 
"Fighting Back"

### Rosann and Jim Plautz

Copyright 2013 Jim Plautz

Smashwords Edition

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means without written permission from the author. Printed books may be shared with friends. It is illegal to copy, transmit or read books, including EBooks, PDF and RIF files, without paying the author for the additional copies.

ISBN 9781301988549

Hard Copy: www.customsportsnovels.com

"Fighting Back"

Offers a recipe for fighting back against a deadly, incurable disease - that's what Rosann's doctor called it - incurable.

### My recipe is simple:

### A big heart

+

### A fighting spirit

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### A strong support group

+

### Prayer

=

### Victory

### Thank You for your Prayers,

### I need your help!

### ****

### What is Victory?

Is it living forever?

Rosann defined Victory like this:

* "Living life day-by-day, enjoying the little things,

* Celebrating living versus waiting to die,

* Enjoying the small victories,

* Getting back into my daily routine,

* Being thankful for my friends and family,

* Being thankful for Jim, my lover, #1 cheerleader, helper and shower boy,

* Beating the odds - living one more day, month or year longer than odds makers predicted,

* Being grateful for what I have, and looking forward to my next challenge - my next opportunity."

" **I will die, eventually, but death on my terms means that**

I won this fight."

### Heroes and Villains

"There are so many **heroes** that I cannot begin to thank you all enough for helping me Fight Back. I especially want to thank;

1. Each person that sent flowers, cards, telephoned or visited me at the hospital; it meant a lot to me; I feel your love;

2. My Family in St. Louis, especially my mother Helen, Linda and Nicole for being at my side during my hospital stay;

3. SSM Health Care Center in O'Fallon, Mo. and all the Doctors, Nurses and staff that saved my life and helped me recover from the operation;

4. SSM Rehabilitation Center for helping me get started with my Fight;

5. South West Airlines for the outstanding support they provided to me on my flight home;

6. Tampa Bay Cancer Center radiation oncologist Janelle Park, M.D. and her staff - they were wonderful. It's too bad Dr. Park's Cyberknife operation was such a disappointment.

7. University Community Hospital Outpatient Rehabilitation - specifically therapists Cara Bryan and Kevin Bobos.

8. My son, Dave, for helping me fly back to Tampa and, well, for being my son. I love you;

9. My Art Group in Tampa, especially my friend and teacher Kathi Hobbs;

10. My Golf Group; Brenda, Carol, Barb, Lee, Vi and many others;

11. My Notre Dame High School classmates many of whom sent me cards and offered payers;

12. My Beta Sigma Phi Sorority sisters; we were just starting to have fun!

13. My special friend Lillian Stickel, who would do anything for me, and has;

14. My husband, Jim. He didn't bargain for this, but never flinched. I love you lots;

15. Every one of you that prayed for me; you are the true heroes. Keep it up!!!!!

Villains

There are no villains, just disappointing actions. I truly believe there is good in all of us. However, there were several notable disappointments.

1. Gloom and Doom Doctors who were too absorbed with telling me that adenocarcinoma of the lung, stage 4, is incurable and I'm going to die. 'There is no other option, you're going to die.' I say to them; "Get a life"!

2. Doctors that should have stopped practicing medicine years ago, or maybe should never have been allowed to practice. Treat your patients with dignity!

3. Insurance Plans that provide you a Bill of Rights and list of resources that you are entitled to, and then foster roadblocks that bar you from accessing theses resources. "It's was two months before Chemotherapy or Radiation was begun."

4. Arrogant doctors who become so enamored with their technology and power, they overlook the patient's needs.

About This Book

  This is a story about a courageous woman (center) who is Fighting Back against long odds. On March 5th, 2011 Rosann Plautz was blindsided by a terrible disease. Twenty eight hours after attending her 50th high school reunion, she underwent an emergency craniotomy to relieve pressure from blood accumulating in her brain. There was little warning.

Rosann survived the operation but the news was not good. The doctors told her the bad news Tuesday;

* You have three metastatic tumors in your brain; one tumor had burst, Dr. Martin performed a craniotomy to reduce the swelling.

* There is a large mass of cancerous tissue in your left lung, the source of the three brain tumors; it's inoperable;

* Your diagnosis is Adenocarcinoma of the lung; Stage 4.

Oh, and by the way, you are 900 miles from home and cannot fly home to Tampa until the swelling in your brain subsides."

"Is that all? Are you through?" she thought.

Did I forget to tell you that your loss of vision is permanent? You are legally blind. Rehab will be very difficult.

These are the cards that Rosann was dealt. This story is about how she plays these cards and the people that help her.

The story is told by Rosann with the help of a third party narrator to fill in some of the blanks. Rosann's statements are in quotation marks. Much of the actual writing was done by Jim but this is Rosann's book. These are her ideas and her thoughts.

Friends and family have contributed greatly to this book. Their input is in _italicized quotations_. These quotes provide insight into Rosann's character and make the book interesting and unique.

Rosann: _"This is a story of hope. It's my story, but I want it to be something that others can read and maybe pick up a few ideas on how to fight their battles, day by day. This story is about fighting the battle, not winning the war. That's why I paused on May 2nd and published this book, 'Fighting Back'. I wanted to ask for your prayers and help. I knew this would be a long struggle. Victory is not all about winning and losing; it is about how you face your challenges."_

Samples of Rosann's paintings precede each Chapter and can be found at www.customsportsnovels.com & Rosann's website @ http://www.expressionsinart.net/index.html

### Chapter One

### Alive and Kicking

Lady in Red Shawl

"It hasn't been easy, but I'm still here, alive and kicking. Only God knows how much longer I have on this earth and I'm going to make the most of it. What else can I do? Give up? Not a chance. I admit there have been times when that I've thought about giving in, but my husband, Jim, has always been there to pick me up. He won't let me quit. I don't think I could do this without him. He is my rock."

Jim: _"I try to be there for her when she needs me. Rosann says I'm her rock, but in truth, it's a two-way street. I get depressed too and she picks me up with her words, attitude and inner strength. She is so nice that her friends and even family sometimes underestimate her inner strength and resolve. I'm so lucky to have found her. We make a good team."_

Tuesday morning, March 8, 2011, 58 hours after surgery, Dr. Martin gave her the bad news. She had cancer of the lung that had spread to the brain. It was bad news. Her family already knew, but no one had yet told Rosann. She had her suspicions, but this was the first time anyone had uttered the C-word.

Rosann remembered little of the previous two-plus days that started with the severe headache at the church service and the ambulance ride to the hospital. There were two ambulance rides before she arrived at SSM St. Joseph Health Center in St. Charles, Missouri.

Jim had arrived that night and stayed with her in her hospital room. They had held each other and cried and promised each other they would fight this together. The next morning she remembered very little of their conversation.

Jim: _"Rosann didn't react to what the Dr. Martin said. I had told her the previous evening that it was bad, but I didn't go into any detail. She didn't ask; I think she already knew in her heart that it was cancer. Rosann had lost a daughter to breast cancer that spread to the brain. You never forget that."_

"The first couple days were a blur of doctors, nurses, medications and sleep. Everyone asked me what my birthday was. I really can't remember thinking about why I was in the hospital. I just laid there and let it happen. I felt like a guinea pig, but in a nice way. The doctors and nurses were all so nice. I vaguely remember Jim holding me and talking about a 'bucket list', but I was so tired I just wanted to sleep. I knew something was happening to me but I was too groggy to care."

Dr. Martin explained to Rosann Tuesday morning that he had operated on her brain to relieve pressure from blood accumulating in the right rear portion of her brain. The blood was from a bleeding tumor that had come from a cancerous mass in her lung. The diagnosis was adenocarcinoma of the lung, Stage 4.

Rosann's first question said it all. _"What can I do about it? What's the next step?"_

Jim: _"I recall thinking she must not understand what the doctor had just said. She is handling the bad news so well."_

Dr. Martin said that other doctors would talk with her about treatment. He's a neurosurgeon and further surgery was not a consideration. He was pleased with Rosann's appearance and how well she had handled the surgery. Dr. Martin told the family later that he had been concerned about her chances for surviving the operation.

Jim asked about her chance for a full recovery. Dr. Martin stated her left-side motor skills might improve with time and therapy but doubted that her eyesight would ever improve significantly. The swelling had occurred in the portion of the brain that controlled Rosann's left side motor skills including vision in her left eye, her good eye before the swelling and surgery.

Jim: _"The good news is that the swelling did only minor damage to her memory, speech and thought process. More importantly, she hadn't lost her will to fight."_

The victories were small at first. Each day brings a new challenge and a new opportunity to succeed. Let Rosann give you a recent example.

"I walked into Coast Dental Monday, April 25th, carrying two bridged crowns in a small plastic bag, a casualty of 15 full head radiation treatments. The glue lost its cohesiveness. One crown was a molar from the lower left jaw that had fallen out eight days earlier. I just chewed on the right side. The second crown was for an upper right molar. This happened last Thursday, leaving me no place to chew the roast I prepared Easter Sunday. I feared the worst and was dreading the ordeal and expense of getting new crowns made. Neither Jim nor I had ever had a crown that could simply be glued back on. Thirty minutes later I walked out of Dr. Hite's office with the crowns glued securely in my mouth. This was a HUGE relief. I am thanking God that that Dr. Hite could fix everything so quickly. I feel so much better."

The first big challenge in St. Charles was getting home - back to Tampa, Florida. This was accomplished Wednesday, March 16 with the help of her son, Dave. The trip was very difficult for Rosann but enabled the treatment and recovery to begin in earnest.

"I am grateful to everyone that helped me at SSM including my case managers' Julie and Shelby. I especially want to thank Dr. Martin. I still cry when I recall him telling me he had stayed awake the night before worrying about me flying home because the CT scan still showed air pockets from the surgery in my head. He told me he had done his own research and talked with a pilot-friend before deciding that the benefits of getting back home and starting treatment outweighed the possibility of incurring severe headaches during the trip. I had been very afraid of flying and he made me feel comfortable. I can never thank him enough for going the extra mile. The doctors and nurses at St. Josephs were terrific. I couldn't have been treated any better and feel very lucky that I had this happen to me in a place where I had access to such quality care."

Jim: _"Neurosurgeons are famous for their brilliance and equally notorious for lacking the people skills necessary to interact well with patients. Dr. Martin is the exception. He is smart and has the ability to deal well with people. Most of his patients live near the hospital. I commend him on recognizing the unique challenge that this situation presented and dealing with it accordingly. Think about it; from a selfish standpoint, the surgeon has no upside in allowing the patient to fly if there is_ _any risk at all_ _of the patient suffering adversely. Dr. Martin took this chance and we will always be grateful."_

One month, to the day, after the operation, Rosann reached another small milestone. She walked into the Outback Steakhouse holding Jim's arm for guidance and support. This was a weekly occurrence before the surgery and consequently Rosann knew many of people at the bar including Steve, the manager, and bartenders Ashley, Serena and Brandon. This was the first time Rosann had been 'out' since her surgery.

Rosann: _"It was a big challenge to be seen in public. I spent considerable time choosing my clothes and applying makeup. A baseball hat covered my head where 20 staples had etched a scar. The cap also hid my blond hair which earlier had fallen out in clumps when I showered. Surprisingly, the loss of hair from radiation doesn't seem to bother me. I witnessed my daughter go through this same thing six years ago._

I was so afraid that I would embarrass myself. I was still weak from the surgery and the radiation treatments really make me tired. But the worst thing is that I can't see much at all. Everything appears fuzzy. We left the 'walker' in the trunk and I hung on to Jim's elbow for balance and direction. We parked close to the door but still ran into three friends in the parking lot. Jim needs to tell me who is there because I can't recognize anyone until they get close or I hear them speak. We finally made it inside and found our usual seats at the bar. All my worrying was for naught. Ashley was bartending alone when we arrived. She came around the bar and gave me a huge hug. The people at Outback are so wonderful and made me feel so good. I'm so lucky to have such nice friends."

This is what two of them had to say about Rosann."

Ashlee Zuilkos: _"I learned what happened two weeks earlier. I was working behind the bar that day. The shift had started out real slow until Jim walked in. I said to myself, 'Now there's a couple I haven't seen in a while.' But he was alone, no Rosann. I thought to myself, Rosann must be out of town again and Jim is going to joke about how he has the whole house to himself and is out for a wild night on the town. Something isn't right though. Jim doesn't have that silly grin on his face and, come to think of it, Rosann should be back in town from hert trip to St. Louis. I went up to Jim with a big smile on my face that shortly turned into a frown. I don't even remember exactly what was said from that point on. All I remember hearing is "stage four brain cancer." I was in shock. Please don't let Jim see me cry. I have to be strong for him. I quickly ran to the back because I could no longer control my emotions. How could something this terrible happen to such an amazing person?_

Jim and Rosann are more than just customers. They have been coming into Outback for years. I have had the privilege of serving them for the last three and have become very fond of them both. I always joke with my coworkers that I would like to adopt them as my second set of parents. They are more than just customers to me; they are like family. Rosann is so selfless; she is genuinely caring and can put a smile on anyone's face any day. Jim is the ultimate joker, always making people laugh, especially Rosann. I remember when they went on a cruise and Rosann got these cute bohemian- style bracelets for me and a couple of the girls at work. It made me smile to know that she was thinking of us on her vacation. Then there was the art show in a hotel lobby near downtown Tampa. I recall Rosann being so nervous.... I am not sure why because she is a very talented artist. I still love that painting of the backside of what I thought looked like a Native-American woman. She said that this is also one of her favorites.

Two weeks later Jim came in again, this time with Rosann at his side. My emotions swelled up. I came around the bar and gave Rosann a big hug and let a few tears come to the surface. She looked a little tired, but was still beautiful. She is in my prayers."

  Jerry Meatyard: _"Please accept my apology for not writing earlier. I found it difficult to admit that Rosann was really ill and feared that writing about it would somehow make it so. Rosann is such a wonderful person and loved by so many, especially me. I pray that God sees His mistake and corrects it quickly. Please let me know if there is anything I can do for you."_

Jim: _"I started suggesting we go to Outback three weeks earlier. Rosann wasn't strong enough the first week. She needed a walker to get around, and she wasn't going 'out' until she could stand on her own two feet. Last week she might have done it but we had a real long day with radiation and Ophthalmologist' appointments. We practiced 'getting out' by going to the grocery store, drug store, Target and the like. We also practiced walking together, how she wanted to hold my arm, how I would tell her who sitting at the bar, and so on. Believe me, this was a big thing for both of us. Rosann was great! I was so happy she had a good time."_

They split a flatbread pizza and Rosann sipped at her chardonnay, consuming almost one or two ounces. It wasn't much, but she was out. She felt alive. They only stayed about 90 minutes before it was time to go. She was tired despite a two hour nap. The radiation saps her stamina. Friends mentioned they would be at the Bonefish Grille Saturday if she felt like joining them. Rosann said she would try to make it. She was starting to feel normal again.

The Outback' staff gave Rosann a wonderful Hallmark card with personal messages of support and love. It was beautiful. This is what they wrote.

" _We all love you and you will continue to be in our prayers. In times like these we must remember that God has everything under control. Stay strong knowing that He loves and watches over us all. The two of you are amazing people. I pray for your strength and faith. We're here from you when you need us."_

Warmest Regards,

Bryan

  " _You are in our thoughts and prayers. Stay strong and know that everything that happens is the plan of the Creator. You are a special couple and if you need anything please do not hesitate to ask."_

_Always,_ Ashlee

  " _Please keep your spirits high knowing that we are all thinking and praying for you on a daily basis. You are our amazing couple. We will get through this."_

Serena

  "We all love you guys and hope you the very best. You are so kind and great and we will continue to keep you in our prayers. Best wishes and regards."

Jess

" _I'll keep you in my heart and in my thoughts. I hope you know how wonderful you are and know that we are all rooting for you. Please let us know if there is anything you need."_

Brandon

  " _God is with you in this walk (drawing of cross)."_

Steve

"It's Tuesday, April 26, 2011. Jim and I just got back from a 1/3 mile walk on the Northdale Trail where we once rode our bikes. I still need to hold Jim's arm for guidance but I was almost walking without support. It would be so much easier if I could see. Two days ago we saw a small gator in the pond below the walking bridge. Today we saw an albino raccoon. To be honest, Jim saw the gator and raccoon, what I saw was blurry. I couldn't pick out a raccoon from a lineup of armadillos. I take Jim's word for it and use my memory to visualize. It's just so nice to be outside. My stride is improving and I felt strong today, but Jim only graded my walk as an A- because I stumbled a little getting into the car. He's tough, but that's what I need to fight this thing."

We're finished with the full-head radiation treatments and waiting for the MRI to tell us if the three tumors are gone. If not, Dr. Park says we might need to go after them with a directed radiation, CyberKnife procedure. We are optimistic that the brain tumors can be handled.

We are looking forward to starting chemotherapy treatments to attack the cancer in the lung, the source of the problem. The full body PET Scan was good news. The cancer had not spread to other organs although there was a small glow at the GE Junction, where the esophagus meets the stomach. It's not a significant factor. It might just be a lymph node or some other benign substance.

Rosann: _"I cried when I heard the good news. I realize this is a small victory. Once the cancer has spread to the brain, little else matters. Dr. Mendez told me that. It's like celebrating one's safety while sitting in the eye of a tornado. It probably won't last but I'm enjoying life while I can. What's the alternative?"_

### Chapter Two

### Lifestyle Adjustments

Belle Fleur

"These are some of the activities I loved to do before my brain surgery. I'm trying to get back into the swing of things, but it hasn't always been easy. I'm still working on it, I'm improving.

I'm a Golfer:

Northdale Golf & CC Ladies Association

"I was never a great athlete, but at that moment, no one was better."

She watched as her tee shot landed in front of the green, rolled toward the flag and dropped gently into the hole. It was what every golfer dreams of; a 'hole in one'. Her mind struggled with the reality of what just happened. A 38-handicap golfer, who did not have the length off the tee to reach many Par 3s, had made a hole-in-one.

"All I could think about was that I wouldn't need to putt," Rosann said later.

The silence was shattered by her husband who had been watching from the cart path, 5' below the elevated tee box. Jim had watched the shot and yelled "get-up, get up" as the ball headed towards the pin. He screamed in delight as the ball dropped and raced to congratulate his wife. Rosann was still staring at the pin when Jim threw his arms around her. She didn't seem to grasp what she had accomplished until Jim's excitement rubbed off.

"He was jumping around like a monkey. I could tell he was genuinely happy for me. I wished it would have been his hole-in-one. I know he's never had one."

Jim: _"I couldn't have been happier. It means so much more to her than it would to me. She gets erotically excited when she birdies a hole. Besides, I would have known that I had to buy the drinks."_

"I can't believe he wanted me to buy the drinks, I'm the one that got the hole in one. People should buy me drinks." The clubhouse was closed when they completed their round so Rosann avoided one problem. Jim took her to a Lee Roy Selmon's Restaurant to celebrate, but not even the manager or waiter could convince Rosann to buy.

Jim: _I didn't care. It was fun to see her happy. The next day I went to a trophy shop and a week later presented her with a trophy to display the ball and scorecard. It still has a prominent place in our bookcase. Nothing can take away from that accomplishment."_

Good golfers typically play with good golfers. Even poor golfers want to play with better golfers because it makes them play better. Who wants to play with a 36 handicapper? Who wants her on their team? Who would invite her to be their partner in a member-guest tournament? The answer in this case is easy - everyone who has enjoyed the privilege of playing golf with Rosann.

Dave Glandt (golf pro): _"Rosann is always trying to improve her game and find those extra few yards with every club. Several years ago we worked on her short game, she picked that up quickly. Her putting ability is amazing; especially the way walks up and drains the dreaded 2-4 footers. She seldom misses. Touring pros could learn a lot from her. Then her focus turned to hitting the ball farther. That has been tougher although it's not for lack of effort. It seems that every time we see each other she has a new tip or idea. 'Will this work for me?' she asks? I'm impressed with her dedication. She works harder to break 100 than pros do to win the Masters."_

Lee Goodin: _"Rosann always said "I'm not really very good at golf" - BUT she has determination. One day she won a handicapped tournament! The prize was a pair of earrings and she was so excited you would have thought it was a million dollar purse. A few tears were actually shed - hers and mine. We all love her."_

Carol Smith: _"When our Women's Association at Lake Jovita announced we were going to have a one day Member-Guest I immediately asked Rosann, my great friend from Northdale Golf Course, who was there with me when I first began learning to golf twelve years ago. Rosann and I had more fun together just working on all the complexities of the golf swing. We have all kinds of reminders that we tell each other like "Keep your eye on the ball", "Remember the shoulder turn", " Follow-through" " Slow down and stop at the top" Rosann and I always play golf for fun and I wanted to have with her at our Member-Guest. Unfortunately we have to wait until next year for the tournament but we are going to start working our game again just as soon as she is ready. What amazed me most about Rosann's sudden brain surgery and diagnosis was the fact that when she woke up from the surgery she asked her sister Linda to call me to let me know she could not play in the tournament. Who else but our dear sweet Rosann would be thinking about others, instead of herself, at a time like that?"_

Barb Eberwein: "Rosann and I have known each other since I joined the Northdale ladies group after we each moved here from St. Louis. Coincidenciology! We always have so much fun talking, crafting and golfing. We took a "one stroke painting" class and sort of got kicked out, or maybe just got the feeling from the teacher that we shouldn't go back! The latest fun time we had was at Eastlake Susan B. Komen golf outing. Rosann is always agreeable to any silliness. At the luncheon our foursome wore pink outfits, long pink wigs, and pink leis. Rosann was really cute!! There are pictures to prove it. Neither of us hits the golf ball very far, but boy, are we straight? Yes!!!"

  " _Brenda Bruno: For My Special Golfing Buddy and Dear Friend_

Two high handicappers often partnered to win

In golf events we'd aim for closest to the pin

We'd repeatedly tried to use our favorite iron or wood

But never would get a trophy, though we felt we could

We'd sacrifice our kudos by saving others from last place

Consistently coming in with our own style and grace

On the course, we created new systems with laughs and a blast

No matter if our scores often placed us surprisingly last?

For our efforts, Rosann, you decided we deserved some rewards

So you ordered us two very special "Good Sports Awards"

Hence, when others were presented with trophies for their shelves

We knew we had our accolades and snickered to ourselves.

We had our own special trophies like no others we knew

We could be proud of our golfing like our pals were too

Thank you, my dear friend for sharing so many good times

And allowing me to put my admiration in rhymes

There are many other tributes you have on your agenda

But none so heartfelt as from your friend, Brenda."

Lillian Stickel: _Taking up golf at age 57 is not highly recommended but was one of the best decisions I have ever made. That decision brought me to one of the most rewarding friendships I will ever have. Golfing with Rosann gave her and me a fun place to solve the problems of the world, gripe about things that no one else cared about and laugh like teenagers until we couldn't laugh anymore. We have a lot of griping, laughing, and appreciating to do yet so I can't wait until we are able to get back on the course and get started. Love you Rosann!"_

"Dave Glandt (son): _"Playing golf with mom is the most fun I have on the golf course. Besides spending time with the greatest mom in the world, her knowledge of the game, great pace of play and overall love in playing the game, makes it so relaxing and enjoyable. It's priceless to watch her reaction when her tee shot carries to the fairway or makes it over the water, or she sinks a par or birdie putt. I was fortunate to be in the clubhouse when she made her hole in one. She called me on my cell and I was there in minutes to share her excitement. It's a memory I will always cherish."_

Rosann's most recent game was February 28, 2011; Jim's birthday. It was just five days before her surgery.

"I wasn't real happy with my game, but I've played worse. I was having a little problem focusing on the ball. Jim played great even though he hasn't played much lately. I'm looking forward to our June golf vacation in Arizona."

"I'm coping. It's tough, but I haven't given up. I probably will never break 100 again, or get another hole in one, but that won't stop me from having fun. Six weeks after the operation Jim and I played nine holes. I putted a few holes and swung my wedge, but mainly I just rode in the cart and felt the joy of being outside with the man I love. We had a great time."

Radiation treatments were over and I was slowly weaned from steroids. Every three days I would drop my steroid usage by 20%; from six pills a day to 5/day, 4/day and so on. I took my last steroid on Holy Saturday. I am gradually regaining my strength and the puffiness in my checks and ankles is gone. I'm getting better and hope to ride 18 holes soon. I might even try and play the par 3's. Let's pray that the chemo and radiation treatments don't sap my strength too much.

**I'm an Artist: (** Examples of Rosann's paintings begin each chapter)

  "This was the pinnacle of my art career; my own show. It wasn't a New York gallery or even a weekend show at a Tampa gallery. It was just four hours in a hotel lobby in West Tampa, but it was MY show. It was my 20 canvases. It was my reputation on the line. I've sold a few paintings and have a website where visitors can view my work (www.expressionsinart.net). But this was the first time I've been 'on display'. It's like opening yourself up and allowing strangers to see inside you. This was a big deal for me."

Jim and Brenda helped set up the paintings in the hotel lobby. People were already there when we arrived. The hotel provided most of the easels and offered $1.00 drinks and free hor'derves.

"I was scared. It was hard for me to say; here I am, these are my paintings, take it or leave it. I'm so thankful for my friends that attended and for Jim and Brenda's help in setting up. I'm so glad I did it."

  The show was a huge success. She didn't sell any paintings but people liked her work. Most important, it made Rosann a stronger person. This is what Rosann's friends said about her show.

Joy Ickes: _"I went to Rosann's art show. She had many of her beautiful paintings surrounding her. She worked the room like she owned it. She was such a gracious hostess, made everyone feel welcome and special. She has that knack with people. I was ready to buy, LOL. We also painted wine glasses together one time. I enjoyed the one on one time with her. She inspires me with her limitless creativity. Rosann is an amazing woman whether she is painting, golfing or just sitting and sipping win. I am truly thankful we ended up in that Wednesday art class together."_

Joan Hofmann: _"I had done the same show as Rosann a few weeks before she did, so I knew exactly the emotions she was experiencing. I am always in awe of Rosann's talent. Her paintings are so vivid, full of life and expression. Every time I see them, I am amazed by her talent and the beautiful work that she creates. Her style, color and expressions give me such joy to be able have her for a friend all these years and to have the pleasure of looking at the art that she creates."_

Lillian: _"Rosann mentioned to me while playing golf one day that she "did some painting." That's like saying Tiger Woods "plays a little golf." I couldn't believe it when I saw her work. I must have told her a hundred times that she was good enough to have her own show only to see that shrug of her shoulders like I was just being nice. When she told me she had finally lined it up she was absolutely beaming. What a great night the show was. I was so proud to be there as a friend of a great Artist"._

Brenda Bruno: _"I had seen a few of your works from time to time and they were always notable. The time that I was amazed and most impressed by your artistic ability was when I helped you transport many of your canvasses for a viewing. Your artistic abilities were so evident not only to me but to many of the attendees who came to the event and admired your work."_

"I have been drawing and painting for as long as I can remember. I paint in oils and acrylics and prefer figurative, florals, landscapes and seascapes. I've done some portraits but portraits are tough. My personal collection includes paintings inspired by travel to many beautiful countries on the Mediterranean Sea, Costa Rica and the Caribbean."

Jim: _"We have a painting she did of Santorini that takes me back to 1999 each time I see it. The white buildings with blue domes, on a steep cliff overlooking the darkest, blue water I've ever seen, depicts one of our fondest memories of a great cruise. Rosann captured the essence of the island in a single painting."_

"My art teacher, Kathi Hobbs, is helping me expand my horizons. Kathy is a wonderful teacher and a great friend. I would not have developed the confidence or talent to do an art show without her help."

  Kathi Hobbs: _"Rosann came to my class five years ago. She was already an accomplished artist. Her eye for detail, patience and natural ability were obvious from the start. As she progressed she began to relax and enjoy the process of learning how to discover and express herself. The friendship and encouragement from the other people in the class helped her to flourish and take some risks........creativity followed. We all got to see the sweet, fun, "girly" side of this beautiful woman. Now we see the strength and positive determination to live and be as independent as she possibly can. We are now learning from Rosann. It is a privilege to know this woman.....she is an inspiration to us all"_

"Wednesday art class, from 11 AM to 1 PM, has been a highlight of my life for the last few years. There are 8-10 other 'students' in the class - many of them are very good and have sold many paintings. We have so much fun. Last week I went to my first class since my operation and I am going again today (4/27). My vision is not good so I'm changing from realism to abstract paintings, from Edwin Hopper to Kandinsky. My 'class mates' have been so supportive since my surgery. I'm so grateful to them."

Sunny Rogers: _I began painting one year ago, and had the great good fortune to be Rosann's "seat mate". The first thing I observed was Rosann's physical beauty--especially her eyes. It was apparent from the first moment that Rosann was generous with herself and willing to share her painting experiences with this beginner; helping me with mixing and squeezing her paint onto my palette when I needed a color I didn't have. She was quick to be pleased when her eye and her brush created beauty, but was just as quick to mumble and complain in frustration when her painting was not going well. When Rosann returned to class following her illness, she painted her first (to my knowledge) abstract painting. It was simply stunning. She delighted in the discovery of a certain shade of lavender. It was an answer to prayer to see her spirit rising with each brush stroke. I love you dear Rosann."_

  Aleida (alie) Griffey: _"Once upon a time I met lady, a 'real Lady', lovely, talented and unassuming. Her name is Rosann and she brightens our art class. Recently she has had to face some serious health issues and we've found that on top of everything else, she has strength too. We all love her and want to help anyway we can."_

  Tinna Knight: "Rosann is a flower in my garden of friends, a beautiful spirit that never offends;

She has bright blue eyes that sparkle and shine, her eyes become bigger when she drinks her sweet wine;

She is fun to be around when we're in art class, we laugh and joke and the time goes by so fast;

Rosann, I love you, you are a big part of me. You fill me with happiness, hope and glee.

I love you!"

