No Warning Before My Pancreatic Cancer Diagnosis

Cliff Ramos

• Surprise diagnosis leads to chemo and radiation
• Complications delay Whipple procedure for two months
• Another example highlight
• Finally, this is a last highlight example

On April 6, 2018, a week after my 65th birthday, I played three sets of tennis, worked in the yard for an hour and worked out for an hour in the gym.

The next day I began to feel ill in a very debilitating way. My urine was the color of Coke, and I had a very sick feeling in my abdomen.

On Sunday, April 8, I went to urgent care. They did blood and urine tests and sent me to the emergency room in nearby Braselton, Georgia. I was given a CT scan, which showed a tumor on the head of my pancreas. I then had a biopsy, which showed it was malignant. I was diagnosed with adenocarcinoma pancreatic cancer. I had very little warning.

Tough Chemotherapy Before Surgery

The doctors at the hospital in Braselton referred me to a surgeon at Emory, in Atlanta. I started treatment at Emory and had three rounds of FOLFIRINOX there. I was supposed to have surgery in late August, but I had a blocked bile duct that required a stent. When the temporary stent was replaced with a metal one in early June, my gall bladder ballooned to twice its normal size. This required a cholecystostomy tube to be inserted through my liver into my gall bladder. The fluid drained into a bag hooked to my leg until the day of my surgery. I was very sick for a couple of weeks, and nobody had an answer. We saw doctors in Atlanta, Braselton, and Gainesville, Georgia.

My daughter is a nurse, and she had a connection at MD Anderson in Houston, so my wife and I moved from the Atlanta area to Houston in early June, 2018, so that I could receive treatment and surgery at MD Anderson. After I met with Dr. David Fogelman I had one more round of FOLFIRINOX, and then 10 days of radiation to prepare for the Whipple surgery. I didn’t do well with the FOLFIRINOX, and each subsequent round was worse than the preceding one. I persevered through constant nausea and general malaise.

Because of the gall bladder complications, the surgery was postponed until the fall. I finally had my Whipple procedure on October 4. The surgery went well but my surgeon, Dr. Matthew Katz, was not able to remove some areas of microscopic cancer cells.

Tough Recovery After Surgery

After my surgery, I had some serious complications. I spent nine days in the hospital before returning to our temporary apartment in Houston. During the first week in the apartment I endured much pain, nausea, fevers, and practically no sleep. I don’t remember doing this, but I took several sleeping pills and woke up two days later in the hospital. Then a few days later I developed high fevers, which were caused by several liver abscesses. I spent two more weeks in the hospital with several tubes draining the abscesses. I am a retired wrestling coach, and during my recovery, one of the nurses told me to talk to myself the way I talked to my wrestling students. I took her advice and it helped.

After the surgery I had to wait a few extra weeks to resume chemotherapy. Then I went through five cycles of gemcitabine and capecitabine and am currently off chemo. We moved back home to Suwanee just before Christmas of 2018. I travel back to Houston every three months for tests but I am now back home in Atlanta, where I see Dr. Bassel El-Rayes at Winship Cancer Institute (he’s now at the University of Alabama Birmingham). Since returning home in late December, I have been hospitalized twice at Emory for an impacted colon. I have had ongoing digestive problems since having the Whipple surgery.

Currently I am feeling pretty well, but still have problems with constipation and diarrhea. I have a blood clot in my jugular vein brought on by the chemo. The blood thinners I’ve been on have caused relentless rashes. I also have a very large incisional hernia that is beginning to cause some problems.

Continuing My Life

With all the complications, I still feel like I’m doing well. I’m coming up on 15 months after being diagnosed, and at the present time, my last tumor marker counts were good and my CT scans were clear.

During my treatment, I was inspired by Randy Pausch’s The Last Lecture. So I wrote a book about my philosophy of coaching wrestlers, and how I have been facing pancreatic cancer. One More Practice was published in April 2019 and is now available on Amazon, with all proceeds going to Pancreatic Cancer Action Network (PanCAN).

In June 2019 many of my former students came together for one more practice. I coached wrestlers of all ages and we raised more money for PanCAN.

Cliff lost his battle with pancreatic cancer two and a half years after his diagnosis. His spirit and love of coaching was shared with his students, his friends, and his family. Our deepest sympathy to his family.