In July of 2001, Terri is diagnosed with Stage IIA breast cancer. She decides on a masectomy and a round of chemotherapy. Over the next year, her follow-ups continue to show her body free of cancer. But in the summer, she starts to experience some headaches and tires easily. At times she feels something isn’t right but test continue to show nothing conclusive.
On Tuesday, August 13th, she visits her oncologist and reports pain on her right side and along with some slurring in her speech. A CT scan of the abdomen is highly suggestive of metastic disease and a bone scan shows “intermediate probability” for metastic disease. Her doctor wants to perform more tests, but needs authorization from Kaiser. Early indications point to a reoccurrence of cancer but nothing can confirmed until they perform more tests with more conclusive results.
On Saturday, August 17th, some friends take her to the ER after experiencing shortness of breath and that night she is admitted to the Boulder Community Hospital cancer ward. They immediately start running some more tests and there seems to be a sense of urgency. The tests continue over the next few days. Since her primary physician is out of town, each day a new doctor comes by with the results from the previous day. Their main concern is, and has been, to see if the cancer had spread to the brain. After finally getting a conclusive MRI and spinal tap, the brain and spinal cord appear to be free of cancer but they still cannot explain her speech problem. A few days later, a group of doctors review her case in what they call “the tumor board” and conclude there must be something in the neck or lower head but it is likely too small to reveal itself in the scans. Also, there is a chance the slurred speech is totally unrelated to the cancer but the coincidence seems suspect. We bring her home late Wednesday night so she can sleep in her own bed and be at home until her chemotherapy starts two days later.
Right now the diagnosis is Stage IV (metastic) breast cancer. So far cancer is showing up in the liver, spinal column and chest cavity. Physically she tires easily and has lost weight. We talked to her about moving to California so we can try to offer more help, but she wants to be at home in Colorado. The doctors would like to see her stay active with walking and regular exercise. Her chemotherapy started on 8/23/2002 and will likely continue for 6 months, possibly longer depending on how the cancer responds. Containment and shrinkage is the goal and the doctors feel radiation is not necessary at this time. The doctors should know after 3 or 4 treatments if the cancer is responding to the chemotherapy combination. Every third week she is receiving a dose of Taxotere 130mg through a port in the chest. In addition, she is also taking 5 tablets of Capecitabine 500mg each day, Dexamethasone 4mg to reduce swelling, Warfin 1mg to keep the blood from clotting and Zofran 8mg for nausea.
In November an opportunity came up to fly to Houston for an appointment at M.D. Anderson Cancer Center. She went down to the clinic and met with a doctor to go over her medical records. The clinic felt her needs would be best met in Fort Collins.
A week before Christmas and a week before flying to California, Terri meets with her radiologist oncologist to go over her recent tests. The news could be better. Recently she began to experience numbness on the right side of her face. The slurring in her speech has gone from improved to worse. The next step is radiation and for her doctor to design a specially fitted mask for her face so the radiation treatments will only effect the desired areas. Tests show a few lesions on the brain and around the jaw. After spending the week in Santa Rosa and visiting family and friends, Terri decides not to pursue radiation treatment.
Here comes January and now she spends most of her time resting. Scott, Briana and their new baby, Sierra, fly out to Colorado to visit her for a few days. This was the first time she sees her grandchild and the visit goes well. However, her speech has become incomprehensible. It is nearly impossible to understand what she is saying. One of the problems is she has developed thrush. Since her slurring started in August, thrush is only making the problem worse. She is also not sleeping well since she is unable to sleep on her side without discomfort.
International Biocare Clinic in Tijuana, Mexico
A friend passes on a recommendation to visit the International Biocare Clinic in Tijuana, Mexico. Her friends call the clinic and research a couple references. There are quite a few similar clinics on the other side of the border. There isn’t a lot of information available on the clinics, especially success and failure rates. The main approach of these clinics is to heal through diet, detoxifying the body and then replenishing with vitamins. The cost is quite expensive, nearly $5,000 a week. Terri begins to have lots of hope. The plan is for her to go for 3 weeks, staying in San Diego and crossing the border each day.
On January 11th, her aunt Bonnie flies out to Colorado then the next day her and Terri fly to San Diego. Sunday night is spent at the Best Western then Monday morning is crossing the border and arriving at the clinic. The first day raised her spirits. However, her condition has deteriorated to the point where making the daily trip across the border is too much. So they decide to stay at the clinic fulltime. Immediately her attitude is positive. The first week her doctor starts her on Laetrille.
I’ve talked with her a few times since she started her therapy at the clinic. She is still very positive but her speech doesn’t seem to have improved. Talking with her is difficult and often I can only pickup one word at best. I can tell she is frustrated under the circumstances and sometimes she will even try to spell out the word. We are planning to drive down after work on Friday (1/24) to spend Saturday with her.