  Joy Ickes: _"I pray for Rosann and I am truly grateful for her friendship, she is beautiful, inside and outside. We started art class at the same time, and it would always piss me off she was SO GOOD!!! Ha-ha. She came in with her own style and it was fun to watch her open up and become crazy like the rest of the class. Her first paintings were very dark but soon she began painting colorful, happy, women. She would come to class a little down sometimes but would always leave smiling. I hope we all had a good influence on her because she sure did on me. She has the grace of a beautiful swan with the personality to match it. Listening to Rosann talk about all the fabulous places she has been and fun things she has done inspires me to live my life to its fullest. Class is a place to come in and have some serious girl time with lots of laughs, understanding and sharing. Her absence from class is felt when she misses class on Wednesday."_

Beverly McDonald: _"Rosann was one of the first to send her thoughts to me when she found out about my husband's cancer. This was before she knew about her own. You could never say that Rosann was self centered. Another time I insisted she take one of my 'Readers Digest music books home with her. She kept it an extra week and thought I would be mad, but of course I wasn't. The next week the music book was returned, wrapped up like a real treasure. I could give you many examples. What a jewel she is!"_

  Jerry Gilbert: _"I'm the one male in the art class that Kathy Hobbs mentioned in her e-mail to you. I've known Roseanne since she came to class and enjoyed the benefit from her sitting at the easel next to me. I have to admit that I don't know what she would look like without that smile on her face and that gracious demeanor. I'm confident that her smile and demeanor will endure during these trying times. I look forward to seeing her in art class."_

  Jo Davis: _"Rosann has been a delight from the first moment I met her. As a new student in Kathi's class, Rosann made me feel welcomed and a part of the group. She is a warm and caring person. Whenever I sit down in the seat next to hers, I can hear her motherly reminder to always wash my brushes before coming to class."_

Barbara "Barbie" Manning: _"I have known Rosann in our art class for almost five years. She has always been a beautiful woman and a very good artist. I always thought of her as rather quiet, but she would speak her mind when it was appropriate. Our class is always very talkative, and she contributed her share. I am a lifetime member of Weight Watchers, and I discovered that Rosann had also been a lifetime member when she told me she wanted to join Weight Watchers again to lose some weight. I was surprised because she certainly didn't look like she needed to lose a pound to me, but I know how personal weight can be. I also knew that she had a lot of patience and determination from being with her in our art class. She said she was going to a high school reunion soon and she wanted to look good. So she started going to the same Weight Watchers meeting that I attend, and she went on a regular basis until she reached her lifetime weight again, which didn't take very long. I honestly couldn't see a lot of difference but I think it made her very happy to know that her weight was where she wanted it to be."_

Rosann has also done several "commission paintings", most recently for her friend Brenda. It was a tough assignment that her art teacher advised her not to try. Brenda wanted an exact reproduction even though the photo of the little girl sitting in front of the mirror was off-center, creating blank space where the viewer's eye would gravitate. Rosann did the painting - Brenda is her friend.

Brenda Bruno: _"I had saved a special snapshot of my granddaughter as a child taken haphazardly by my daughter. It was something that I had always thought I would like to see put on a canvass and done in oils. I had been waiting for many years for just the right artist to do this. When I viewed your works at that showing I knew immediately that you had the talent and were that special artist that could make my dream come true._

I asked you if you would do this for me. After discussing the picture you agreed to try. When you returned the finished canvass you told me how this picture was not an easy one to paint. You had put a lot of work into it and had taken it with you to your art lessons for input.

  _There it was in all of its glory. The picture I had dreamed about for many years. It took me a day or two to absorb all of the details of the canvass. You could feel the textures, the likeness to the original picture, the placement and proportions of the objects and the colors were all perfect, plus it told a story. I, who knew nothing about art, was totally absorbed in this wonderful and beautiful picture._

_I said nothing to either my granddaughter or daughter about having this treasure and placed it in a significant spot in my great room for all to see. When my granddaughter came to visit me she was engaged in conversation when suddenly her vision lifted to the picture. There was a sudden squeal followed by many tears of joy. "Oh, Nana," she said. "That's me. I'm famous. I'm in a special picture. What other recognition of great artwork could one want?_ "

I'm a Business Woman:

Beta Sigma Phi Business Sorority, North Tampa Chapter

"Jim and I have two businesses. Jim handles Greenman Funding which brokers commercial mortgages and project financing. I was in charge of Gemco Leasing which offers equipment leasing to businesses. We once had our own funding line but now we are primarily brokers. A typical leasing deal would be for a hotel that wishes to purchase a $75,000 telephone system. The hotel can pay cash or enter into an equipment lease and stretch the payments over 48 or 60 months. The buyer may also go to his bank and borrow the money. There are pros and cons of each alternative.

It's a complicated business that creates a lot of paper and computer files. My office is filled with paper files and my computer is filled with websites addresses emails and data files. Keeping track of the lenders can be a full time job. My office is a mess, but it's my mess. I knew where everything was. The economy and banking failures has changed everything. 80% of the lenders that offered equipment leasing five years ago are now out of business or stopped offering leasing. I kept track of the lenders we could use. I also prepared lease documents, invoiced customers, handled the deposits, paid bills and balanced the checkbooks. Not anymore, Jim's now on his own. I'm just looking forward to getting back with my friends at Beta Sigma Phi."

Jim: _"We made a good team. I would bring in the business and Rosann would take it from there. She was also invaluable in developing and maintaining contacts for marketing campaigns. Business has been slow the last few years so maybe it was time to retire anyway. I'll miss her most when we try to develop new business. That can wait; we have a lot going on right now."_

**I'm a Homemaker** :

The first month was the worst. My biggest adjustment was not being able to do the little things. Laundry, cooking, vacuuming, feeding the cats, making the bed and the scores of other routine tasks that housewives do every day without a second thought. I was too tired and I just couldn't see well enough to get around. Jim has to do everything. Sure, he used to help me out around the house, but now it's his responsibility.

Jim: _"I couldn't believe how tired I get, especially my lower back. It wasn't any heavy lifting; just doing the mundane tasks like the laundry, getting pots and pans from the cabinets, pushing the vacuum cleaner around and so forth. Part of it was bending over to help Rosann, but most of it was my new job. I was using a different set of muscles. It's amazing what a person finds out when forced to walk in another person's shoes. It isn't as easy as it looked."_

I'll give you some examples:

"I love to cook but Jim had to do it all the first four weeks, breakfast, lunch and dinner. We were fortunate to have friends bring 'dinner done' freezer-to-oven meals, roasted chickens from Sams, pulled pork and other food that Jim could prepare easily. Jim was still stuck with breakfast and lunch but he surprised me. He made some nice meals and even got creative a few times."

"I used to do all the grocery shopping. It wasn't until the fourth week that I started going with Jim or my son, Dave, as a way to exercise and get out of the house. I hang onto the cart for balance and Jim guides the cart to make sure I don't run into anyone."

Jim: _"I couldn't believe the 'sticker shock'. The first day I almost came home empty. Who is going to pay $2.69 for a quart of milk or $1 for a can of tomato soup. I remember when a can of Campbell's tomato soup cost 25 cents (and gasoline was $.27/gallon)."_

"I just sit and wait to be served meals and after, Jim cleans up the mess and loads the dishwasher. I guess being ill has some rewards, but if I had a choice, I'd rather be helping out."

Jim: _"Before the surgery, there must have been a kitchen fairy that came three times a day. Who else rinsed the dishes, put the dishes in the dish washer, put the food away, cleaned the counter and swept the floor? Now I see what Rosann was doing while I read the paper or watched TV."_

"Believe me; I miss the old routine. I'm looking forward to when I'm in control. Jim used to help out by carrying dishes to the kitchen, occasionally running and emptying the dishwasher and other jobs. But now it's all on him. He learned that it wasn't so easy. I'm trying, but I'm still too weak to carry anything out to the kitchen or even empty the dishwasher, but I still won't let him hire a 22 year old French maid. There's nothing wrong with my instincts."

I enjoy my Daily Rituals

"Everything has changed. I can no longer do the little things I used to do to occupy my time. Sudoku puzzles and crossword puzzles that I once could do without thinking, are tough. Watching PTI, House, Chicago Code and other favorite shows is not much fun. The picture is blurry and it's difficult to follow the plot. I have my own herb garden but now I have to ask Jim to cut some rosemary or basil. I used to enjoy going outside in the morning to get the newspaper or pick up the mail. Reading the newspaper is now a chore and I can't see well enough to go outside alone. Sometimes I feel trapped.

Jim used to make me a daily fun-pack of puzzles. He would make two copies of the Sudoku puzzle and crossword puzzles from the Tampa Tribune and the Sudoku from our daily calendar. We added a 'scramlet' puzzle' to make five. He would 'blow-up' the puzzles on our copier to make them easier to read. Jim drew hearts below the calendar Sudoku and wrote in something like 'J loves R' or 'J & R 4-ever'. It was his daily 'love pack'.

It's a ritual that has ended, at least temporarily. I can no longer do the Sudoku puzzles, even the easy ones. Two weeks after surgery I had lost all recollection of how to start a Sudoku. I'm improving, but I still have a long way to go. I'm not too bad with crosswords."

Jim: _"It's sad and frustrating to see her struggle with these little things. She tries, but the effort to concentrate on a newspaper article or a crossword puzzle makes her tired. Cara, Rosann's speech therapist, says this cognitive thought process will improve with time and mental exercise. I hope so."_

I'm a Biker (bicycles only):

"Five years ago I was afraid to ride a bicycle. In fact, I couldn't ride a bicycle more than a few feet without crashing. I had forgotten how and it made me feel old. I hate that feeling.

I learned how to ride again thanks to Jim's help, and patience. It's been a great experience. There's a new walking/bike trail in North Tampa less than a mile from our house that ends behind a county park. The subdivision is mostly rural and peppered with horse ranches and riding stables. Jim and I rode about five miles three or four times a week. We played a game and count how many unique 'birds and animals' we saw; cat, dog, egret, heron, cardinal, hawk, frog, turtle, etc. Our record count was 36 including our favorite emu and swan. We also saw an eagle and deer that day. Our record count of horses-only, is 43. Jim tells me that one private owner that kept six horses in their backyard pasture, closed and moved to Nevada. Sadly, one horse died in transit. Jim says he counted 45 horses last week but it's not an official record because I wasn't there to verify his count. He cheats sometimes.

I can't ride anymore; I'm still too weak from the surgery and radiation. The long term problem is my lack of vision. Unless my vision improves dramatically, which is unlikely, I won't be able to ride again. That hurts.

We are looking at 'tandem bikes' as a way to get out and enjoy the weather and the fragrances. I couldn't see much but Jim would be my eyes and jog our memories. I need to get a little stronger before we try. I'm afraid I might get dizzy and fall off. Riding again would be nice for me and also for Jim. It would make me so happy if I can do that for him."

Jim: _"Riding a bike doesn't seem like much, but conquering this seemingly simple task made Rosann feel good about herself. It was beautiful to see. Riding was also a lot of fun. A friend suggested a dual recumbent bike or maybe a three-wheeler; I'm looking into that. It's very sad to ride our bike trail without Rosann."_

I'm a Cat Lover:

Jack & Cloe - my babies

Jack and Cloe are a constant source of pleasure for me. Their love is unrelenting. We found both cats at the Humane Society. I swear Jack looked at us and said 'pick me'. Jack is the smartest cat ever and the only cat I've had that responds when I call him. I'm sure he knows his name. He curls up next to me at night and adjusts his position whenever I move.

Cloe isn't nearly as smart but has her good qualities. She starts purring whenever she hears a can of food pop open or the refrigerator door open. She had a tough childhood before we adopted her. They both know there is something wrong with me and constantly hover around me with sad eyes.

There is one other thing I used to love. I'll let you guess after I tell you that Cloe's full name is Clos Du Bois Chardonnay and Jack's full name is _______? Yeah, you guessed it."

Jim: _"Getting Rosann to fly home from St. Louis was a tough sell until I mentioned how the cats must miss her. You laugh, but I really do believe that her desire to see Jack again tipped the scale in her decision making process. She loves those little fur balls. I love Jack too. Cloe's weird."_

I'm a World Traveler:

Amalfi Coast, Italy

"Jim and I have gone on so many nice trips, places that I never dreamed I would ever see. He started by taking me to Costa Rica which still is one of our favorite places. We were still dating and I was trying to impress him. We did everything; snorkeling, climbing down a steep cliff to swim under the waterfall, riding a runaway horses that caught the scent of the barn before I dismounted; walking through the Monteverde Rain and Cloud Forest in pouring rain; stepping out on the balcony of our A-frame chalet and looking down at the clouds; climbing to the lip of Mt. Arenal, one of America's most active volcanoes; sailing a catamaran to an island where our boat captain helped me dive 15 feet down to touch a stingray buried in the sand; and my favorite event of all; white water rafting where I got thrown from the raft, hit in the face by the kayak that was supposed to rescue me and finally dragged into the boat like a blubbering fish. Other than snorkeling, I'll never do any of that again, but what great memories.

We went to the most romantic restaurant I have ever seen; Tara, modeled after the Scarlett O'Hara plantation. Jim and I walked out on the terrace overlooking San Jose and I started to cry, it was so beautiful and romantic. I knew then I was with the right guy.

The Rome to Istanbul cruise is our favorite. Every American should have the opportunity to 'feel' how young the United States is compared to these countries. It puts things into perspective. Jim and I took a cab to the old part of Istanbul, still referred to as Constantinople. We had dinner Al Fresco at the foot of one of the three bridges spanning the Bosphorus River, connecting Europe and Asia. It was a cool evening and the waiter brought me a blanket for my shoulders. Jim and I were in awe of our surroundings and the feeling you get looking across the river to another continent. The next day we took a boat ride down the river and could see why Istanbul has remained a strategic and fascinating city for so many centuries.

Jim and I want one more trip, a river boat cruise through Eastern Europe. This is at the top of our bucket list. Viking has a cruise on the Rhine River, from Basil to Amsterdam. We did the Viking Portraits of Southern France cruise in 2006 and had a terrific time. It's so nice to step off the small river boat and walk 100 yards into a different culture. Four days in Paris and three in Nice made it even more special. We have always planned to do one more river cruise. I hope we get the chance.

Jim: _"Tomorrow evening, May 3, Rosann and I are invited to a party hosted by our travel agency. The regional marketing director from Viking will be there and 2011 cruises are on sale. We are hoping to schedule a cruise for August. Rosann isn't strong enough to fly to Europe right now and there are no direct flights from Tampa to Europe. That makes it a long day. It took us 18 hours to fly home from Nice, France. Rosann couldn't do that now. Let's pray she gets stronger."_

Rosann, May 2, 2011

"All-in-all, I think I'm doing all right. I'm going to start playing the piano again soon. It's hard because I play from written music, not from memory. Who knows, maybe I'll even get Jim to take me dancing again. Sometimes when we are walking for exercise he will hold me and twirl me as if we were slow dancing. We also jitterbug a little. He says these are exercises to help me regain my balance and coordination but I know it's dancing. A girl can hope."

Jim: " _There will be no dancing; I'd Do Anything For Love, But I Won't Do That (Meatloaf)."_

### Chapter Three

### Subtle Warnings

Slow Night

"Should I have seen this coming? I don't think so. There were a few subtle hints, but nothing that got my attention. I hadn't felt 100% for several weeks, but nothing that I could put my finger on. I've always had poor eye sight due to a detached retina in my right eye. Cataract surgery in 2010 helped a little, but I still relied almost entirely on my left eye for vision. My optometrist recently gave me a stronger prescription for my contacts which helped a little. My eyesight still wasn't great but I was living an active and normal life. Everything was good."

"Saturday, just a week before the surgery, Jim and I went to Home Depot and selected laminate flooring for our two home offices. We chose a nice, rich Pergo that would contrast with the light laminate that Jim installed five years earlier for the family room and hallways. I figured leaving him with 900' of flooring to play with would keep him out of trouble while I was in St Louis. I bumped my head pretty hard on the side of the door window getting out of his car and was groggy for about five minutes. Jim had me sit down when we got inside the store and 10 minutes later I was fine."

Jim: _"She took a long time getting out of the car and I wondered what she was doing. I didn't know she bumped her head until we were in the store. She was acting a little 'off' and I told her to sit down. It wasn't anything obvious and later she seemed okay and I forgot about it. I don't see how we could have done anything differently. Doctors later said that bumping her head was just a symptom. The accumulation of blood in her brain was not caused by trauma."_

"A few days earlier I was driving to the grocery store and found myself hitting the lane divider speed bumps a couple times. My eyes told me I was in the center of the lane, but I wasn't. I was also having trouble picking things up off the floor. The objects would be a couple inches away from where I thought they were. I made a mental note to see my optometrist or maybe get an appointment with a new ophthalmologist. The one that did my right eye cataract surgery no longer accepted our insurance. That was the last time I drove my 1997 BMW Z3. The mileage stopped at 28,542 miles.

"Jim and I played golf on Monday, February 28th. It was his birthday. It was part of his birthday present and an attempt to get him playing more again. We planned a golf vacation in Scottsdale, AZ for June. I played okay, but had problems focusing on the ball. My depth perception wasn't good and was fortunate not to whiff any shots. I blamed it on my new prescription and made another note to talk with my optometrist when I got back from St Louis.

Jim: _"I didn't notice anything unusual. She had some good shots and bad. I've seen her play a lot worse. We had fun."_

Tuesday I flew Southwest Airlines to St Louis without incident. I didn't have to drive. Jim drove me to the airport and my sister, Linda, picked me up at Lambert and took me to my mother's house. I recall having difficulty keying the numbers on my cell phone. Later, while I was telling Linda and my mother about the problems I was having with depth perception, I tried to put a spoonful of creamer in my coffee but overshot the cup by a couple inches."

"Linda and I went shopping Wednesday in Old St. Charles. SSM St. Joseph's Health Center is only a few blocks away. I had problems navigating the cobblestone streets and the high curbs. Something was wrong. Everything seemed a bit 'off'."

Thursday I made an appointment with my new ophthalmologist for the day after I returned to Tampa. Obviously, I never kept the appointment. Coincidentally, my 92-year old mother had an appointment with her eye doctor. She had made the appointment for that day because she knew I would be in town to drive her, but I couldn't. She drove."

50th High School Reunion - March 4, 2011

Notre Dame H.S. Class of '61 (Rosann - far right)

"Friday was my 50th Notre Dame High School reunion. I had been looking forward to this for several months. I dreaded driving and fortunately had arranged for two friends to drive. It's an all-girls school and husbands weren't invited. Marge and Mary picked me up home and drove downtown to Kemoll's Top of the Met Restaurant. The restaurant and food were great and I had a great time seeing old friends. I had a little problem keeping the Salmon on my fork, but nothing anybody else noticed. I was home by 10:30 PM."

These are some comments from Rosann's high school classmates;

Marge: _I have spent a lot of time rehashing Friday night since all this has happened. We talked on the phone early in the week and you were very enthusiastic and excited about the reunion. You did not mention feeling poorly and you sounded great. Friday night it was pouring rain when Marci and I picked you up. I was really impressed with how wonderful you looked. We chatted all the way to Kemoll's. You mentioned that your vision was not quite right and we then started talking about your eye surgery you had shortly after graduation. We visited with lots of people and even went in different direction for a bit. You ordered a glass of wine but drank very little of it. You had a slight headache and didn't know if you should be drinking. That was the first indication that anything was unusual. You did not eat much of your meal but did say it was excellent food. When it came time for the picture, we had only a half of chair to sit on and your balance was good. Fight, fight, fight and know that we are pulling and praying for you."_

Kathy Lohmueller: _When I arrived at our reunion I was so thrilled to see you standing there and you looked lovely. Later at the table you shared pictures of your beautiful paintings with us. You are an outstanding artist, and I am so proud of your accomplishments. The evening went much too fast because we could have talked all night. You are a "tough cookie" and know you can beat this. Never give up hope--so many people love you! I love you and treasure you always!!!"_

Millie: _"I didn't notice anything wrong that Friday night – I remember making the comment how great you looked, and how I was going to visit your website. But you looked happy, healthy and beautiful as always. Hang in there my friend; you are on many prayer list, and always in our hearts. Love."_

Nancy Thebeau Schilling: _"Rosann, I remember when you first walked in the dining room Friday night; I didn't recognize you at first. You looked great! We talked a few minutes and you seemed fine. I thought that I would visit with you a little later and the night sped by. People started to leave and I saw you just before you left and I remember thinking she looks a little tired. I was so shocked when we got the phone call that you were in the hospital with an aneurism. I couldn't believe someone who looked so good on Friday could be so sick. I hope you are feeling better and I will keep you in my prayers."_

Mary Ann (Lesyna) Braun: _"Hang in there Rosann, I have always believed God works in strange ways and you certainly are an example of that. Our prayers and good thoughts are with you each and every day. I hope this makes you smile. When we got word of your circumstances on the reunion Sunday morning there were maybe 40+ of us at River City Casino having breakfast. We were in a wide open area and we gathered around several tables that had been pulled together and formed a sprawling circle. We prayed right then and there for you._

We didn't give a hoot or holler what anyone thought 'cause the girls were praying for our 'sister'. I wish you only good things."

### Chapter Four

### March 5, 2011

### The Day My Life Changed

Wading Ankle Deep

Saturday, March 5, 2011. "Linda drove my mother and me to the 12 PM funeral service at Assumption Church in O'Fallon, Missouri, about 35 miles from Affton where I grew up and my mother still lives. The weather was nasty, especially for a Floridian. I remember being unusually cold as we walked into the church. The funeral mass was for the paternal grandfather of my daughter's oldest children, Kyle and Cassie. We offered out sympathies to Rita and to Kyle and Cassie. We took our seats towards the rear of the church.

Ten minutes later the headache began. It was the granddaddy of all migraines. The pain was unbearable. My mother asked me if I was okay but I couldn't respond. I'm told that Kyle's girlfriend and her mother saw I was in distress and her mother and my sister, Linda, helped me to a bench at the back of the church. I was still in pain and Allie's mother called 9-11. I remember feeling bad that I was disrupting the church service."

Helen Folk (Mother): _"Rosann seemed normal that morning. Linda drove us to the church and Rosann was chatting away like sisters. The first sign something was wrong was when I saw her holding her head and grimacing. I could tell she was in pain."_

"I don't remember much after that. I knew I was in an ambulance and felt sick to my stomach. I had no recollection of being transferred to a second hospital. People kept asking me my date of birth. I kept telling them but the next person would ask me the same question. I told them again. The rest of the day was a drug-induced blur. Someone else will need to tell what happened."

Rosann was taken by ambulance to St Josephs West where she was evaluated. The non contrast CT scan of the head showed a large 6.7 x 4.5 cm bleed in the right rear portion of the brain (right parietal occipital lobe) and a 6 mm shift of the brain midline caused by the swelling. There were also signs of additional damage and areas of concern. The lab called Dr. Kennedy with the CT results at 3:10 PM. He decided to consult with Dr. Martin, a neurosurgeon, by telephone. They agreed the patient should be transferred to St. Josephs Health Center and Dr. Martin would see the patient there in ICU. Rosann's family followed close behind.

Dr. Close evaluated Rosann at the request of Dr. Martin. Consulted family who noted she struck her right temporal region of the skull on a car door 9 days earlier. _"The patient complained of a headache and is falling asleep in mid sentence. He noted the Head CT showed abnormal appearance in the left occipital/parietal region as well as the right; will need an MRI to get a better look at the lesions."_ Dr. Close completed his evaluation at 6:15 PM.

Dr. Martin was evaluating the patient while Dr. Close was finishing his report. _"She continues to complain of headache and notes weakness on her left side which is present since today. Patient is in moderate distress. She was able to name the current president and 1/3 objects after five minutes. She had decreased attention span and a good fund of knowledge. I suspect she has an underlying tumor, most likely metastatic. I am inclined to hold off on emergency surgery. I think her prognosis is fairly poor although the diagnosis is uncertain. I suggested to her family that her husband come here from Tampa because of the gravity of the situation."_ It was about 6:30 PM and Dr. Martin went home.

Three hours later Dr. Martin changed his mind. He had been monitoring the case from home and had read the lab reports and MRI. Her condition had worsened and he would need to operate. It isn't clear whether it was the additional detail provided by the MRI or Rosann's general condition that caused him to come back to the hospital on a Saturday night, but it didn't matter. He's the expert and it's his call. It speaks well for his character that he was this involved.

Jim: _"Dr. Martin called about 10:30 PM EDT and said her condition had worsened and wanted permission to perform emergency surgery to relieve the pressure from an accumulation of blood in the brain. The Cat Scan and MRI showed a bleeding tumor in the right-rear portion of the brain in addition to a large mass in her lung that was probably the source of the brain tumors. He had been monitoring Rosann's progress from home and decided he needed to operate now; tomorrow might be too late. He left no doubt that the situation was serious and I should make plans to fly to St. Louis soon. I gave permission to operate. He didn't say so directly, but I could tell the Dr. was afraid that Rosann might not make it through surgery."_

Procedure Notes: Right occipital craniotomy and excision of intraparenchymal hemorrhage and the subdural hematoma. The operation began a little before midnight CST and continued into Sunday, March 6. It went as planned and the pre and post operative diagnosis were the same; 'Right occipital hemorrhage, rule out tumor'.

Dr. Martin: _"I harvested the majority of the clot for patholologic examination, but really saw no gross signs of tumor, but rather edematous and swollen brain surrounding the hematoma cavity which measured 5 cm in maximum dimension. Having achieved decompression, I then worked over the surface of the brain...finding and removing small pockets of hematoma. The patient was transported to ICU in stable condition having tolerated the procedure well."_

Jim: _"Dr Martin called again, about 1:30 EDT. I had dozed off waiting for the call but was immediately awake. I answered the phone with some trepidation. He said, the operation had gone well and Rosann was resting, but his earlier fears were confirmed. They wouldn't know for sure until the biopsy was complete, but it looked like adenocarcinoma of the lung, adeno meaning the tumors in the brain came from a gland, probably the lung in this case. Further operations were not an option. He said Rosann's condition was serious and repeated his suggestion that I get to St Louis quickly. We talked for 10 minutes and Dr. Martin pointed out that Rosann would be not be able to 'fly' for ten days due to the possibility of air pockets in her brain that could expand at high altitude. He mentioned there was a chance that she had suffered a partial or complete lack of vision in her lefty eye caused by the trauma in the right, rear portion of the brain."_

Hospital Records: Dictation notes show that Rosann answered questions and provided information to nurses and doctors at both hospitals, but became confused and would occasionally dose off. She submitted to at least four or five evaluations at two hospitals, answering question after question, but doesn't recall much of anything that happened to her. She named the president, related her medical history and recalled 1 of 3 objects after five minutes, but cannot remember much of that day. Her mind is good and her overall memory is good. No mention was made of her loss of vision.

Rosann would remember very little about what happened. The arduous events and the trauma she suffered have been blocked from her memory.

Two more exams were performed in the early morning hours after Rosann was transferred to ICU. A portable chest XR machine revealed 'no pneumothorax or active disease in the chest area. A CT Thorax Abdomen Pelvis with contrast revealed "a soft tissue mass in the left lung measuring 2.8cm x 2.7 cm x 6.5 cm. This lesion is of concern for primary lung cancer.

The liver, spleen, adrenal glands, pancreas and kidneys were unremarkable." Dr. Karen Gladden, M.D. signed off on both reports at 1:20 AM and 2:56 AM, March 6, 2011.

### Chapter Five

### ICU

### Sunday and Monday

The Parasol

Recovery:

"I knew I was in a hospital but didn't really care why. I'm sure someone told me I had an operation but I don't recall anything about the previous day. I remember being in church for the funeral service and talking to Kyle and Cassie and vaguely being in an ambulance. I don't remember anything after that. I'm sorry, I'm not much help."

Dr. Martin stopped by and later said he was pleasantly surprised. Rosann was doing better than expected.

Nurses and doctors came and went. Dr. Vickers, Dr. Meier, Dr. Garcia and the nurses and techs that needed to draw blood or give her medication. They all asked the same question; 'Do you know your date of birth'? Relatives were shuttled in when Rosann was awake and time permitted. Mother, sister, sister's husband, niece and others waited for an opportunity to visit with Rosann.

Mother: _"I was surprised she looked as good as she did. She was a little groggy but was able to talk with us."_

"I knew my Mother and Sister were in the room but I was so tired that I kept on drifting off. I kind of remember talking on the phone with Jim but don't remember what he said. The drugs were in control."

Rosann's condition improved and Monday afternoon she was transferred from Intensive Care to a monitored care unit and a new set of nurses and technicians.

"Monday was much like Sunday. Doctors and a new set of nurses came and went, my mother and sister were at my bedside and I kept answering the same old question; 'Do you know when you were born?' I would think they would have known that by now."

Mother: _"She seemed to be getting better and was awake more. Nurses let us visit with her longer especially after they moved her upstairs."_

Jim arrived from Tampa about 12:30 AM, Tuesday morning and found Rosann sound asleep.

From Jim's Perspective:

Jim: _"I had just completed a third consecutive 14 hour day work day to install laminate flooring (Pergo) in our offices, which are really converted bedrooms. The tough part was empting the closets and moving the furniture so I could get to the floor. The final challenge would be remembering where everything belonged. Laying the flooring was easy once the baseboard was removed and painted. I had been working since 4:00 AM and was dead tired, but happy because I was on schedule. I was sipping wine and watching ESPN' NCAA basketball coverage when the phone rang. Caller ID on the TV told me the call was from Rosann. It was about 6:30 PM EST."_

Kyle Hefner: _"We were in the ICU waiting room and I decided someone should notify Jim that his wife was in the hospital. I used Rosann's cell phone to make the call."_

Jim: _I recall saying hi honey and asking why she hadn't called earlier as she promised, before finding out it wasn't Rosann. It was Kyle, Rosann's oldest grandson. He gave me the bad news. Rosann had collapsed at church and taken by ambulance to the hospital. The doctors said that I should get there as soon as possible. Kyle didn't know any details about what happened because he had been sitting in the front of the church. Someone would call me later when they found out more."_

Jim: _"The next couple hours are a little hazy as I waited in Tampa for more information. At some point I learned that doctors were waiting for an MRI to confirm the CT Scan that showed tumors and an accumulation of blood in the brain. About 8:30 - 9:00 PM (EST) Linda called and told me that Dr. Martin, the neurosurgeon, had decided to operate and was on his way to the hospital. He would call me to ask permission to perform the surgery."_

I called my son and daughter in law, both doctors in Virginia. I needed to talk with someone. This was a big decision."

Drs. Mike and Claire Plautz: "Dad called us to give us the bad news and to get our input. We were able to give him some comfort. We told him that it sounded like they needed to drill a hole in her head to remove the pressure from the accumulation of blood. It sounds bad, but it's not a big deal. I've done that surgery myself as an ENT Surgeon. There was no way to know what additional procedures would be done once the neurosurgeon was in there. Give him permission and let him do his job. That's why they pay neurosurgeons the big bucks."

