The Journey Begins -- A Doctor's Perspective on Battling Cancer

The Journey Begins -- A Doctor's Perspective on Battling Cancer
James R. Milstead Emergency Physician Terre Haute, IN

He was done mission work all over the world for the last 20 years in Northern Iraq, prisons in Ecuador, Palestine, Peru, Turkey, Liberia and West Africa. He is the medical director for Grace on Wings Air Ambulance service charity since it opened in 2006. He was a tail gunner in the Air Force from 1971-1975.

My wife, Becky, wakes me from sleep at 5:50 AM. She places a cup of coffee on the sink in the bathroom and says, “I didn’t want you to have to go up and down the stairs this morning.” As I slowly get out of bed I remember the circumstances. I am scheduled to receive my first blood transfusion this morning. As I lean over the sink, heart pounding and out of breath from walking from the bedroom to the bathroom, I wonder if I’ll have enough strength to take a shower without passing out. After a few sips of coffee, I step into the shower. I am quickly exhausted. Light-headedness overtakes me and I feel as though I may black out. Toweling off nearly does me in. I am forced to sit on a chair, chilled and gasping for air, as I try to get dry.  

We send out e-mails detailing what we know—a form of leukemia is ravaging my body. The oxygen carrying component of my red blood cells, hemoglobin, has been depleted to a dangerous level in the past few weeks. The last recorded hemoglobin level, drawn two days ago, was 7.8. To put this in perspective, my normal hemoglobin two years ago was 15.6, twice what it is now. How could this be happening to me? Just nine days ago I was working as an ER physician. That turned out to be my last shift. Now my journey as a patient has begun. 

The oncology transfusion nurse takes very good care of me. After five hours, the blood is in. Back at home, I slowly climb the steps leading upstairs. I am pleasantly surprised to feel only mild shortness of breath and rapid heartbeat, which lasts for a minute or so. I think about all the people that are chronically anemic and yet have no opportunity to get a blood transfusion. Malaria affects millions of people each year causing crippling anemia, often resulting in death in children who are afflicted. Through medical mission trips in multiple third world countries, I have seen the devastating health effects of malaria, intestinal parasites, tuberculosis, and other diseases on the patients we served. I am thankful to have excellent medical care available to me. 

My diagnosis is myelodysplastic syndrome, a type of bone marrow cancer. I had been feeling more tired and fatigued, especially when I was working a lot in ER. I just assumed it was a matter of getting old and/or being physically out of shape. The grueling 12-hour shifts and increasing patient volume were definitely taking a toll on me. Never once, however, did I imagine there was a deadly cancer slowly siphoning the life forces from my body. 

Things finally came to a head in mid-September, the week of my sixty-second birthday. One day, as I was doing some weed eating in the yard during the heat of the afternoon, I nearly passed out. After that incident, I scheduled an appointment with my physician. My CBC revealed that my hemoglobin was 9.8.  

I saw the oncologist in late October. Chemotherapy started, and transfusions are to be given whenever my hemoglobin falls below 8.0. The oncologist says the prognosis is not good. My only chance for a cure is to take chemotherapy and hope that my condition improves enough to where I can receive a stem cell transplant. He says I have a 60% chance of making it to a stem cell transplant and a 35-50% chance of surviving the transplant. Not great odds, but without treatment I’ll last only three to six months. 

So what have I learned on my journey thus far? My strong faith in God keeps me going each day no matter what circumstances I encounter. Beyond that, a warm blanket and a cold drink make the hours of chemotherapy and transfusions tolerable. I used to feel put out when an ER patient asked for those same comfort measures. Now I see things differently. Maybe that’s why I am on this journey. After more than thirty years of serving others, I still have a lot to learn about being a patient, and a compassionate and loving person.