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Jessika Macken Ritchie Morgan 3/19/1978-2/12/2011 My friend, my patient and sweet sister-in-law

Our journey together...

2001 LEEP procedure performed related to cervical dysplasia.

2004 Gave birth to Sydney and had tubal ligation. March 2010:

3/7/2010 I met Jessika in Statesville to give my niece back to her. She was sitting on a blanket and had been having severe vaginal bleeding. I made her go to the ER that night because of the amount of bleeding she was having and she was examined and discharged with Provera. She was instructed to follow up with her OBGYN.

3/11/10 She had endocervix curettage for the bleeding and because of the intuition and guidance God had given her doctor, several cervical biopsies were taken.

3/12/2010 Jess, Spence and I were informed that she had squamous cell carcinoma of the cervix. I started a caringbridge site for Jessika. We named her tumor “Miller” after the doctor who just out of chance biopsied her cervix.

3/17/2010 We met with her Oncologist.

3/19/2010 Jess had her PET scan, her 32nd birthday.

3/22/2010 PET results, Jess was diagnosed as having Stage 1B-1 cervical cancer with lymphovascular space invasion. The retroperitoneal lymph nodes involving the left pelvis, the left iliac and left paraaortic nodes were involved. April- June 2010:

4/2010-6/2010 Jess received Chemo and Radiation (brachytherapy).

5/14/2010 MRI showed positive response to chemo and radiation.

6/17/2010 Jess was discharged to follow up in 3 months. Her total weight loss was 12 pounds and she did not loose any hair because the chemo med that was used. Overall, Jess did well. Dehydrated a few times but did say she would never go through treatment again if she needed it. July 2010:

7/2010-10/2010 Life is Normal. Jess took a part time job, spent the summer with her children, went to the beach, etc. August 2010:

8/10/2010 Follow up with Oncologist. Jess was given a Referral to Gastroenterologist for mild nausea and vomiting. PET scan ordered.

8/13/2010 Follow up PET scan.

8/16/2010 Follow up with Radiation Oncologist. PET scan results **********There was a suspicious area to the right iliac chain along the lumbosacral level. The previous abdominal and pelvic retroperitoneal lymph nodes had “essentially resolved”.

8/20/2010 Follow up with Oncologist. CT ordered for 6 weeks. September 2010:

9/1/2010 Visit with Gastroenterologist. He scheduled a gastric emptying study and placed her on a reflux med.

9/27/2010 Jess had her PET scan ollow up with a abdominal/pelvic CT scan.

9/28/2010 *********The suspicious area was concluded by her Radiation Oncologist as post radiation inflammation. October 2010:

10/9/2010 Jess gave my niece a birthday party and this was also my brother’s birthday. Jess looked pretty good that day and was as hyper as usual.

10/15/2010 Jess started having worsening/uncontrollable nausea, vomiting and abdominal pain. She also started having mild back pain around this time.

10/25/2010 Appointment with her Oncologist. She had a normal urine test and was placed on Percocet for her back pain. Jess was also placed on more meds for her stomach issues.

10/26/2010 Admitted to hospital for dehydration. Jess had a Endoscopy with biopsies and was diagnosed with gastroparesis. She also had a MRI of her lower back which showed normal postradiation changes with adenopathy. She had a MRI of her pelvis and it showed “no acute findings. No evidence of residual disease”.

10/28/2010 Gastric biopsies came back as normal.

10/30/2010 Jess had her gastric emptying study. She was diagnosed as having delay in gastric emptying related to the radiation she had been exposed to. Placed on Reglan. November 2010:

11/3/2010 Follow up with Radiation Oncologist. Jess was instructed to increase her Reglan and was referred to the pain clinic for “dependency related to the pain medications as well as concerns about psychological issues that may be playing into her use of the medications”. **********He also wanted to “hold off on further imaging as she has just recently undergone repeat CT imaging” which had “essentially unchanged”. He also wanted her Oncologist to “consider a PET scan in January 2011”.

11/5 and 11/10/2010 Jess went to hospital again for her symptoms. Admitted once. During October and November Jess continued to loose weight, get weaker and sicker. We felt like she needed some form of supplemental nutrition but her doctors did not feel the same.