I don't think I ever considered saying no but I felt much better after talking with Mike. I was better prepared for Dr. Martin's call. While I waited, I looked into flight schedules using Travelocity and Expedia. Getting to St. Louis quickly is not as easy as it sounds, particularly at a reasonable cost. Earlier I had tried to schedule a flight that evening, but at 6:45 PM there were no more flights to St. Louis from Tampa or St. Pete. The next flight left Tampa around 6 AM and arrived Sunday afternoon. I held off making any decision and waited until I spoke with the doctor.

Jim: _"Dr. Martin called about 10:30 PM EDT. Rosann's condition had worsened and he wanted permission to perform emergency surgery to relieve the pressure from the accumulation of blood in her brain. The MRI showed a bleeding tumor in the right-rear portion of the brain and another tumor on the left side. The CT Scan showed a large mass in her lung that was probably the source of the brain tumors. He had been monitoring Rosann's progress from home and decided he needed to operate now; tomorrow might be too late. He left no doubt that the situation was serious and I should make plans to fly to St. Louis soon. I gave permission to operate. He didn't say so directly, but I could tell the Dr. was afraid that Rosann might not make it through surgery."_

I spent a couple more hours on the computer and tried to stay awake. I was starting to lose the battle when the phone rang.

Jim: _"Dr Martin called again, about 1:30 EDT. I had dozed off waiting for the call but was immediately awake. I answered the phone with some trepidation. The operation had gone well and Rosann was resting, but his earlier fears were confirmed. They wouldn't know for sure until the biopsy was complete, but it looked like adenocarcinoma of the lung. Further operations were not an option. He also said Rosann's condition was serious and repeated his suggestion that I get to St Louis quickly. We talked for 10 minutes and Dr. Martin pointed out that Rosann would be not be able to 'fly' for ten days due to the possibility of air pockets in her brain that could expand at high altitude. He also said there was a chance that she would suffer a partial or complete lack of vision from the head injuries caused by swelling and surgery."_

I was tired but tried to evaluate my options. Was it necessary to get on the first flight to St. Louis? Was this the best course of action? Surgery had already been performed and Rosann was resting comfortably. Her condition was serious but she was not in immediate danger. I was without sleep for almost 22 hours and physically sore from four days of moving furniture and laying flooring. A 6 AM flight would get me to St Louis Sunday, but what then? Rosann would be sleeping most of the time and I would be dead on my feet. Rosann's inability to fly home for ten days was another consideration. Maybe I should drive a car to St. Louis? I decided not to catch the early morning flight to St. Louis.

Jim: _"I didn't dwell on the bad news. Maybe it was adrenalin, or maybe I was overtired, but I fell asleep dreaming about getting Rosann home and how we would beat this thing. I didn't dwell on the negatives."_

Sunday morning I evaluated options to get Rosann home by car. I called Rosann's son, Dave, who lives nearby. He already knew the bad news. Yes, Dave would be more than happy to share the driving, just let him know what I decided. He could leave anytime.

I called my daughter Kelly in Atlanta to tell her and Brandon the bad news. She suggested that Dave and I could sleep there if we wanted to make it a two day trip. Their house is only 20 minutes off the route we would take. Mike and Claire said we could stop in Virginia at their place, especially on the way back if we needed help with Rosann. There were plenty of options.

One sticking point was that Rosann, at her best, doesn't like long car rides. She couldn't sleep. I needed to talk with Rosann before deciding to fly or drive to St. Louis _._

Jim: _"I finally got through to Rosann Sunday afternoon after several 'I think she's sleeping' messages from the ICU nurses. I certainly didn't want to wake her._

She seemed fairly lucid on the phone but I could tell she was weak. After the 'I love you stuff', I told her the Doctor wouldn't let her fly home for ten days and asked what she thought of driving back to Tampa. I told her Dave had agreed to share the driving if necessary. Rosann was more adamant about not wanting to drive than I expected. She didn't want to be in a car that long, the same argument she gave me for a seven hour trip to Atlanta. She wasn't fully grasping the fact that Dr. Martin said she couldn't fly for ten days. I knew, though, that it would be hard to convince her to ride in a car for 16 hours. I didn't push. I decided to fly up to St Louis and postpone the decision on how to get her back to Tampa"

I made plane reservations for the following day. The expected arrival time in St. Louis would be about 11:00 PM Monday. The 4:00 PM departure saved me a few hundred dollars and gave me time to get the house ready for when Rosann came home. I spent the remaining part of Sunday and Monday morning working on the flooring project and straightening up the house.

Jim: _"I'm not talking dusting and cleaning. I'm talking about moving file cabinets off the patio into my office, finishing the floor in Rosann's office so I could move her desk and art supplies back where they belong and hang all the clothes that were piled in the guestroom back into her 'overflow closet'. I wanted the house to be clean for Rosann when she returned. I wanted her to be able to sit down at her desk and use the computer and check her email. I wanted her to get back into her routine. Alas, I did not yet realize how difficult this would be. At this point, I did not know how weak she was and how much her vision was impaired. I didn't realize that she wouldn't be able to even see the new floor clearly."_

Dave Glandt drove me to the airport. I was still cleaning up the house when he arrived and we left in a hurry. In my haste I forgot my packet of information that had my rent-a-car reservation and the trip-tic from the airport to the hospital. I would need to rely on memory.

The flight arrived in St Louis on schedule but my memory failed me. It was after midnight and I was hopelessly lost when I pulled up to a red light next to a tow truck, rolled down the window, and asked for directions. The driver started to tell me and then stopped and said, 'follow me'. Ten minutes later I was in front of the SSM St. Josephs Health Care and the driver was pointing to where I should park my car and enter the hospital. What's the movie, Pay It Forward? Well, I owe three strangers a big favor.

Rosann was sound asleep when I arrived at her 2nd floor, monitored care room. She barely murmured when I hugged and kissed her. Nurses suggested it might be a couple hours before they would wake her to give her medications. The cafeteria is open if I was hungry. After feasting on airplane pretzels for eight hours, I took their suggestion. I ate a small pizza and came back to the room to wait for Rosann to awaken. Nurses provided me with clean sheets for my recliner which converted to a bed. I lay in my makeshift bed waiting for Rosann to open her eyes.

### Chapter Six

### Hospital Highlights

### The Next Eight Days

Flowers in Glass

"I can't come close to telling you what happened day by day, but I can tell you what I remember most."

My awesome support group!

"I was 900 miles from home, but never felt alone. My mother and sister, Linda, were at the hospital continually along with my niece, Nicole and various other relatives. They must have set a record for visitation hours. Flowers were everywhere and nurses continually told me how beautiful they were. I couldn't see well enough to appreciate them fully, but it meant a lot to me. Thank you. Every day someone would read me the cards that came that day from relatives, golf friends, my Tampa art group, Notre Dame Classmates and just plain friends. It meant so much to me that all these people cared about me and were praying for me.

Evenings and weekends were filled with visits from friends and relatives. My son in law, Dave Jalil, brought my younger grandchildren, Lauren and Emma. Kyle, the oldest, brought his girlfriend, Allie and a single flower. Allie's mother was the one that sat behind us at church and called 9-11. Cassie, a freshman at the University of Missouri, came home on the weekend to see me. I'm so proud of these kids. I wish their mother, Dawn, was alive to see how wonderful her kids have turned out.

Claudia Perry, my best friend from my days in St Louis, twice made the 40 mile trip from Belleview, Illinois. I recall how she entertained Lauren and Emma. Kathy Hahn, my best friend from high school, and her husband, Bruno, visited. There were so many others. I am grateful to them all for taking the time away from their busy schedules.

Jim's three children and families were also supportive with flowers, cards and well wishes passed on to me by Jim. The wonderful 4-foot wide poster that Ella (6), Coco (4) and James (1) made, with only a little help from Kate and Bill, adorned the door of my room for days. Jim slept in my room three nights before checking into a Quality Inn to get some sleep. He went home to Tampa, Monday, but left me and the rehab nurses a gift. Unfortunately, the medical staff could not save the 'Frosty the Snowman' Jim made.

Getting back to Tampa - Planes, Trains and Automobiles - so many choices.

Steve Martin and John Candy had an easier time getting home to Chicago for Thanksgiving. Doctors told Rosann she could be discharged Thursday, there was nothing more that they could do for her here. The question was discharged where? Home is in Tampa, but she can't fly commercial until next Tuesday at the earliest, 10 days after the operation. The doctors don't want her make the 1,000 mile drive because they couldn't be certain that appropriate medical services would be available if something happened. One doctor suggested a train since Amtrak had major stations in St Louis and Tampa. Several people suggested Medivac and other emergency air lift services. Private airplanes, staffed with medical staff and equipment, are available at little or no cost to the patient. The insurance company is billed.

Jim: _"Amtrak was easy to check out. I had a laptop and Amtrak had software that gave you the best routing from St Louis to Tampa. Cost was substantially less that the cost of commercial airlines, and connections were good. We could leave Tuesday at 7 AM and arrive in Tampa at 3:30 PM, Thursday, two days later. The route is St Louis to Chicago to Washington DC to Orlando to Tampa; so much for Amtrak."_

The free, or near-free, medical airplane never materialized. Jim asked three people that suggested the idea to look into it.

Jim: _"I just didn't have the energy to spend on what I thought would be a wild goose chase." No one got back to us. Don't get me wrong. There are plenty of charitable services including Air Compassion America, Mercy Lift and Angel Flight. The National Patient Travel Center HELPLINE provides a screening and referral service to match a patient's needs to available services. There are low-altitude flights available but we didn't find one. Cost is based upon the patient's financial strength. We're not rich, but we do have equity in our home and some other assets, I suspect that the cost would have been prohibitive, but that's just a guess; I don't know for sure."_

The most viable option seemed to be an automobile or better yet, a SUV or van that would allow Rosann to lie down. Sixteen hours for two drivers is not a difficult drive. That's how Rosann and I each got our families to Tampa fifteen years ago. We had plenty of volunteers to drive including her son Dave, but Rosann was against it. Dr. Martin was also against driving so that pretty much nixed the overland route as our primary option. I decided to concentrate on the most straight-forward method of travel; commercial air service.

Southwest Airlines has daily nonstop flights to Tampa and the tickets go fast.

Jim: _"Thursday evening I bit the bullet and reserved the last two seats for Wednesday, March 16th. This was the 11th day after the operation. The seats were reserved under Rosann's name and my name. We had 24 hours to confirm or change the reservation. I asked Rosann who she wanted to escort her. The following evening we changed the name of my ticket to her son, Dave."_

The reservations were confirmed and we were now committed to a date. Dr. Martin had earlier shown me two cat scans of Rosann's brain; the one he saw before the operation and the one they took Thursday after her relapse. There was still a lot of air trapped in her cranium, air that could expand at high altitudes and cause severe pain and headaches. Rosann vividly remembers well the severe headache and excruciating pain that had preceded the surgery and didn't want to experience that pain again. She was against flying home as long as there was any chance of reliving that pain.

Jim: _"I wanted her to get home and start getting better. I knew I was taking a chance, but this was not an ideal situation. The guideline of 7-10 days limitation on flying at high altitudes is fine for people that get sick 15 miles from the hospital and need to postpone a business trip or vacation. It's not as black and white for people that are stranded 900 miles from home, 1,012 by car, with insurance that doesn't cover 'treatment' outside of Florida. In these situations, the question of greater good becomes relevant. What are the odds of incurring severe headaches versus the benefits of starting radiation and chemo treatments as soon as possible? Purchasing the tickets put some pressure on Dr. Martin."_

Nowhere to go - the Rehab decision

The Doctor's said Wednesday that Rosann could go home as early as Thursday, but where should she go? She couldn't fly until next Tuesday at the earliest and the neurosurgeon was against a 16-hour drive to Tampa. The options were to stay at her mother's house in Affton, about 40 miles away. That's where Rosann would have stayed if this trip had gone according to plan. The house is three stories including a basement bedroom, but going up and down stairs was impossible. We considered putting a hospital bed in the living room and hiring physical rehab people to come to her mother's home. Doctors would still want to monitor Rosann's progress so transporting Rosann to and from the hospital would be a challenge. It was soon apparent this option had many drawbacks and would only be used as a last resort.

SSM St Joseph's Rehabilitation Hospital is a wonderful facility located on the 4th floor of the SSM Healing Center. The Rehab Center is a separate entity from the hospital, but works closely with the Hospital staff. They offer all three types of therapy that Rosann needed; Physical Therapy to help her regain strength, Occupational Therapy to help her with basic functions such as getting dressed & getting in and out of a car and Speech Therapy, or more specifically, Cognitive Rehabilitation, to overcome the Rosann's loss of vision and damage caused by the swelling in the brain and surgery. SSM Rehab was the logical first choice.

We hoped Rosann would be admitted to Rehab Thursday morning, but first, Robyn Barnes RN, the admission's nurse liaison officer, needed to determine if Rosann was strong enough to benefit from their services. Two physical therapists performed a physical and mental assessment of Rosann's condition and needs. Could she use a walker to get around? The second specialist evaluated Rosann's ability to perform simple hand eye tasks such as picking up objects from a table. It was clear that Rosann needed therapy to regain the synapses injured by the bleeding tumors and surgery. Rosann was approved for admission, subject to resolving insurance issues.

Julie Buckley, Rosann's case manager, took charge of getting the authorizations needed for discharge into the Rehabilitation Hospital. This included determining if Humana Gold Plus would cover rehabilitation costs. It's a Florida Insurance Plan and understandably, Humana is reluctant to cover out of state costs from specialists that are not part of their network. It was not a decision that could be made by caseworkers. It took two days but approval was granted. Rosann was now cleared to enter the Rehab Hospital.

Robyn also sent therapists to her room to begin Rehab as an outpatient. The first day she walked only 30 steps; the second day 120 steps. Everyone was optimistic, but the third rehab session didn't go so well.

One Step Back - Relapse

Thursday afternoon Rosann fainted just before the third rehab session after being moved from her bed to a chair. Witnesses said she just lost consciousness and collapsed in her chair.

It was 'back to the second floor' where nurses could monitor her condition. All plans for discharge to the 4th floor Rehab Hospital were put on hold. Nobody is sure why she collapsed.

Jim; _"I believe she just fell asleep, for two reasons. That morning doctors had given her a new anxiety pill and advised us the side effects could be drowsiness. At the time we thought this would be a good thing if it helped her get more sleep. More importantly, Rosann had not eaten for 24 hours. We ordered food but she didn't eat it. Falling asleep was the combination of the side effects of the pill and her low caloric intake. She had no energy. Why didn't she communicate this? Because it's not part of Rosann's make-up to tell the rehab specialists that she was too tired. She would try to comply with their wishes."_

Doctors took another CAT scan and compared the scan to the pre-op scan. The following morning the doctors were grim. The technicians interpreting the scan believed Rosann's condition had taken a turn for the worse. The new scan showed new areas in the brain that were most likely cancerous and the cancer had worsened since the operation. The implication was that Rosann's condition was critical. The cancer was spreading.

Jim: _"I was at the low point since my arrival and shared my feelings with Rosann. I told her the news wasn't good. We cried."_

Dr. Martin arrived an hour later and did his own analysis. His prognosis was more optimistic.

Jim: _"Dr. Martin used a computer terminal at the nurses' station just outside Rosann's room to access the relevant data. He called me over and brought up the two CT Scans side by side and pointed out what the technician had seen and why he wasn't as concerned. Yes, there was another smaller tumor on the other side of the brain that he could not reach, and yes, he was not able to get all of the mass where he had operated, but neither item was of immediate concern. The cancer in the brain was not spreading." Optimism returned!"_

The mass in the lung was now the main concern. Robert Kraetsch, M.D. a Medical Oncologist with SSM Cancer Care, told Jim the pathology report confirmed the tentative diagnosis; Adenocarcinoma of the lung. He said the long term prognosis was not good.

Jim had already used his laptop to Google the statistics for survival and knew Rosann's chances of surviving six months were low _._ He asked Dr, Kraetsch if it was necessary to tell Rosann?

Jim: _"I've told her it's bad but I don't think anyone has talked numbers or percentages with her. What's the point in laying that on her at this time?"_

Dr. Kraetsch: _"I'll give her the diagnosis and talk to her about treatment options, but if she asks, I'll have to give her the information. It's my job."_

Rosann didn't ask.

Jim: " _I've read Dr. Kraetsch' case notes and am impressed with his thoroughness and demeanor. Rosann would have been in good hands if he could have stayed involved but he knew that once we got to Tampa our new medical oncologist would ignore his notes and recommendations. Doctors would look at the slides and make their own diagnosis. Little did he know that as of May 2, no one has yet asked for the slides he gave us ._ "

Rosann started eating again and later that day was transferred back to a regular hospital room on the sixth floor. Sunday afternoon she was transferred to the Rehabilitation Hospital on the 4th floor, a significant step in her recovery process. She was beginning to Fight Back. Sunday she was transferred to Rehab.

The Trip Home

The day had arrived. Rosann was going home to Tampa. Her son, Dave, would escort her home. They had Business Class tickets on a Southwest Airlines direct flight departing St Louis at 9:30 AM and arriving in Tampa at 12:30 PM EDT. Everything was pre-arranged to make the flight as easy on Rosann as possible.

"I was afraid to fly even though they told me it was unlikely I would get bad headache. I didn't want to go through that pain again. Having Dave with me made it so much easier."

Dave had arrived Tuesday afternoon from Tampa and spent the day and night with his mother at the Hospital. Unfortunately for Dave, Rosann now had a roommate and he was forced to curl his 6'3" frame into a recliner. The night nurse was startled to find a strange man in the room but reluctantly allowed him to stay.

Shelby Hartley, Rosann's Rehab Case Manager for her three days in the Rehab unit, made sure everything was ready for an early and smooth checkout. Shelby remembers Rosann as a hard worker, determined to get better.

Dave Glandt: _"I was scared of letting my mom down. What if something happened and I couldn't handle it? I would never show it or say it to mom, but I was scared._

Aunt Linda met us at the hospital. We had it all planned out; tickets, luggage, walker, check. From the second Linda met us, I knew the trip would be smooth. I requested a wheelchair as soon as we pulled up to the Southwest terminal. An attendant, John, wheeled up and promised he would take good care of us, and that he did. He expedited us through security and got us to the gate an hour before boarding time.

Mom held my hand and said she was glad I was the one there; nothing was going to go wrong. I wouldn't trade that hour at the gate for anything; my mom and me, just sitting there talking about everything. I remember every second and every word spoken in that hour.

Southwest Airlines treated us like royalty, I informed the attendants mom couldn't walk far and they allowed us to take the wheelchair to within a step of her seat. I gave mom the pillow we brought with us and she smiled and got calm. She kept thanking me saying, that I had done it. I really didn't do much, but I was happy; mom was safe and comfortable. She fell asleep and we were in Tampa in no time. The flight was the smoothest I had ever been on. I can't thank everyone at Lambert Airport and Southwest Airlines enough.

Jim and Lea met us in the baggage area and we got mom home without a hitch."

Rosann entered through the front door and went directly to her bedroom. Other than a slight headache, she had survived her journey well. Jack soon came out of hiding and curled up next to her, purring softly. She was glad to be home.

### Chapter Seven

### Fighting Back -The first 45 Days

Chicks with Attitude

" _Joy lies in the fight, in the attempt, in the suffering involved, not in the victory itself" - Mahatma Gandhi (Indian Philosopher_ _)_

Rosann's battle was fought on several fronts.

Humana Gold Plus - the role of the PCP

Everything goes through the 'Primary Care Physician' under the Humana Gold Plus plan. Rosann's PCP is Dr. Daniel Heinig M.D., who is also serves as a member of the board of directors of Gulfside Regional Hospice.

Tampa is blessed by having a great cancer research hospital; H. Lee Moffitt Cancer Center & Research Institute. It is world renowned and has an excellent reputation; deservedly so. Rosann's family just assumed she would be treated at Moffitt. Her friends in Tampa told stories of the wonderful treatment their friends and associates received at Moffitt.

Moffitt is also part of the Humana insurance network which means nothing unless the PCP refers you to a Moffitt doctor. Rosann's PCP did not. Moffitt was not part of the group of the small group of doctors that he dealt with.

Jim: " _I fought this battle three years earlier when I had knee replacement surgery. Friends recommended a group of knee surgeons, but my PCP wouldn't refer me to them. I argued my case with him, but it did no good. I finally agreed to see one of the three surgeons my PCP dealt with. I selected Dr. Mac McClimans and couldn't have been happier. This was a similar situation. I mentioned Moffitt to Dr. Heinig once. He replied that his referral group of doctors was equally qualified, possibly better. I needed a doctor, not a hospital or a research center. Experience told me I couldn't win the fight even if I tried, and who knows, maybe Dr. Heinig's doctors would provide Rosann with the quality care she needed. I dropped the subject."_

Dr. Heinig was already familiar with Rosann's situation. Julie Brinkley, Rosann's SSM case manager, had contacted his office to coordinate referrals and paperwork issues necessary to get approval from Humana to cover emergency medical expenses and rehabilitation. Dr. Kraetsch, the SSM medical oncologist had also called to discuss Rosann's treatment needs once she got back to Tampa. Dr. Heinig called Jim in St. Louis to let him know he was ready to help and would meet with Rosann as soon as she got back to Tampa.

Rosann met with Dr. Heinig Thursday morning. He had already made appointments for Rosann to see a Janelle Park M.D., a radiation oncologist Friday morning and Pedro Mendez M.D., a medical oncologist Monday. Early in the conversation Dr. Heinig asked Rosann if he could speak frankly. Rosann nodded yes. It was a mistake. He should have asked if he could be 'brutally frank'.

Rosann: "He asked me if he could be frank with me and I nodded yes. He then proceeded to tell me that I was going to die and asked if I wanted him to make an appointment with a hospice group. I couldn't believe what I was hearing. I know the graveness of my situation, but I was looking for treatment. Encouragement would have been more important at this point than realism. I wanted to fight this battle, not plan my death. It was too soon for that."

Jim: _"These are discussions that should not be had in front of the patient. If they need me to provide a power of attorney, so be it. The idea of entering a hospice program at this point was incredulous. Rosann was determined to fight back against this terrible disease, not enter a program that is associated with death. It's a testament to Rosann's strength that she didn't let this (and other conversations) throw her into a depression. The Doctor's 'bedside manner' needs work."_

Hippocratic Oath excerpt: _"I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug."_

Rosann declined Dr. Heinig's offer to set up an appointment with Hospice. It wasn't the right time.

Jim: _"Several weeks later I did some research into the services that Hospice organizations provide. There are many and most of them are free. For example, there is no $25 per visit co-pay to see a specialist as there is under the Humana program. However, I also discovered that Hospice only pays for palliative services. Curative services are not excluded. I recalled Dr. Heinig's statement to Rosann that she was going to die (from this disease), 'you're going to die, there aren't any other alternatives'. Aren't doctors supposed to heal?"_

Over the next several weeks Heinig's office would recommend ophthalmologists, rehabilitation specialists and imaging services that would perform PET Scans and MRI's. All referrals and paperwork flow through Dr. Heinig's office. The patient makes the appointment and then asks the PCP to forward the appropriate information to the specialist. The specialist will not get paid by Humana unless the referral and paperwork has been provided to them in advance.

Jim: _"There were a few problems, but to be fair, the office staff did a better job with the referrals and paperwork than 'my' PCP & staff did when I got my knee replaced. (I have a different Primary Care Physician). Maybe the problem is with the system? I spent many hours trying to verify that paperwork was in place whenever we made an appointment. Rehab was delayed two weeks because of paperwork issues. We finally figured out that the paperwork was being faxed to the wrong fax machine. In another instance, Rosann showed up for the PET Scan and there was no paperwork. Fortunately Rosann had a copy of the original referral that Dr. Park had sent to Dr. Heinig's office."_

Prescriptions

Rosann was still on the same seven prescriptions provided to her when she was discharged from SSM St. Josephs Health Care hospital in St. Louis.

Famotidine 20mg

Levetiracetam 500mg (anticonvulsant/seizure)

Hydroodone (Tylenol 3) pain reliever

Dexamethasone 4mg (steroid)

Mirtazapine 30mg (antidepressant)

Zolpidem 5mg (insomnia)

Lorazepam (anxiety)

She had no further contact with the St Louis' doctors after she was discharged and came back to Tampa. Who was monitoring her condition and determining if the prescriptions were still appropriate? The situation came to a head when Rosann's cheeks and ankles became puffy and she began experiencing numbness in her feet. 'Google' told her this might be a side effect of steroids.

"I was still undergoing radiation treatments so Jim and I asked Dr. Park to review my medications. She agreed to do so after Dr. Heinig agreed to assume the responsibility of monitoring the medications on an ongoing basis. Dr. Park gradually weaned me from the steroids and the Famotidine. This eliminated the puffiness and numbness in her feet."

Rosann provided blood and urine sample to Dr. Heinig's office and set up an appointment to review the lab results. Rosann's friend Lillian Stickel drove Rosann to the appointment.

Jim: _"The day prior to the appointment I took a call on Rosann's telephone from the nurse in Dr. Heinig's office. The lab results showed Rosann's cholesterol level was high, both the good and bad cholesterol. Dr. Heinig would be recommending new medications. I wasn't sure that I should laugh or cry. I called my son Mike (M.D.) to get a different perspective, Are they serious? He said not to worry;' it's probably just a call by the nurse who read the lab report and automatically called the patient. I'm sure the Dr. wished the call had not been made. Nobody is going to worry about Cholesterol levels when the patient is fighting lung cancer.' I agreed with Mike at the time but wasn't so sure after I found out what happened at the appointment the next morning."_

Lillian: _"Rosann warned me that his bedside manner was a little on the dark side. I was still not prepared for the "gloom and doom" in the room. Dr. Heinig was personable and greeted Rosann with a friendly smile. After exchanging greetings, he told her that he was available to her any time of day or night (this is going well I thought.) Dr. Heinig then asked Rosann who she would call if she had a stroke in the middle of the night, would she want to go to the hospital or just be made comfortable at home?, Rosann's head dropped and the smile was gone. She responded that she didn't want to talk about that because she wanted to fight this with everything she had._

Dr. Heinig was persistent. He asked the question twice more and twice more got the same answer. I suggested that if in fact she had a stroke in the middle of the night it wouldn't be her making the call. Maybe we would let her and Jim talk about this. He wanted to be sure that we were well aware of how dire her condition was. We assured him we did.

Rosann asked if he knew anything about a new CyberKnife procedure being used in treatment (she soon wished she had that question back). Dr. Heinig related a story about how one of his patients was operated on with CyberKnife as a last effort and didn't make it off of the operating table. I motioned for him to please stop and he did. I suppose honesty can be the best policy but hearing it more than once doesn't make it any less depressing."

Rosann hasn't seen or talked with Dr. Heinig since this appointment. There hasn't been any need and she has no desire to put herself through another depressing conversation. Jim coordinates referral appointments and prescription needs with Dr. Heinig's staff.

  **Radiation Oncologist Treatments: Tampa Bay Cancer Center, Janelle Park, M.D.**

"My five-week experience with Dr. Park and the nurses, staff and technicians at the Tampa Bay Cancer Center has been a totally pleasant experience. I can't thank them enough for their help and love."

Rosann met with Dr. Park Friday morning, March 18th, 2011 and three hours later was fitted for a radiation mask. Dr. Park recommended full head radiation treatments even though she is a Medical Director of CyberKnife, a directed radiation procedure that would specifically target the three tumors in the brain that appeared on Rosann's CAT Scans and MRI done in St. Louis. She explained there was a strong likelihood that other cancer cells have been emitted to the brain (from the lung) that had not yet grown to tumor-size where they show up on an MRI. 'Studies show that most patients that start with a CyberKnife procedure eventually require full-head radiation treatments. It's better to get rid of the undeveloped cancer cells before they grow to be tumors.'

  Dr. Janelle Park: _"Mrs. Plautz is a true trooper. She came to the clinic for her initial consultation, and was determined and ready to do whatever she needed to do. We discussed the use of CyberKnife versus whole brain radiation therapy upfront; due to the fact that she had had a bleed in the brain that was, in light of the final pathology, related to a metastatic lesion, I felt that there was a high risk for additional tumor cells to be within the intracranial space. These would not be addressed if we started with CyberKnife first; thus we opted to go with whole brain radiation treatments first, and re-evaluate after completion of the whole brain radiation for potential CyberKnife boost to any residual disease._

During her 3-week treatment course, Mrs. Plautz exuded grace and courage, and her inner spirit shone through. Her ability to do various activities gradually improved during the course of her whole brain radiation treatments. PET-CT whole body imaging on April 11 revealed uptake in the left lower lung and left posterior brain. Repeat MRI brain imaging on April 28 revealed an enhancing lesion in the left occipital lobe, smaller than before. We are now planning on giving concurrent chemoradiation therapy to the lung tumor, and planning for CyberKnife boost in June to the left occipital area.

As always, I am truly honored to be allowed into another human being's life during their most private, personal, and trying moments, and to be entrusted with their faith and belief in the proposed treatment plan. It is this, in the end, which comprises the true meaning of life, and is essential to the human experience."

  Rosann's radiation treatments were scheduled for 15 consecutive weekdays, commencing the following Wednesday. The total elapsed time from door-to-door was about 90 minutes including travel time. The treatments themselves took only 10 to 15 minutes. Jim drove her to the first and last appointment and once during a heavy rain storm. Her son, Dave, drove her once to see for himself what his mother was going through. Golf and art friends volunteered to drive Rosann to the other appointments.

  Lizette (receptionist): _"I never saw anyone with so many friends. There was a different person driving her every day. It was easy to see why. Rosann was always in good spirits and never once complained. I hope she can beat this. She is so nice."_

  "T" - Radiation Therapist: _"Rosann is a model patient, always a trooper about her treatments; always upbeat. We enjoyed having her as a patient. We missed her when she finished. I'm happy to hear that she might be coming back and I look forward to helping her through her treatments."_

  Sharon (LPN): _"Rosann is a true warrior and Jim is the most supportive spouse, always there to hold her up physically and emotionally."_

This is what Brenda, Jim and Rosann said about the Tampa Bay Cancer Center.

Brenda Bruno (scheduler): " _Rosann has so many friends that wanted to do something for her. It was easy to get volunteers to drive her back and forth. I'm still getting calls asking if there is anything else they can do. Everyone was happy to help out. All were very complimentary about the building and staff."_

Jim: _"The office is clean and bright as is the office in Brandon where we had the 'mask' fitted for Rosann. The roomy waiting area, the crossword puzzle to work on and the free cookies and coffee, create an environment that says this is a healing center. Rosann was always in a good mood after her appointments; tired, but in a good mood. We certainly recommend this group to others requiring radiation treatment. "_

"Everyone was so nice to me at the Cancer Center; I can't thank them enough. They always greeted me like a friend and made me feel comfortable. I couldn't have been treated better."

