Advice to New Readers

Welcome to The Last Train!  If you’re a new reader, my advice would be to begin by reading the “Introduction” and then work your way up the topics from oldest to newest (see the recent posts on the right).  That way you will start from the beginning of this journey rather than joining on a later stop.  Welcome aboard…and I hope you become a regular “rider” on The Last Train!

Jeff Schmahl


May 6, 2014

A week ago at the end of a 30-minute phone conversation, a good friend of mine said, “you should start writing, it would be good for you, and you’re a good writer.”  Terry Pettit has written several books and has a mind that looks at life from just a slightly different perspective.  But in turning that crystal ever so slightly like Terry does, an array of light exposes an entirely different vantage point and I have always loved to discuss, argue, laugh, and be enriched in my time with him. Continue reading

Facing Your Fears

Some of my most vivid memories are when I’ve been afraid…really afraid.  I can still remember with absolute clarity some fearful situations that I encountered all the way back to elementary school.  No doubt about it…fear is one of the most powerful emotions we must all face.

In the midst of the most joyful time in my life, I faced a fear that scared me to death.  It occurred about 10 minutes before Zach was born.

Everything had been going smoothly in Maria’s labor…easy for me to say at least.  Maria was a trooper despite the obvious pain during contractions.  The nurses were calm, relaxed, and professional…and Dr. Lucas, in his cheerful and humorous manner, indicated that everything was going smoothly.

But as Zach entered the birth canal, everything changed in a matter of seconds.  When Maria had a contraction, his heart rated dropped below 50.  Dr. Lucas said the umbilical cord was likely wrapped around Zach’s neck and added emphatically “we need to have this baby now!!!”

The calm didn’t quite turn to chaos…but it was clear that our baby was in possible peril.  A nurse threw a surgical mask and gown at me…pointed to a room and said quickly, “get changed right away and meet us in the operating room at the end of the hall.”

I went in the small room and began uncontrollably weeping.  I had never been so afraid in my life.  We didn’t know if our child was a boy or girl…I had never even met this person….and yet I had never felt such a powerful love and I would have done anything to ensure my yet to be born child’s safety.

I said the most sincere prayer of my life…asking God to please, please protect our child and let him be born safely…and then hurried off to the operating room.

The mood there was extremely tense.  Dr. Lucas had a huge pair of forceps ready to go in and extract Zach…but they were the wrong type.  He shouted something like “get me the 15 inch Simpson forceps now!”   Maria started to have another contraction and Dr. Lucas implored her to push with all of her might as I stood watching helplessly, still gripped in a terror I had never experienced before.

Seconds later, Zach was born.  He was slightly bluish in color and Dr. Lucas deftly used his index finer to take the umbilical cord from around Zach’s neck.  Zach immediately started crying as his color quickly turned normal.  Dr. Lucas shouted with joy, “It’s a boy and he looks great!”

It’s been more than 31 years since that emotion filled day when I experienced a love…and a fear…unlike anything I had felt before.

As a result of that day, the one thing I like to tell first-time to be parents is that “human beings do not fully comprehend their capacity to love until they experience the birth of their child.”

And few things bring more joy to my heart, than when I see new parents totally enthralled with their young child…knowing that there is nothing they wouldn’t do to protect that child which they love with every inch of their being.

As life begins…and as life ends…we overflow with love and that is when human beings are at their best.

There are a couple of things that have allowed me to face my mortality with a minimal amount of fear…at least thus far.  The first is my faith.  Secondly, I remember others who have gone before me, like my father, who have faced death with courage and dignity…and it is comforting to know if they can do it, so can I. Finally, it is very comforting to feel and hear of the love and concern of friends and family.  Having others to support me on The Last Train, has been a tremendous lift.

Often times when our children are afraid we say, “don’t be afraid” but I think that’s the wrong message.  Fear is real and it is not easily dismissed.  Instead, when our children are scared I think we should take them in our arms (or let them sleep in our beds) and say “it’s okay to be afraid.  Daddy sometimes gets afraid too.  But I’m here to protect you and I won’t let anything bad happen to you.”

Being afraid of death is natural and is one thing all humans have in common.  I only hope that by sharing my journey you can have just a little less fear when it is time for you to board your last train.

