59-Year-Old Retired Resourceful Recycler Turns to Dr. Pass in Rebuilding A Body Wracked By Mesothelioma. Midland,MI

John Pomranky was born in Midland, Michigan. His forefathers were among the first pioneers of Midland, their name gracing many streets and parks in the area.

John was the second youngest of 10 children, eight boys and two girls. The family remains extremely close. They are in constant contact and are always available to lend a hand with the smallest project. The 10 children were raised by parents who did not coddle them, but encouraged them to fend for themselves, solve their own problems and be independent.

John and Ann Pomranky were married on October 21, 1967. They have two adult children, Kara Malkowski, age 30, and Steven, 28, and four grandchildren.

They have struggled with cancer before. As a teenager, Steven was diagnosed with non-hodgkin's lymphoma. Ten years ago he underwent a bone marrow transplant. He has had two recurrences over the last several years. Despite his troubles, Steven managed to become a police officer in Midland.

Tall, quiet and unassuming, John is an inventor and builder. His backyard and large barn are cluttered with tossed-away items - wheels, frames, fans, boxes, boards or broken equipment. He turns trash into "treasure." A prime example is his renovation of a 100-year-old storage building that had been rotting away for years in a corn field. John convinced the owner to give him the old storage building and within days, John and his brothers had the building jacked up and towed to his 10-acre hideaway, located about 20 minutes from his home. John proceeded to refinish the building into a comfortable cabin. He cut wood from his land, dried it out, planed it and finished it. The once rotting building in the middle of a corn field became John's getaway, known as the "Recycled Inn."

Behind the finished cabin is a garden, where John grows squash, pumpkins, beets, corn, cherry, peach and apple trees. Every piece of the Inn comes from recycled materials. An avid outdoors man, he hunts and traps on his land and has several coyotes, fox and mink pelts hanging on the walls of the Inn. As a fisherman, he favors walleye and perch. His love for the outdoors comes a close second to his family.

John's troubles began in November, 2002. He and his son Steven were deer hunting, and John shot a buck early that morning. When it came time to leave, John was unable to help Steven drag the buck back to his truck. He tried to carry the guns and other gear but found that he had to stop to catch his breath every few yards.

John consulted with his doctor. In December he was diagnosed with bronchitis and treated with antibiotics. In January, 2003, he was diagnosed as having a bad sinus infection.

During the next few months, John pressed on with his daily chores, trying to ignore his shortness of breath, weight loss, and fatigue. He began to spend day after day just sitting in his chair. His wife and daughter urged him to see a doctor. John finally agreed and contacted his doctor in May.

To reach a diagnosis, John's doctor ran a series of tests. A chest film revealed the presence of a large pleural effusion and prompted a CT scan and referral to a pulmonary specialist. The pulmonologist performed a bronchoscopy along with a pleurocentesis during which 50 ml. of fluid were removed. Cytological testing of the fluid was inconclusive. In early June, a fine needle tissue biopsy was also attempted on a mass that had been found during a previous CT scan, but this procedure was unsuccessful.

John continued to suffer through the summer with no confirmed diagnosis. In late August, John was admitted to the MidMichigan Medical Center for an exploratory right thoracotomy and biopsy of the pleural mass. The surgeon entered his chest cavity through the bed of the fifth rib. The pleura at that point was quite thick, approximately one centimeter. The lung, which was enshrouded almost in its entirely by thick viseceral pleura, was detached from the chest wall. The surgeon attempted to further decorticate but the peel was very adherent and there was concern that any further removal might result in significant air leaks. The chunks of the parietal pleura were sent to Pathology and, on frozen section, were found to be consistent with mesothelioma.

John remained hospitalized for eight days. Two drainage tubes inserted for post-surgical drainage remained until August 26th. The excruciating pain associated with both the invasive surgery and the cancer was controlled with morphine. John described the surgical scar, located directly under his right shoulder blade, as a foot long running from his backbone to the right side of his chest.

After being told by his surgeon that he had mesothelioma, John was in a state of shock. He had heard the word mesothelioma on television. Now he was faced with the reality that he had a terminal disease. The doctors suggested that he contact Dr. Harvey Pass at the Karmanos Cancer Clinic in Detroit, Michigan. (Link to Pass).

John met with Dr. Pass on September 8, 2003. Dr. Pass ordered a number of tests to determine his suitability for radical extra-pleural pneumonectomy (EPP). Based upon his examination, and the review of the performed tests, Dr. Pass recommended that John first receive chemotherapy followed by a right-sided extra-pleural pneumonectomy (EPP) and adjuvant radiation treatments.