Rosann is now waiting for the results of the MRI taken April 28th. She is hopeful that the brain tumors are gone and they can finally begin chemo treatments for the lung cancer.

Florida Eye Center

The lack of progress of improvement with her eyesight is the most disappointing aspect of Rosann's rehabilitation. There doesn't appear to be any hope. Jim and Rosann tried, but admittedly, maybe not hard enough.

Her optometrist directed Rosann to the Florida Eye Center. The optometrist recommended she see a 'low vision specialist' although they will probably want you to see an ophthalmologist first. Jim made the appointment after getting a referral from Rosann's PCP. After waiting for 90 minutes in various waiting rooms, Dr. Arey told Rosann there was nothing he could do for her. "You could come back and take a 'full field test' but I don't thing that will change anything."

Rosann asked about seeing a low vision specialist.

Dr. Arey: "We don't have one on staff. We do have someone that has done some research of low vision products available on the internet, but we don't have any specialist. You might try the Lighthouse for the Blind. I'll be happy to give you a referral."

Jim: _"Dr. Arey was nice and sincere in his offer to help, but we were disappointed that there was nothing that could be done such as further cataract surgery on her right eye or some other magical cure. Rosann was exhausted when we left the Eye Center that day. She never went back for the field test. Sitting and waiting for 90 minutes is tiring, especially for a person that cannot see clearly."_

"I wish a doctor, or someone that could help me, 'see what I see' for a few hours. It's so tough to describe. Maybe they could tell me why magnifying glasses don't work for me? It's so frustrating."

Jim: _"I did Google the Lighthouse' website, and numerous other websites, to look at various low vision aids. We found a 'talking watch' that tells her the time if you press the correct button, and sings revelry if you press the alarm button next to it. It's a great watch for people that can see. We also got some great suggestions from Kevin, the Occupational Therapist at UCH, but nothing that solves the underlying problem."_

Rosann and Jim agree that her lack of vision has made rehabilitation much harder, five, maybe ten times harder?

"What can I do, give up. No, that's the one option we won't consider. I want to Fight Back."

UCH Outpatient Rehab

  Rehab started at St. Josephs Rehabilitation Center in St, Charles, Mo. and was supposed to continue uninterrupted in Tampa. Rosann needed two types of therapy; occupational therapy and cognitive rehabilitation, a subset of speech therapy. Her speech was fine, but her problem solving skills had been disrupted by the swelling in the brain and the surgery. Shelby Hartley from SSM Rehab explained Rosann's unique needs and faxed the file to Christian in Dr. Heinig's office. Christian said they had just the group.

Jim: _"I was given the name of a therapy group just down the road from our house. It was too good to be true. I called to make an appointment. Occupational therapy was not a problem but they did not have a speech therapist on staff. I was transferred to the owner who confirmed his receptionists answer. He went on to say that he knew of two therapists that were available for in-home therapy which was what I had when I had knee replacement surgery. This sounded good. He recommended I check with my PCP which I did. Dr. Heinig's office said that Rosann did not qualify for in-home therapy. It's meant only for wheelchair type patients that cannot get to a hospital. Rosann is legally blind and recovering from brain surgery performed three weeks earlier, but did not qualify for an in-home therapy. Go figure."_

Rosann finally met therapists at University Community Hospital fifteen days after returning to Tampa, after more delays caused by missed faxes and miscommunication. She had two appointments, back-to-back with Cara (Speech Therapist - Cognitive Rehab) and Kevin (Occupational Therapist). They were breaths of fresh air in what had been a long journey. The initial appointments were to assess Rosann's condition.

"Cara talked with me and asked what my interests are and what problems I was having. I told her about my love of art and how much I wanted to get back into painting, even if I had to start painting abstracts. I told her about my problems with working on the computer; even finding the cursor. We talked about a lot of things. Jim told her I was having problems doing crossword and Sudoku puzzles."

"I told Kevin about the difficulty in walking or doing day-to-day activities because of my lack of vision. I mentioned the computer problems again and also talked about difficulties in cooking, getting in and out of cars and other daily tasks. I told him I wanted to get stronger. I remember he gave me a bunch of tests to evaluate my strength and coordination on both sides. I told him the left-side weakness I experienced after surgery was improving."

Rosann had her follow-up appointment on Tuesday, April 26th. Both therapists had prepared exercises that Rosann could work on at home. This is what Cara and Kevin say;

  Cara Bryan: _"_ _When I met Mrs. Plautz, she presented like a defeated woman. Although a very willing historian and participant in her cognitive evaluation, her eye gaze was frequently functioning, specifically problem-solving, thought organization, processing, and short-term and delayed recall deficits. A significant barrier to her function was her limited visual ability. In a matter of a few weeks, Mrs. Plautz went from leading an active life of traveling, cooking, gardening, painting, and playing the piano to having extreme difficulty seeing, thinking clearly, not being able to participate in any of her previous hobbies, and relying heavily on her husband for overall function. To add another layer of difficulty, she was dealing with perpetual dry mouth (i.e. xerostomia). There is no wonder she appeared defeated, who wouldn't be? After a full assessment and discussion, we decided to establish a home program for cognitive rehabilitation. Two weeks later Mrs. Plautz (and her wonderful husband) returned for treatment. As I do with all of my patients, I asked Mrs. Plautz how she was doing. She reported that she had started painting (although more abstract than previously) and cooking some. I was very pleased that she felt comfortable enough to resume these activities as this is one step closer to her feeling whole again. With the support of her husband and Mrs. Plautz' determination, she will do well in her rehabilitation."_

  Kevin Bobos: _Rosann needed to improve her overall strength but more importantly she needed to be able to navigate her surroundings both in her home and out in public. Rosann's low vision was the priority. The loss of her vision acuity made reading difficult and being able to get around in her home and community. After learning from Rosann that a magnifying glass did not work for her, I was able to find monoculars on amazon.com. Monoculars magnify printed letters and surroundings to overcome the vision loss and to improve her ability to be able to get out and enjoy her surroundings. Rosann was given information about a class at the Tampa Lighthouse for the Blind. This organization helps individuals with low vision or vision loss be independent in the home and in the community. Rosann has the ability to regain most of her independence. The strength will come back over time through exercise and recovery from her hospitalization in Missouri. Through practice, low vision techniques, and assistive devices Rosann can enjoy a productive and fun-filled life."_

Rosann: "I'm so thankful for the work Cara and Kevin did for me. Cara is so easy to talk to her and she seemed genuinely pleased that I had gotten back into art. Kevin even did research and found me low-vision aids on amazon.com. I'm trying to work on the exercises they each gave me. They are such nice people."

Jim: _"I was really impressed with the facility and the therapists. Cara's perception that Rosann needed to work on her problem solving abilities was right on the mark. I would recommend the UCH outpatient rehab facility, and specifically these two therapists, to anyone. Thank you."_

Jim has assumed the title of in-home rehab specialist including physical therapy as well as occupational and speech therapist.

Jim: _"I don't like being the task master but who else is there? It's difficult to be her best friend and also her workout guru. She gets tired doing the exercises that Cara and Kevin provided and has to be prodded to keep going or some days, get started. A professional therapist would do a better job. The most fun we have is during our morning walks along a portion of the trail that we used to ride our bikes. She works hard and is so pleased when I give her a good grade. I need to give her a few A-pluses. She deserves it."_

Rosann: "I try to please Jim, but sometimes I'm just too tired. I know he's disappointed in me but I also know how much he loves me. This is hard on him too."

Humana Dental Plan

This episode has all the characteristics of a theatrical drama or better yet, a three ring circus. It started badly and it wasn't at all funny to Rosann. Her teeth began to fall out or more precisely her crowns. First, a three-tooth bridge fell out from her lower left jaw. This wasn't too bad; she just chewed on the right side. Five days later another crown fell out from her upper right jaw. Chewing became difficult.

"Losing the first crown was uncomfortable but I told Jim not to worry about it. I could get by. It was the least of my problems. After the second crown fell out, we needed to do something. I was afraid I would need two new crowns. This meant time, money and something else to worry about. What else can they do to me?"

Jim: _I called Humana. I started with Humana's medical side and told them that Rosann's teeth were falling out as a result of the full-head radiation treatments. Is she covered? The answer was yes; under the Medicare Dental Plan' Medicare procedures paragraph. I was relieved, but now the fun began!"_

The medical side referred me to the dental side. They agreed Rosann was covered but told me I needed a referral from my PCP. Dr. Heinig's office told me they had never filed a dental claim, I should call her dentist. Both my dentist and Rosann's dentist are part of the Humana network but neither had ever prepared a referral form or knew anything about the $25 Medicare provision. Their Humana rate book showed $49 per crown to glue it back on and $849 for a new crown. I tried my PCP again but got nowhere. They checked with their Humana regional representative who said the dentist should cover the cost under their cap. I called the dentists back and received a fast answer. No way.

It was back to Humana. After several calls, I was referred to the authorization department who said they needed service codes before they could authorize the procedure. Call your PCP. Instead, I called Rosann's dentist who said they couldn't give us service codes until they saw the patient. That made sense to me. We made a 9 AM appointment for Monday, April 25.

The dental assistant wanted to take x-rays and was put off when Rosann said they couldn't because of the radiation treatments she had undergone. 'But how will the doctor know if there isn't an underlying cavity that could present a serious problem in a couple years?'

It was a good question. I asked the assistant if we could talk privately. We stepped out of the room and I informed the young lady about Rosann's condition and long term prognosis. She said she would tell the Doctor.

A half hour later Rosann walked out of the office with her crowns glued securely in place and a broad smile on her face."

Rosann: "I can't thank Coast Dental Carrollwood and Dr. Pamela Hite enough. I feel so much better about myself."

Jim: " _We submitted the $136 claim to Humana for payment and are waiting for a reply. I'm sure Humana management is asking why we didn't first get a referral. Humana has ignored our request for reimbursement. We call & they say they will get back to us, but they don't. They never paid."_

Chemotherapy - The Mendez Fiasco

Rosann and Jim eagerly awaited their second appointment with their Medical Oncologist, Dr. Pedro Mendez - M.D. They were eager to begin treatment for the lung cancer which had already spread to the brain. The PET Scan results were good news, the cancer had not spread to other organs. Rosann cried for happiness when the Radiation Oncology Nurse told her the good news. There was a small glow at the GE Junction, but it could be a lymph node or something else that was non-cancerous. It was not a major concern.

Dr. Mendez walked into the appointment room and began reading the file. It was obviously the first time he had seen the PET Scan. After telling Rosann that she looked a lot better than she did at their first appointment, he sat back and said to Rosann; "We have only one question here. Do you want me to give you chemotherapy?"

Rosann and Jim were silent for a few seconds before Rosann replied; "You are the expert. What do you recommend?

"The only question we have today is whether you want chemo or not. I'll give it to you if you want me to."

After a few seconds, Jim asked about the PET Scan. "We thought it was good news except for the spot at the GE Junction. Do you agree?"

Mendez was irritated, like we were wasting his time. "The glow at the GE Junction could be anything. Once the cancer has spread to the brain it doesn't really matter. The only question is whether you want chemo."

Rosann replied, "I want to do everything I can to fight this thing. Yes, I want chemo."

Mendez then began describing the delivery regimen; twice a month for two months and one then one month off. He might have named the specific chemo drugs, we don't remember.

Jim then asked about the pill that Mendez had mentioned as a treatment option at their first meeting, way back on March 20th. "What about that experimental pill you mentioned last time. You said that Rosann met three of the four criteria for optimum results."

Jim: " _This wasn't an idle question. Rosann and I had discussed it several times and were eager to try it. Rosann wanted to be aggressive."_

"We can try that after we finish this," Mendez replied before abruptly walking out of the room without saying another word. Five minutes later the nurse, BJ, came into the room to explain the schedule and the side effects some people experience with chem.

"Oh, I see that Dr. Mendez has changed the schedule. He wants you to come in once a week for 24 weeks. Each visit will take about three hours." We chose Tuesday as our chemo-day. Treatments would commence the following week; May 3, 2011.

Jim: _The Doctor's rudeness was obvious but I wasn't angry when I left his office. Rosann and I were trying to remain optimistic; we were finally starting treatment - we were now Fighting Back. I was disappointed that we had wasted so much time waiting for the PET scan when it was obvious that Dr. Mendez cared less. I was also disappointed that he didn't even consider the experimental pill that he was keen on just a month ago. But it wasn't until I Googled the chemo medications that he prescribed that I started to get irritated. The one-page instruction sheets BJ had given us were dated 2005; the page on Cisplatin was barely legible. The other medication was Paclitaxel. Both drugs had been around for 30-40 years. That doesn't make them bad, but neither drug seemed to fit Rosann's request for an aggressive treatment program. I woke up in the middle of the night asking a bunch of unanswered questions;_

Why did Mendez keep asking the same question; 'Do you want chemo? I'll give it to you if you want.'

Why didn't Dr. Mendez ever look at the "slides" we brought from St Louis? Doctors at SSM Health Care Center in St Charles were certain that Tampa doctors would need the slides to form their own conclusions. Did Mendez even look at the PET scan or just rely upon the lab tech's notes and conclusions?

Why weren't we given options? Option one being an aggressive approach, with these side effects, versus Option two, a safe, moderate treatment that won't cure you, but will have less severe side effects. Dr. Mendez seemed to have decided on option two despite Rosann's wishes.

Isn't the Medical Oncologist the one doctor who is qualified to discuss which treatment options offer the best chance of success? Was this the reason why, in our first appointment, that Mendez told us that convoluted story about being sued by a patient's family because he offered too much hope? Has he stopped being a Doctor?"

Why did Mendez abruptly walk out of the room? Why did he change to 24, weekly dosages after talking with us about a more typical regimen of three weeks on and one week off?

Are we stuck with getting all our information from our Primary Care Physician, Dr. Doom? I thought this was the responsibility of the medical oncologist."

We knew it was important to start chemo treatment as quickly after diagnosis as possible, doctors in St, Charles said two weeks was the norm. Time was of the essence but Rosann and I decided we needed a second opinion. I asked Dr, Heinig's to find Rosann another medical oncologist so we could get a 2nd opinion. Dr. Heinig asked why and I related much of what we wrote above. His reply was, "She is going to die; there aren't any other options".

It appears that Heinig and Mendez share the same no-hope philosophy. We know the statistics for beating lung cancer, but aren't doctors supposed to be healers that offer patients an opportunity to Fight Back?

Rosann: _"I was surprised Dr. Mendes didn't have any recommendations. I expected him to say something like; 'I recommend you try this medication because..., but he didn't. I hoped the new pill he talked about in the first appointment would be the answer. I'm not Asian, but I met the other three factors that he named. Sometimes I wonder why all this is happening to me"_

Rosann has an appointment with Dr. Y. K. 'Peter Park' on Thursday, May 5, 2011. They are hopeful this doctor will help Rosann Fight Back.

Church - the daughter factor

St. Timothy Catholic Church, Lutz, Fl

Rosann is Roman Catholic. She attended Catholic parochial schools as young woman, got married in a Catholic Church and raised her two children as Catholics. She takes Holy Communion when she attends mass and occasionally, confesses her sins to a Priest. Like many Catholics, she has broken Church rules. Most notably, she got divorced and remarried without an annulment.

Rosann and Jim, also a Roman Catholic, were married in a private ceremony but remained Catholics and attended church semi-regularly. That changed when her daughter, Dawn, died of breast cancer at the age of 38, leaving four young children without a mother. It also left Rosann without a daughter and the loss was devastating. She thinks about Dawn every day and asks, why. Why take a good person so young? Rosann didn't get the answers she sought and gradually drifted away from the Church.

Rosann: _"I was bitter. Dawn was such a great mother and a great person; it just wasn't fair."_

Five years after her daughter died, Rosann is faced with many of the challenges that her daughter faced. Her daughter fought off the breast Cancer for almost five years. Rosann wants to do the same with her lung cancer.

SSM St. Josephs Health Center is a Catholic Hospital.

Jim: _"I flagged down a Catholic priest a few days after the operation and asked if he would stop and see Rosann. I told the Priest a little bit of the story and suggested Rosann might offer some resistance. She didn't and Rosann's religious turnaround began."_

"The Priest gave me a rosary that a held on to during my hospital stay. It made me feel better. Jim and I attended church on Holy Sunday and again, the Sunday after Easter. I was weak, but Jim insisted we go. He said it's time to talk to the Big Guy one-on-one and work things out. I did. I asked for His forgiveness."

"I sometimes lie in bed at night and asks, why me? Why is this happening to me? I'm not bitter anymore. I pray to God to help me with this battle because I know in my heart that He has the power to heal me. I ask for your help. Pray to God for me - help me Fight Back."

Rosann and Jim continue to go to mass on Sunday and thank the Lord for His part in Rosann's miraculous progress and to pray for His blessings. It's difficult to believe that He has not played a major role in Rosann's good fortune.

### Chapter Eight

### Who I Am

Martini ala Maimon

"I'm much more than a golfer, an artist and cook. Like most women, I wear many hats."

I'm a Woman:

"I'm proud of the way I look. Does that make me a vain person? I don't think so. It does mean that I spend a lot of money on clothes and look forward to my weekly nail and hair appointments when I can afford them and biweekly, or less, when I can't. Am I the only woman that spends a little money to make 'me' feel good? I don't think so.

Yes, I have too many shoes and dresses that have been worn only once. Some of the once worn clothes in my closet I wore to my 50th high school reunion. Tell me it wasn't worth it. I felt good and I felt attractive. Several women, Notre Dame is an all girls school, complimented me on my looks. It was worth it!

Some people think I'm too skinny, that I would look better if I gained some weight. That's okay; they're entitled to their opinions. I think weight is a personal decision. I feel good about myself at a certain weight. Others might feel good with a few extra pounds and that's their choice. I do know that in my day, I could turn a few heads when I walked into a room. My husband tells me that's still the case but I know better. Youth must be served; it's one of the problem's of growing old. However, I don't have to like it. I still fight hard to look my best.

I like music, all types of music, including some of the new stuff, but '80s music is my favorite. Dire Straits, Brothers in Arms; Bruce Springsteen, Glory Days; K.C. & The Sunshine Band, Philadelphia; I liked them all, but one song best describes me; Don Henley's, 'All she wants to do is dance'. I do love to dance but it's the lyrics that grab me. I'm not a fighter, I'd rather make romance. But don't underestimate me. I'll Fight Back if pushed into a corner. Don't underestimate the strength of a woman fighting for her family and her life."

I'm a Friend:

Rosann is blessed with many friends, many of whom have contributed to this book. This is what Rosann looks for in a friend.

"I consider most people to be my friends. There are very few people that I dislike and none that I hate, life's too short for that. My close friends are people that I can count on and know they can count on me. We share interests and have a good time together. We laugh a lot but can be serious too. Sometimes we cry. We don't need to agree on everything but we listen to each other. That's important."

Rosann is blessed with many friends, many of whom have contributed their feelings in this book. We asked a few to tell us what makes Rosann special.

  Tom & Pat Oswald (at Claire's wedding): _"I don't think I've ever met a "Southern Belle", but you are who I imagine – Gracious, Generous, and Lovely. I love talking about cats with you and watching you with them. The pleasure you exhibit is contagious. Tom and I are pleased to be your friend, Pat."_

Claudia Perry, a.k.a., Des: _"Rosann is my best friend, my dearest friend, the sister of my soul. We can go months without talking, and pick up on the next sentence when we see each other again. She has that extra special something that makes people turn their heads when she walks into a room. When she's feeling down or insecure, I remind her that she's_ _"Rosann"..._ _meaning there's no one else quite like her in the world. She's a classy lady with bright blue eyes that sparkle with love and mirth. Yet she can be a wild and crazy friend. We like to laugh at that greeting card that says: "A good friend will come bail_ _you_ _out of_ _jail_ _, but a true friend will be_ _sitting_ _next to you_ _saying...'Damn, that was fun!'" We've seen each other through the best of times and the worst of times. You only have one best friend...and she's mine. I love you, Ro"_

  Lillian Stickel: _"It's funny how things work out in this strange life. I found a true friend in Rosann from the very first day we met. She is one of the most generous people I know. I'm not talking about the monetary kind of generosity (although she is a great gift giver, always meaningful) but the giving of her time, a shoulder to lean on, and kindness beyond all expectations. She asks about my husband, my kids and even my wiener dogs and she genuinely listens to the answer. Rosann has allowed me to experience friendship in the purest form of the word. I truly believe that the Good Lord dropped her into my life for a reason. I am blessed to know her and call her "FRIEND."_

Brenda Bruno: _Thank you, my dear friend, for being the artist that you are, having the talent that you do and possessing the ability to make so many people happy with your efforts. I am so fortunate to have your painting in our family and to have so many great golf memories. We even have a trophy to commemorate your good sportsmanship. Thank you for being my friend. You are a very special person in my life."_

Kathy Hobbs _: "When Ro first joined class she was quiet and reserved. She's in a class with several strong women....and one guy. I'm sure this can be intimidating. I try to be a teacher, but cannot resist the urge to make friends.....it always helps to be empathetic. As time went on, because of the sharing/intensity/caring of this safe atmosphere (I believe) friendships breed. I came to know Ro as a colleague. We are the same age and have both worried needlessly about our physical appearance. She went to a private all girls' school and shared several painful experiences, as did I .This is a powerful connection.....insecurity paralyzes the spirit. Now I see the marvelous way she has overcome this problem with a strength I can only hope to acquire at such a time of need. She deserves all the respect and love that she has received from us all."_

Carol Smith: _"When Rosann and I first met at Northdale Golf Club many years ago it was like we had been together from birth, in fact many times when we were together away from Northdale everyone thought we were sisters, she the much younger and prettier one of course. In fact one of the first times she came out to play with me after we moved to Dade City everyone in our pro shop just assumed we were sisters. Dave her son was also with us that day and from then on he called me Aunt Carol._

Rosann is a soul sister and I have a deep feeling that she makes everyone else feel as I do about her. She is one of the kindest and most caring people I know. She never has anything negative to say about anyone and even after we taught her all the negative and rude golf language on the golf course she never uttered a word she wouldn't say in front of her grandchildren.

One summer Rosann spent a week in Tennessee with me and six other women golfers. We played golf for 7 straight days and had so much fun on one of the days that Rosann and I thought it would be fun to go out again that night and play 9 holes on an executive course that they lit up at night for playing. What we didn't realize was that in order for you to actually see your ball you had to hit it straight ( a concept she and I hadn't quite figured out at that time) we lost about 10 balls and then it started raining. The golf gods were saving us from loosing every ball in our bags but we didn't car. I don't think we ever laughed so much playing golf. We arrived back at the villa soaking wet but proud that we out there trying. Rosann is and always be my dear friend and dearer sister. I love you."

I'm a Daughter

Rosann is the daughter of Tony and Helen Folk. Tony passed away in July, 2001 at the age of 86. He worked for Southwestern Bell for 50 years.

"My dad was a good man, a true gentleman and a great father. He was handsome, charming, and kind. Everyone loved him; especially me. He loved to golf with his buddies and even took Jim with him a couple times. I remember him with love and cherish many fond memories."

  Helen Folk is 93 and lives alone in the Affton house where she raised Rosann and her other three children. She is the matriarch of the Folk' Family, the glue that holds them together. A bad knee has slowed her down a tad but not much. She still volunteers, babysits her great-grandchildren and volunteers at St. Anthony's Hospital. She remains strong despite losing Tony and two of her four children. 'They don't make them like her anymore'.

"My mom is an amazing woman. Everyone knows she is strong but she also has a gentle side that makes her the perfect mom. You always know where you stand with mom. I know it hurt her when we moved to Tampa but it made my visits even more special. I look forward to seeing her again because I love her so much. Thank you for being my mother."

 Helen Folk: _"My darling daughter cannot be sick---Where did this beastly illness come from? There was never any cancer in our family before Dawn, and now Rosann. During childhood she was always skinny little girl, who I just couldn't fatten up. But she was always my healthiest child. Her gentle, pleasant disposition attracted everyone to her as evidenced by all the loving friends she has even as a youngster. With all the prayers being offered for her, and hopefully the very best treatment and skilled doctors available for her recovery, somehow, if God wills it, she will get thru this. But I say again where, oh where did this beast come from? Thank you for being such a great daughter. You have been a great comfort to me and I think of you often. I love you."_

I'm a Sister:

Rosann is the second oldest of four children. Ken, the oldest, died in a car accident with his wife, Beverly. He had just taken a job with Anheuser-Busch Brewery in Tampa, Florida. He was 26 years old and had been married just three months. Carol died in 2009 of complications from MS after a long fight against this terrible disease. Linda is almost ten years younger than Rosann and lives in St Louis with her husband, Nick.

"Ken was four years older and I worshipped him as a big brother. We were just becoming good friends in the couple years before he died. I was pregnant with Dawn and Ken drove me to many of my doctor appointments. It gave us time to talk and get to know each other. I miss the good times we could have had but cherish his memory."

"Carol was three years younger and I try to remember the good times. I remember the little things like sharing clothes and practicing dancing in the basement. She became an avid Cardinal fan, baseball and football, as well as an American Idol and Clay Aiken's groupie. Carol had a tough life. I pray she has been rewarded."

  "Linda and were 10 years apart and don't have many childhood memories so I'm so glad we were able to get to know her better these last few years. I really looked forward to our 'sister day' when I go to St Louis. We walked the cobblestone streets and the stores in Old St. Charles this year and had a good time. I need to get better soon to help her take care of Mom."

I'm an Aunt

Linda and Nick Angeli have two adult children, Nicole and Neil.

  "Nicole is a beautiful woman with a big heart. I enjoyed watching her perform with the local theatre groups; she is so talented. I love her and know she loves her Auntie Ro. Thank you for being there for me at the hospital. I really enjoy my conversations with Neil; he's interesting to talk with and knowledgeable about so many things. Neil also has a big heart and helps takes care of my mom whenever he's home. I know you have a bright future."

I'm a Mother

Rosann and Gordon were blessed with two great children, Dawn and Dave. Dawn was a RN and mother of four. She passed away in 2004 at the age of 38 after a 4-year fight with breast cancer. Rosann took it very hard. Dave is a people person, like his mother. He has held various jobs in the service industry including restaurant manager and head gold pro. He has one son, Corbin (19).

  "I have never gotten over losing Dawn. I think of her every day and admire the way she fought off breast cancer for so many years while being a mother to four young children, wife, and nurse. She had a great sense of humor and many, many friends. Dawn, you are my hero. I miss you so much. It's not fair that you did not get to see how well your four kids turned out."

  Dave is my pride and joy - always has been. We have always been extremely close and continue to provide support to each other. It was so much fun watching his soccer games and meeting his friends. I remember what he said when I asked him if he was okay with Jim and me getting married. "Mom, I want whatever is best for you. Just remember, if something should happen, I'll take care of you.' I have a big place for Dave in my heart and a place for him in my home if he ever needs me. I am so proud of him. He's more than a mother could wish for. I'm so lucky."

Dave Glandt - My Mom: _"Every son will say that their mother is the best, but I'm sure others would agree that my mom is truly the best. She has always been there for me, from the first memories I have as a child, to this very day. She managed to work a full time job, cook dinner every night, and always was there for what seemed like endless sporting events I was participating in. I can still hear her cheering me on at the indoor soccer arena, knowing I had 1 or 2 more games that day, and being there for all of them. Being a catcher playing baseball, the fans, really the parents, were close to me behind the backstop. As grown up as I tried to be at 13 or 14, turning around and seeing my mom in the stands, cheering me on, even getting kicked out of a game arguing for her son, was the best feeling in the world. I could never understand the kids who didn't want their parents around with their friends, because my mom was the coolest, I always wanted her there to share my triumphs, and my not so triumphs._

I always smile when I think of the great conversations we would have as I was older, a lot of them in Hop's Bar and Grille over lunch. We are always on the same page with life, knowing that being happy and not worrying about what friends or family say about our choices or decisions. We never judge each other, and support whatever happens in our lives.

I find myself to this day wanting to introduce everyone to my mom, I am the proudest son ever. The first time she came to Tampa Palms to play golf, I almost made her late for her tee time; I was so busy introducing her to everyone. My members thought there was a celebrity at the club, and to me there was. My mom is here, you have to meet her! All my staff knew to roll out the red carpet, because my mom was at the club, and she gets anything she needs. My assistants always told me I lit up when she was around. Everyone who has ever met my mom goes out of their way to tell me how special she is. She is my one and only hero in my life. I love you, mom."

I'm a Grandma

Rosann has five grandchildren. She and Gordon Glandt moved to Tampa in 1985 but kept in close contact with Dawn's four children; Kyle and Cassie Hefner and Lauren and Emma Jalil. Dave's son Corbin lives in Tampa.

"I get to St Louis two or three times a year to visit my mother and see Dawn's four kids. Kyle (19) and Cassie (18) Hefner are the oldest.

  Kyle is graduating from Rankin Technical School and will take over his grandfather's lawn care and handyman business. Cassie is a freshman at the University of Missouri and is so beautiful. Both of them were on the swim team in high school and have that healthy, athletic look about them. I'm so proud of them.

  Lauren (13) and   Emma (12) live in St Louis with their father, Dave Jalil, Dawn's second husband. Dave was there for Dawn during her entire fight against cancer. Both girls are beautiful and growing up to be fine young ladies.

I know Dawn would be proud of all four children"

I'm a Step Mom & G-Ma to the Plautz Kids and Grand-kids

Jim has three children in his first marriage and eight grand children. Bill lives in Seattle with his wife Kate and their three children; Ella (8), Coco (6) and James (3+). Mike and his wife Claire live in Virginia with Cassidy (8) and the 6-year old twins, Luke and Logan. Kelly, the youngest, and Brandon have one daughter, Maddie (26 months) and are expecting their second. They live in Atlanta. It's Rosann who keeps track of birthdays and sends the appropriate gifts.

Rosann: _"I love Jim's kids and spouses. They have always made me feel like I was part of their families. The children all have their own personalities. It's so much fun to watch them grow."_

  Bill and Katy:   _Our kids love Rosann and remember her in their prayers every night "God bless Grandma Rosann!_

  Ella: _"Coco and I could be twins since we both have blue eyes and yellow hair...Grandma Rosann could be our twin too! She gave us matching PJs for Christmas!"_ Special Memories: Drawing with Rosann and staying together in Florida.

