All-American Mom and home decorator puts meso in its place

March 25, 2008

Healthy, active, and always involved in a dozen different projects, Marilyn Stratton’s active lifestyle meant that she was accustomed to lots of physical activity without ever batting an eye.

As a career interior decorator, Marilyn was used to lifting boxes, carrying heavy samples of rugs, tiles, wallpaper, carpets, and countless catalogs that showcased the tools of her trade. Until the summer months of 2006, when she began experiencing pain in her chest, Marilyn had been healthy her whole life long.

Concerned that someone as fit and active as she would be suffering from chest pains, her husband insisted on a visit to the doctor. X-rays taken in early June revealed a build-up of fluid around her lung. Was this pneumonia? The doctor was concerned and insisted on a thoracentesis later that month at St. Vincent’s Hospital in Portland.

What began as a simple chest pain developed into news of the most horrific sort: pathology analysis of the fluid resulted in a diagnosis of malignant pleural mesothelioma.

Circling the wagons

On October, 16, 2006, her doctor performed a biopsy and talc pleurodesis. Like most people diagnosed with mesothelioma, Marilyn had to make a series of complex, rapid-fire decisions with her doctor about what next to do.

The difficulty with meso, of course, is that even the physicians who specialize in its treatment have different opinions on the best course of treatment. The disease is almost individualistic, requiring doctors to carefully weigh their options depending on staging, lymph-node involvement, age, co-morbidity factors, cellular type, and a host of other criteria. All of this must be done at utmost speed, because time is always the enemy.

Marilyn was referred to an oncologist in Portland who had her undergo four rounds of Alimta/cisplatin chemotherapy. Although this regimen is the only procedure approved by the FDA for treatment of mesothelioma, surgeons and oncologists recognize that the best survival outcomes are generally obtained by multimodal therapy that includes surgery as the bedrock treatment.

While she was undergoing chemo, Marilyn was referred to Dr. Eric Vallieres at the Swedish Cancer Institute in Seattle for a surgical consultation. One of the nation’s leading meso surgeons, after meeting with Marilyn Dr. Vallieres concluded that she was a candidate for the surgery. Marilyn decided to undergo an extra-pleural pneumonectomy (EPP) with Dr. Vallieres.

Girding for battle

In the work-up prior to surgery, it was discovered that Marilyn had a lump in her throat. On January 5, 2007, Dr. Vallieres performed a mediastinoscopy. Pathology analysis of the node was negative for malignancy. This was a huge relief to Marilyn, because the lymph nodes are the super-highway of the body, capable of instantly spreading cancerous cells to distant locations. Because the node was not malignant, the surgery could go forward as planned.

This major operation went extraordinarily well, owing in part to the skill of Dr. Vallieres and in part to the toughness and resiliency of Marilyn. She came through it with flying colors and was on the fast track for the day that every patients dreams of: a hospital discharge and ticket to go back home.

Aftershocks

One week after surgery, however, Marilyn got a lung infection and had to go back into the hospital for antibiotics to quell the infection. Having only one lung, any type of viral attack could be critical. From the end of January through the onset of radiation was when she felt the worst. She was weak, out of breath, and not feeling good for months. The combination of the infection and the inflammation had taken a toll early on in her recovery, but as a strong and tough fighter she finally she got beyond it.

One consequence of the EPP that has remained with Marilyn is chronic shortness of breath. She was admitted to Swedish Hospital in Seattle in March to determine the cause of the shortness of breath. As soon as the testing for the cause of her shortness of breath is completed, Marilyn is scheduled to begin a course of 30 radiation treatments that will be administered over a period of six weeks.

Calm waters

Marilyn had a December consultation with her pulmonologist and surgeon, as well as a CT scan, and the results were completely clear. Her next scheduled appointment is in April. As a result of the CT scan she’s been taken off all her medicines: heart medications, coumadin, Alimta/cisplatin, prednisone (steroid for post-surgery infection and inflammation in remaining lung, high dosage), prilosec, sulphasalazine (colitis—still taking), metotrolol (heart medication), warfarin (heart medication), magnesium because level had dropped post surgery (quickly regained normal rates), oxycodone (painkiller), and zofran (anti-nausea drug to combat side effect of steroid).

Dr. Vallieres is very optimistic and has been positive through the whole process. Even during the lung infection he said it was “just a bump in the road,” and is very pleased with the good health and strength of this courageous woman. The pulmonologist said that she would never completely get her breath back, but time would tell and significant improvement has always been a reasonable and very attainable goal. The radiologist said that she had every reason to be optimistic because it appeared that the chemotherapy did a very good job. Dr. Vallieres’s skillful hands seemed to have removed all of the gross tumor, and the radiation had “sterilized the area.”

Marilyn is constantly amazed at how an extremely busy surgeon like Dr. Vallieres seems to have all the time in the world for her when she’s in his office. “He’s so friendly and always gives me a hug. He’s very different from many of the other physicians with whom I’ve had to deal,” Marilyn says with a laugh.

Marilyn couldn’t be happier about the results of the CT scan and being “cancer clear.” Although she doesn’t feel 100% yet, she’s very pleased with her status. She’s feeling better and her friends tell her she looks wonderful.

Living with mesothelioma

Marilyn’s life has been night and day different since surgery. Before, she rarely sat down, was a workaholic, always healthy, and didn’t tire easily. Meso has pulled her former lifestyle up short. During these last few months Marilyn has led a totally different lifestyle. She used to walk five miles twice/weekly, and all her other activities and she worked full time.