Medical/Personal Update:

I had my 19th chemotherapy treatment on Tuesday.  Dr. Ocean changed my regimen, taking me off the chemo drug that has been making me so sick and adding back the powerful platinum drug that I can only take in limited quantities (because of negative side effects).  We’re hoping that six treatments of the platinum chemo will get my tumors back under control and hopefully even eliminate them.

The FDA has also recently approved the use of PARP inhibitor pills for ovarian cancer patients.  PARP inhibitors have also shown to be effective in the treatment of some pancreatic cancer patients so hopefully I can get approval to start taking PARP’s in the near future.  These are the drugs that Dr. O’Reilly and Dr. Ocean have been studying and using in clinical trials.

In late December/early January, Maria and I had a great time in Nebraska and Kansas visiting our moms, brothers and sisters, as well as our 12 nieces and nephews on Maria’s side that we love so much.

I then spent a couple of days skiing in Breckenridge with a college buddy Tom Beam and also got to ski with my nephew Nick and his girlfriend Emily.  It was awesome…although I did cut my skiing short when I took a hard fall on an icy black (expert) run.  I fell hard on my left hip resulting in the biggest bruise of my life…made worse by the blood thinners that I am on.

My nephew Nick, his girlfriend Emily and I Tom Beam and I
From Left: Nick, Emily and I; Me and Tom Beam

bruised hip photoOUCH!

The hip looks way worse than it feels…and don’t worry…I’ll be back on the slopes in March and will work hard to keep up with all the young bucks in our family ski trip with more than 25 of the Adler clan.  It will be a blast!


Next Stop: My rollercoaster ride

A “Mixed” Report

I didn’t get the news I was hoping for from my CAT scan last week. It’s not all bad news…but certainly not all good news either. A “mixed response” is the term the radiologist used.

The tumor in my pancreas shrunk slightly and is now 1 centimeter x 1 centimeter, which is about the size of a fingernail. In my liver, a 2 x 2 cm tumor is gone and two other tumors shrunk slightly and are now in the 1 x 1 cm (fingernail) range.

On the bad news side, one tumor in my liver grew from 1 x 1 cm to 3 x 3 cm and two new tumors have appeared that are both in the 1 x 1 cm range. My latest blood tumor marker number also went up to 46 (below 40 is normal), which is another indicator that there is still tumor activity in my body.

Compared to my first scan back in April, the size of my tumors are significantly smaller…but the big c is fighting back in my body…so we’re going to keep fighting as well and try to zap the suckers with a stronger chemotherapy regime.

In my first six chemotherapy treatments, we used a “platinum” drug that has a history of being very effective against my type of tumors. The only trouble with this drug is that it has potential for permanent side effects…specifically neuropathy (numbness) in your feet and hands…and because of its toxicity, there is a limited amount that you can take.

Dr. Ocean is going to put the platinum chemo back in my therapy for the next six treatments with the hope that this can reverse the current activity.

I also met last week with Dr. Eileen O’Reilly at Sloan Kettering, the best cancer research hospital in New York City. Dr. O’Reilly is one of the world’s top oncologist’s and she has done a lot of work in the field of the Brca2 gene, which is the type of mutation that I have. Dr. O’Reilly will be consulting with Dr. Ocean on my case and hopefully in the near future I will be a candidate for one of the Parp Inhibitor drugs that Dr. O’Reilly has helped develop and shown to be effective in pancreatic patients that are in remission.

The side effects from chemotherapy have been making me quite sick the last three months, so I was really hoping for a scan report that would allow me to get off chemo. But I’m still optimistic about the future and thankful that the drugs have worked so well thus far.

As I told Zach last week, if you would have told me back in April that I would have eight good months and then things would go down hill, I would have taken that. Well…I’ve had eight good months…and am looking forward to a great 2015!

Medical/Personal Update:
Maria and I will be in Kansas and Nebraska visiting family this week…and then I’m headed to Colorado for a couple of days of snow skiing with a college buddy, Tom Beam.

When I was first diagnosed, I wondered if I would ever ski again and I also really hoped that I would at least make it to Christmas. Maria, Zach, and I had a wonderful Christmas together…and I’m excited for our upcoming trip to see family and also to experience the thrill and beauty of strapping two boards to my feet and flying down the mountain!

I am blessed!

My best wishes to everyone for a happy and healthy New Year.

Next Stop: Facing Your Fears