Coco: _"Grandma Rosann? I_ _love_ _Grandma Rosann!"_ (Coco bonded with Rosann keeping warm while Ella and the grown-ups played in the big Seattle Snow of 2008).

  James: Not saying much but drooling all over the cute Adidas sweat suit Grandma Rosann sent for his 1st birthday.

We all love Grandma Rosann!

  Mike and Clair: _"Rosann always puts others first. She has always been sensitive to others' feelings and the first to say thank you for anything. She seems to put herself in the other person's place effortlessly and has never uttered a negative comment about someone else in the ten-plus years I've known her. All of the memories I have of her have these things in common."We are very, very lucky to have grandparents who shower our kids with so much love (and gifts, clothes, toys and time)."_

  Cassidy (51/2) has Grandma Rosann's love of art and eye for color. She loves to draw, paint, create and has boundless imagination. Cassidy just beamed when she opened the box of art supplies Gma Rosann and Gpa Jim sent on her birthday (Gpa got credit, but we know who the real mastermind was behind that). We see Gma Rosann in all of Cassidy's paintings and drawings that decorate our walls, and Cass is looking forward to someday having personal lessons from the pro.

  Twins Logan and Luke (4 yrs) remember Grandma Rosann's kindness and patience with them. They push EVERYONE's buttons, but cannot seem to find that button with Gma Rosann. Logan remembers running around the Veritas winery while Gma chased him around. He didn't have his glasses yet then, so he was easy to find.

Luke remembers the luau at Disneyworld with both Gma and Gpa, watching fireworks and dancing on the beach afterwards. He enjoyed riding the monorail on Grandma's lap, even though he tried to escape a few times. He is sorry for climbing on Gma's chest and shoulders while trying to swing from the handrails on the ceiling (although I am pretty sure he will try that again, if given the chance)."

" _These are only a few of so many fond memories. Mommy Claire remembers Jim and Rosann's wedding in Tampa, fashioning bouquets and the altar on Thanksgiving Day; fun times on the Caribbean cruise and lounging on the beach in Puerto Rico; enjoying dinner in Staunton while talking about family. Our family has been so blessed to have had this time already and we can't wait to make more fun memories with Grandma Rosann._

We love you, Grandma. Your warmth and kindness, family values and vibrant love for life are all forever present in us and our children and will never go away. Keep fighting; we are all fighting with you. See you soon!"

Love; Claire, Mike, Cassidy, Logan and Luke.

  Kelly and Brandon: 'When God made, you, He blessed this family with its very own angel, on who fills life with love. Happy Mother's Day'

" _Rosann, I thought this card was perfect for you because I do think you're a down-to-earth angel. You are kind and compassionate and always thinking of others._

_Dad talks about how you are the best gift-receiver because you are so thoughtful and make the gift-giver feel great. He is so right. It's just_ _one_ _example of how you give and show kindness at every opportunity, and it's just_ _one_ _reason why you are so special._

I should tell you all of the time but please know on this Mother's Day that you are truly loved and admired as a mother, wife and friend. Love, Kelly."

  Maddie only 6 months, but she loves to wear the clothes that Gma sends.

I'm a Wife

  Rosann and Jim were married in 1998, the day after Thanksgiving. Rosann assigns a date to their anniversary but it's easier for Jim to remember it's "the day after Thanksgiving" rather than November 27th. Once every four or five years he gets it right. Her previous marriage to Gordon Glandt ended two years earlier after 32 years. They remain friends.

"Jim opened a whole new world for me and encouraged me to grow as a person. He knew I loved to play the piano so he bought me a baby grand. He encouraged me to get back into art and take lessons. We joined a golf club and went on many great golf vacations. We traveled to Costa Rica, the Caribbean, Rome, Istanbul, Constantinople, Paris, Nice, Venus, Monte Carlo; places I never thought I would ever see. Traveling truly does broaden a person's perspective. I can never thank him enough. But mostly, he has been there for me. We share so many things. He jokes around a lot but still cries when we watch sappy, Hallmark movies. He's really a softie at heart. Jim is truly my best friend and my true love. He gives me little paper hearts under my coffee cup in the morning that says stuff like 'JMTP & RMGP 4-ever' or 'J luvs R Always. I never get tired of getting them. Thank you Jim for taking such good care of me."

  Jim: _"You deserve it Rosann, and more. It's been fun watching you grow and become more self confident. We have a wall full of great trips and great memories, but I will always cherish the private moments we have together. You make me a better person._

Writing this book together has made us even closer. Events such as the Packers winning the Super Bowl seemed so important at the time. Now I know better. This fight we are going through puts sports and other non-essentials into perspective. You are what is most important to me.

I read the beautiful thoughts that so many people have expressed in this book and I realize that I should have been telling her these things every day. Rosann, you are special; you are an angel; you are everything your friends say. You are also the woman that makes me complete. I love you, Rosann, 4-ever."

### Chapter Nine

### Today, July 13, 2011

### Taking Inventory

Dancing in the Meadow

"This book isn't about winning or losing, it's about how I play the game. It's playing the cards that I was dealt. I'm winning this battle, one day at a time. What else can I do, give up? This is where I stand as of July 13, 2011."

I'm Proud of my accomplishments:

* I'm alive and kicking and enjoying being alive;

* Jim and I have grown closer (and we were very close before);

* I'm back into painting. I'm proud of my first abstract painting; I'm going to do better now that daily radiation has stopped.

* Jim and I take long walks on our 'bike trail'. It feels so good to be outside; I so-much look forward to our walks and getting outside.

* I'm helping Jim with the cooking and we go shopping together;

* Jim and I are still getting 'out' to restaurants once or twice a week;

* My girl friends take me to nail appointments and other girl-stuff;

* I survived the 15 full-head radiation treatments for the tumors in the brain and the 33 lung radiation and six chemo treatments;

* My attitude remains positive.

* I'm very tired and looking forward to a respite from radiation and chemo.

There have been a few disappointments:

* My eyesight has not improved; this makes everything more difficult; I just tried a new prescription that we thought might help, but it didn't. You can't believe how much this limits what I can do.

* My computer skills are still weak;

* Reading is a chore. I need to concentrate better;

* It's been almost two months and as of May 2nd, treatment for the cancer in my lung has not begun.

My Health is good, considering...

* I'm not in any pain, no more than most women over 50; I have been getting more headaches the past two weeks and am concerned.

* The PET Scan showed no spread of cancer to other organs, other than the brain; a new PET scan is scheduled for August 12, 2011.

* A UT infection set me back a ways, I'm very weak;

* Two weeks ago I was getting around without the walker, just holding someone's arm for direction and stability. The UTI put me back to using the walker 70% of the time;

* My appetite is good, I've gained a few pounds;

* I'm sleeping better.

I'm looking forward to the following medical procedures:

* A clean MRI showing the brain tumors are gone;

* CyberKnife radiation on any remaining tumors in the brain, if necessary;

* A Chemo doctor that cares and provides me with a plan that gives me a chance to Fight Back. Dr. Yon Park is great. Six treatments have been completed; chemo will restart August 23, probably at a higher dosage since radiation has ended.

* Directed radiation treatments on my lung to supplement the chemotherapy. The 33 treatments have been completed.

* A new CT scan on July 20 that shows my lung tumor is gone.

* A new PET scan on August 12 that confirms the lung tumor is gone and the cancer has not spread to other organs.

Personally, I'm looking forward to Victory;

* Living life day-by-day, enjoying the little things,

* Celebrating living versus waiting to die,

* Enjoying the small victories,

* Getting back into my daily routine,

* Being thankful for my friends and family, (yes!),

* Being thankful for, Jim, my lover, #1 cheerleader, helper and shower boy; Jim continues to be Sooo supportive and is turning into a pretty good cook.

* Beating the odds - living one more day, month or year longer than odds makers predicted

* Being grateful for what I have,

* Looking forward to my next opportunity.

Rosann: Posing for camera

Rosann: feeding fish & turtles

" **I will die, eventually, but death will not mean that I didn't win the fight."**

### My recipe for Victory is simple:

### A big heart

### +

### A fighting spirit

### +

### A strong support group

### +

### Good Doctors

### +

### Prayer

### =s

### Victory

"It's impossible to fight this battle alone. I need your prayers to help me sustain my fighting spirit. Believe me, it hasn't always been easy. I couldn't have gotten this far without your help and prayers. I need your prayers now to ask God to intervene, for He is the only one that can save me in the long run. I know that and I'm asking for your help in reaching out to Him. **Please pray for me."**

### Back Cover

Rosann attended her high school's 50th reunion on March 04, 2011. She looked ravishing. Twenty eight hours later she underwent emergency brain surgery to save her life. In a single day, with little warning, her life changed. Rosann has Stage 4 lung cancer and statistics say she has only a few months to live. "I'm living my life one day at a time. What else can I do? I'm not giving up."

Rosann is still an attractive woman, but her priorities are different. She can't do many of the things she once could do easily; she has had to adjust her thinking. Most of her vision is gone, so golf is out, for now. Rosann is also an artist, mostly oils and acrylics. Her style was realism; now it's abstract. The painting above (right) was finished April 27th.

"This is a story of hope! It's May 2, 58 days after my surgery, and I am "Fighting Back" with all my strength, but I can't do it alone. My husband, family and friends have helped me so far. Now I need your help. Please Pray for me."

This is Rosann's book. Jim did the writing but these are Rosann's thoughts and viewpoints. We thank the friends that contributed their thoughts and views; this is what makes this book unique.

Rosann and Jim - Barcelona to Venice Cruise \- 2006

### Book Two

"Fighting Back & Winning"

### The Fight Continues

### Chapter Ten (excerpt)

### The Next 70 Days

### May 3 - July 20

" _I have not wavered in my determination to fight back against what's happening to me, but it certainly hasn't been easy. There have been many ups and downs, and days where I wondered if it was worth it, but Jim was always there to pick me up. Your prayers helped me through the valleys and gave me the strength to go on._

Then suddenly, and unexpectedly, I learned the tumor in my lung shrunk by two-thirds. Was it just the radiation and chemo treatments that shrunk the tumor or did your prayers play a role? I don't know, but I like to think it was a little of both."

Two heroes have been added to their list. Dr. Yon 'Peter' Park and the Florida Cancer Specialist is one. Dr. Park's upbeat demeanor and enlightened approach is a welcome change from Rosann's first medical oncologist who had written her off as a hopeless case.

The 2nd new hero is an unlikely source for someone that is fighting back and refuses to give up hope. LifePath Hospice and the 'Blue Team' have played an important role in Rosann's fight for victory

***

Book Two captures Rosann's courageous, roller coaster journey from May 3rd through March 7, 2013. There were obstacles including blindness and botched CyberKnife treatments, but Rosann's resolve never weakened. Did Rosann win the fight? You decide.

"Fighting Back & Winning" is available from Smashwords. Hard copy and PDF Books are available using PayPal at **www.customsportsnovels.com**

### Other Novels by Jim Plautz

 **PHENOM I** **– Let's Play Basketball -** Too good to be true, a mid-year transfer student leads his high school basketball team to the State Championship and along the way helps others become better students and young adults. Matthew Wilson's past finally catches up with him when the Russian Mafia seeks retribution for past transgressions. This is a feel -good love story and suspense novel structured around a basketball theme.

 **PHENOM 2– Search for the Ark of the Covenant –** Matthew Wilson leads his school to four successive NCAA championships and then forms a globe-trotter team to travel the world and play all star teams from China, Africa, South America and Europe. But basketball for Matthew's quest to find the Ark of the Covenant, an event heralded by Muslims and Christians as a precursor to the second coming of the Lord.

 **OUT OF BOUNDS** \- Drug smuggling and corporate finance structured around a 36-hole club championship golf tournament. A Miami-based drug cartel is pitted against Swiss financiers for control of a new resort and casino in Cabo San Lucas, Mexico. The match-play tournament stakes are 'winner-takes-all'.

 **DOUBLE FAULT at ROLAND GARROS** \- Four junior tennis players destined to meet at the French Open Tennis Championship get caught up in Basque terrorist plans to destroy the newly rebuilt Roland Garros Tennis Stadium; a story of love, jealousy and revenge.

*****

### Phase Two

### The Fight Continues

### May 3, 2011 - December 31, 2011

### Chapter Ten

### The Next 70 Days

### May 3 - July 20

" _I have not wavered in my determination to fight back against what's happening to me, but it certainly hasn't been easy. There have been many ups and downs, and days where I wondered if it was worth it, but Jim was always there to pick me up. Your prayers helped me through the valleys and gave me the strength to go on._

Then suddenly, and unexpectedly, I learned the tumor in my lung shrunk by two-thirds. Was it just the radiation and chemo treatments that shrunk the tumor or did your prayers play a role? I don't know, but I like to think it was a little of both."

Two heroes have been added to their list. Dr. Yon 'Peter' Park and the Florida Cancer Specialist is one. Dr. Park's upbeat demeanor and enlightened approach is a welcome change from Rosann's first medical oncologist who had written her off as a hopeless case.

The 2nd new hero is an unlikely source for someone that is fighting back and refuses to give up hope. LifePath Hospice and the 'Blue Team' have played an important role in Rosann's fight for victory

These are the highlights of Rosann's fight from May 3rd through July 13, 2011 (written in July, 2011).

Florida Cancer Specialists - Dr. Y.K. 'Peter' Park

Rosann met Dr. Peter Park for the first time on Thursday, May 5, 2011 after first meeting with his assistant, Bonny Karr, ARNP, AOCNP. They med at the Doctor's 3000 medical drive office near University Community Hospital. She and Jim were immediately impressed with Dr. Park's earnest sincerity and pleasant demeanor. His smile and confidence are contagious.

Rosann was unusually weak that day, probably because her body was fighting an infection later diagnosed as a UTI. The 45 minute intake interview with Ms. Karr had sapped most of her energy. Nurse Karr collected the necessary information while maintaining an open, friendly dialogue. She did an excellent job, but answering the myriad of questions was fatiguing. Jim helped answer many of the questions.

Jim: _"I didn't know at that time what ARNP (Advanced Registered Nurse Practitioner) meant and thought that nurse Karr was a trainee, why else would her tile be 'nurse practitioner in training'? By the end of the interview I was impressed by her thoroughness and friendly demeanor. Later Rosann (whose daughter was a RN) told me that an ARNP was at the top of the hierarchy and the extensive training required to earn that designation. Fortunately I hadn't said anything stupid."_

Dr. Park pulled his stool close to Rosann and asked some of the same questions that Ms. Karr had asked previously. Rosann told Dr. Park that she wasn't giving up and wanted to fight this cancer. She was hoping for an aggressive treatment program.

Dr. Park described the chemotherapy program he had in mind. He mentioned the possibility of an experimental chemo program but wouldn't make that decision until he reviewed her blood work and case file. He also wanted to discuss the case with Dr. Janelle Park (no relation; "Park" in Korea is like 'Smith' in the U.S.), Rosann's radiation oncologist. He envisioned a chemo program that would complement the radiation treatments. Chemo treatments could start a week from Tuesday.

Rosann: _"I liked Dr. Park immediately. He has a great smile and way about him. I was exhausted but agreed to provide a blood sample before going home."_

Jim: _"I asked Dr. Park about his view of doing Chemo and Radiation simultaneously; Rosann's previous medical oncologist had insisted on waiting until the full-head radiation treatments were finished before starting chemo. Dr. Park replied that that viewpoint is old-school. 'There are benefits of doing the two treatments together if the efforts are coordinated.' This answer made me even more confident that we had made the right decision to come to Dr. Park."_

Nurse Karr provided Rosann with a wheel chair to transport her to the lab for her blood work. Jim subsequently used the wheel chair to take Rosann to the car. Rosann was too tired and unsteady to use her 'walker'.

Rosann & Dave @ chemo

Rosann's 1st chemo treatment was Tuesday, May 17th, two months and 13 days after her operation and diagnosis of adeno carcinoma of the lung, stage 4. St Louis doctors said they like to start treatment within 10 days. Part of the delay can be attributed to spending the first 11 days in St. Louis, but the majority of the delay was a tragic waste of precious time. Many doctors did not believe that she would live two months and 13 days.

Chemo treatments would be weekly, three weeks on and one week off. Rosann and Jim chose Tuesday as her 'chemo day' and decided to have the treatments done at the N. Armenia office which Dr. Park described as 'homey'. It was also only a couple miles from where she received radiation treatments. They originally thought that on Tuesdays Rosann could have her radiation treatment and then zip down the road for her chemo treatment. This synergy never panned out.

Jim: _There were scheduling issues that made it difficult to get the appointments so that there was less than a two-hour gap, but this was not the only concern. Back-to-back scheduling was too taxing on Rosann. We tried it one time and Rosann got home at 5 PM, went to bed, and slept through the night. She needed a break after radiation to grab some lunch and a one-hour nap."_

The 'chemo cocktail' consisted of:

* Aloxi IVP (0.25 mg)

* Decadron IV (10 mg)

* Taxotere (30 mg)

* CARBOPLATIN (265 mg)

Rosann's favorite blood tester!

Rosann has her blood tested each Tuesday to verify her body could withstand another chemo treatment. Rosann's white blood cell count, an indication of the body's ability to ward off infections and disease, was dangerously low when initially tested in Dr. Park's lab on May 5th. Since chemotherapy reduces the white blood cell count even more, Dr. Park had told Rosann he couldn't start chemo treatments unless the blood work showed improvement. He believed the low count was due to her body fighting off the infection. The test results were better and chemo began on May 17.

The first set of chemo treatments went smoothly but on the 'off week' Rosann's white blood cell (wbc) count was dangerously low. She was also running a 100 degree fever so Bonnie Karr proscribed Filgrastim, a drug designed to stimulate the production of white blood cells. Rosann was given injections on three consecutive days with the hope that her wbc count would improve and she could receive her 4th chemo treatment the following Tuesday as scheduled. It was not to be as her blood count fell again to a new low (anc = 1.2). Rosann received three more shots of Filgrastim and chemo resumed the following Tuesday, albeit at a lower dosage. Rosann received the 2nd chemo treatment of this new script on May 28.

Dr. Park: _"We reduced her dosage by 20% because it was apparent that Rosann's body was not tolerating the effects of the higher dosage combined with her daily radiation treatments."_

Bonny Karr: _"The following week, June 28, Rosann's blood work was much better; both red and white blood cell counts. Rosann's color and overall appearance also improved."_

There were only 10 more radiation treatments remaining as of May 28th and Dr. Peter Park decided to stop chemo treatments after the July 5 dosage. The following week, July 12, was a scheduled off-week which corresponded to the final radiation treatment scheduled for July 13th. It was a good time to stop and assess their progress. It would also give Rosann a much needed break and let her body throw off the affects of the combined radiation and chemo treatments.

Dr. Park scheduled a CT scan of the lung for July 20th and a PET scan three weeks later. The PET scan is more comprehensive and will also determine if the cancer has spread to other organs. Positron emission tomography (PET) scans look for a cancer cell's heat signature and require a one month 'cooling off period' after radiation treatments have stopped. CT scans can be done much sooner.

Jim: _"We asked Dr. Park for the lung CT scan because we were eager to determine if the lung tumor was gone. Rosann badly needed some good news; the debilitating effects of the radiation and chemo were taking their toll. The doctors might not need the CT scan, but we did."_

The LifePath Hospice 'Blue Team'

Joining LifePath Hospice was a two-edged sword and was taken only after considerable deliberation. The decision to look into Hospice was Jim's, Rosann's husband and primary caregiver.

Jim: _"I realized I wasn't totally prepared to answer the tough 'what-if questions. What would I do if Rosann needed emergency treatment? Do we have a valid living will? If Rosann died suddenly, who would I call? These were unpleasant scenarios, but something we needed to address. I called my PCP and asked for a referral to a Hospice organization._

The toughest part of the process was explaining my decision to Rosann and convincing her that nothing had changed; I was still committed to Fighting Back against this disease, we just needed to be more prepared. 'Let's hear what they have to say', I pleaded. I could tell that my explanation was falling on deaf ear; I had lost her at the word 'hospice'. She was noticeably deflated."

Rosann: _"I heard the word 'hospice' and I immediately thought that I'm going to die. Sure, I knew I had lung cancer and the odds of survival are against me, but now Jim was telling me I was dying and had less than six months to live (LifePath admits patients with a 12 month life expectancy). It was a low point in my recovery. I trusted Jim so I agreed to meet with the LifePath people but it was a depressing moment."_

The next morning (Tuesday, 5/3/11) Leslie and Sue from LifePath were explaining the program to Rosann and Jim. Rosann's eligibility was not in question since from day one her PCP had told her she was going to die. The central issue was whether enrolling in LifePath Hospice would allow Rosann to continue 'Fighting Back'. Rosann and Jim were impressed with the benefits LifePath Hospice offered but made their position clear; 'we want to do everything we can to beat this thing; we are NOT giving up'.

Leslie and Sue assured Rosann that LifePath Hospice would not stand in her way although LifePath pays only for palliative treatment and services; they did not cover 'curative' treatments'. In other words, they treat the symptoms such as pain and nausea, but won't pay for procedures designed to cure the disease. They provided several examples;

* Yes, chemotherapy treatments are covered;

* Some types of radiation treatments are covered;

* No, some CyberKnife radiation procedures are not covered because they are classified as a 'curative' procedure.

The CyberKnife exclusion was almost a deal-breaker because Jim and Rosann still hoped that Dr. Janelle Park would decide to use CyberKnife on the tumor in the lung which was the source of the cancer. Humana Gold Plus insurance covers CyberKnife.

LifePath offered to enroll Rosann into LifePath but allow her to withdraw if the CyberKnife procedure was approved. They promised there would not be a problem with Humana or her PCP. Jim and Rosann believed it was a win-win opportunity and Rosann signed the LifePath enrollment application. She was now a hospice patient.

The CyberKnife precaution was not required. On Friday, May 6, Dr. Park informed them that CyberKnife was not appropriate for Rosann's lung tumor.

Jim: "Dr. Park told me that _CyberKnife works best for small tumors with a precise location. This is very difficult to define with lung cancer patients because the lung is constantly expanding and contracting while the patient breathes. Dr Park had decided that a full beam radiation treatment was more appropriate."_

The next day two Hospice nurses did an intake exam and evaluation. They found Rosann to be weak and shivering, early symptoms of a urinary tract infection. One of the nurses confided to Jim that Rosann probably had only three months to live.

Jim: _"Having access to this type of input was one of the reasons we joined LifePath. I appreciated the nurse providing her opinion. It was a little unsettling to hear such a grim assessment, but we had heard worse. Rosann was running a fever and was having a bad day. I didn't lose my optimism. I didn't tell Rosann"_

Rosann was assigned to the LifePath "Blue Team. Rebecca, the RN assigned to Rosann, stopped over Friday. 'Becca' would be Rosann's primary contact with LifePath. She would meet with Rosann weekly, order prescription refills and in general, serve as the point person for the blue team. LifePath uses a team approach to providing palliative care and Becca is the person responsible for determining the appropriate resources that are required at any particular time.

Rosann: _"I wake up at night and worry. It is very comforting to have access to a team of health care professionals. Becca was able to explain many of the things that were happening to me like why I'm so weak, why I lose track of time and become confused and fifty other little questions._ "

Jim: _"Rosann doesn't yet need 24-hour 'emergency care' and I hope she never does, but we know it's there if we need it. They already proved they can respond quickly. Rosann was in severe discomfort and LifePath sent a nurse to our home. Two hours later the problem was solved and Rosann spent a comfortable weekend. Our Humana PCP would have asked us to make an appointment for Monday or Tuesday."_

The distinction between Palliative treatment which is covered by LifePath Hospice and Curative treatments remains an issue. This issue will be addressed if the new CT scan on the lung and PET scan show good results. The remaining brain tumor is an ideal candidate for CyberKnife radiation.

LifePath Hospice's decision not to pay for full beam radiation treatments:

This is the wonderful part of Rosann's story. These are the facts;

* LifePath Hospice covers some 2D and 3D radiation treatments;

* The radiation oncologist (Janelle Park, M.D.) chose an aggressive external beam radiation treatment called IMRT;

* LifePath said this treatment she chose was "too aggressive" and was considered a curative procedure. They would only pay for radiation procedures that were palliative. Dr. Park should choose another treatment;

* Dr. Park said no, this procedure was best for Rosann, and decided to absorb the cost of the 33 radiation treatments;

* After 17 treatments a new CT scan showed the size of the lung tumor has been reduced by two-thirds;

* Rosann now has a much improved chance of beating this 'incurable disease'.

We will talk more about Dr. Park's decision in the next section, but for now, let's address the LifePath Hospice rationale for refusing to cover the radiation procedure recommended by the radiation oncologist.

1. LifePath Hospice covers only palliative care and precludes treatment that might also cure the underlying disease, even though the cost of treatment is the same. Does this make any sense?

2. Palliative and curative care apparently cannot co-exist in a case like Rosann's where the patient refuses to concede death. There is no room in LifePath for people that still believe in miracles.

3. Rosann's lung tumor has already shrunk to one-third its original size due to 'aggressive' radiation and chemo treatments. Would this have occurred if Dr. Park had used the traditional 2D radiation procedures approved by LifePath Hospice?

Jim: _"Rosann and I believe that LifePath Hospice has played a positive role in helping her maintain the physical and mental strength required to fight her cancer. The people at LifePath are awesome and have helped Rosann immeasurably. Would the tumor have shrunk without their help? We don't know for sure but we would not want to try to do it alone. The role the human spirit plays in healing and creating 'miracles' cannot be measured. Doctors agree that the willingness of the patient to fight back greatly improves the odds of recovery. Rosann and I agree and thank LifePath Hospice for the support they have provided."_

Definitions:

Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people facing serious illness. It focuses on relief from the symptoms, pain, and stress of serious illness - whatever the diagnosis. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a team of doctors, nurses, and other specialists who work together with a patient's other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.

Curative care refers to treatment and therapies provided to a patient with the intent to improve symptoms and cure the patient's medical problem. Antibiotics, chemotherapy, a cast for a broken limb -- these are examples of curative care. The term is often used in contrast with "palliative care," which is a treatment or therapy that does not aim to cure the patient.

Tampa Bay Cancer Center - Dr. Janelle Park

Jim: "We asked Dr. Janelle Park _about the decision by LifePath Hospice (not to pay for the radiation treatments). She responded by saying that she believes in providing her patients with the best medical treatment possible and was not going to change her recommendations because insurance doesn't cover the procedure. She refused to let insurance companies dictate how she treats her patients."_

Does this sound too good to be true; too corny; too trite? Well, the Tampa Bay Cancer Center and Dr. Janelle Park specifically, put their money where their mouth is. When LifePath Hospice refused to pay for the recommended radiation treatment, she went ahead with the procedure anyway, regardless of cost and reimbursement. TBCC is absorbing the cost of Rosann's 33 radiation treatments.

Jim: _"When we discovered that Dr. Park was planning to go ahead without reimbursement from LifePath, I called her office and offered to withdraw Rosann from Hospice and reenroll her in Humana Gold Plus. Humana would reimburse TBCC for the radiation treatments. The next day her nurse got back to us and rejected our offer. She said Dr. Park did not want Rosann to lose access to the services provided by LifePath Hospice. TBCC would absorb the cost of the treatments._

ASTRO (American Society for Radiation Oncology) states in their brochure that "radiation therapy is the use of high energy x-rays to safely and effectively kill cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them. Healthy cells may also be damaged but are able to repair themselves."

The procedure used by Dr. Park for treating Rosann's lung tumor is "intensity modulated radiation therapy (IMRT), a specialized form of 3D-CRT that modifies the radiation by varying the intensity of each radiation beam."

CyberKnife, which eventually will be used to treat Rosann's brain tumor, is a stereotactic body radiation therapy (SBRT) that delivers high doses of radiation to small and very precisely defined targets." Both IMRT and SBRT are relatively new procedures for treating lung cancer and for this reason, are considered "too aggressive" to be covered by LifePath Hospice. .

The ASTRO brochure also states that "radiation oncologists use radiation therapy to try to cure cancer, to control tumor growth or to relieve symptoms, such as pain." Maybe 'curing cancer' is the problem for LifePath, but wouldn't curing cancer also treat the symptoms? Are they mutually exclusive?

Dr. Park ordered a new CT scan after Rosann's 17th radiation appointment. Her objective was to get a clearer image so they could recalibrate their radiation-delivery machine (called a linear accelerator). The byproduct of this decision was the discovery that the lung tumor had already shrunk by two-thirds. It was a shock to both Dr. Park and Rosann.

"I couldn't believe it she told me. I started to cry. I cried again when I got home and told Jim. We both cried."

### Chapter Eleven

### Side Effects

The effects of chemotherapy and radiation on Rosann's 'psych' were insidious and cumulative. Rosann was fortunate that the physical effects of the treatments were minimal; chemo didn't make her nauseas and the radiation didn't irritate her skin. Hair loss was expected and initially she handled it well.

Rosann: _"I knew my hair would fall out and initially it didn't bother me too much. I bought a couple wigs and thought I'd be okay. Eventually the loss of hair and a myriad of other things caught up to me. I was no longer in control of my own body and my life."_

Fatigue, short term memory loss and difficulty in thinking are typical side effects of chemo and radiation treatments. Rosann was undergoing both treatments simultaneously, Not unexpectedly, the side effects increased. Fatigue was the major problem.

Rosann: " _I'm always tired, sometimes more tired than others. I push myself to help Jim out around the house and keep up a good attitude, but it's not always easy. It's not fair to Jim that he has to do all the work."_

Jim: _"Rosann get's around the house with a little help and guidance. She does fine when she is feeling strong. It's dangerous when she is tired or disoriented which frequently happens when she gets up in the middle of the night. Chronic fatigue, combined with her lack of eyesight, make it difficult for her to help out much. She might help make the salad, but be prepared for a lot of salad dressing."_

Short term memory loss is embarrassing and undermines Rosann's self confidence. What day is it? Where did I put my wedding ring? What time is my radiation appointment tomorrow? Is it dinnertime? What day is it?