It was decided that John would receive what at that time was considered the experimental chemotherapy combination of Alimta and Cisplatin. Prior to its approval by the Food and Drug Administration on February 5, 2004, Alimta was offered on a "compassionate use" basis only. Therefore, John would have to travel from Midland to Detroit every three weeks for administration of the chemotherapeutic agents.

In late September John and his wife Ann made the trip back to Detroit. It took approximately one and one half hours to intravenously administer the chemotherapy, which needed to remain in his body for 12 to 14 hours. After the treatment period the drugs were flushed from his system. Each treatment required an overnight stay at the hospital. With the first session under his belt, John returned home. Three days later, John became so ill with nausea and diarrhea that he ended up in the hospital emergency room. There he was given fluids intravenously, anti-nausea medication and suppositories to combat the diarrhea.

Three weeks later, John traveled to Detroit for his second treatment. This time he was given more anti-nausea medication and OxyContin for pain. After returning home, he did nothing but sleep for almost five days. When he finally got up, he felt much better.

However, John again required emergency hospitalization, on October 20, 2003, for a blood clot in his left leg. He was treated with intravenous heparin and Lovenox until his discharge on October 23. On October 24, 2003, a follow-up MRI revealed a blot clot near the left lung. John was ordered to stay off his leg and self-injected Lovenox every 12 hours into his stomach. This pushed back John's treatments by a week.

John received his last cocktail of Alimta and Cisplatin on November 25, 2003. A CT scan and other preoperative tests were conducted during the next several weeks to determine if he remained a suitable candidate for the EPP. It was Dr. Pass's recommendation, based partly on the lack of other reasonable treatment options, that John proceed with surgery. The surgery was scheduled for January 26, 2004.

At the time of the surgery, Dr. Pass chose not to enter through the previous incision because it did not provide adequate access to the diaphragm. Once inside, Dr. Pass found a very bulky tumor that was invading the last layer of the inner chest wall, the diaphragm, heart sac, and the lung itself. The pleura was incredibly hard and thickened in areas up to 1.5 cm. The tumor was stuck like "Crazy Glue" to the top of the chest, making the dissection of the vena cava and the subclavian artery difficult and tedious. The diaphragm was also completely involved with the tumor and had to be resected en bloc with the lung. Dr. Pass had no other alternative but to perform an extra-pleural pneumonectomy.

Fortunately, there was no invasion through the diaphragm into the abdomen or the pericardium onto the heart. After removing the lung, pleura, diaphragm, pericardium and lymph nodes, Dr. Pass used Gortex, a synthetic implant material that does not dissolve, to reconstruct the diaphragm and the pericardium. The surgery took approximately four hours to complete.

Since the surgery, John has been recuperating at his home in northern Michigan. His recovery has been slow and painful. There was no deer hunting last fall and no ice fishing this past winter. But John is hoping that as each day passes and with the arrival of an early Spring he will be able to return to the "Recycled Inn" to begin work in his garden. John is determined to return to his cherished days of retirement, to camp on the Upper Peninsula, to end the temporary "stay" enjoyed by the walleyes and perch, and last but not least, return to his old hunting grounds for another buck.

Kara Malkowski is John's daughter. Her thoughts follow:

I am the daughter of John Pomranky. His family is very proud of him for taking on this challenge...he is a role model for us all. I just hope that his story will encourage others who are faced with this disease. There are so few survivors, which makes finding a glimmer of hope so important. We never would have expected that eight months after diagnosis, and three months after a extra-pleural pneumonectomy (EPP), my dad would be up and around, puttering around his shop and occasionally going to Friday-night fish fry with his wife, children and grandkids. He even went fishing two times last week with his brothers and nephew, which he hasn't been able to do for many, many months. Which is not to say he doesn't have bad days. But the days that are good, he makes the best of. We give the credit to God who has gifted my dad's doctors with their talents and who has blessed us with strength and comfort, even on the worst days.

What you may not realize is that he is the best "papa" in the world. Even during this illness, even when the disease was ravaging his body, my dad always has a hug and a smile for his grandchildren. His twin grandsons were born while he was in the hospital recovering from the EPP, so we brought a laptop computer into his hospital room so he could see the pictures of them. There were no words necessary as the tears of joy ran down his face. He generously gives of his time every weekday afternoon to care for his two granddaughters. There is nothing like seeing a little four year old girl run up from the creek behind the house with a freshly caught sucker hanging from the hook on her fishing pole -- all done with the help of Papa. Papa's lap is the place for rides on his old Ford garden tractor, softly told naptime stories and the gentle brushing of curly blond hair. Now that I think about it, he is the best dad in the world too, although to tell that story would be much longer than I can type here.

We'll keep you posted on the progress of this determined, resourceful man.

*** POSTED APRIL 7, 2004 ***

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Mr. John Pomranky passed away on August 23, 2004