All about the end

I expect that Vaiva's many friends and colleagues would like some information on how she met her untimely end. Let me sum up.

Vaiva's breast cancer recurred in August 2007. There was a visible tumor in the same breast as before (the one that had the radiation treatment), and there were some indications of spread to the spine and into the breastbone. Chemotherapy with taxol was very effective at bringing the tumor down to an undetectable level by spring 2008. At that point she asked to have a mastectomy, but the doctors refused because of the indications of metastices, even though none were then detectable.

In August 2008 another lump appeared in the same breast. The moral of this story is to forget about lumpectomies, she should have had the mastectomy in the first place seven years ago. We might have avoided the recurrence, and the radiation treatment would have been unneeded.

With the third tumor, the doctors agreed to a mastectomy, but wanted another course of chemo first. This time the chemo was utterly ineffective. Vaiva had a double mastectomy October 27, and healed well.

However, Vaiva was becoming a bit confused during the recovery. At first I attributed it to the pain medication. But as we reduced that the confusion got worse. I called the doctors one week before Thanksgiving, and on the Friday before took her in. An MRI revealed that the breast cancer had invaded her brain.

We began a course of radiation treatment of the brain coupled with steriods to reduce swelling in the brain. I was told that it was highly effective in most cases, but Vaiva was not like most, as we all know. She grew more disoriented, and rapidly lost mobility. Within days she was unable to stand up or walk without assistance. Her lucidity varied from day to day and moment to moment. She always knew us, and had some short term memory, but that was about it.

On Tuesday, December 9, Vaiva complained "tummy hurts." Pain medication and antacids were ineffective, so I took her to the emergency room around midnight. A CAT scan revealed that fluid and gas had entered the abdominal cavity from a perforation in the intestine. This was likely a side effect of the steroids. In Vaiva's weakened condition, surgery to correct this was not feasible. What's more, the CAT scan also showed a new tumor in the liver.

Vaiva was put on a morphine drip to eliminate her pain Wednesday evening. She declined steadily until her death Saturday evening.

Liepa came home from Clemson, SC on Wednesday, Sirvydas came from Northfield, MN on Thursday, so they were able to be with Vaiva before she died. Vaiva also had a phone call from Aras, Renata and Adrija on Friday, and we were able to have a video conference with them in Lithuania from Vaiva's hospital room (free WiFi in the patient rooms!). She was able to respond somewhat to all of these stimuli, we believe that she knew they were there.

We're working on the funeral; details will be posted on this blog.