A Quick Trip To Tijuana
We get a late start on Friday and don’t get out of Santa Rosa until 6:45 PM. It’s been a long week at work and Nicole has been home sick all week. I thought about flying down, but no flights were available on Saturday, likely due to the Super Bowl. So we rent a car and make the drive. We stopped for the night in Santa Clarita and we are at the border a little after noon on Saturday. It took some time to park and get across. A van from the hospital meets us near the border crossing and 10 minutes later we pull up at the hospital.
The clinic is located a couple miles from the border and is situated on a short street between small offices or houses. Stepping out of the van, the temperature is at least 80 degrees but likely warmer. We enter the clinic and learn my mom and Bonnie’s room is the first room on the right. We walk in and exchange smiles and hugs.
Visibly, it is obvious she has lost weight. She has an IV feeding her through the port in her chest. We talk for awhile then decide to go outside to the patio to enjoy the sun. She seems awfully weak and we take her to the patio in a wheelchair. We spend about 30 minutes outside talking. Pretty soon her back starts to hurt so we head back inside.
The thrush in her mouth has improved though her speech is still very difficult to decipher. She is having a hard time swallowing which is contributing to her weight loss. Her doctor left by the time we arrived so we’re unable to get more clinical information. We stay with her till about 4 PM, sharing some coffee, tea and stories. Late in the afternoon we say good-bye then get a lift back to the border.
It takes awhile to cross the border, almost an hour. We’re both tired and Nicole is still sick, but we climb in the car and start heading home. We stop in Carlsbad for a quick dinner then keep driving. At 2:30 AM on Sunday morning we make it home.
Two weeks later, Terri and Bonnie make the trip home. The thrush has improved making conversations comprehensible. She has decided she wants to move to California and is making plans to sell the house in the spring. I feel a little better knowing she will be closer and we can offer more help.
Fluid In The Lungs
Around 12:30 PM on Friday afternoon on February 21st, I have a message from Jackie Peterson saying her and Carol Pohlman took my mom to the hospital because she was having difficulty breathing. I call the hospital and speak with Carol. The doctor is concerned with fluid in the lungs, making it difficult for her to breathe. I talk with her a couple times on Friday and she was a little nervous about the procedure of removing the fluid.
Saturday morning I have a couple messages from my mom on the answering machine. She sounds anxious and wants a call back. Around 10 AM we connect and she is worried about signing a living will form, whether to do a full resuscitation or do not resuscitate. The doctor is not willing to do the procedure unless she signs the form and is worried that she is so weak that a full resuscitation would be too painful and cause so much damage she would require life support. After a few minutes, she agrees that she does not want resuscitation. A little while later, we get another call that they removed 1 liter of fluid from one lung but there was some difficulty. After some thought, we decide it would be best if I went to be with her. So we quickly make travel arrangements and head to the airport.
Around 9 PM Saturday I make it to the hospital. I land in Denver through heavy snow, but there is no snow the entire drive from Denver to Fort Collins. But it’s cold! I spend about 1 1/2 hours at the hospital, getting up-to-date on all the excitement and the latest news.
Sunday brings a new but tough day. I am out the door by 6:45 AM to put in my training miles. I had left Santa Rosa in such a hurry I had forgot my jacket and gloves. It is no more than 5 degrees with light snow on the ground, a brisk and bitter morning. My 8 miles are quickly cut in half as my hands start turning purple. I make it to the hospital at around 8 AM and she is already down in X-Ray. Forty-five minutes later she is back in the room. Anne stops by after church then Dr. Scott stops by the room at around 9:30 AM. Outside the room, Dr. Scott expresses her concern that Terri is not strong enough to be at home and thinks a short stay at a rehab clinic would do some good. The doctor asks what the goal is and we think it is to get her to Santa Rosa. The doctor thinks at this point, if the goal is to get to Santa Rosa then she should travel in the next few weeks. She doesn’t think she is strong enough to fly on a commercial airline and driving is out of the question. Another option would be a private corporate jet that flies medical patients at no charge. We think this is a great idea and bring it up to Terri but she gets upset over the idea of staying in an assisted living environment. She just wants to be at home. Emotions surface and the discussion gets a little heated. Around this time, more friends from church stop by and Bill pulls out his fiddle. For nearly an hour everybody sings and enjoys the sounds of Bill on the fiddle. The troubles are forgotten and the mood lightens.
A little later in the afternoon, the right lung is drained. Terri does a lot better with this procedure as it takes about 15 minutes to drain another 1 liter. To witness this procedure is something not to forget. A long needle is inserted into the back with a long tub connected to the needle by a long hose. It takes between 5 and 10 minutes to fill two 500 ml bottles with a brown, almost tea colored, fluid. As the doctor extracts the fluid, Terri coughs every few seconds. This is due to the lung expanding. A few minutes later, the procedure completed, Terri starts feeling much better and visits with some teachers from the Harmony preschool. Early in the evening, Jackie and Carol stop in for a visit.