Rosann: _"I can remember that the Celebrity Millennium was the cruise ship we took for our Barcelona to Venice cruise in 2006 but I can't remember what day it is? Jim puts a daily to-do list on my bedroom mirror but I still forget. I feel I'm losing my mind."_

" _Jim: "I show Rosann literature saying that memory loss is typical and not to worry about; she's not alone. It's still frustrating for her. She might ask the same question five times. Lately she has begun to apologize for asking because she knows she should remember. It's hard to convince her that it's normal and there is nothing to apologize for. I try to preempt her concern by frequently telling her what day it is, what time it is and what's on the agenda for the rest of the day. She loves to hear me say that we have no more appointments today or that it's Saturday and there is no radiation appointment."_

The worst side effect has been the inability of Rosann to think clearly. All of us experience times when we forget what we are talking about half way through a sentence, at least I do. But Rosann has developed an ability to mix three subjects in one sentence without missing a beat. It isn't funny, but in a way it is. We need to laugh or it will drive us crazy.

Rosann has difficulty solving problems; Sudoku is a prime example, and just about anything that requires patience, logic and persistence. Her computer skills, once excellent, are deteriorating.

Rosann: " _I feel so stupid at times. I know Jim must be so disappointed with me."_

Jim: _"Frustrated, yes; disappointed, never. It hurts me so much to see her struggle with simple tasks and problems. I remind her that this confusion is typical, but sometimes she won't listen."_

Dr. Janelle Park: _"I told Rosann that her primary job is to submit to radiation and chemo treatments. I think she and Jim are trying too hard to rehab. There is time enough to get her physical and mental strength back later."_

Side effects versus Damage from Brain surgery

We know that not all of the side effects are attributable to the chemo and radiation. The swelling in the brain and the resultant brain surgery caused damage to her eyesight and to her problem solving ability. Rosann had problems with Sudoku puzzles before she started radiation and chemo. Doctors tell us that the damage to Rosann's eyesight is permanent, but much of the other damage can be repaired with therapy. This is the speech therapy - cognitive rehab program that Cara, from University Community Hospital Rehabilitation, prescribed earlier in this book.

Rosann: _"I know I will never see well but I'm hoping for some improvement, anything. I also that the brain surgery destroyed some of the synapses in my brain and I might never be the computer whiz I once was, but I know I can get better. I'm looking forward to getting my strength back and beginning the rehab exercises. I want to be useful again."_

Jim: _"We are cautiously optimistic that Rosann can regain her independence. We know it won't ever be the same as it was before March 05, 2011, but we are looking forward to the challenge. We are in a much better place today that we had a right to expect back in March and April. We have hope."_

### Chapter Twelve

### A small miracle

**New CT scan taken July 20th -** The doctors did not want to take a CT scan of the lung. They wanted to wait for the PET scan results which provide a more accurate picture of the lung tumor. CT scans often cannot distinguish between live and dead cancer cells and therefore might provide misleading results. PET scans, however, cannot be taken for 30 days after the last radiation treatment.

Jim: _"Rosann and I did not want to wait until mid August to determine whether the lung tumor was still there. We 'needed' to know sooner. Rosann and I were both worn out physically and mentally and desperately needed some good news to keep us going. I called Bonnie Karr and explained our position. We didn't want to wait. I admit that I probably needed to know more than Rosann did. The next day Dr. 'Peter' Park called me at home and agreed to do the CT scan. He understood the psychological part of fighting a disease like lung cancer."_

Rosann got the news of the CT scan results on July 26th. Dr. (Peter) Park walked into the waiting room and was all smiles. "The CT scan showed no evidence of the tumor in your lung. It's gone," he said, as he leaned over to give Rosann a warm hug.

Rosann: _"I was stunned. Jim and I had hoped for good news but this was beyond our dreams. I wasn't sure how to react. I finally stood up and gave Dr. Park another hug and kiss. He was so happy for me."_

"This is what we work for," Dr. Park replied softly.

July, 2011 - What's next?

Much depends upon the results of the new PET scan that will be taken in early August. Rosann and Jim are optimistic. There is no reason to expect that the cancer has spread since the last PET scan taken in April.

Assuming positive results, Dr. Janelle Park will schedule a CyberKnife radiation procedure to eliminate the last of the three original tumors in the brain. Dr. Park says there is no urgency to perform this procedure.

Dr. Peter Park has indicated he will design a new chemo script to ensure that cancer cells that were previously emitted from the cancerous lung tumor are killed in their infancy, before they multiply. The new chemo script will probably begin in mid August.

Rosann: _"I'm looking forward to 30 days without chemo or radiation treatments. I'm looking forward to waking up knowing what day it is and that I don't have any appointments with doctors or nurses that want to stick a needle in me. I want to make breakfast for Jim and me, check my Facebook and maybe reply to a few emails. I want to regain my old life again, at least some of it."_

Jim: _"A European river boat cruise is the top of the bucket list we made in St Louis. We would be making reservations today but we are confident that Rosann will be alive and stronger next spring. Our immediate plans are to spend time at home recovering and visit relatives in Virginia in August. They have a six-year old girl and twin four year old boys. Kelly and Brandon are bringing Maddie, our 10-month old granddaughter and Bill and Kate are bringing Ella, CoCo and James, ages six, four and two. Europe might have been a more relaxing trip for Rosann, but she is looking forward to seeing everyone again. Four months ago it did not look possible."_

These were heady times. The future looked bright. The lung tumor was gone as were two of three brain tumors; the 3rd reduced to less than one half its original size. They looked forward to 30 days without Chemotherapy and for Rosann to regain her strength.

Jim and Rosann issued the following Press Release.

For Immediate Release

" **Rosann, Your Lung Cancer is Gone"**

Rosann Plautz cried. Five months earlier Rosann barely survived emergency brain surgery for a bleeding tumor. The diagnosis was adenocarcinoma of the lung - Stage 4. Rosann is 'Fighting Back', and now there is hope, real hope.

Tampa, Fl - August 1, 2011 -- This fantastic news is by no means the end of Rosann's fight, but it's a long way from when her doctor told her she was going to die; "there are no alternatives, you are going to die." Her first medical oncologist dismissed the PET scan results that showed the cancer had not spread; "once it's spread to the brain nothing else matters." Hospice intake nurses estimated Rosann had three months to live.

 There was little warning. Rosann attended her 50th high school reunion the previous evening. She played golf five days earlier. Suddenly, on March 5, 2011, the headache began. Six hours later a neurosurgeon performed an emergency craniotomy to relieve swelling in Rosann's brain; one of three metastatic tumors had ruptured. Rosann survived the operation but lost 90% of her eyesight.

Rosann is 5'6', 113 lbs, with a heart of a lion. The progress she is making 'fighting back' against an incurable disease is a testament to her inner strength and refusal to give up. She likes to say that "all I can do is play the cards I've been dealt - what are the alternatives, give up? Never!"

 There are many heroes in Rosann's story including Dr. Janelle Park, Tampa Bay Cancer Center, who did the 33 lung radiation treatments at no cost when Hospice refused to pay because IMRT is too aggressive; "I'm not going to let insurance companies tell me what's best for my patients," Dr. Park explained.

Dr. 'Peter' Park (no relation), Florida Cancer Specialists, debunked the notion that chemotherapy and radiation treatments cannot be done together. Dr. Park had the privilege of telling Rosann the good news. "These are the miracles that make it all worthwhile," Park exclaimed as he embraced Rosann.

The unsung heroes are hundreds of friends that have prayed for Rosann and the One who listened to these prayers. This crisis caused Rosann to reach out for His help and has undoubtedly contributed to

Rosann's story is not over. Rehab will be long and arduous. Her husband marvels at Rosann's courage. "Every day she fights to do little things that she once did easily. Her loss of vision is a constant challenge, but every morning she wakes up with renewed optimism. Rosann's 103-page book, 'Fighting Back', offers a formula for victory over an 'incurable' disease; Stage 4 lung cancer."

Rosann asks for your continued prayers.

*****

### Chapter Thirteen

### Family Reunion in Virginia

They didn't know it at the time, but this trip was the apex of Rosann's recovery. It would be the only trip they would take; August 18th - August 22nd, 2011. Five days at Mike and Claire's house with the three Plautz kids, three spouses and seven grandchildren, ages one thru six.

The plan was for Rosann to regain her strength after 30 days without chemotherapy or radiation. It didn't happen. There may have been some recovery, but very little. Rosann needed help walking and was not strong enough to climb more than a couple stairs. The trip presented several obstacles.

Jim: _"There was no easy way to get to Charlottesville. There is a direct flight from Tampa to Dulles, but that meant renting a car and a two hour drive. We decided to fly to Charlotte and catch a commuter plane to Charlottesville. My daughter-in-law, Claire, would meet us at the airport and drive us home. The problem was boarding the small plane in Charlotte. I envisioned using a wheel chair to and then somehow carrying Rosann up the stairs to board the plane. It would be difficult"._

Rosann: _"I was afraid about the entire trip, but I knew it meant a lot to Jim for me to see the kids. I wish I were stronger. At least we would have access to good medical help once we got there; Mike and Claire are both doctors."_

Jim: _"We had thought Rosann would be stronger after 30 days without Chemo. Still, I thought the trip would be good for Rosann. We needed to push the envelope if we were going to beat this thing. Rosann is stronger than she knows."_

Jim and Rosann arrived at the airport and were told they could fly to Charlotte, but all connecting flights to Charlottesville were cancelled due to weather. They would have to spend the night in Charlotte. The US Air ticket agent recommended they go home and try again Friday.

Jim: " _Neither option was acceptable, nor was driving from Charlotte, with Rosann. I begged, pleaded, threatened and finally, played the cancer card. "My wife is dying and this is her last opportunity to see her grandchildren. Isn't there any way we can get there, I asked?"_

Rosann did her part by sitting meekly in her wheelchair, totally unaware of our predicament. The US AIR ticket agent asked Jim to wait a minute and left. Ten minutes later he returned with two boarding passes for a United Airlines, direct flight to IAD, departing in 60 minutes. He had already switched their bags. Jim could have kissed him.

Jim informed Rosann there was change of plans and headed to the departure gate, pushing Rosann ahead of him.

Jim: _"I was lost in thought, knowing I had to tell Mike and Claire about the change in plans and try to figure out how we would get from Dulles Airport to their house. I had never been there. All of a sudden I realized we were on the up-escalator and Rosann's wheelchair was tilting precariously."_

Rosann: _"I was so scared and was ready to catch the next cab home. Everybody was looking at us."_

Somehow the two lovebirds made it to level ground and Jim was forgiven after a considerable amount of apologizing and groveling. The rest of the trip fell into place. Jim reached Mike at his office and notified him of the change in plans. He took care of everything. United Airlines met them in D.C. with a wheelchair and transported them to the t the Dulles' luggage turnstile where they were met by a driver who led them to his van. Mike had hired a private transportation company to drive Jim and Rosann door-to-door. Three hours after the landed they arrived at Mike and Claire's home.

Jim: _"It would have been difficult to rent a car and find our way to Mike's home, even with a good GPS. We were thankful for the royal treatment even though, alas, there was only water and cokes to quench our thirst."_

The five days went quickly. Swimming, eating, napping and more swimming. Then, the next day, we did it again.

Kelly, Maddie & Brandon...... Claire, Luke, Cassie & Logan

........ Mike & Logan.......... Maddie with G-Pa Jim & Rosann

Kelly, Maddie & Brandon........... Bambi (in back yard)

.. Claire (cooking breakfast) .. The 3 girls & James (local winery)

..... Luke, Logan & Cassie...... Ella & Courteney

View of Heated Pool & Porch....... Bill with Ella & CoCo

........... James & Bill...................... Maddie, Kate & CoCo

It was the perfect setup for Rosann. Their home is a huge, 3-story house, on 5 acres backed up against the scenic Blue Ridge Parkway. Rosann and Jim stayed in a guest room on the main floor, just off the kitchen. Mike and Claire and their three kids were upstairs; Bill and Kate and their three kids were downstairs although Ella and CoCo ended up sleeping in Cassie's room. Kelly and Brandon and Madeline stayed with her mother. The pool deck was just off the kitchen and family room. Rosann had privacy when she needed to rest, easy access to all the fun when she wanted, and best of all, no stairs to climb.

Getting home wasn't as bad as we feared. Charlottesville airport did not have passenger loading bridges for their small puddle-jumpers, but luckily for Rosann, they had a wheelchair accessible ramp that allowed Jim to push her right to the door of the plane. They pre-boarded and had a comfortable ride to Charlotte for their connection to Tampa.

Rosann: _"The whole was perfect. I was tired when we got home, but happy that we went. I felt safe knowing that if anything happened, Mike and Claire were there for me."_

Jim: _"The whole trip was a 'reach' for Rosann. Other than the wheelchair incident, I was pleased with how things went. It was great for both of us to see everybody. The airline travel was tough on Rosann. She definitely isn't strong enough to fly to Europe unless it's a direct flight."_

### Chapter Fourteen

### The CyberKnife Saga - Getting Humana Approval

Dr. Janelle Park called Monday, August 15th, three days before the family reunion trip to Virginia. She had seen something in the latest PET scan and decided it was time to do the Cyberknife surgery. She needed to know soon because there is a 15-day waiting period before Rosann's insurance could be switched from Hospice to Humana Gold. Hospice does not cover CyberKnife.

This phone call marked the beginning of a tragic chain of events that left Rosann legally blind, disappointed and with the same tumor that was there to begin with.

Jim: _"I was excited. We were finally going after the one, remaining in Rosann's brain that had been reduced in size, but not eliminated, by the 15 full head radiation treatments done in June, 2011. The latest MRI and PET scans showed the lung tumor was gone and the cancer had not spread to other organs. Rosann would be tumor-free."_

Rosann: _"I was initially reluctant because of my poor eyesight. The craniotomy had left me blind in my right eye and only limited vision in my left. I didn't want to take any chances on losing my remaining vision I expressed my concern to Dr. Park. She assured me there was minimal risk and that the risk of doing nothing was just as great. Cyberknife is a very precise surgical procedure, she said."_

They asked for time to talk it over and said they would call later with their decision. Jim was swayed by Dr. Park's statement that there was an even greater risk of doing nothing. He also pointed out that the remaining tumor was in the left occipital region of the brain, which controls eyesight in the right eye. Your left eye is your good eye. Rosann relented and they called Dr. Park with their decision.

**Humana Insurance:** Rosann had enrolled in LifePath Hospice in early May, fully aware that Hospice does not cover Cyberknife surgery. It is considered curative surgery, versus palliative. Hospice, by definition, does not pay to cure the patient. Rosann withdrew from Hospice effective September 1st with the understanding she would re-enroll after Cyberknife was completed.

Getting Humana to approve the surgery was not easy. All decisions start with the patient's Primary Care Physician (PCP) and Rosann's PCP was Dr. Daniel Heinig, the same Dr. that told Rosann in their first visit that; "let me be blunt, you are going to die, there is no alternative. You need to get your affairs in order. Would you like me to contact Hospice?"

Yes, everyone is going to die eventually, but what Dr. Heinig clearly meant was that Rosann had no chance for recovery and was going to die soon. Rosann stated that she wanted to fight, but Heinig was not hearing her. He repeated; "you will die; there are no alternatives". Six months later Rosann was forced to rely upon this same Doctor for a positive recommendation to Humana.

They met with Dr. Heinig and his nurse on August 25th. After 15 minutes of discussion Dr. Heinig informed Rosann that he would not recommend to Humana that they pay for the Cyberknife surgery. He said Rosann had scored only a 60 on a test that measured her ability to function on her own, a criteria that was used by Humana to determine whether Cyberknife was worth doing.

Jim: " _Wow. I reminded Dr. Heinig what he had said in April and suggested that Rosann still being here, alive, might be an embarrassment to his medical prognostication skills and that his position on the LifePath Hospice Board of Directors might be a conflict of interest. Isn't it the role of a PCP to keep the patient alive rather than prepare them for death? I let him know that we would go directly to Humana and fight his recommendation."_

Jim looked into the relevance of using the Karnofsky scoring test for evaluating a patient's chances for recovery. Several sources questioned the applicability of the test results for handicapped patients such as Rosann who was legally blind in one eye and had only minimal vision in the other eye. Didn't this adversely impact her ability to function independently?

Two weeks later, after numerous phone calls, Humana approved the surgery. The reasons for approving the surgery were not given and Dr. Heinig's office steadfastly refused to provide the patient with a copy of the written recommendation they sent to Humana. Did they change their recommendation or did Humana overrule?

Rosann: " _I was just happy to get this over with. I don't like to argue."_

September 14th was a long day at Brandon General Hospital where Dr. Park's Cyberknife clinic was located. Rosann was scheduled for a CT scan at 10:30 and a MRI at Tower Diagnostics, just around the corner from BGH. Dr. Park asked Rosann to come to her Cyberknife office after the MRI, but had already left for the day when Jim and Rosann arrived.

Jim: _This was unfortunate because we had not spoken to Dr. Park since her August 15th phone call. Her staff told me Dr. Park was going to talk about the Cyberknife "Plan" and what we should expect. A meeting with Dr. Park might have prevented later problems. We did get to see the Cyberknife machine._

Rosann: _"I was so tired. It was a long day and I just wanted to get home"._

The Cyberknife surgery was scheduled to begin Wednesday, September 21. There would be five treatments. Dr. Park had called a week earlier and informed Jim that a Dr. Holasek was designing the "Plan" and would be overseeing the surgery. Dr. Park would be out of town for the surgery.

Jim: _"The warning bells were going off, but I wasn't listening. I did ask the staff why there were five treatments planned when Dr. Park had told us several times that the tumor could be dissolved in one session. They said the Doctors had decided on multiple, low dosage treatments. Dr. Park had also been vague about why she wanted to do the surgery now. She had always said there was no hurry. The reason she gave was; 'I thought you wanted to be aggressive.' Her reply didn't make sense to me at the time."_

### Chapter Fifteen

### The Cyberknife Fiasco

Jim and Rosann were early for their 9:00 AM appointment on September 21, 2011. Traffic was light and the one hour drive had taken only 50 minutes; they had allowed for 75 minutes. The reception room was bright, spacious and comfortable, so they didn't mind waiting. It was 9:15 before Dr. Holasek hurried through the waiting room, ignoring Jim's 'good morning'.

Fifteen minutes later they were ushered into a patient office and Dr. Holasek explained the planned procedure to Rosann. Jim and nurse, Patty Polo, were also present. Dr. Holasek explained that they were targeting debris around the cranial cavity that was made when the emergency craniotomy was performed in St. Louis.

Jim interrupted; "the craniotomy was done on the right side of the brain. I understood we were going after the last tumor in the left occipital region of the brain."

"What tumor?" Holasek asked. She consulted her notes on the MRI performed September 14th. "There is no mention of a tumor."

Jim: _"In retrospect, we should have walked out right there, but I wasn't thinking clearly. Rosann and I were so excited about getting rid of the last, remaining tumor, that it would have been difficult to walk away. So instead, I suggested they look at any of the old MRIs or the notes from Dr. Stanley, the neurosurgeon that performed the craniotomy. They all mention the tumor."_

Dr. Holasek consulted Dr. Martin's notes which did indeed mention the tumor in the left occipital region. Dr. Holasek and Nurse Polo went to Tower Diagnostics of Brandon to talk with the interpreting Radiologist, who admitted his error. He might have caught his error if the BGH Tower Diagnostics had access to the Tower Diagnostics computer systems (and prior MRIs). Brandon General Hospital had withdrawn from the system a year earlier, but kept the Tower Diagnostics name..

Dr. Holasek came back to the office and suggested they redo the Cyberknife Plan and go after both the left and right occipital regions simultaneously. She could revise the Plan in a couple hours but they needed the technician to revise the Plan in the machine. She suggested we come back tomorrow.

Jim: _"I looked at Rosann and saw she was absolutely deflated. I agreed, and ignored the many questions that flashed through my mind. Why didn't Dr. Park (Janelle) tell me they weren't going after the tumor on the left; did she forget? Why was Dr. Park out of town when she was the one pushing for the surgery at this time?_

Jim mentioned the one major concern that Rosann had expressed previously. "Dr. Holasek, Rosann told Dr. Park that she didn't want to do anything that might jeopardize the remaining eyesight in her right eye. Is there any risk?"

Dr. Holasek replied as she moved closer to Rosann and looked her in the eye; "No, there is no danger. Eyesight is controlled from the upper regions of the brain, not the lower (occipital) regions. We will not be anywhere near these areas."

Jim: _"I knew this was wrong at the time. Dr. Martin had warned me that loss of eyesight was a real danger when he requested my permission to perform the craniotomy. Dr. Park later admitted the statement by Dr. Holasek was false. I should have walked away, but I didn't."_

Rosann had her first two Cyberknife treatments Thursday and Friday. Over the weekend she started complaining that her eyesight was deteriorating. A friend took Rosann to her 3rd Cyberknife appointment Monday. They met with Dr. Park, now back from vacation, but made no mention of her loss of eyesight.

Dr. Park called Monday afternoon and said she had reviewed the revised Plan Dr. Holasek had developed and wanted to make a few improvements; "You know me, Jim, I'm a perfectionist. Let's reschedule Rosann's 4th appointment to Wednesday."

Tuesday evening Rosann again complained about her eyesight. "I think it's getting worse," she said.

Jim and Rosann arrived at the Cyberknife clinic Wednesday and Jim immediately told the reception about Rosann's complaint. A few minutes later Nurse Polo came and stood in front of Rosann, offering her a glass of water. Rosann looked at Nurse Polo, smiled, and answered her questions, but made no move to take the water. It was obvious to Jim that Rosann didn't see the offered cup of water. Nurse Polo's face changed as she slowly realized that Rosann was virtually blind. She walked away and two minutes later Dr. Holasek canceled, not delayed, the remaining Cyberknife treatments.

Two months later Dr. Holasek gave up her medical practice and retired from medicine, at the age of 51; coincidence?

### Chapter Sixteen

### Chemotherapy - Dr. Peter Park

### May 3 thru December 31, 2011

Radiation treatments were over, but Chemotherapy continued. They were necessary to keep the cancer cells at bay. Three weeks on - one week off. Rosann was scheduled for Tuesday afternoons at the Florida Cancer Center's Armenia Ave. location. Each session had three components;

* a blood test to determine if Rosann's system was strong enough to withstand Chemotherapy. The tests were done on-site and uploaded to the computers within 15 minutes

* a meeting with Dr. Park or Bonnie Karr to evaluate the blood work results and talk with Rosann about her general condition. Dr. Park opened his appointments with a huge smile and a warm hug; he closed each appointment with a 3-part admonition to keep moving, keep eating and keep praying.

* The Chemotherapy treatment was done in the adjacent building. Treatments usually took about 2 1/2 hours and were performed by three lovely nurses who nicknamed; loud, louder and loudest. Rosann's son, Dave, was her regular chemo partner. Jim was the backup.

The physical conditions were seedy, at best (Florida Cancer Specialists has since moved into new offices), but the people were great.

Rosann: _"I love Dr. (Peter) Park. He's a very good person at heart. I liked the nurses too, but most of all I liked spending time with Dave. We would do crossword puzzles to pass the time and Dave would flirt with the nurses. Chemo wasn't so bad although there was one nurse who hurt me every time she drew blood. I hated the Neupogen shots."_

  Dave: " _I looked forward to sitting with my mom each week. We would just talk, do crosswords or eat. Every week I would go to Wendy's and bring back a hamburger and fries. Sometimes we just listened to music. I was always proud to be with her."_

Jim: _"I looked forward to the meetings with Dr. Park and Bonnie Karr; the chemo not so much. Sometimes the music was so loud, and the nurses even louder, that I couldn't hear myself think. They did have fun, though. I have to admit that I was happy that Dave volunteered and enjoyed it so much. Some of Rosann's golfing friends volunteered, but Rosann preferred to spend the time with Dave or me - preferably Dave."_

Rosann was fortunate that she tolerated the Chemotherapy as well as she did. She never took the nausea pills that were prescribed or experienced fainting, severe weakness or other symptoms that were not uncommon. It's difficult to say whether Rosann's overall weakness was due to Chemotherapy, or just her overall condition, because she didn't bounce back, as expected, when Chemotherapy stopped.

Rosann's main problem was due to her White Blood Cell (WBC) count falling to levels that endangered her ability to fight off infections and disease and made it too dangerous to get Chemo treatments. Dr. Park would proscribe three shots of Neupogen to help the body generate sufficient white blood cells. The shots were administered in the arm, stomach or buttocks and the injections often hurt. They also caused a deep pain in her thighs and arms, a not uncommon side effect of Neupogen.

Rosann's final Chemotherapy treatment was done on December 20, 2011 when her WBC count was 4.2, the minimum. The following two weeks the WBC was 3.4 and 3.1 and Chemo was not given. For comparison, her WBC count was a healthy 7.0 six months later. Her body obviously enjoyed the break from Chemotherapy.

### Chapter Seventeen

### Exercise and Diet

Walking was Rosann's primary source of exercise in 2012. The routine seldom varied. Jim helped Rosann into the car, drove to the Northdale Trail parking lot and helped Rosann out of the car. Jim got the wheelchair from the trunk and the one mile, roundtrip, walk began. Rosann held Jim's left elbow for balance and Jim pushed the empty wheelchair with his right hand. The wheel chair is there 'just in case'.

Jim: _"We didn't always take the wheelchair, but learned our lesson. For whatever reason, one day, Rosann couldn't make it back all the way and I was forced to leave her leaning against a split rail fence while I ran for the car. Fortunately, the gate was not locked and I was able to drive my car down the walking trail and rescue her. I was just in time. She was leaning precariously and in a few more minutes would have been on the ground. We have taken the wheelchair with us ever since."_

Rosann: _"I don't always need the wheelchair, but half the time I get tired and let Jim push me home. It's my security blanket. I just enjoy_

  It's a short walk, but sort of a poor-man's nature trail. There are horses, egrets, blue heron, a variety of birds, occasionally a deer along the trail. There is a bridge that crosses a small lake, where there are fish, turtles and an occasional gator.

Four times a week they would make the same trip. Rosann would occasionally do calf extensions and standing push-ups against the railing of the bridge, but primarily they just walked.

Jim: _In the summer, we tried to leave the house by 8:00 AM to beat the heat, but late autumn and winter allowed us some leeway. After Rosann's further the loss of vision in September, the smooth,_ _blacktopped trail was essential. Sidewalks had too many bumps that she could not see._

Rosann: _I wish I could learn to ride a bike again, but my balance isn't good. We used to ride our bikes 3 or 4 times a week. I miss that. We feed the fish and turtles with food from our old koi pond. The turtles love us._

**Home Exercise Programs:** Rosann was never one to exercise regularly, other than dancing and walking. She loved to close the door and dance to 80's music. Weights, cardio machines, jumping jacks or sit-ups weren't her thing. She needed to regain her strength, but it was difficult. She tried lifting light weights, doing the stretching machine that hung on her office door, but these programs never lasted more than a few days. It just wasn't who she was.

Jim: _"I would outline a program for her to follow, but she would resist. After a week or two, I would give up (until the next time). She needed a personal trainer."_

Rosann: _"Part of the problem was balance. The craniotomy affected my balance. I couldn't reach down to pick something off the floor without getting dizzy. I couldn't even walk very far without holding on to Jim's elbow for support."_

Jim: _"The worst experiences we had were when we tried to practice getting up off the floor. We wanted to see if she could get to her knees and then use the bed or some other piece of furniture to get up. She had fallen twice and couldn't move until I found her and helped her up. She couldn't. Part of it was the strength issue, but a large part was the dizziness. We didn't try that again and fortunately, she hasn't fallen (until her hip injury, July 1, 2012)."_

Rosann's typical home exercise program was to walk the hallways, stopping occasionally to do calf-stretches or counter pushups. Sometimes she lifted 3 pound weights. Jim was always there in case she lost her balance."

**Food:** If exercise was never at the top of Rosann's wish list, neither was food, at least the quantities of food that most people consume. She enjoyed a good meal, but in moderation. Don't we all wish we could do this?

Yes and no. Rosann had dieted before her 50th high school reunion on March 4th, 2011, and weighed about 118 lbs before the surgery; she weighed about 106 lbs when she returned home to Tampa twelve days later and was never able to regain the lost weight. Her weight hovered around 112 lbs, fully clothed.

She ate a good, high-protein breakfast; bagel (Thomas, original Nooks and Crannies), bacon (extra crispy) cottage cheese and sometimes juice were her staples. She also drank an 8-ounce Ensure high-protein drink, supplemented by eggs, bananas, strawberries and whatever else was close to the blender when Jim made the concoction. Coffee tasted bad since the surgery and she drank very little. Rosann had a decent lunch and dinner, but all in moderation. She seldom snacked.

Rosann: _I felt I was turning into a tubby. My clothes didn't fit and I felt unattractive. Jim kept trying to get me to eat more but I didn't want to. He said I looked good, but that's not how I felt."_

Jim: _One of the problems was that the Rosann's body had changed after the operation and during chemo. Her stomach was a little bloated making her panties and slacks tight. She didn't feel good about herself. The other problem was habit. Doctors, nurses, friends - everyone, was telling her that she needed to gain weight to regain her strength, but gaining weight was not in her make-up. She just couldn't make herself think that way. It's not who she was."_

**Wine:** Like coffee, Rosann did not regain her taste for wine. It's probably a good thing since alcohol and medications don't mix well, but it's tough on Jim.

Jim: _"We used to enjoy 'cocktail hour' and usually drank a glass or two of Chardonnay most nights. Two or three night a week we would go to Outback, Bonefish, Grillsmith or Leroy Selmon's and sip a glass, or two, of wine at the bar. We would split a dinner or just have snacks and talk to friends. No more. I miss it."_

Rosann: _"I miss it to, but wine just tastes so bad now - like vinegar. I hope I get my taste buds back to normal when Chemo is over."_

Their cats, Jack (ala Kendal Jackson) and Cloe (ala Cloe de Bois) hope so too.

### Chapter Eighteen

### My Eyesight

The craniotomy performed March 5, 2011 took away most of Rosann's eyesight. Her worst fear since her craniotomy was that she would lose her remaining eyesight. Then it happened; she became legally blind. She still had some sight in her right eye, but not much.

Was it the Cyberknife surgery or a huge coincidence? We thought so at the time, but it's almost impossible to prove. It defies logic and common sense to believe that the Cyberknife surgery did not at least contribute to the onset of blindness. But, at this point, it didn't matter. What mattered was how Rosann and Jim dealt with this setback.