11/16/10 Jessika was extremely sick and I suggested she come to the hospital I work at an hour away. She had given up on getting answers and began to slowly loose her strength to fight. 11/16-12/13/2010 Jess stayed at the hospital I work at. She was admitted for malnutrition. Jessika had an excellent hospitalist who searched and searched for answers. Jess had more X-rays, ct scans, MRI's, endoscopies, a exploratory laparoscopy, a colonoscopy, another gastric emptying study, etc. Jessika had a feeding tube placed and was diagnosed and discharged as having severe malnutrition and failure to thrive. December-January 2010:

12/14/2010-12/23/2010 Jessika stayed at her home. Jess continued to have nausea, severe back pain and would vomit when she would eat. She had episodes of tightness or fullness in the center of her chest but overall as long as she did not eat her abdominal pain was tolerable. Jess also just used her feeding tube to take medicines. She started to develop lymphedema to her left leg and foot although she went to the local ER three times during this time she was never admitted and was able to be there for her son’s 11th Birthday. Jess developed lymphedema to her left leg but her Radiation Oncologist felt this was related to the previous radiation treatments.

12/24/10 Jessika continued to be sick and so my brother brought her back to the ER where I work since she had been seen 3 times in 9 days where they live. Jessika had run out of her pain medicine 5 days prior to this visit and she appeared to be in withdrawal. She was not dehydrated at this point so was not admitted but was given a prescription for the pain medicine she was previously on. That night Jess and I stayed with my mom. Unfortunately she was too ill to be home Christmas morning and slept through most of Christmas day. 12/26/2010-1/19/2011 Jessika lived with my girls and I. Jessika, my brother and I felt that it was best for her to stay with me since my brother would not be home during the day to monitor her pain meds and care for her. He had to work, take care of their children and we did not want her children to continue to see her so sick. Jess, Spence and I continued to feel as though something was being missed but with all of the doctors that had taken care of her our only option was to trust what was being said. I knew I had to help her get off her pain meds slowly to avoid withdrawal symptoms since Jess was already so fragile and her body could not take much more. I also knew we would not be able to get a doctor to prescribe more pain meds since all of her test appeared to be normal. Jess continued her tube feedings at night while attempting to increase her caloric intake during the day. Jess continued to have severe pain to the right side of her back. I can’t tell you how many times a day I would rub a variety of back creams on her back to try to help her pain. I also used heat, muscle relaxers, anti-inflammatory meds, her pain med and countless Epsom salt baths in an attempt to decrease her back pain. As we attended follow up visits during the day and watched Sex in the City at night we became very close. A closeness I will never forget. We had bad days, fair days and even a good day here and there. We had a heck of a time keeping her feeding tube stitches in and even got to the point where we would laugh because we knew we would be in trouble by her doctor if they came out a third time. On 1/13/2011 I began looking for resources for Spence and Jessika in attempt to help with their over powering medical cost. I went to DSS and decided to submit an application to Medicaid for Jessika so that we could ask for assistance from the charity funds at the hospitals she had been at. While taking care of Jessika I realized how costly her medicines, doctor co-pays and formula (not covered by insurance) was costing my brother. Unfortunately, Spence can’t even put a dent in the medical bills he is and has been faced with.

On 1/14/2011 I created a group on facebook to keep Jessika's friends up to date on how she was doing while at my house. Jessika was typically too sick to keep in touch with her friends by phone.

1/17/2011 I took Jessika to one of her many follow up doctor visits. I asked him if he would mind ordering her PET scan so that we would not have to drive to Charlotte to get it done and I had a fear her Radiation Oncologist would delay it again. Spence had called him on several occasions to tell him how sick Jess continued to be and since he held off in November I figured he would again in January since she had a lot more radiological procedures in December. Luckily, this doctor agreed to the PET scan and also wanted to repeat an endoscopy.

1/19/2011 Jessika had the repeat endoscopy with biopsies. The results were abnormal and showed narrowing of her esophagus from the outside. 1/20/2011-2/12/2011

1/20/2011 Jess had her second follow up PET scan and also that day we saw a kidney doctor for the severe right flank/back pain she had been having as requested by the pain clinic. I had mentioned to him that she had just had a PET scan and so he looked it up on his computer. He informed us that her right kidney was fine but the left kidney was blocked. He also mentioned that she had some fluid around her left lung. He did not feel intervention was needed unless she needed chemo at some point.

On the way home Jess decided she wanted Mexican. I could not believe what I was hearing but was excited she wanted to try to eat real food. My mom was at my house waiting to see her so I dropped her off and went and got the chips and refried beans with cheese on top as she requested lol. The most I could ever get her to eat was broth, dry cheerios, ensure and milkshakes. My mom and I could not believe how she was going to town with the chips and dip. This was one of the funniest moments we had together. However, this was the last moment we had together at my house. I walked my mom out to her car and then came in and I told Jess I was going to go get her pain meds. When I came back into Taylor’s room to give Jess her meds I found her lying on the floor. She wasn’t sure how she fell and I did not hear her fall but after looking her over, checking her blood pressure and heart rate, I called EMS just to be safe and she ended up in the ER.

