Carole Snyder-Raugust sent the most important thank you note of her life recently.
It began: “Dr. Koehler: You may not remember me, but we will never forget you! You removed half of my left lung and lymph nodes Dec. 19, 2008. You also removed a cancerous tumor, and in so doing saved my life.”
Dr. Richard Koehler is a thoracic surgeon at Virginia Mason Medical Center, one of the many doctors to come into Snyder-Raugust’s life after she was diagnosed with lung cancer just a few months earlier in October 2008.
The diagnosis didn’t come as a shock to Snyder-Raugust, 68, a longtime heavy smoker.
“I thought, it’s your fault — you smoked,” she said.
She began smoking at 18 while attending the University of Washington.
She said she smoked “plenty” in the next 50 years, and while she told her cancer doctors that she smoked about a pack and a half a day, she admits the actual number was much higher.
“I smoked a cigarette about every 15 minutes,” she said, her voice still raspy from the prolonged throat irritation.
She also had throat polyps removed several years ago but continued smoking.
Snyder-Raugust said she tried many times to quit over the years, but nothing succeeded; and for good reason.
“I tried everything, but I never really wanted to quit,” she said. “Every time someone told me to quit, I wanted to smoke more,” she said.
Snyder-Raugust was born in Walla Walla and had a long career as the owner of a court reporting service near San Francisco.
She didn’t marry until she was 35, when she met California Highway Patrol motorcycle policeman Robert Raugust.
“We got married after just three months,” Snyder-Raugust said. “It was the luck of the draw.”
The couple married in 1977 and, in 1987, decided to look for future retirement property on the North Olympic Peninsula, which they had discovered while visiting relatives
They didn’t like the old houses in Port Townsend (“too much work”) or the beach in Sequim (“too rocky”), but they fell in love with a wooded lot on the bluff just west of Port Angeles.
They purchased the lot, and after Robert retired in 1995, she sold her business, and they moved to Port Angeles.
They rented a house while their dream home with panoramic water views was being built. They moved in a year later.
Things went well until they took a Mediterranean cruise in September 2007, and Snyder-Raugust fell ill on the voyage, with a wracking cough that wouldn’t go away.
She ended up in the emergency room at Olympic Medical Center, where Dr. Katrina Weller was on call.
She gave the long-time smoker some sobering news: she had bronchial pneumonia and severely diminished lung capacity. Weller told her she couldn’t leave the hospital without an oxygen tank.
“I knew that if I had to drag around an oxygen tank, I just wouldn’t leave the house,” she said. “Then I heard a voice say, ‘if you don’t stop smoking now, you’re dead.'”
That was finally the push she needed.
“I was really motivated,” she said. “That was my ‘a-ha’ moment. It was difficult, but attainable.”
Her doctor prescribed the stop-smoking aid medication Chantix, which she credits with helping her to finally quit her 50-year habit.
She began exercising and leading a healthier lifestyle and felt better than she ever had, but danger was still lurking.
The following year they went on another Mediterranean cruise, and again she fell ill.
She was sent to Dr. Rebecca Corley, pulmonary medicine specialist at Olympic Medical Cancer Center in Sequim.
Synder-Raugust said Dr. Corley was unable to get a biopsy sample from her scarred lungs, so she sent her to Koehler in Seattle.
“He did extensive testing for two days,” she said. “It was worse than the surgery.”
The tests showed Snyder-Raugust had stage 2 nonsmall-cell lung cancer.
“I was a terrible candidate for surgery because of my years of smoking,” she said. “I already had limited capacity from smoking.”
But her heart was surprisingly strong, thanks to the exercise regimen she had adopted after she quit smoking a year earlier.
On Dec. 19, just two months after her diagnosis, Koehlor performed a minimally invasive surgery, called VATS — video assisted thoracic surgery — to remove the top lobe of her left lung and an affected lymph node.
Rather than slicing her open from back to chest and spreading her ribs to reach the affected lung, Koehler was able to make several small incisions on her left side and insert a fiber-optic thoracoscope, a small camera, to guide the surgery, and a remotely controlled scalpel to remove the cancerous tissue.
The pieces that were cut off were placed into a watertight bag, also inserted through the small incision, so the specimens wouldn’t break up while being removed.
Snyder-Raugust was able to leave the hospital in just four days.
The surgery was followed up with three months of chemotherapy, administered at Olympic Medical Cancer Center in Sequim.
On June 11, a year and a half after her surgery, Snyder-Raugust received a clean bill of health. A CT scan showed no sign of cancer.
She immediately sent a thank you e-mail to Koehler, saying, “Robert and I joke that cancer may have been the best thing that could have happened to me. It changed the way I take care of myself. I lost 30 pounds. I changed my diet, I work out every day and I don’t smoke anymore.
“We just got back from a wonderful trip to Maui that would never have happened if it were not for you and your outstanding surgical skill. We know that my cancer could come back but you gave me a fighting chance to beat it, and I have every intention of doing just that. Thanks again for that chance, Dr. Koehler, and believe me when I say we will never forget you.”
Snyder-Raugust knows she has as much as a 40 percent chance that the cancer will return, and she may not beat it a second time.
But for now, she and her husband are appreciating every day.
“I feel so much better than I did 10 years ago,” she said. “I didn’t know I felt bad because I didn’t know what it felt like to feel good.”