Rosann: _"I was so depressed. I kept asking; what else can they do to me? Why me? It isn't fair. Jim kept telling me that we are in this together. I couldn't keep fighting if it weren't for him."_

Jim: _"Rosann was unbelievably strong. I know it was a tremendous setback, but her attitude didn't change. She didn't complain and still was the same, kind person. We kept saying that all we can do is play the cards that we are dealt; what's the alternative?"_

These are some of the ways that Rosann and Jim coped with this new challenge;

**Television:** Rosann and Jim watched a couple TV shows every night; House, Grimm, Criminal Minds, etc. Before the Cyberknife, Rosann could pretty much follow the plot by herself although Jim would do a recap of the plot every so often. Jim was now forced to interject whenever there was something to read, like signage or change of time like '4 months earlier'. You'd be surprised how often this occurs. They moved the 50 inch screen closer to the two recliners and Rosann could pretty much see what was happening. It was fuzzy, but she could keep up.

Rosann: " _I can't see as much as I would like, but I actually like Jim's narratives and recaps of the plot. I'm able to follow along pretty well."_

Jim: _"Keep in mind that Rosann underwent major brain surgery in March; loss of eyesight was never her only problem. The 'recaps' I gave her are partially because of her cognitive loss. I enjoy helping her by reading the signs and unspoken words. The main difference is that it's almost impossible for Rosann to watch TV without me."_

**Walking:** It's more difficult now for Rosann to use a walker because she can't see obstacles and doorways as well. Using a 'walker' was always a challenge because of her lack of arm strength. She prefers to hold Jim's elbow.

**Restaurants:** Eating lunch or dinner at a restaurant is not as much fun for Rosann. Jim, or her girlfriend, needs to tell Rosann who is approaching, who is bartending or who is sitting at the next table; it's a little embarrassing although Rosann never complained.

**Reading:** Newspapers and magazines are more difficult to read. Rosann hasn't been able to read books since the operation because of her loss of cognitive functions, but now it was worse.

**Exercising:** Walking the "trail" is still doable because the path is smooth and familiar. It's difficult to walk on sidewalks because of the uneven surface caused by tree roots.

**Household:** Rosann has not done much cooking or cleaning because of her general weakness and dizziness. She cannot reach down for pots and pans, for example. She helped Jim cook by reading recipes and proving insights. It's even more difficult now.

They have looked at the services provided by Tampa Lighthouse for the Blind, and purchased a few products including a talking watch and large clocks. Next year, after Chemotherapy is complete, Rosann intends to become more active and join one of their classes. If nothing else, she wants to see how other people cope with a complete or partial loss of eyesight. It's not easy.

### Chapter Nineteen

### Taking Inventory as of 12/31/2011

This is the year-end email that Rosann and Jim sent to friends and family. Jim does the typing, but Rosann edits to make sure it reflects her views.

********

Friends and Family!

2011 was not a good year for me, but I'm still here – and Fighting Back with your help and prayers. Let's hope our efforts are rewarded in 2012.

The three ghosts of Christmas have compiled their year-end report:

' _Today'_ _\- I'm weak and need help getting around the house. I cannot do much on the computer because of my eyesight and get headaches if I try to read too much. I'm a mess, but at least my general health and spirits are good. I just wish I could see better._

There are only two more Chemo treatments scheduled. Dr. 'Peter' Park will get a body-PET scan and decide what's needed. The latest CT scan taken in 11/28/11 was clean – my lung cancer is gone. We are hoping to take 4-5 months off from chemo and regain some strength.

Dr. John Koval, my new Radiation Oncologist, has scheduled a head-MRI in February just to make sure the tumor in the brain is stable. The post-CyberKnife MRI taken 11/7/11 was good. The 'activity' around the area where the 3/5/11 craniotomy was done is okay, but something they will need to monitor. They are now saying the tumor on the left side might not even be a tumor; either way, it is

My eyesight is not good. The CyberKnife surgery in September destroyed most of the eyesight I had remaining. What I do see is blurred; like looking at the world through a dirty window. This is the most difficult obstacle in dealing with what has happened to me in 2011.

' _Tomorrow'_ _\- A European river boat cruise in June or July is still at the top of our bucket-list. I need to get stronger. I also would like to take classes at the 'Lighthouse for the Blind'. The classes are 5 hours per day, 5 days a week. That's without a nap. I need to get stronger._

Jim and I are finishing a follow-up book to "Fighting Back" published in May, 2011. I hope it has a happy ending.

' _Yesterday'_ _\- Here are the highlights, good and bad._

  1. _3/05/11 - Emergency craniotomy in St. Louis to remove bleeding tumor in right occipital area of brain. Saved my life, but destroyed 80% of my eyesight and some cognitive functions such as short term memory. There was little warning; I had golfed four days earlier and attended my 50_ th _high school reunion the previous evening. Thank you Stanly Martin M.D. (neurosurgeon) for saving my life. The diagnosis was adenocarcinoma of the lung – Stage 4. The prognosis was 2-4 months._

  2. 3/16/11 – arrived back in Tampa with Dave to begin recovery. Thank you to the doctors, nurses and rehab professionals at SSM Rehabilitation Hospital in St. Charles, MO.

  3. Radiation Oncologist, Janelle Park, M.D. – 15 full head radiation treatments eliminated two of the three tumors in the brain. 33 directed IMRT lung radiation treatments, together with Chemotherapy, wiped out the lung tumor. Thank you Dr. J. Park.

  4. Medical Oncologist Dr. Yon 'Peter' Park, M.D. – 21 chemo treatments and an effervescent disposition was vital in wiping out the lung tumor and preventing the spread of cancer cells to other organs. Thank you Dr. Park and nurse-practitioner Bonnie Karr, ARNP.

  5. LifePath Hospice, especially 'Nurse Becca'. Thank you for all you have done for me. Sorry if I haven't complied with your timetable.

  6. Boos and Hisses to;

* Dr. Daniel Heinig, my Humana Primary Care Physician, who in our initial meeting told me I was going to die, there are no other options. We have switched to a new PCP who will help me live, not prepare me to die.

* Dr. Pedro Mendes, Medical Oncologist, who refused to even discuss options for treatment.

*Dr. Janelle Park, CyberKnife Medical Director for Brandon Regional Hospital. You misled me, took my vision and left the tumors intact, yet you claim the CyberKnife treatments were successful. Did you have fun on your vacation while Dr. Holasek was revising the original CyberKnife Plan without your input?

*Dr. Maureen Holasek, the person that redesigned the CyberKnife "Plan" that was used, who didn't know that the occipital areas of the brain are vital to vision. Do you know now?

I am lucky to be alive and so thankful for friends and family like you. Keep up the prayers.

I Love You,

Rosann

Phase Three

### Living Day-to-Day

### 2012

### Chapter 20

### Doctors, tests and procedures

### Winding Down

Dr. Peter Park - Medical Oncologist

The New Year began and Chemotherapy continued, at least that was the Plan. Dr. Park wanted to do two more Chemo sessions to complete the Plan, take an MRI, and go from there. Things don't always go according to the plan. Rosann's white blood cell (WBC) continued to be too low for Chemo and Rosann was reluctant to go through the pain of more Neupogen shots. Jim sent the following Email to Dr. Park;

*******

1/6/2012

Dr. Park;

Happy New Year,

Please consider suspending future chemotherapy until after the PET Scan and head-MRI scheduled (by Dr. Koval) for February. We hope that the results are good and can suspend chemo until July or August. We really want to go on a river boat cruise in June or July. This is at the top of our bucket list.

Today, Rosann is very weak and our 'walks' that she enjoyed so much are few and far between. Without eyesight, she needs something to look forward to. She needs to regain her strength. We are hoping that stopping chemo treatments will help more than hurt.

We have very good friends from Wisconsin visiting us in late January (1/24 – 2/1). We would like to be able to do a few simple things with them such as go out to dinner or have them over to our house. They have already decided to stay in a hotel because of Rosann' condition. I'm afraid that two more chemo sessions would set her back and delay her recovery.

Rosann and I respect your judgment and will do what you recommend – she doesn't want to give up. She will do more chemo if you believe it's necessary.

I'm thinking the CT Scan was good and that the PET scan will also be good. I'm more concerned about why Dr. Koval ordered a new MRI so quickly. She just had an MRI 11/7.

We look forward to seeing you Tuesday.

Respectfully,

Jim and Rosann

******

They met with Dr. Park on January on January 10th and mutually decided to indefinitely suspend Chemo treatments.

Dr. Park: _"Rosann's in no pain, but not getting any stronger. I agree it might be time to step back and live your lives."_

**Final PET scan:** Dr. Park gave Rosann and Jim warm hugs, and repeated his mantra; keep moving, keep eating and keep praying. He scheduled a PET scan for February 25th and on February 28th Dr. Park told them the results. The PET scan was clean. There is no sign that the cancer has spread to any other organs.

"That's great news," Jim said. "What a great Birthday present for me."

"It's your Birthday," Dr. Park exclaimed, "mine too".

Rosann saw Dr. Park several more times, the last visit on October 23, 2011 at their new offices, and the WBC counts gradually improved. Every visit includes a warm hug, huge smile and a repeat of Dr. Park's philosophy; keep moving, keep eating and keep praying.

**Dr. John Koval, Tampa Bay Radiation Oncology;** Medical oncologists (Dr. Peter Park) work on the body from the neck down. Chemotherapy has little effect upon cancer cells above the neck because most drugs used in chemotherapy do not cross the blood-brain barrier, the protective membrane that acts a filter between substances in the circulating blood and the brain. Radiation oncologists treat cancers above the neck.

Rosann's oncologist had been Dr. Janelle Park, but she was now persona non-grata since the CyberKnife. Rosann needed to establish a relationship with another Radiation Oncologist to get a second opinion on the before and after Cyberknife MRIs. They wanted access to further treatment, if needed. Dr. John Koval became their new radiation oncologist. He also does Cyberknife surgery.

**Final MRI -** Dr. Koval and the team of doctors he works with saw little, if any, difference in the MRI taken after the Cyberknife surgery. They also agreed the tumor in the left side of the brain was non-threatening and might not even be a tumor. He scheduled another MRI for February 29th and gave Rosann the results on February 27th.

**Dr. Koval:** _"There is no change since the previous MRIs. That's good news. There is nothing more to do other than keep an eye on things and get another MRI in a few months."_

Dr. Koval also confirmed that the October MRI done after the CyberKnife surgery was almost identical to the MRI done before the surgery. Rosann is too weak to undergo further Cyberknife treatments so that unless things change, there are no further plans to see Dr. Koval or schedule another MRI.

**Dr. Pritesh Patel, Humana Primary Care Physician (PCP):** Dr. Patel has been Jim's PCP for several years and Rosann's PCP since January 1, 2012. Dr. Patel replaced Dr. Heinig ("you have no chance - you are going to die"). Since Rosann is enrolled in LifePath Hospice, the Humana PCP is responsible only for matters that are not cancer-related. For example, Hospice said Rosann's desire for sleeping pills was not related to the cancer so Dr. Patel proscribed a sleeping pill paid for by Humana Gold.

Hospice also claimed that Rosann falling and breaking her hip was not related to the cancer, even though her weakened condition obviously led to the accident. Dr. Patel's office did an excellent job coordinating Rosann's treatment at St. Joseph's Hospital - North and post-discharge rehabilitation.

Rosann has visited Dr. Patel's office twice and was very impressed. She no longer is strong enough to make office visits so future issues will be handled by phone.

**LifePath Hospice - Blue Team:** The face of the Hospice team is the nurse assigned to the patient; for Rosann this is been Rebecca since Rosann joined Hospice in May, 2011. Other nurses fill in when the nurse is off, but Becca has been the constant for Rosann. Unfortunately, Becca has been on sick leave since early December. Other nurses have filled in admirably, but it's hard to break in a new pair of shoes.

Hospice also has nurse's aides that will give Rosann a bath, change her clothes and provide other services. So far we have not needed this help, but the time will probably come. Dr. Walker has also seen Rosann several times as has Jennifer, the team leader.

Hospice prescribes and home-delivers from their pharmacy most of the pills that Rosann takes, which as of 12/31/12, are;

* Tylenol - Pain

* Naproxen - Pain

* Senna - Laxative

* Oxybutynin - bladder control

* Omeprazole - acid reducer

Several other prescriptions are available on as-needed basis; Hydrocodon (Vicodin), Ondansetron (nausea) and Temazepam (sleep). Recently Rosann began taking Vicodin rather than Tylenol for arthritis-like pain in her hands and knees. The arthritis pain is new.

The hospice team displayed their worth on Thursday, December 13, when Rosann suddenly became almost totally responsive. Jim called his son, Dr. Mike Plautz, that evening and described the symptoms, and Mike immediately suspected dehydration. "She needs to get fluids into her as soon as possible, and maybe she will snap out of it. It's worth a try," he said.

Jim immediately began exhorting Rosann to sip water from a bottle, 1/2 ounce at a time, and managed to get 16 ounces into her by the next afternoon. He called Hospice the next morning and they confirmed Dr. Plautz's viewpoint - it was a worth a try. Early Friday evening Hospice began an I-V and around the clock care to monitor Rosann's condition. Saturday morning the I-V (33 ounces) was empty. Jim woke and leaned over and said 'good morning Rosann', and was amazed when Rosann opened her eyes and replied good morning. These were the first words she had spoken in days.

Jim: _"Tears of joy came to my eyes. It felt like a minor miracle. I thought I had lost her. I'm thankful that Hospice was here to help."_

**St. Josephs Hospital - North (Hip surgery):** July 1, 2012 was a turning point for Rosann's recovery, but not a huge one. About 9:30 AM, Rosann tried to walk from the bedroom to the kitchen table and cut through the living room. Jim suspects she tried to use the swivel recliner for support. It turned and she lost her balance. Doctors theorized the hip "fractured" from the twisting of her thigh in the hip joint, not from hitting the hardwood floor. Rosann was already weak and getting weaker. Jim believes that is why she fell.

Rosann: _"I really don't remember much except lying on the floor and being in a great deal of pain."_

Jim: _"I was in my office and heard a crash and then saw the cats running scared. I knew something bad had happened. Rosann was on the floor in pain, but we weren't sure how bad it was. After five or ten minutes we tried to get her up, but it hurt bad. I managed to lift her to a chair and eventually a wheelchair. I knew we had to see a doctor, but which one? I started making telephone calls to determine where to take her."_

Hospice didn't want anything to do with it. They said it wasn't cancer-related. Rosann's Humana PCP hadn't returned Jim's call by 1:00 PM so Jim managed to get Rosann into the car and drove to a walk-in-clinic because that's what Humana insurance specifies. Going to go to a Hospital Emergency Room is too expensive.

The walk-in clinic techs took x-rays and the doctor verified that the hip was fractured. They couldn't do anything except send Rosann to St. Josephs - North Hospital with a referral and the x-rays. The doctor helped load Rosann back into the car. Rosann was tolerating the moves pretty well.

It was after 5:00 PM when Rosann was admitted to St. Joe's emergency room and after six before they had taken new x-rays and determined that, yes, Rosann had a fractured hip. That's okay, Obama will pay for it.

It was 7 PM when Rosann was admitted to a private room; they are all nice, private rooms at St. Joes. Dr. Chang operated the next day and inserted three screws to help the healing. The prognosis was good. Rosann spent five days at St. Joes; the food was excellent, the nurses and doctors were great and the in-hospital rehab was painful. She was sent home (by ambulance) on Friday, July 6th, to continue her recovery.

Jim _: Kudos to St. Joes. It was a good experience for Rosann. Rehab was a challenge because of her lack of strength. The rehab team wanted to do more walking and exercising but Rosann was too weak. The rehab therapist recommended Rosann go to a rehab facility but we said no thank you. Psychologically, it was very important for Rosann to get home. I had to sign a waiver before they would discharge her."_

Rosann: _"I wanted to go home so badly. Jim can help me do the exercises."_

Fortunately, Jim got some help. Humana approved an 8-session home rehab plan and later approved a 2nd round. Rosann liked her therapist and was diligent about working on the exercises with Jim between sessions. Her mobility got back to roughly where it had been before the accident. She experienced some pain, but it was tolerable.

Rosann: _"It still hurts, particularly if someone presses on my leg. I can walk okay (with Jim's help)."_

Jim: "Rosann did a good job with her rehab exercises. In some ways, she came out of this ordeal a little stronger."

Complicating everything is Rosann's lack of strength and the upper left arm injury she suffered in March. She has gradually lost additional strength in her left shoulder causing that arm to be almost useless. They're not sure how it happened.

Rosann: _"I think it was when I tried to do arm exercises in bed using my 2 lb weights. I was flailing around and might have hurt my shoulder. Sometimes the pain is in my shoulder and other times the pain is in my arm. The doctors say it's most likely arthritis."_

Jim: _"I used to help her up from chairs by holding her hands and pulling her up. I might have yanked too hard, who knows? Now I reach behind her back with one arm and lift. One day she was fine and the next day it hurt. I'm not sure about the arthritis diagnosis by our PCP."_

Regardless, the lack of arm strength makes it difficult for Rosann to use a 'walker'. Rosann walks by holding on to Jim's elbow. Jim uses his free hand to hold her up by grabbing Rosann's pant's waist in back. It works and is easier than using a 'belt'..

By the end of 2012 Rosann's assisted-walking is almost entirely from the bed to the living room. The days of walking the bike trails are only a good memory.

Fractured Hip Rehab - "Dave" and Rosann, July, 2012

### Chapter 21

### I Can See

Rosann never stopped hoping for the miracle. Her eyesight had not changed since the Cyberknife surgery in September; no better, no worse. She could watch some TV with Jim's help and with the 50" TV pulled to within ten feet. She could get around the house and not bump into the doorway or furniture. But she couldn't read the paper, help Jim cook, sort the laundry or do the little things that would have made her life more enjoyable.

Rosann: _"I just felt so helpless and dependent upon Jim for almost everything. This isn't how getting old was supposed to be. I decided to ask Jim to make a follow-up appointment with Dr. Arey."_

Jim: _"I was surprised at her request. Dr. Arey had offered no hope when we saw him in late March, 2011. Dr. Arey was nice, but told us that there was nothing that they could do. We talked about low vision aids and he suggested talking with the Tampa Lighthouse for the Blind. He offered no hope. In retrospect, I think he saw how weak Rosann was and concluded she wouldn't live much longer."_

Jim called and set up an appointment at the Florida Eye Center for April 11, 2012, @ 1:50 PM. They arrived on time and Jim procured a wheelchair for Rosann, remembering the long afternoon that Rosann had endured a year ago. To their surprise Rosann's name was called ten minutes later and a nurse wheeled her into an examination cubicle. Jim followed close behind and watched as they tested the right eye and then the left eye.

Jim bolted to attention when the nurse commented offhand to Rosann; "That's quite a large cataract that you have there."

"Are you referring to the cataract surgery on her right eye that she had done 10 years ago," Jim asked?

"No, once you have cataract surgery the cataracts don't come back. Your wife has a large cataract in her left eye. I measure it to be a size four on a five point scale. Let's see what the doctor says."

Jim and Rosann waited in a second waiting room to see Dr, Leonard Cortelli, one of the four doctors at the Florida Eye Center and Dr, Mark Arey's partner. They were excited.

Jim: _"I wouldn't let myself believe it could be this easy. Dr. Arey had never mentioned a cataract. Rosann appeared pretty calm although that was her emotions were generally muted since the craniotomy. We didn't talk about it; we just waited."_

Rosann: _"I knew, but I wasn't going to get excited until we saw the doctor. I've been disappointed too many times in the last year."_

Thirty minutes later Dr. Cortelli confirmed the nurses' findings. "The cataract is definitely a big one. Getting rid of it should result in close to perfect vision with the right prescription. You can make up an appointment for surgery at the front desk."

There weren't any tears, but there were hugs and kisses. Jim made the appointment and the operation was performed on May 1, 2012. The operation went well and Rosann the outpatient clinic with an eye patch.

The following morning Dr. Cortelli removed the patch. There were tears in Rosann's eyes when she saw the colors on the nurse's smock. Jim says May 2, 2012 is one of the happiest days of his life.. Later, Jim wrote the following emails to family and friends.

******

Hi Kids; 5/2/2012

This morning they took the patch off Rosann' left eye and I waited for her reaction. "I can see so much better; it's not perfect, but I'm not complaining," she said. "I can see colors again."

The Dr. measured it at 20-70 and said it might improve a little in next 2-3 weeks. We are ecstatic. It's more than we hoped for and much more than we feared.

She said she can see my face again, but didn't answer when I asked her if I am as handsome as I told her I was. Maybe she suffered a loss of hearing?

We are soooo happy!

****

Thanks Bill and Kate & Kids; 5/3/2012

We just went for a short walk (2/3 in the wheelchair because she is weak). We fed the fish from the 8' high bridge and she was able to see the fish eating, ducks and turtles. It's been 8 months since she saw that much.

Dad

****

Hi Sandy; 5/20/12

The cataract surgery went great and the results are MUCH better than anyone expected. Rosann's optometrist (Jennifer Buzzett, O.D.) whom she has known for 20 years) said "it's a miracle" after she tested Rosann Friday; she was actually crying.

Rosann should get the prescription glasses Wednesday. I'm hoping this will give Rosann a reason to renew her fighting spirit.

P.S. - we had to wait a couple weeks after the surgery before we filled the prescription. We got it filled by Buzzett rather that Cortelli because she has been friends with Rosann for so long.

****

Rosann: _"It meant so much to me that Dr. Buzzett was so happy for me. These last few weeks have been so unbelievable - I can't tell you how good it feels. It really hit me when Dr. Buzzett examined me and kept clicking down to see if I could read the next line. I read the 20-40 line easily and she said; "you can drive a car again". You don't know how good I felt."_

Jim: _"Before the Cyberknife surgery and loss of vision, Rosann would ask me if I ever thought she would drive (a car) again. She hated not having the flexibility to drive to the store, go shopping, whatever. It was symbolic._

 _We had sold Rosann's_ _1997 BMW Z3 (29,956 miles) a few months ago because it was clear she would not be able to get into and out of a sports car, or drive a stick-shift. That hurt her. Dr. Buzzett's comment about being able to drive again was huge to Rosann's self esteem; huge!"_

Two weeks later Jim surprised Rosann by driving her to Lake Park just north of their home. It's a large County park with hiking an horseback trails, archery range, picnic areas, fishing; well, you get the picture. It was large enough that on a weekday morning, they could find a private area where Rosann drove their Honda Accord.

Rosann _: "I was so afraid at first, but gradually it all came back. I panicked when a car approached and pulled over and stopped. I tried it again but stopped when I saw a jogger heading our way. Despite all this, I felt so good when I got home."_

Jim: _"She did very well, but certainly wasn't ready to drive in traffic. I doubted if she ever will be. Our goal was to make her feel good about herself, and we did that."_

There were 4 or 5 more lessons, the final two being on lightly traveled roads. Rosann was improving, but the experiment abruptly ended on July 1st when she fell and broke her hip. What a ride she had while it lasted.

Rosann's eyesight remains good. She thanks God every day for allowing her to see again. It's tough enough to go through what she has gone through, but what would it be like if she were still blind? Rosann is thankful for the gifts she was given and does not dwell on the negatives.

### Chapter 22

### Living Day by Day

Rosann regained her eyesight, but regaining her strength was another matter. The fractured hip still bothered her occasionally but that wasn't the main problem. Her body never recovered from the surgery performed March 5, 2011. The subsequent radiation and Chemo treatments irradiated the tumors in her lung and brain, but her body paid the price. Rosann and Jim developed a daily routine that might not sound exciting, but they were happy.

**Breakfast** was Rosann's high protein meal. It started with a mug of coffee and cantaloupe, or another seasonal fruit. Rosann gradually reacquired her taste for coffee which she lost after the surgery. Usually a half-cup was just fine. She could sip coffee and nibble at the cantaloupe while Jim prepared the main course of crisp bacon, cottage cheese and a Thomas' Nook and Crannies with lots of butter. This was her favorite breakfast. Jim would occasionally prepare an omelet or poached eggs, but they always returned to the basics; bacon-cottage cheese and an English muffin.

Rosann: _"I know it was a lot of trouble for Jim to fry the bacon and stuff, but this is what I enjoyed. I don't like oatmeal or cereal."_

Jim: _"I didn't mind. It was a high protein breakfast which helped elevate her white blood cell counts. It got to where I could almost do it in my sleep. I usually ate a packed of sweetened oatmeal which I micro waved while the bacon was sizzling."_

The location of the breakfast table changed after the hip surgery. Rosann liked to sit at the pub table in the kitchen area. There were two, comfortable, swivel barstools that provided a view of the pool area. This is where Rosann was heading to when she fell on July 1st. After the fall, and as Rosann gradually lost strength, it became too difficult to sit upright on the barstool. Instead, Jim would help Rosann to her living room recliner and serve her breakfast in a half-reclining position with the food on her lap. It's a pretty good perk if you can find someone to serve you. Jim didn't mind.

Rosann liked to listen to one of the music channels which play continuous music from a particular era or genre and provide information about the artist and albums. They both prefer 80's music with a little classic rock thrown in for variety. The Dire Straits' Brothers in Arms album was her favorite. This passed the time for Rosann while Jim cooked breakfast.

The daily regimen of radiation and Chemo appointments had ceased and the days were wide open. Three to four times a week they would go for walks, as described in an earlier chapter. It was a comforting ritual and brought the couple closer together. Rosann held Jim's elbow for support and comfort. When Rosann tired and wanted to ride, Jim walked next to the wheelchair and pushed with one hand rather than push from behind. This way they could more easily talk and share the vistas.

Penultimate Walk - November, 13, 2012

They usually returned home by 10 AM and killed a few couple hours on the computer, talking on the phone or watching TV. The schedule changed as Rosann's eyesight fluctuated. She never did get back to being the 'computer queen' she had been before the 2011 surgery and she basically stopped checking emails or browsing the internet after the CyberKnife surgery. The same goes for reading books or magazines. It was a combination of poor eyesight and diminished reasoning capabilities caused by the surgery. It wasn't a question of intelligence, because Rosann maintained her sharpness, it was more a lessoning of the ability to concentrate.

Rosann was still the queen of crossword puzzles. She could no longer do Sudoku, but her memory was excellent. They would do a couple puzzles every day, one in the morning and one or two at bedtime. Jim would read the clues aloud and Rosann would spout the answers if she could. If not, Jim would go to another question and try to find clues. Once in a while he might even know the answer.

Rosann _: "It was more fun doing the puzzles together and having Jim read the clues. At night I would just close my eyes and wait for the clues."_

Jim: _"It's a lot easier when you can see the whole puzzle. I was truly amazed at how well she did. Her abilities lessoned somewhat as the year progressed, but not much."_

**Lunch** was a regular event at the beginning of the year. Soup and sandwiches with a few Pringles for a snack was a typical bill of fare. By year-end Rosann was getting up later, eating breakfast at 10 AM and lying down for a nap by 1:00 PM. Lunch became a bottle of Ensure or nothing at all.

Once a week they would go out for lunch or Rosann would ditch Jim and go to lunch with girlfriends. It was something to look forward to and a small reason to keep fighting. One of the last places they went was the new O'Brien's' Irish Pub. They had both been regulars at the previous location and kept going there after they met. Bernie O'Brien happened to stop in at lunch and joined them at their table. It was nice to reminisce. They lunched at Applebee's in early December and had a nice time. This might have been their final trip.

Rosann _: "It's nice, but I'm getting too weak to get out of the wheel chair. I feel more comfortable at home."_

Afternoons are usually dominated by a nap. The length of the naps has increased to 4-5 hours, but nobody was complaining. That's what her body needed.

**Dinner** was more fun when Rosann helped plan the meals and assisted Jim when she could. Jim would put out the ingredients and Rosann would make the salads. She wasn't able to bend over to reach the pets and pans - that was Jim's job. Early in the year she did her share and helped Jim learn the difference between an Idaho potato and a sweet potato. As the year progressed, Jim was more on his own. Rosann was still available to answer questions and provide guidance.

Jim: _"I was amazed at how difficult it is to get a three course dinner together so that everything is ready at the same time and I could sit down with Rosann for dinner. I remember my mother saying; 'start without me'. Now I understand."_

Rosann: _"Jim does a fantastic job. He is really is a pretty good cook. I miss not being able to help, I really do."_

Dinners were served in the living room, in front of the TV, other than on special occasions such as holidays. It was easier for Rosann to hold the food on her lap and later in the year, it was easier for Jim to help her with her eat.

**Evenings** usually involved watching a couple TV shows, maybe a phone call or two, and going to bed early. Favorite shows included the Mentalist, White Collar, Grimm, NCIS, Criminal Minds, NCIS LA, Hawaii Five-O, and a few quiz shows. Neither liked Reality shows. Rosann was still pretty good at jeopardy although they hated the host. Rosann's favorite movie in 2012 was Hachi, an Akita dog that bonded with a college professor (Richard Gere), and kept returning to the train station to meet the professor, years after his death. It's a true story. They cried every time they watched it and will again the next time they watch it.

Rosann usually was in bed by 9 PM. Jim would join her and they do a crossword puzzle together, turn off the lights. Rosann fell asleep quickly and Jim would get up for awhile to clean the dishes and maybe watch another hour of TV. Jim got up early 3-4 times a week and went to the YMCA to exercise. He would try to get back before Rosann awakened. As the year progressed, Jim's schedule shifted accordingly. He no longer had to get up at 5:00 AM.

These were simple days, spiced up by occasional visits from family and friends, IPad FaceTime phone conversations with the grandchildren, telephone calls and laughter, lots of laughter.

Lillian Stickel and Ro having Lunch

They still talked about a bucket list trip to Europe, each of them knowing that it wasn't likely to happen, unless there is a major miracle. They still held out hope. It was a simple life, but it wasn't bad. It was better, by far, that the alternative. Rosann and Jim were happy. They had each other.

### Chapter 23

### 2012 Holidays - Something Special

Rosann: _"_ Each and every holiday was special. I am lucky to be alive."

Feb. 14th - Valentine's Day

Last year's card has been hanging in their kitchen for more than a year. Rosann didn't want Jim to take it down.

Jim: _"It hangs right next to the pub table where we had breakfast in the morning, right next to the Birthday Card. Why take it down? I gave her a nice card this year and took her to Bonefish for dinner. We had a nice 'sweethearts' day - better than most people I believe."_

Rosann: _"I like it when Jim makes me cards on the computer. I guess I need more assurance since my illness. I tell Jim that he can't say 'I love you' too often."_

February 28th - Jim's Birthday

Rosann cannot go shopping by herself, so she asked Jim to drive her to CVS Pharmacy and look for birthday cards. It took awhile, but she found the perfect card;

Rosann _: "I wrote some notes in the margins and underlined a few key words for emphasis, just like Jim does when he gives me cards. It felt good to find a card by myself even though Jim had to drive me."_

Birthday Bike

 Rosann: _"Somebody stole Jim's bike out of the garage the day after X-Mas. I wanted to get him a new one so he could continue to ride our 'trail' and count the animals he sees. It makes me feel good when he comes back and tells me what he saw. I so miss our rides together."_

Apr 8th - Easter

2012 Easter' Love

Each plastic egg had an "I love you cuz" note stuffed inside; cuz you are nice; cuz you are a good cook; cuz you make me happy; cuz you are a great.... You get the picture.

