Bismarck, North Dakota News

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Doug Sande didn't really want to move into an unfinished landscape, but, well ... he points to a rising hill black with topsoil awaiting landscaping, beyond the picture window.

The thing about illnesses is that they make you deal with more than just treatments and symptoms. They make you rearrange your entire life. Where you go. When you go. Where you live. Where, or if, you can work. Who you see.

When illness drops into your life, like a rock slamming into calm water, family, friends, jobs, shopping, recreation, are all jostled by the ripples of the expanding circle of change.

Doug Sande was diagnosed with Parkinson's disease in 1996, at age 56.

"We knew things would change," he said.

The first thing he did, looking ahead to what the future might be like, was to, literally, put his house in order. And his garage. He cleaned out, threw away, cleared the decks.

Over the next decade and more, Parkinson's claimed more and more territory in his life. A year ago, the Sandes moved from their home in the Pinehurst area of northwest Bismarck to this single-level home. Today, Doug Sande is not totally homebound, but his good hours come and go unpredictably. Furthermore, his wife doesn't like to leave him for long for fear he will fall. Since Nancy Sande worked for many years as a nurse before she retired, she takes care of organizing Doug's medications, which he takes every two hours.

They plan their shopping trips carefully. Family and friends look in and help out.

But it's still an isolating thing, to not be as mobile as they once were.

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The Sandes have had some fun times, Doug Sande said. They both say they're glad they got to go to Europe, to see Florence, Venice, Rome. She was the art historian; he served as the route manager.

"The Lord was looking at the Sandes," he said.

The trip was just in time. A month after their return, in the spring of 2005, Nancy Sande was diagnosed with stage three ovarian cancer.

The prognosis wasn't very good, she said. The cancer, having spread to her intestines, was "treatable but not curable," her doctor said. She had surgery, had a portion of her intestine removed, and underwent a couple of courses of chemotherapy, which didn't do much for her.

Her relevant blood count numbers, called CA-125 - normal at 0-35 - reached 900.

In the fall of 2007, she went to Mayo Clinic in Rochester, Minn., for surgery.

"They opened me up and closed me right back up again," she said. Many small tumors were found scattered throughout her abdomen. A biopsy of her tissue was sent to California, to be tested against various chemo chemicals. They put her on a medication called Doxil. Nancy Sande now has chemo once a month. Her veins, collapsed by the chemo, have become too hard to hit, she said. For an hour and half, chemo medication is administered through a port in her chest.

The initial doses burned the mucus membranes of her mouth and left her skin blistered, which raised the danger of infection. So the chemo has been slowed down to smaller doses.

Chemo also means she's losing her hair, again; in fact, she's ready to go in and have it all shaved off, but it's no matter, compared to the fact that that important blood count number has dropped dramatically to 54.

"I suppose I'll have to wear a wig again, but that's a small thing," she said. Her husband teasingly calls her, with her pixieish blond hair, his "Sharon Stone."

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The couple's lives have had some very typical North Dakota markers.

She was raised in Cooperstown; he in St. John, near Rolla. She went to the University of North Dakota to study nursing; he went to North Dakota State University to get his degree in sociology.

He volunteered for service, spending two years in the Army. He worked at a bank in California, then for the Highway Patrol. The couple were married in 1968. When they lived in Fargo, Nancy Sande worked on the neurosurgical ward at what was then St. Luke's Hospital.

Moving to Bismarck in 1976, she spent many years in nursing, including teaching at Bismarck Hospital School of Nursing and working at Medcenter One. She also worked as a home health nurse and developed a certified nurse assistant curriculum at Bismarck State College, among other things.

He worked in the drug enforcement unit of the attorney general's office and the couple owned a sign company in Bismarck.

They have two grown daughters, Kristin, of Bismarck, and Karli, who lives in Minneapolis.

Their challenges, too, are both unique to themselves and shared with lots of others who face ill health.

Life narrows. The taken-for-granted things - socializing with a group of friends, doing things with other couples, even attending a Parkinson's support group meeting - become more challenging. Spontaneity is a luxury left behind. Everything must be planned out, thought through, strategized around medications and how-things-are-today. Reading becomes a lifeline. Most hours of the day are spent at home; isolation can't be banished entirely.

And illness brings its unwelcome companions, such as depression, which goes hand-in-hand with Parkinson's, Nancy Sande said.

But fortitude is part of the story, too. Every day, Doug Sande said, he and Nancy determine to be positive, to say nice things to each other.

The couple is now in the process of determining whether Doug Sande will qualify for a procedure called deep brain stimulation. If her careful documentation shows he responds well to dopamine (the brain chemical that Parkinson's patients underproduce, leading to characteristic tremors and stiffness), he would be eligible. During the procedure, the patient wears a metal halo and undergoes an MRI to pinpoint the exact spot in the brain that produces dopamine. A hole is drilled and a sensor inserted into the location; from there, it runs out under the skin to a battery pack in the chest to stimulate the production of dopamine.

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Old friends, including nurses and former students of Nancy's and Highway Patrol personnel, are sponsoring a benefit for the Sandes on June 8, their 40th wedding anniversary.

They hesitated when they were approached about the idea; finally, their friend Mary Leetun just said flatly, "We're doing it."

"When I decided to do this, it was a bit overwhelming," Leetun said of the benefit. But, she said, she met with so much cooperation with everyone that the anxiety dropped away.

"Everybody we've asked has been more than willing,"Leetun said.

The outpouring of kindness from everyone has meant so much to her and her husband, Nancy Sande said.

To be out of the center of things, "you think people have forgotten about you,"Nancy said, "but you find out otherwise."

Leetun, who was a colleague of Nancy's at Medcenter One School of Nursing, and also a neighbor until the Sandes moved a year ago, said it's natural for the Sandes to feel separated from society because of their illnesses, both in their day-to-day living and their connection with people.

The couple have always dealt with their trials with an independent spirit, without expecting anything from others, she said.

But the uniformly positive response from their friends, "It helps give them faith and hope in people again, and that the Lord is working for them," she said.

(Reach reporter Karen Herzog at 250-8267 or karen.herzog@bismarcktribune.com.)