“You have cancer.”
When Lupe Maldonado heard those dreaded words from his doctor March 30, he responded as a true infantryman: “Can I still deploy?”
The staff sergeant is disappointed he won’t be deploying with his fellow soldiers to fight America’s enemies in Afghanistan this summer. Instead, Maldonado will be home in Copperas Cove facing a battle for his life against stage 4 colon cancer — a diagnosis that he’s told would have been much less life-threatening had it been caught when he first showed symptoms in early 2010.
“I wanted to deploy. I wanted to do my Afghanistan tour,” the three-time Iraq War veteran said last week. “It tore my heart.”
As a member of the 1st Cavalry Division’s 1st Battalion, 5th Cavalry Regiment, 2nd Brigade Combat Team, Maldonado has been training heavily with his unit, which left for the Joint Readiness Training Center at Fort Polk, La., last week. Watching them leave was not easy, and he still tries to keep up with everyone from the red recliner in his living room.
On April 12, Maldonado had surgery, which determined the cancer had spread beyond the outside walls of his colon and was now touching his spleen and pancreas. He was inoperable.
“We won that first battle with surgery,” said his wife, Yerika Maldonado. “Now it’s just the cancer that hurts.”
On Wednesday, he began chemotherapy in Round Rock at Texas Oncology. Yerika Maldonado said the doctors give the treatment a 50 percent chance of shrinking the cancer down to the point where it can be surgically removed.
Lupe Maldonado, 35, was diagnosed at Seton Medical Center Harker Heights on the Saturday before Easter. At 2 a.m. that same day, he’d gone to Carl R. Darnall Army Medical Center’s emergency room by ambulance, but Maldonado said in the five minutes he saw the doctor, he was asked mostly about his upcoming training and deployment. Maldonado said he was told he had a torn or pulled muscle causing him abdominal pain. He was sent home with Celebrex, an arthritis medication.
For Yerika Maldonado, this was the final straw. She, and the staff sergeant’s fellow soldiers, urged Lupe Maldonado to go to a civilian hospital without a referral. They could see the pain he was in.
“With my son, it breaks my heart. It gets to me,” Yerika Maldonado said of helping her 7-year-old son, Gael, monitor his type 1 diabetes. “But they are two different things, because this guy, he’s tough. … It’s hard for me to see him like this.”
The Maldonados, who also have 3-year-old twins, are now sharing their experience with the on-post medical center, not to put down the Army, but to raise awareness that every soldier’s voice should be heard.
“The Army isn’t to blame. The (emergency room) needs to make sure it takes soldiers seriously and do the right tests. Look at their medical history,” Lupe Maldonado said. “They shouldn’t be worried about who’s going into the field or not.”
The infantryman didn’t know he was anemic until mid-February when he tried to donate blood at his company’s blood drive and was denied.
Once he was diagnosed, his wife got all his medical records, which are less than an inch thick printed on paper, and spread them across her living room floor to read every page.
Signs of illness
During a 2009 deployment with the 2nd Brigade’s 1st Battalion, 8th Cavalry Regiment, Maldonado said he went to a unit medic with blood in his stool. He was told it was likely hemorrhoids, and because he never had any pain, he didn’t think twice about it.
A medical evaluation upon redeployment in February 2010 showed Maldonado was anemic and had blood in all three stool samples taken.
“There should be follow-up of any labs to include those that are normal (at least at the next visit) and calling the patient in for an appointment if abnormal,” Margaret Tippy, Army Medical Command spokesperson, said in an email when asked what the command’s standard procedure is for medical lab work of this nature.
“In the case you have outlined ... anemic, with no easily discernible reason, and with blood on all three stool samples taken, a colonoscopy exam and/or other studies would be usual,” she continued.
However, no one ever followed up with Maldonado.
The Maldonados then moved to Fort Benning, Ga., and though Lupe Maldonado continued to have blood in stool, he never thought twice about it. He returned to Central Texas in June to his current unit and after Christmas break, he said he felt like he was getting old.
“I just could not get back into shape,” he said.
Then he failed the running portion of his physical training test for the first time in his career. He also was starting to feel what he described as a scratching feeling in his abdomen. It didn’t hurt, but it didn’t feel right.
“I was acting platoon sergeant and I didn’t want to give my spot up,” he said of not going to sick call sooner. “I went to sick call finally when my platoon sergeant came back.”
Standard of care
On Feb. 25, Maldonado visited sick call, where, again, tests showed he was anemic and had blood in his stool.
It was determined he needed a colonoscopy to learn the cause, but the soonest appointment he could get was April 25 — much later than the 28 days Darnall outlined as Tricare’s standard for an initial evaluation.
“All referrals are initially sent to the (Darnall) Gastroenterology Clinic,” stated a release from the hospital’s public affairs office. Colonoscopy referrals to the clinic average about 215 a month. “If a patient cannot be seen in the Gastroenterology Clinic within the 28-day access to care standard then they are referred off-post for care.”
On average, Darnall sends five to 10 colonoscopy referrals off-post each day, the release said; but despite asking, Maldonado’s referral was refused.
“My leadership, my (physician’s assistant), everybody tried to help me,” he said.
He visited the Darnall emergency room one other time on March 13 for extreme pain in his abdomen. He said he was told that because he had an appointment already scheduled for a colonoscopy, there was nothing that could be done for him. Even this second visit was outside the 28 days of standard care.
“I was worried how I would make it through the next field problem,” he said. Regardless, he joined his unit in the field, popping over-the-counter painkillers to mask the pain.
Darnall diagnoses three to six GI cancers annually through the clinic, according to the public affairs office, and some cancers can be treated on-post without a referral. In 2012, Darnall received a three-year reaccreditation from the American College of Surgeons Commission on Cancer who stated, “(Darnall) treatment and management of these cancers meets and/or exceeds both state and national standards of care.”
The Maldonados also said they took every step the hospital suggests patients do, when they feel they are not receiving the appropriate level of care. They went through Maldonado’s initial provider, the chain of command and filled out a patient survey.
Show of support
On the “Fight for Lupe” Facebook page, loved ones and strangers alike share their support and prayers for the Maldonados, in both English and Spanish.
“I want it to bring in prayers,” Lupe Maldonado said.
Yerika Maldonado’s close friend and neighbor, Sammi Jo Marsh, helps update the page, which was begun to keep friends and family informed of Lupe Maldonado’s fight. The page now has a following of more than 6,000.
Marsh said she hopes people read the Maldonados’ story and realize just how much things can change in an instant.
“The people that you love the most can get very, very sick in the blink of an eye and you have no control over that,” she said. “I want people to understand they can push their doctors. … If they don’t listen, you can go somewhere else. Had somebody done that, then we would not be going through this now.”
Though asked often, the couple does not want to take legal action against anyone. They simply want soldiers to be heard.
“I tell them, I need to make sure he gets out of all this so I can get my family back,” Yerika Maldonado said. “He still wants to be in the Army.”
Before the diagnosis that turned their world upside down, Lupe Maldonado made the promotion list.
“I love my job,” he said. “I want to re-enlist.”