Dr. Mault: "Like a Breath of Fresh Air"
I received my first E-mail from Lisa Whiting on October 21, 1997. She was very worried about her brother, Bob, who at the age of 50 was diagnosed with pleural mesothelioma. Her family had been reading our website and had contacted Dr. David Sugarbaker in Boston. They made a trip to Boston for preliminary testing and scheduled an EPP at a later date.
Bob prepared diligently for the surgery. He flew to Boston on the appointed date, October 23, 1997. Bob was scheduled to have an MRI prior to the surgery so they could assess the performance status of the "good lungs." An MRI is very important, as the imaging is precise enough to detect possible perforations of tumor through the diaphragm or mediastinum. According to Dr.Sugarbaker and others, the MRI is superior to the Cat scan. Without the test, the patient may undergo the extremely invasive surgery only to have the tumor reappear later. Under that grim scenario, the patient has not made a significant gain, as he will spend the next several months recovering from the difficult procedures.
Bob was apprehensive about having an MRI. Speaking from experience, I know how clausterphobic it can be when you're inserted in the center hole what looks like a very large roll of toilet paper. He wanted to be sedated. According to Dr. Sugarbaker, his team offered to sedate Bob or put him under a general anesthesia. A miscommunication arose, unfortunately, and the MRI was not performed.
The following day, Bob was prepped for surgery. As he was being taken to the operating room, Dr. Sugarbaker informed Bob that without the MRI his candidacy for surgery could not be determined. Dr. Sugarbaker's protocol requires an MRI. Dr. Sugarbaker's policy is to make certain that the tumor has not invaded the diapghram or mediastinum, without exception, and the best tool available to determine that is an MRI. [Dr. Sugarbaker has advised that more than half of the patients who contact him are not eligible for surgery]. Bob decided to return to Nebraska without the surgery.
On October 27, 1997, Lisa wrote me again and asked if I knew other patients who had chosen not to have the surgery. She wanted to know what Bob and their family could expect. They had been told that Bob's survival rate was seven to nine months without surgery. They had so hoped that the surgery would push Bob past all the grim statistics and give him a fresh start.
As it turns out, I had just corresponded with the wife of an insulator in Colorado (see Sandy and Frank Wallic story) whose husband had been operated on by Dr. James Mault in Denver. I called Dr. Mault and we talked about various options and his particular approach. I mentioned Bob to Dr. Mault and he volunteered that he would be pleased to consult with him.
Lisa and Dr. Mault began corresponding on the phone and Internet. In a few days, they had scheduled Bob for surgery with Dr. Mault.
Today, December 2, 1997, I received the following E-mail from Lisa Whiting. This makes it all worthwhile.
I cannot thank you enough for recommending Dr. James Mault at UCHSC in Denver. He performed an Extrapleural Pneumonectomy on my brother on November 25th. I have to tell you that the first time I ever called his office, just asking about credentials, etc., Dr. Mault got on the phone, himself, and spoke to me for about twenty (20) minutes. After our awful experience in Boston, Dr. Mault has been like a "breath of fresh air." Bob's surgery took nearly eleven (11) hours, and we were frantic by the time Dr. Mault came out to talk with us. Much to our surprise, he said that the surgery had taken longer because the tumors were so small that they were more difficult to remove. He also said that this was the "best" case of Mesothelioma that he's treated! He indicated that the Mesothelioma was in early stages and that the prognosis looked good.
We have a long way to go, we know that. But, we have so much more hope now that Dr. Mault has done the surgery. Having a surgeon that cares enough to communicate effectively makes all the difference!
By the way, Bob never did have an MRI. As it turns out, Dr. Mault requested a CT Scan, which he said was more than enough. My first thought was, "We wasted 2 ½ months because of an MRI that wasn't even necessary!" But that's not true; waiting for Dr. Mault gave Bob and our family peace of mind, and that means a lot!
Thanks, again, Roger!
Sincerely,
Lisa Whiting
** POSTED DECEMBER 2, 1997 **
[Note: I try to leave this website forum open to everyone. I am not a doctor and I am not trained to endorse one medical procedure over another. However, the issue over whether an MRI should be preferred over a CAT scan remains controversial. Several doctors, including Dr. Sugarbaker, require the MRI. By reprinting Lisa Whiting's letter in its entirety above, I am not necessarily endorsing her views about whether an MRI is necessary or not.]