  Bob and Sandy Schaefer, friends of Madison Wisconsin, were touring Florida and stopped to visit.

Rosann: _"We sat outside by the pool and talked. It was a nice day."_

Jim: _"Sandy is a nurse specializing in care for the elderly. She had some good insights and suggestions for medication. Rosann was good for about two hours and then needed to rest. She enjoys the visits, but tires quickly."_

Sandy: _"I thought Rosann was a little depressed and suggested she try some anti-depressant meds. Maybe she was just tired?"_

October 19, 2010 - Maddie's Birthday

Kelly and Maddie came to visit the weekend before Maddie's 2nd birthday. This was the first of several birthday parties that Maddie hosted. Rosann thoroughly enjoyed the 4-day visit.

Rosann: _"All that energy. I remember those days."_

October 31 - Halloween

Halloween is Jim's mothers' birthday. Marion would have been 95. They all out with decorations this year and donned the Halloween Shirts that Rosann had purchased five years early. This year Jim took the lead in greeting the 46 kids that came trick or treating. Rosann stayed in the background and watched and listened from the recliner. The neighbors brought their one-year old inside to visit with Rosann.

Rosann _: "Everyone said our decorations were great. I enjoyed listening to Jim. He is real good with the kids. I had fun."_

Jim _: "Rosann was far better at greeting the kids. She would make each little kid think their costume was the best, except that 15 year old that mooned her a couple years ago. She was just too weak this year to take the lead. I'm so glad we decorated and handed out the candy. It was therapeutic for both of us."_

November 22 - Thanksgiving

This was a repeat of last year's glutinous feast although last year's turkey was only 20 pounds. Rosann was in the kitchen last year planning the menu and reading the recipes. This year she relied on Jim's memory.

Jim: _"I still had the recipe we used last year. This year Rosann was in the living room but I kept her involved. We had fun again. We had a lot to be thankful for."_

Rosann: _"We had so much fun last year that we decided to do it again. I'm so proud of Jim. This year I wasn't much help."_

Thanksgiving Dinner - leftovers for sure (22 lbs)

November 27th - 14th Anniversary

Fourteen years ago they got married on Friday, the day after Thanksgiving. Jim can remember that. Rosann insists that their anniversary was the 27th. Once every four or five years they agree.

Rosann's favorite dinner is lobster.

Jim also gave Rosann a special card, listing many of the trips they had taken together in the 16 years they had known each other.

* New Orleans

* Costa Rica

* San Francisco & Napa/Sonoma wine country

* Rome to Istanbul

* Barcelona to Venice

* Madrid to San Sebastian (Basque country)

* Hawaii

* Scottsdale, Arizona golf

* New York U.S. Open & Broadway Shows

* Etc. etc. etc.

Rosann: _"I never dreamed I would see so much of the world. I am so lucky."_

Jim: _"We had fun remembering the various trips and some of the not-so-fun events; like when Rosann almost drowned when we were white water rafting in Costa Rica, hit in the face by the Kayak during the rescue and then was berated by our guides for losing her paddle. I, of course, was only concerned for her safety (and the camera she misplaced while she was catapulted into the Class 5 rapids)."_

December 9th - Rosann's Birthday

Did I say that Rosann's favorite dinner is lobster (and steak)? Dave stopped over with a card, hug and lots of love and that she liked home-made cards?

Talking with Mom

Another Computer Card from Jim

Jim "gave" Rosann this song (Rosann gave Jim "Simply the Best")

December 25 - Christmas

They decorated like it was

Rosann's last Christmas, the same as they did in 2011. This year Jim went all out with the decorations and baking cookies.

Jim: " _We watched Christmas movies together, every night. The Hallmark channel movies are our favorites." Christmas Eve we watched It's a Wonderful Life, just like we did last year nd the year before."_

Rosann _: "The movies are easy for me to follow. I like it that Jim isn't afraid to cry during the sad movies. I had a great Christmas"_

Rosann decorating the tree & Rosann with Dave & Karen

Hats from Dave & Karen wearing Jim's Northside sweater

It's a Wonderful Life (with fireplace on the left)

Harry Bailey sledding down a hill into the frozen pond & George rescuing his brother, but losing hearing in his left ear.

### Chapter 24

### Year-End Status report

2012 was a roller coaster. There were ups and downs. Following is an email that Rosann and Jim sent to friends and family. There wasn't the same optimism as there was a year ago, but Rosann was not complaining. She felt lucky to be alive.

*******

Friends and Family!

I feel blessed. It's been 21 months since Doctors gave me 2-4 months to live, so Jim and I are thankful for what we have. 2012 was tough, but I'm still here, and Fighting Back with your help and prayers. Let's hope our efforts are rewarded.

The three ghosts of Christmas have compiled their year-end report (Jim typed, but these are Rosann's words and sentiments).

1. 'Today'

I'm doing pretty good. I'm weak and can't get around without Jim's help, but at least I can see. Jim and I do crossword puzzles and watch TV. We enjoy talking with family and friends and doing face-time with the grandkids. We have fun. I went for a walk Xmas day 'in my chariot', but we don't do that very much anymore. Getting into and out of the car is tough. I sleep a lot.

We are done with Chemo and Radiation so at least I don't have that to worry about. My body couldn't take the blood tests, CT Scans, MRIs, etc.

I'm in a little pain, but not too bad. Dr. "House" gives me a couple of his Vicodin every day to ease the pain.

Jim tells me that he loves me more now than ever and I believe him. He makes my days enjoyable. I love him so much.

We take things as they come, day-by-day. What else can we do?

2. 'Tomorrow'

I hope and pray that I get stronger. A European river boat cruise is still at the top of our bucket-list, but probably unrealistic. I'd settle for being able to get out of bed and walk to the living room.

Jim is finishing a follow-up book to "Fighting Back" that was published in May, 2011. It will have a happy ending.

I'm looking forward to enjoying my life with Jim.

3. 'Yesterday' Here are the highlights, good and bad.

a) February, 2012 – The head-MRI and the PET scan (body) came back clean; the tumors are gone and the cancer has not spread. The small tumor that the Cyberknife surgery did not get is non-threatening, if it indeed ever was a tumor. These are the final 'scans'. I'm not in pain and my body is too weak to undergo further surgery, so what's the point of more tests? I've put myself in God's hands.

b) The last chemo treatment was in December, 2011. We were hoping that I would get stronger as the effects of the chemo wear off. We talked to a travel agent about European cruises in July. We're very disappointed when my strength doesn't come back and we need to postpone our trip. Doctors say that my body couldn't recover from the 20 chemo and 65 radiation treatments that I underwent. They don't know why.

c) I joined Lighthouse for the Blind, but was not strong enough to attend their all-day classes. I had hoped to meet other people that were blind and learn from them how to cope. I had 10% vision in my left eye and could see a little, but it was awfully tough. We prayed for a miracle, and got one.

d) April, 2012 – We made an appointment with the eye clinic I had gone to a year earlier where a Doctor had told me there was nothing that could be done. This time they told me I had a large cataract in my left eye that could be removed by surgery. Two weeks later I had 20-20 vision (corrected with glasses) in my left eye. This was truly a miracle. Three weeks later I drove a car (in a park, far away from people and danger) – what a thrill!

e) July 1, 2012 – I fell and fractured my hip trying to walk alone from my bedroom to the kitchen. I should have waited for Jim to help. I recovered nicely, but have never regained the strength to walk alone again. My physical therapist was quite a hunk so rehab wasn't too bad. I had been getting weaker before I fell so my inability to walk unaided is probably due to general lack of strength, not the hip injury.

f) The Holidays, from Halloween to Xmas, were great. We also celebrated our 14th anniversary in November and my 39th Birthday in December. Jim decorated, cooked great dinners and made every day special.

g) Jim – "We had a scare 12/13/12 when Rosann became dehydrated and was 99% non-responsive for two days. I-V fluids and sipping water from a bottle brought her back.

We had fun in 2012. I am lucky to be alive and so thankful for friends and family like you. Keep up the prayers.

Happy New Year!

I Love You,

### Rosann

### Phase Four

### Final Days

### 2013

Rosann's Women

### Chapter 25

### January, 2013

The New Year started as 2012 had ended. The daily routine was pretty much the same. Rosann slept 16-18 hours a day. Jim helped Rosann walk to the living room recliner about 9:30 AM and the day began. Walks on the hiking trail had ceased although there was still quality time; Jim prepared Rosann's favorite breakfast (fruit, bacon cottage cheese and a Nook & Crannies muffin) and tried to get her to drink a souped-up Ensure energy drink. Rosann listened to the 80's music channel while Jim worked in the kitchen.

After breakfast they read the newspaper headlines aloud, watched one or two of their regular TV shows, did a crossword puzzle and maybe returned a phone call to Rosann's mother, sister or friends. Rosann would start to get tired after a few hours and Jim would help her walk back to the bedroom for her afternoon nap. Three hours was about all her body could take before it needed rest. Jim would often join her for an hour, particularly if he had gone to the Y to work-out that morning. They cuddled and Rosann soon fell asleep.

Evenings were similar. Rosann would wake up around 6 PM and Jim would help her walk to the living room. Rosann would snack on peanuts and listen to the music channel while Jim prepared dinner. After dinner they would watch TV shows or a movie that Jim had saved on their FIOS DVR. Rosann would tire after one or two shows and ask to go to bed. More often than not she was too tired to walk, even with Jim's help, so she rode her chariot to the bathroom where she brushed her teeth and got ready for bed.

Rosann's strength dissipated rapidly. She started the month walking three of the four daily trips to/from the living room. This ratio slowly changed and by month-end Jim would help her into the wheelchair for each leg of the journey. Rosann no longer was strong enough to walk.

There were other changes. It was becoming more difficult to feed herself so Jim moved his recliner next to Rosann's so he could help. She found it more difficult to concentrate on TV shows. She was often confused.

Rosann: _"My body wouldn't let me walk anymore. It hurt so much and I was so afraid of falling. I didn't want to disappoint Jim, but I know he understands."_

Jim: _"The slow degradation of her mind and body was difficult to watch, but there was still enough of the 'old Rosann' to have some fun. She had not lost her sense of humor or quick wit. Most important, she had not lost her spirit and kindness to others, especially me. She remained a kind and loving person with a big heart."_

Painting was something that Rosann missed dearly and kept saying she wanted to get back into it. Last November she realized she wasn't strong enough to attend Wednesday's art class so Jim decided he would help Rosann paint at home.

They started by attempting to copy of one of Rosann's best paintings; "Chicks with Attitude". Rosann helped paint the Gesso undercoating and the background colors, but after that she assumed the role of consultant. Standing or sitting over the canvas for more than a few minutes was too taxing.

Chicks with Attitude

Rosann's Painting Jim's Version

Jim: _"I knew I wasn't an artist but I didn't realize how difficult it is until I tried to mix skin colors and paint faces. Rosann was really good. Take a close look at the differences between the two paintings. Rosann's art teacher summed it up best when she looked at my p_ ainting; 'those women are really ugly. _' They are ugly, but Rosann and I had a great time working on it. It kept her involved and was so happy I was doing what was so dear to her for so many years."_

Rosann: _"Jim did a wonderful job. I'm so proud of him. I love to watch him painting. It makes me feel involved."_

Jim painted another picture using a picture puzzle as a model for "Sharks Hunt Snorkeler" picture shown below. Rosann loved the bright colors."

"Sharks Hunt Snorkeler"

Jim: _Rosann was so complimentary and supportive, but that's the kind of person she was. She made me feel so good."_

Jim and Rosann sometimes talked about the future. There was no specific date or formal decision, but they gradually began to realize that they would not fulfill the top item on their Bucket List. Rosann was not strong enough to enjoy a long airplane flight or a European River Boat Cruise, not without a major miracle. They each held out a vestige of hope.

### Chapter 26

### February, 2013

Rosann's condition continued to decline with occasional spurts of energy that allowed Jim and Rosann to hope. The first two weeks she was eating, just not as much; one piece of bacon, cottage cheese and half an English muffin. Jim still tried to get her to drink a 7-ounce bottle of Ensure, but usually settled for 3 or 4 ounces. They continued to watch a little TV together and do crossword puzzles.

Rosann now slept close to 19-20 hours a day, but they were still living a pretty good life. They tried to laugh at least once a day. One evening Rosann decided she wanted to walk back to the bedroom and with Jim's help, she made it.

Jim: _"I couldn't believe it. She hadn't walked in two weeks and out of nowhere, she did it. I asked her what got into her, but she didn't know, or wouldn't say. She always was a tease."_

Rosann: _"I just wanted to show myself that I could do it."_

Conditions worsened a couple days before Valentine's Day. Rosann started experiencing even more pain in her joints and it became difficult for Jim to get her out of bed. Her appetite decreased and she became more confused.

**Valentine's Day"** \- Jim presented Rosann with an original oil painting, "Water Crashing onto a Sandy Beach". Rosann immediately said it reminded her of the beach in San Sebastian, Spain, called Donostia by the Basque. Five years earlier, in October, 2007, Jim had etched a heart on this beach, for Rosann. She remembered.

Jim: _"I wanted to give her something special - something from my heart. I was so happy when she said the painting reminder her of the beach in San Sebastian. I added the little white sign in the lower left corner later that day. The Basque have a special meaning to us and were featured in my 2nd novel, 'Double Fault @ Roland Garros'."_

San Sebastian - Donostia (Basque name)

Rosann's mother and sister flew up from St. Louis for a short visit on the 17th and 18th and got to see Rosann one last time. She was bedridden the first day but mustered enough strength to get to the living room Monday to make it easier to talk. She lasted a couple hours, but Rosann immediately went back to bed and slept until the next morning. Still, it was a visit and a nice way to say goodbye.

Rosann made it out of bed (to the living room) one last time two days later. She lasted only an hour before she became too tired to sit up. Jim helped her get in the wheelchair and back to bed. Her condition deteriorated quickly as she became more lethargic and non-responsive day by day.

By February 24th Jim began to wonder if she might be nearing the end. Her condition was not dissimilar to the catatonic state she was in mid-December when she became dehydrated and needed an I-V of fluids. She wasn't quite that bad, but getting closer each day. She drank water when she took her pills, but not enough water.

Jim decided to give it one more try and began exhorting Rosann to drink a pint of water each day, telling her it was for her own good.

Jim: _"I told her I wasn't giving up on her. You need to drink this if you are ever going to talk with me again and grant my Birthday wish"._

Rosann managed to swallow 16 ounces of water four consecutive days. Four days later on February 28th, Jim's 70th birthday, Rosann granted Jim his wish. She uttered; "Happy Birthday, Jim, I love you". That was all she said that day.

Jim: _"Wow. That's the best birthday present I have ever received because it was everything Rosann had to give."_

### Chapter 27

### March, 2013

### Actively Dying

Rosann's condition worsened. Rosann has been basically non-responsive since she spoke to Jim on his Birthday.

Jim: _She still wasn't eating. She did manage to respond 'I love you, too' a few times, but said little else. I had problems understanding her when she did try to talk, partially because of my poor hearing._

This is being written on Tuesday, March 5, 2013, the 2nd anniversary of when this Fight began. Two years ago Rosann was in an ambulance on her way to SSM Rehabilitation Hospital in St. Charles Mo. Ten hours later Dr. Stanley Martin, neurosurgeon, would be performing an emergency craniotomy to relieve the pressure on Rosann's brain. She was given three months to live. Twelve days later after she returned to Tampa and her PCP told her she is dying; there is no hope. Hospice intake nurses estimated 2 - 3 months.

Jim: _"Rosann, I am SO PROUD of you. We were the only ones that knew what a fighter you are and how strong you are, inside, where it counts. I love you so much."_

Rosann hasn't eaten much of anything in 10 days; a little fruit, a few ounces of Boost and one bite of the Jim Beam soaked tilapia Jim made for his birthday. That is the last piece of solid food she ate. Over the weekend she began having trouble swallowing and it became difficult to get enough water into her system.

Sue, the Hospice RN, gave Rosann liquid morphine because she could no longer swallow the Vicodin and Naproxen pain killers. Her joints ached. She was in pain. She was non-responsive.

Jim asked Sue and Cindy, the nurse's aide, how much longer...? They both thought that Rosann was actively dying (is that an oxymoron or conundrum, or both?). "It could happen today, tomorrow or the next day, but probably not any longer. It depends upon how strong she is."

Jim: _"Rosann and I talked after they left; or rather, I talked and she listened, and understood. We are ready."_

Dave (Rosann's son), Brenda Bruno and Kathi Hobbs visited Wednesday to say goodbye. I'm sure Rosann could hear them, but was non-responsive. Kathi followed up with a beautiful card.

" _So many wonderful memories.... The class misses you and your own, special 'class'. I miss your gentle spirit that always lifted everyone around you. I'm praying for you, especially at night. I can see your smiling face and feel the warmth of your smile. I will always love you, Ro.... Signed; Kathi and your Wed. Art Class."_

Rosann passed away in her sleep Thursday, March 7, 2013 @ 1:17 AM.

Jim: _"Rosann was sleeping hard and breathing through her mouth. At 12:34AM I wet her lips and tongue to keep them moist. I did this often and could tell she liked it. I dozed and woke up abruptly at 1:17 AM and heard nothing. I knew. I was happy for her."_

She is in a better place.

Thursday, March 7, 2013 - Jim's Long Day

Hospice arrived by 2:00 AM to make it official. Aaron handled the paperwork and disposal of Rosann's prescriptions. She also obtained permission from the medical examiner's office to ship Rosann's body to a funeral home which was necessitated by Rosann's fall and hip injury. Aaron then called a transport service that arrived about 4:45 AM.

During the four hour wait Jim had gone back and forth between the dining room where Aaron was working and the bedroom where Rosann appeared to be sleeping peacefully. She looked better than she had in two weeks; she looked peaceful. Jim and Rosann had several long conversations and said their final goodbyes. By 5:15 AM Jim was alone with his thoughts and decided to go to the Y for a workout. It was tough and he lasted only 30 minutes. He came home, showered and began making phone calls. The first call was to Rosann's son, Dave.

 Tom and Pat Oswald, good friends from Wisconsin, were scheduled to arrive about 1:00 PM to see Rosann. Instead, they ended up babysitting Jim.

Jim: _"We walked Rosann's biking trail, fed the fish and turtles, had a couple glasses of wine and went to the Outback for dinner. Ashley and Steve bought drinks and several more of Rosann's friends paid their respects. Tom and Pat drove me home and came in for a minute before driving to Orlando. I was happy not to walk into an empty home alone that night."_

Thanks Tom and Pat for helping Jim through the first day.

It will get easier.

### Chapter 28

### Happy Ending

Rosann requested a happy ending, and without warning, she got one. This 'chapter' is being written on Sunday, May 5, 2013, almost two months after Rosann passed away. No one saw this happy ending coming, especially Jim.

Jim: _The sequence of events leading to the Happy Ending started innocuously. I was trying to schedule a "memorial" for Rosann on Saturday March 30th, Easter Weekend. This was the only day when my three children, spouses and seven and 1/2 grandchildren, could all be there. I soon discovered it was almost impossible to reserve the day chapel or schedule a Mass on Holy Saturday. There was too much going on at Saint Timothy's Catholic Church. I decided to have an Open House at our home_ _."_

_Father John Lipscomb visited_ Rosann in January to offer the anointing of the sick sacrament, sometimes referred to as 'last rites'. He visited a second time at Jim's request a week before Rosann passing to offer final blessings.

_Ji_ m: _"I called Father Lipscomb a couple days after Rosann' passed to get his input regarding burial options including cremation, and options for reserving a chapel at the Church for a memorial service. I just wanted some input. I later decided on the March 3oth Open House. I next talked with Father Lipscomb Sunday, March 30th."_

Father Lipscomb was greeting parishioners as they left Church after the 7:30 AM Mass. Jim stopped to say hello and Father Lipscomb asked what Jim had decided to do. Jim related his decision and Father Lipscomb volunteered to kick things off at the open house with a few prayers.

I was flabbergasted. "That would be great," I said, "but do you have time. That's Holy Saturday."

"Oh sure," Father replied, "I'm free until 8 PM."

Well, Father Lipscomb did come to the open house and added a much-appreciated "touch of God" to the celebration. It was much appreciated by everyone. Even the seven grandchildren, ages 2 - 7 years, behaved.

Why is this important to Rosann's "Happy Ending"? Well, it was really the impact that it made upon Jim. Father John's extra effort opened Jim's mind to the next opportunity.

**Parish Mission - the Apostles of the Interior Life** offered a three-evening presentation to "exhort people in the ways of faith and to encourage perseverance especially in the midst of trail and distress." The three Sisters spoke and offered a short slide show at the end of all Sunday masses and were available to answer questions.

Jim stopped after mass to pick up a brochure and one of the Sisters asked if he had any questions. Jim mentioned that his wife, Rosann, had passed away six weeks earlier and the Sister replied, "you really owe it to her to attend these sessions and dedicate your prayers to Rosann. This, combined with reciting special prayers, confession and communion, will open the door to Rosann leaving purgatory and being invited into His Kingdom."

Jim attended the three sessions in good faith:

Monday - A Call to Holiness and Prayer

Tuesday - A Call to the Eucharist

Wednesday - A Call to Conversion

He confessed his sins to a Priest Wednesday evening, his first confession in many years, and on Sunday, May 5th, 2013 Jim accepted the Eucharist and completed the requirements of the Mission.

Jim: " _It's something I wanted to do for Rosann and it made me feel extremely happy that I could do that for her. She had done so much for me over 16 years. I can't know that my efforts, combined with the Prayers of so many others, allowed her to enter Heaven sooner, but I had nothing to lose. This is my gift to Rosann"_

But the Lord works in strange ways. Rosann wasn't the primary beneficiary of this endeavor.

Jim: _"Each of the three sessions had a message that caused me to think, and rethink. I believe the main theme was to ask the Lord to help you become Holy and accept His Grace. Do this through prayer, reading his Word and through the Eucharist. It made me realize that for over 60 years of being a Catholic, I had no allowed the Lord inside me. I talked to the Lord and asked for his help, but I did not know how to talk 'with' the Lord. I have a very long way to go but I've started."_

Rosann's gift to Jim, using her death as a catalyst for Jim to become closer to Jesus Christ, is equal to Jim's gift to Rosann. Thank you Father Lipscomb and the Sisters from the Apostles of the Interior Life for making this possible.

Rosann has the Happy Ending she desired.

### EPILOGUE

  **I remember Rosann** \- top ten memories that come to mind

1. Her smile

2. Her beauty, especially her eyes. She could still turn heads

3. Her genuine niceness

4. Her love for me

5. The trips we took; especially Costa Rica and Rome to Istanbul

6. The river boat trip thru France and three days in Nice and Monte Carlo

7. Crying together watching movies like Hachi and It's a Wonderful Life

8. Her hole-in-one at Hunters Green, and what it meant for her

9. Her wonderful artwork and the fun she had at art class

10. Her strength, inside, where it counts

**Was it worth it?** Oh yes. The last few weeks were tough for both of us, but that's life. The extra two years together that the Lord gave us were indeed a gift that Rosann and I thoroughly enjoyed. We were happier than most couples.

**Was it tough to be Rosann's full time caregiver?** Oh, yes, but I would do it again. The hardest part was being her best friend one moment and then exhorting her to eat, drink 'Ensure' which she hated, or exercise to get stronger. I often wished we had a full-time rehab, cook, maid and nurse's aide so I could just concentrate on loving her. I tried to hire this little French girl but Rosann said no. She wasn't completely blind.

**What's made Rosann's condition tougher than most?** The blindness was a terrible handicap. Not being able to see made rehab and her day-to-day living so much more difficult. Hurting her left shoulder was another blow. She basically had to do everything with one arm. Also, let's not forget that lung cancer and brain tumors were only part of the problem. Rosann also suffered significant impairment to cognitive functions when they operated to remove the swelling in her brain. She was fighting three battles while being hamstrung by her blindness and lack of strength.

**What amazed you the most about Rosann's "Fight?** Her disposition never changed. Despite everything that was happening to her, she never once took it out on the people around her, namely me. She continued to be the 'nice person' she has always been. She never lost her true self.

**Any Regrets?** Sure, but not many. It would have been great to go on the European River Boat Cruise, but Rosann was never strong enough. I wonder if a less invasive craniotomy or fewer radiation treatments would have left Rosann stronger, but who knows. We were given two more years together. Rosann and I chose to be thankful for what we had and to play the cards we were dealt. We are satisfied.

**Did Rosann have any final wishes?** Yes, she wanted to be remembered as a nice person and she hoped that people took notice when she died. Specifically, she hoped that there would be some kind of Memorial so that friends could gather and say goodbye. I told her near the end, that I was working on completing her book so people could remember her. She said, "that would be nice."

**Any Final Words?** Yes; I can honestly say that I love Rosann more today than I did 14 years ago, or two years ago. The challenges we faced together over the past two years brought us closer together. Thank the Lord and everyone who prayed for us.

### Appendix

This is the email Jim sent to Friend and Family, followed by the Obituary that appeared in the Tampa Tribune.

****

Friends and Family;

Rosann passed away in her sleep Thursday, March 7, 2013 @ 1:17 AM. (more details below – Chapter 27)

I am both sad and happy. It's a terrible loss, but it was time.

We were lucky to have the extra two years that the Lord provided to us. We made the most of it and had fun.

Rosann had two requests:

1. She wanted people to know she had passed away – she said 'some kind of get-together would be nice".

2. She asked that I finish her book, Fighting Back, that we published in May, 2011. She thought it might be inspirational to other people and would be something our Grandkids, and their kids, could use to understand who she was.

Rosann's Memorial

Open House

Saturday, March 30, 2013

1:00 – 4:00 PM

16209 E Course Drive, Tampa, 33624

Call Jim @ 813-968-6867 with questions

(informal, casual dress, beer & soft drinks, a chance to say goodbye to Rosann)

Silent Auction of Rosann's Artwork

**Rosann's Story –** "Fighting Back and Winning **" is available on-line at www.Smashwords.com and www.customsportsnovels.com**

Chapter 27 excerpt

March, 2013

The last days

This is being written on March 5, 2013, the 2nd anniversary of when this Fight began. Two years ago Rosann would be in an ambulance on her way to SSM Rehabilitation Hospital in St. Charles Mo. Ten hours from now Dr. Stanley Martin, neurosurgeon, would be performing an emergency craniotomy to relieve the pressure on Rosann's brain. She was given three months to live. Twelve days later after she returned to Tampa, her PCP told her she is dying and that there is no hope. Hospice intake nurses later estimated two-three months.

Jim: _"Rosann, I am SO PROUD of you. We were the only ones that knew what a fighter you are and how strong you are, inside, where it counts. I love you so much."_

Rosann hasn't eaten much of anything in 10 days; a little fruit, a few ounces of Boost and one bite of the Jim Beam soaked tilapia Jim made for his birthday. Over the weekend she began having trouble swallowing and it became difficult to get enough water into her system. Tuesday, the nurse gave Rosann some liquid morphine because she could no longer swallow the Vicodin and naproxen pain killers. Her joints ached.

Jim asked the Hospice nurse and attendant how much longer... They both thought that Rosann was actively dying (is that an oxymoron, or what?). It could happen today, tomorrow or the next day, but probably not any longer. It depends upon how strong she is.

Jim: _"We talked about it. Rosann and I are ready."_

Rosann passed away in her sleep Thursday, March 7, 2013 @ 1:17 AM.

Jim: _"Rosann was sleeping hard and breathing through her mouth. At 12:34, I moistened her lips and tongue. I did this often and could tell she liked it. I dozed and woke up abruptly at 1:17 AM and heard nothing. I knew. I was happy for her. She is in a better place."_

Final thoughts: I can honestly say that I love Rosann more now than I did fourteen years ago, or two years ago. The experiences we shared brought us closer.

Rosann's remains will be shipped to Kutis Funeral Home (10151 Gravois) in St. Louis, Mo where a funeral and burial are planned by Rosann's mother, Helen Folk. Call Kutis for details (314-842-4458).

Jim

*****

P LAUTZ, Rosann M., 69, of Tampa, formerly of Affton, Mo., died Thursday, March 7, 2013 after a 2-year battle with cancer. She is survived by husband, Jim; son, Dave; mother, Helen Folk; sister, Linda; five grandchildren; and many friends. She is also survived by Jim's three children and spouses, Bill and Kate Plautz; Mike and Claire Plautz; Kelly and Brandon Grimes; and eight grandchildren. Rosann was a golfer and artist. Her body will be shipped to Kutis Funeral Home in St. Louis. A memorial open house will take place March 30, from 1:00 - 4:00 PM @ Rosann and Jim's home in Tampa. Call 813-968-6867 for details.

Published in TBO.com on March 10, 2013

### This Book is Dedicated to:

### Rosann Mary Plautz

### December 9, 1943 - March 7, 2013

### You

### Are

### Remembered!

### ****

### Back Cover

R osann attended her high school's 50th reunion on March 04, 2011. She looked ravishing. Twenty eight hours later she underwent emergency brain surgery to save her life. In a single day, with little warning, her life changed. Rosann had Stage 4 lung cancer. Statistics say she has only a few months to live. Her St. Louis doctors gave her two-four months. Her PCP in Tampa told her there is no hope. She would die. Her medical oncologist told her that nothing else matters once the cancer get's to the brain. The operation left her legally blind and the ophthalmologist told her there was no chance of regaining her eyesight. This was the hand she was dealt and this book tells the story of how she played the cards, and won.

Jim _: "Her disposition never changed. She remained a kind, gentle person who always thought of others first. She was so strong, inside, where it counted."_

Rosann: _"I live my life one day at a time, trying to make the best of what I have to deal with. What else can I do? I'm not giving up."_

"Fighting Back & Winning" is a story of a courageous woman that overcame lung cancer, three brain tumors and blindness. She enjoyed two more beautiful years with her husband, Jim. Rosann was still praying for a miracle when the Lord decided to bring her to a better place.

Rosann wants this book to be an inspiration to others facing difficult situations and to offer a roadmap on how to face these challenges. She wants her grandchildren, and their children, to be able to read this book someday and understand the kind of person she was.

******