Marilyn continues to amaze the doctors who treat her. She’s already made a habit of walking 1.25 miles, and her GP was astounded. To Marilyn the recovery has gone slowly but in perspective she thinks the recovery has been fast. She doesn’t have the strength for pulling fabric off shelves and putting them back up again, or for furniture delivery and hoisting large area rugs she used to carry by herself. On the other hand, she’s discovered that the world has no shortage of people who make a living doing these very things!

Her skills as a decorator have been showcased in three “Street of Dreams” homes and a number of “Showplace Homes” in the Portland area during her lengthy and respected career. At the spry and vigorous age of 73, Marilyn is still coping with the dent that meso has made in her active, productive, and fulfilling lifestyle prior to the onset of symptoms.

Marilyn and her husband Richard once kept active by going on walks together. Their favorite place was at downtown Portland’s waterfront. Now, she is out of breath after simply walking across the room. This has made getting around their multi-story home difficult and painstaking.

In recent years, Marilyn and Richard traveled the world together. Singapore, Bangkok, Canary Islands, New Zealand, Australia, and an annual trip to Mexico are just a few of the destinations they have enjoyed.

A loving mom and grandmother, Marilyn also enjoys spending time with her two daughters, Susan and Shari, both of whom live nearby. She also enjoys spending time with her five grandsons, three of whom are students at Oregon State University, of whom is serving in the U.S. Air Force, and one who is in high school. With courage and an indomitable will, Marilyn continues with great cheer and grace.

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California plumber wins $14.6M settlement

September 24, 2007

San Pedro, CA – Aug. 21, 2007 – A 68 year-old California plumber/pipefitter and his wife today settled their lawsuit in Los Angeles Superior Sourt for approximately $14,600,000 against companies who made asbestos containing products.  Afflicted with mesothelioma, an aggressive form of asbestos cancer, the career plumbing contractor was represented by the law firm of Roger G. Worthington, P.C. in San Pedro and by Simon, Eddins, and Greenstone, LLP in Long Beach.

This is one of the largest settlement amounts ever reached in a Los Angeles mesothelioma case. It took just over nine months from the time the suit was filed until the final settlement. Major defendants included asbestos-insulated equipment manufacturers American Standard, Crane, Foster Wheeler, Weil McClain, Yarway, Ingersoll-Rand, and Bell & Gossett.

The plaintiff was first exposed to asbestos-insulated equipment in the early 1960’s, working on heating equipment, pumps, valves, and boilers. As a plumber in Massachussetts and later in California he was repeatedly exposed to asbestos gaskets, packing, and insulation. This case shows that solvent, viable defendants can be successfully brought to heel even though  most of the major asbestos insulation manufacturers have declared bankruptcy.

According to lawyer Roger Worthington, “Innovative and aggressive counsel with expertise in mesothelioma can still help clients with difficult exposure histories get justice in the courts. Many of the equipment manufacturers are new to the litigation and all of them disputed our theory that they were liable as manufacturers of asbestos-containing equipment.”

Worthington adds, “This is a classic case of a hard-working Californian and family man poisoned by equipment manufacturers who didn’t bother to warn that their asbestos-insulated products were lethal, despite mountains of scientific evidence proving that exposure to even tiny amounts of asbestos is toxic. This sends a clear message to equipment manufacturers who put asbestos in their products that they will be held accountable for their negligence and conscious indifference,” said Worthington.

The case, which settled before reaching a jury verdict, featured testimony by thoracic surgeon Robert Cameron, M.D. According to Dr. Cameron’s testimony, “Like every puff of smoke increases your risk of lung cancer, and each exposure to asbestos, whether small or big, leads to an increased risk of mesothelioma.” Dr. Cameron is the director of the mesothelioma program at UCLA medical school. The plaintiff was treated by Dr. Cameron, receiving a pleurectomy with decortication, radiation treatment, and immunotherapy with interferon.

After the settlement was reached the plaintiff commented, “I’m grateful for the hard work of Mr. Worthington and my attorneys but I’d give it all back in a heartbeat to rid my body of mesothelioma forever.”

For more information on mesothelioma representation, settlements, and treatment options, contact us at 1-800-831-9399, or visit our web site, http://www.mesothel.com.


Malignant pleural effusion and survival with talc pleurodesis

August 6, 2007

Interact Cardiovasc Thorac Surg. 2006 Jun;5(3):307-10, Laisaar T, Palmiste V, Vooder T, Umbleja T., Department of Cardiovascular and Thoracic Surgery, Tartu University Clinics, Puusepa 8, 51014 Tartu, Estonia

From PubMed

This study was analyzed complications and survival after talc pleurodesis for malignant pleural effusion. All patients with morphologically proven malignant pleural effusion who underwent talc pleurodesis from November 1995 to November 2002 were included in retrospective analysis.

Ninety-eight patients (28 male and 70 female) with mean age 59.6 (range 18-82) years were included. Thirteen patients had a bilateral pleural effusion. The most common primary cancer sites were lung (30 cases), breast (25) and ovarium (11).

Twenty-eight patients had postoperative complications (fever in 17 cases). In seven cases pleurodesis was ineffective. Median survival was 8.4 months. Six-, 12- and 24-month survival was 58% (95% CI [0.47-0.67]), 39% [0.29-0.49] and 20% [0.12-0.29], respectively. Survival data after talc pleurodesis advocate use of this invasive treatment method despite the advanced stage of cancer.

Information about mesothelioma medical and legal options provided by the Law Office of Roger G. Worthington, P.C., www.mesothel.com.