 pounds.

On April 10, Nelson underwent a bloodless EPP at the UMass Medical Center. A portion of the pericardium was removed along with the diaphragm and a rib. The doctor said that Nelson had "minimal" blood loss during the surgery. After the procedure, his doctors were very optimistic regarding his recovery, as they believed that they had removed all of the visible tumor (however, it is impossible at this time to eradicate all living malignant cells during the procedure, as "free floating" malignant cells can either embed into or adhere to the chest wall, diaphragm, etc.). For few days after surgery, Nelson did great. He was able to speak with his wife and daughter, he had intervenious tubes and IV's and only nasal oxygen intake. The plan was to move him from ICU to the floor on Friday (four days after surgery). Thursday night he had his first set-back, and he remained in the ICU for the next thirteen days.

Unfortunately, Nelson's post-operative condition plummeted. While in the Intensive Care Unit, fluid accumulated in his remaining lung, he acquired pneumonia. On his fifth night in the ICU, he nearly choked to death on phlegm. On another night his heart rate increased, he had Atrial Defibrillation. He was put on a respirator. The Respiratory Dept. was monitoring him to see if he could breath on his own, he tried very hard because he wanted to get better and go home. His only means of communication, now, was with pen and paper, as he had respirator & tubes in his mouth and nose. On his ninth day in the ICU, he scratched a note to his wife that he was "in a lot of pain." For the next three to four days, he simulated driving a car with his feet in order to get a minimum of exercise to build up his only lung, always fighting trying to regain his health & strength so that he could go home and enjoy as good a quality of life as he could .

On April 26, Nelson passed away at the UMass Memorial Medical Center. He was only 63 years old and he and Olga were planning to move to Florida to enjoy their retirement in the sunshine. Nelson Lachapelle fought to the end. His heart stopped three times. The first two times he was resuscitated, although the doctors diagnosed brain damage and kidney failure. Olga, Nelson's wife of 35-1/2 years, was forced to watch as the doctors tried to revive her once strong husband's now withering body. "This is so unfair," she sobbed. His wife, daughter, her husband, his brother along with his wife watched him take his last breath.

This is so very, very unfair. So very preventable. So very tragic. We need to make the effort to find a cure now so that this tragedy will not repeat itself over and over, time again -- the ultimate injustice.

Postscript:

"It has been difficult, but I'm in a fighting spirit. I do feel that Nelson died "needlessly", he did everything in his power to stay healthy. He took vitamins, made fresh raw vegetable juice to drink, when his "Immune System" started to weaken, he would buy books on health and look into antioxidents, aroma therapy, books on breathing so that he could get more oxygen into his body hoping that it would be the "miracle" cure. He tried to do everything just so that he could feel better. He even retired at 62 so that he could get more time to himself to take care of his health. Our original plan was for him to work until I was 62 (in 2001) and then he would retire and we would move to Florida and enjoy our retirement in the warm climate. When he was in the hospital we had pictures of "Florida" retirement communities to keep his spirits up and I always reasurred him that the minute he got released from the hospital, I would give my notice at work and we would move to Florida earlier. He looked forward to that so much, so did I."

--Olga Lachappelle

*** POSTED JUNE 16, 2000 ***