On Monday, Terri feels much better. The morning and afternoon brings lots of visitors. We meet with hospice and go over the details necessary to get the home ready and safe. At 2 PM I must leave to catch my flight. We say our goodbyes, take a picture and share a hug.
Tuesday means another 1 liter is drained from the same lung where the first liter was drained on Saturday. Then she is discharged on Wednesday and home by 1 PM.
The Home Stretch
With Terri back at home, friends and neighbors continue to go the extra mile to make sure her needs are being met. Her neighbor and friend, Anne, emails me to keep up on the daily details since so often getting anything more than “I’m doing great” from Terri is nearly impossible. Ever the eternal optimist, even in the toughest conditions, she says is doing fine.
Thursday, a day after being home, Terri expresses her concern about her left eye not completely closing. Anne also notices that the face seems a little more torqued to the right, possibly contributing to the eye not closing properly. She is now only on oxygen during the night and can breathe on her own during the day. She helped in the preparation of dinner and started her shots again, so her spirits and determination are holding.
By Saturday she is having more difficulty eating and her strength is fading. She continues to mention moving to Santa Rosa and keeps asking if I have found a house. We are optimistic, and I am looking for something suitable, but also realistic that a move will not be possible. I don’t want to dampen her spirits. Again I recommend if she wants to be in California that she just come now and not worry about packing, selling and moving. In her condition, this will be impossible but she is determined. She is now open to the idea of using a realtor vs. selling it herself. So slowly we are seeing some acceptance.
On Sunday the slide continues and she is now unable to sit in her chair or rest on the couch without discomfort. She is not eating well nor drinking her protein drinks. Receiving injections takes a lot of effort with so much pain in her side and general discomfort. She is unable to walk from the couch to her bed, so the couch has become her permanent residence. We talk a few times on the phone; she wants me to look at a house in Santa Rosa on Sonoma Avenue. Nicole and I drive by, but I finally explain to her that it will not be possible for her to live on her own at this time and she’ll need a place with someone there most of the time.
Monday, March 3, brings change and lots of news. I receive a call at work in the afternoon from Joe of Hospice. We talk for a few minutes about the situation and history and he brings me up-to-date. First, my dad has made arrangements to return to Fort Collins. My mom has asked my dad to come home and care for her. He has planned to return on Thursday. A hospital bed has been ordered and will be placed in the living room facing the backyard. This should help her sleep a little more. She is eating and drinking almost nothing as the body has begun to shut down.
I talk to her during the week and her excitement grows as my dad will be with her by the end of the week. We are all excited at the opportunity of reconciliation and healing. But my dad misses his flight on Thursday so arrives a day later. We talk on Friday and things sound ok. But on Saturday, things seem to be reaching a desperate stage. We talk a few times on the phone and I sense I should be there too.
So on Sunday, March 9, I’m back in Fort Collins. My dad and Fred meet me at the airport. Pulling up to the house, I unload my things and walk up to the front door. So different than 2 weeks ago, snowing with temperatures in the teens, it is a beautiful day with the sun out and their front door wide open. I walk in and see my mom, lying in the bed facing the backyard. Diane and the pastor are with her. In a matter of minutes I am alone with her and we have about an hour all by ourselves. We talk, cry and just touch each other. It is a sad, but memorable time. Visibly, she is wasting away and it is hard not to cry when I look at her. Her eyes have a misty, almost empty look and I can see her body is losing the battle. She now seems to be in that state where she is there but fading. Words are difficult for her to speak. She says it is harder and harder for her to breathe and I sense her mind is slipping into a sleep-like state. She can talk but not for long. In a matter of weeks, she has aged years. We are thankful she doesn’t appear to be in much pain but are concerned that she remain as comfortable as possible. I sense her time is nearing the end and I think she senses it too. When we talk, I ask her if she’s scared. She says no but then asks if I think it’s time. I don’t know what to say but respond that nobody really knows but she would probably know when it was time. And she agrees. Then again says it is getting harder and harder to breathe. She has fought hard the last 8 months, been poked and prodded more than her fair share, and now I think she realizes the mind is strong but the body weak.
She has lots of friends come by during the day and her entire group from church stops by at 7:30 PM and prays for her. It is good to see her today and see her surrounded by her friends.
Monday, Debbie from hospice stops by at 10:30 AM. She openly discusses what to expect in the next few days. She helps with any questions and concerns. Diane and Carol submit Terri’s children’s story, Jackson’s “Forever” Friend, to a contest and we all hope for the best. They insert a catheter before leaving and arrange for an evening massage for Terri to try to alleviate some of the pain. The rest of the day she sleeps. A few friends stop by and some call but she has no energy to speak. In the evening, she receives a massage.