While I was there, I was given the horrifying, unexpected news from the PET scan. Jessika had metastatic cancer throughout her body to include her spine and liver. Since I was alone with Jess and my brother was an hour away I told Jessika she was being admitted for the fluid around her left lung. I could not tell her alone nor could I tell my brother on the phone. When she asked why I was crying I told her that my previous boyfriend and I had gotten into an argument. As I left the ER Jesika said, “Well at least you don’t have to get up with me tonight and you get to sleep in tomorrow”. Little did Jessika know, I would rather do that for the rest of my life then to hear the news I had just heard.

I called my parents and they met me in Hickory so that we could go tell my brother in person. My best friend Kendra drove me and after avoiding a phone call and text from my brother we arrived at his house in Huntersville around midnight. I know that he had the worst possible thought when the four of us showed up at his house but I did not want to wait another moment to tell him. He was in shock as we all were and shortly after we told him he went upstairs and got my six year old niece Sydney. He sat in a chair holding her like a baby as tears rolled down his face. I will never forget that night and this was the night that our lives completely changed.

Jessika was discharged home to Hospice less than one week after getting the devastating news. Her esophageal biopsies from the endoscopy were compatible with metastatic cancer from her primary (cervix) cancer. If Jess would have wanted treatment it was not an option due to the severity of the spreading and state her body was already in.

I went to Huntersville with Jess to continue providing what was now called “comfort care”. In shock, I went from keeping Jess on a very strict morphine weaning schedule to giving her anything she needed to be comfortable. The weaning that I had been doing for over a month while she had cancer throughout her body has been one of the hardest things for me to accept. It is not in a nurses or family members nature to cause suffering and this is something that I have struggled with since getting the PET scan results.

After spending over three months away and less than two weeks home with her children, husband, family, and friends, Jess went home to be with the Lord February 12, 2011 and just one month shy of her 33rd birthday. Ironically, she was diagnosed March 12, 2010 and passed 11 months to the day. We are thankful she was able to spend a little bit of time at home during her passing and we could not have asked for more love and support from family and friends. March, 19, 2011 This would have been Jessika's 33rd birthday. My family had a celebration at the grave-site. They released green and purple balloons with different messages written on them.

2/15/2011 Visitation 2/16/2011 Funeral

3/19/2011 Jessika's 33rd birthday celebration was held at her gravesite. Messages were written on balloons and released up to her. It was a beautiful, sunny day as Jessika shined down.

4/15/2011 We had a successful relay for life and raised $2546 in memory of Jessika! Thank you to everyone for all your continued support.

4/28/2011 I was contacted by EmpowHER, a company that advocates for women's health. They want to spotlight and share Jessika's Journey on their website in memory of her this Mother's day! I am so excited and feel honored that have asked to do this. Their website provides individuals access to women's health information and resources. It is also an online community of women who discuss their own health and wellness issues while sharing their stories..kind of like this website. http://www.empowher.com/

I know God’s plan was set the day Jessika came into this world and I am thankful she rest in peace now.

I pray now that my family and I can accept this devastating even in our lives.

I pray that our story will inspire others to live each day as their last and I know one day I will be healed from my guilt, anger, frustration and sadness.

Jessika and her mother suffered from cervical cancer and I pray that there is a cure before my niece could be affected by this deadly beast too.

As I continue forward on this journey I will use our story, my nursing career and guidance from God to celebrate Jessika’s life while fighting back at this ugly thing called CANCER.

Love, Stacy p.s. you can keep up to date with us on facebook under "Jessika Morgan's Updates"

A portion of a facebook post made by my brother Spence (Jessika's husband) 2/18/11

"Lastly, As I have told some of you already, I do not wants Jessika’s loss to be in vain. I want each and every one of you to take away something from this tragic loss. Whether to live a healthier life, to quit smoking, to exercise more or what ever it is you feel you need to do to improve on in your life. Live every moment like it’s your last. Take that trip you always wanted to take, take the skydiving trip you always thought about, or whatever you dreamed of doing and please when you children ask you to play or to read them a book take the time and stop what your doing and cherish these precious moments with them. I want you all to know that I love each and every one of you and thank you so much for being the loving friends that you are. You were at our side in our time of need and saying thank you is such an understatement. I thank God for the many blessings Jessika brought to my life, in particular her beautiful children. Her memory will live through them and this is the greatest gift of all. I hope to stay in touch with all of you and please feel free to come by anytime. Most importantly remember Gods promise that we all will meet Jessika again in heaven and this is what gets me through each day."

With all my love and Gods strength to you all, Spence, Hunter and Sydney