Tuesday, her condition is a repeat of Monday although she appears to be even weaker. In the morning she admits she is in pain and agrees to try some pain medication. She sleeps throughout the morning and appears to be much more comfortable after trying the pain medication. Some friends stop by in the afternoon and her son, Scott, calls and talks to her for a minute. She can hear our voices and see our faces but has a difficult time getting the words out. I get out at around 3 PM for a run and return around 4:30. We change her sheets, give her a new nightgown and position her a little higher in the bed. This takes some effort as it seems every move causes some pain. Dad and Diane go to prayer group at 7 PM. Around 8:30 PM she starts to become restless. She now wants water and Pepsi, repeatedly. For about 30 minutes I keep giving her water and Pepsi. I ask her what she wants and she says help. Help for what? “I’m trying” I say. “Spetch” she says. Spetch? “Spetch” she repeats. Spetch. So we play charades. Finally, I figure it out. Stretch. So I stretch her legs. More Pepsi and water. She keeps waking up asking for Pepsi and water. We agree to another drop of pain medication then some more Pepsi. She rests a little easier.
Wednesday she sleeps most of the day, coming out of her sleep to say goodbye to friends who have stopped by to visit. She did not sleep well during the night, waking up every hour due to discomfort in her back and legs. Throughout the day, it is as if she uses all her strength to whisper a word or two to a visitor but then she is back to sleeping. Bill comes by in the afternoon to play his violin for her. Other friends and neighbors continue to visit and help but she is becoming less and less responsive.
Thursday she sleeps and does not wake. Again, it was another sleepless night. We are not sure if she has her days and nights confused or if the nights are just harded for her. She is not responsive throughout the day. She does not respond to her name, does not seem to be aware of who is around her and lies in a deep sleep. The day is spent with her, reading some cards that arrived in the mail, talking about past and better times but she does not seem to hear our voices. At 4 PM I slip out for a run but she seems unaware and unconcerned. Again at 7 PM I visit the library for an hour or two to get some work done. Coming back, she seems unchanged and continues to be in a deep sleep. I spend some time sitting at her side and talking to her even though I know she can’t hear me. I head upstairs at 10:30 PM, come back downstairs at 10:45 to say goodnight. Around 11 PM I go downstairs and, walking past her, I notice she is not breathing. I call her name a few times, put my ear up to her mouth and try to rouse her. In a minute my dad comes in to double check. Within minutes, we call hospice and Anne. She must have stopped breathing between 10:45 PM and 11:00 PM.
The sadness and grief had struck me when I arrived on Sunday and would/will overcome me at strange times. Thursday I stepped out for a 40-minute run and halfway into the run the tears started flowing. I must have looked a bit funny but I was suddenly and uncontrollably overwhelmed. But seeing her at peace tonight gave me peace. I had planned to return home on Sunday, regardless of the situation. I had made peace with my mom and the outcome. Peace, that word keeps coming up in my mind but that was really the mood this evening. There was a peace that goes beyond words or description. I’ve tried to do my best to make it comfortable for her and maybe this was her way of making it comfortable for me, making it possible for us to be together at the end. This week has been a process for the living as much for the dying. This week has shown me images I wish I had never seen. And this week has shown me that there should be priorities in life. We need family. We need each other. No one should suffer alone.
It is early Friday morning and I am beginning to fade. There are so many memories that it may be difficult to sleep. But I will keep these memories for life and the best ones I will cherish. She spoke so eagerly of her time beyond this life and I hope her faith has been rewarded.
On Saturday, March 15th, 2003 a memorial service is held at The Evangelical Free Church of Fort Collins. Many friends, fellow teachers and some students attend and share their memories.
Teresa D. “Terri” Cook, 52, of Fort Collins died Thursday, March 13, 2003, at her home. A service honoring her life will be at 2 p.m. Saturday at Faith Evangelical Free Church, 1601 W. Drake Road. Teresa Kratzer was born on Nov. 24, 1950, in San Francisco. She and her family moved to Fort Collins in 1991. Terri was devoted to her family and her work with children. She operated the Children’s Corner Preschool in California for 20 years and most recently taught at the Harmony Christian Preschool for eight years. During her fight against breast cancer, Terri completed her college degree in Early Childhood Development at Regis University. In her words, she “finished the race.” Terri is survived by her husband; her two sons and daughter-in-law, Michael and Nicole Cook and Scott and Brianna Cook; her granddaughter, Sierra; her aunts, Bonnie Milioni, Donna Sichelmeier and Sharon Royer; her sister, Valerie Schrupp; her Bible study care group; and many other valued friends.