Team Oma

From the Leaf Chronicle

Military families know how to fight as well as any other family, but one Army couple’s fight frankly stretches the bounds of the believable and possible, while challenging limitations on the definition of the word “family.”

For Spc. Matt Combes and his wife Shawnna, the idea of taking responsibility head-on is a part of who they are. With five children and a sixth on the way, living on an Army E-4’s salary, they exude fearlessness while acknowledging that a cynical world often questions their wisdom. But they have taken in another addition to their family, and in doing so have placed themselves squarely in the path of a financial and emotional hurricane. Their “adopted” family member is a 55-year-old German woman named Ingrid Branan, whom the couple brought into their home after an unlikely friendship was struck up during Matt’s time at Joint Base Lewis-McCord, Wash. That the couple would take a middle-aged woman who is not a blood relative into their family is unusual. That they would take on the burdens imposed by the virulent ovarian cancer trying to kill her, without much in the way of help from anything but their own limited resources, is something else entirely.

A parking space

In 2008, Ingrid Branan was 51 and transitioning into the role of “empty-nester’ as her three children were beginning their own lives. She had been divorced from her Army husband since 2001, after 19 years of marriage, and the resulting open spaces in her life left a lot of room to be filled.In the course of time, while living in an apartment complex in Olympia, Wash., Ingrid noticed a very pregnant Shawnna Combes struggling to carry in groceries from a distant parking space. A short time later, Ingrid struck up a conversation with Matt and offered up the use of her extra and much closer space.That simple act of kindness was later reciprocated when Matt offered to help Ingrid with her yardwork. Ingrid and Shawnna had become good friends by that time. “It’s really weird how sometimes you just connect with someone,” said Ingrid. “It happens very rarely.” For her part, Shawnna said the relationship blossomed nearly instantly, despite the fact she had grown up with serious trust issues. Shawnna had never experienced a mother figure in her life, and that’s what Ingrid became to her, as well as becoming a grandmother to the Combes children. While still stationed at Fort Lewis, the Combs family moved into a larger house. When Oma’s dwelling developed a serious black mold problem, Matt and Shawnna insisted she come live with them. It wasn’t a two-weeks offer. It was a permanent invitation.

Extended family

Describing the basis of the relationship, Matt said, “A lot of it was the way the kids took to her. She was ‘Oma’ from Day One. She was never Mrs. Branan or Ingrid or any of that.”In Germany, a grandmother is often referred to as “Oma.” Ingrid became Oma to the Combes family. Shawnna and Matt stressed the point at several junctures in the interview, for good reason. The fact has to be understood if any of the rest of the story is to make any sense.To see the Combes family at home is to understand that when they say Oma is a member of the family, they mean just that, without reservation. “Ingrid is a part of our extended family,” said Matt. “She spent time with my family back in Oklahoma, and they all love her. They all call her Oma, and they don’t expect us to come visit without her.”

“They would do anything to help,” Shawnna interjected, speaking from the edge of tears while indirectly acknowledging the dark shadow of Oma’s terrible illness, which at all times hovers just above them in the room, descending down unbidden in quiet moments, kept at bay only by the light of the love they hold like a torch.

‘That’s not good’

Shawnna began the story in a detatched way, trying to fend off emotion as she recalled the day she noticed that Oma wasn’t eating.In 2009, Shawnna was pregnant and seriously bulging. She noticed Oma had a bulge, too, nearly as big as hers.”She was so stubborn,” Shawnna said. “She didn’t want to go to the hospital. She didn’t have any insurance. I said, ‘You can get in the car, or I can call 911; your choice.'” At the hospital, the initial diagnosis was appendicitis, until they found out Oma’s appendix had been removed shortly after birth. “Oh, well, that’s not good,” the doctor responded.It was very far from good. A CT scan and an MRI later and an oncologist was standing in front of Shawnna and Oma telling them that Oma had stage 4 ovarian cancer and that the tumor was very, very large. Ovarian cancer is particularly deadly because many diagnoses don’t come until stage 3 or 4, rather late in the game. Surgeons removed a 30-pound tumor and 800 cc’s of fluid from Oma’s body. The fight was on, but it was only Round One.

Without a net

Oma had been married to her ex-husband for 19 years of his 25-year Army career. In the process of their divorce, she was, like many foreign spouses, at a disadvantage in terms of knowing the laws and regulations. It used to be that a former spouse could qualify for full benefits after 15 years overlap between marriage and military service, but the rules had changed. It was now 20/20/20 – 20 years married, 20 years  service and a 20 year overlap between the two – and Oma had come up a year short on two counts. She had child support for a time and was due a portion of her ex-husband’s retirement, but she didn’t begin receiving the latter until he actually retired, and she was already a year into her fight with cancer. Shawnna handled the nightmarish paperwork mountain and fought what she called the most frustrating fight of her life to get Oma on Washington State Medicaid. She then hired a lawyer to get Oma on Medicare.

“Finally, we won,” Shawnna said, hands clasped and staring at the ceiling. “She was four or five months into the chemo before she was granted Medicare. The surgery went really well. She did really well with the chemo, no setbacks. She rocked it.” By then, Matt had orders to Fort Campbell. Shawnna was pregnant with another child. Three weeks after arriving at Fort Campbell in 2010, Matt was told he was deploying to Afghanistan. Oma, who had come along with the couple, was doing well and had several consecutive, normal checkups with a new cancer doctor. Matt deployed, and while he was gone, another child was born. With so little time at Fort Campbell prior to his deployment, Shawnna hadn’t had time to meet fellow spouses from the unit and was enormously glad for the support from Oma, who appeared to be doing well. “Matt came back in April last year,” Shawnna continued the story, “and then Oma had headaches. We thought it was just the flu, but when she went to her doctor and said she couldn’t get rid of her headaches, he said, ‘Uh-oh, that’s not good.'”

Into the hurricane

A six-centimeter tumor and accompanying large cyst had pushed Oma’s brain over to the right side of her skull. The doctor who came in with the news couldn’t believe she was conscious, standing and not in a wheelchair.Two weeks later, the tumor and cyst were removed at Vanderbilt University Hospital, but despite a successful surgery, the news and prognosis were bad. Oma had a genetic mutation cancer, able to migrate anywhere in her body. No matter the location, it was still ovarian cancer, of a type that the family found out isn’t covered by Tennessee Medicaid or by any charity they have been able to locate. Not that the situation was totally hopeless; Dr. Kyle Weaver at Vanderbilt knew that Oma didn’t have insurance, but he ordered up a PET scan anyway.The scan found six masses in her stomach lining. “There’s no surgery for that,” Shawnna said in a near-whisper. “She also has something near her tailbone and something in her esophagus. They’re currently talking about the risk of breast cancer in her. They want to take both breasts now.”

Climbing the mountain

At this juncture in the story, Oma sat composed. Shawnna was less so, talking about the recent chemo sessions that have nearly killed Oma twice, and about having to find a new cancer doctor in the middle of the process as the bills have piled up and the options have been steadily whittled down. “I filled out so much paperwork,” Shawnna said as the raw emotion broke through. “I have never been so frustrated as to hear person after person tell me her situation isn’t covered, not even by the charities – Livestrong, CancerCare, Hopewell – none of them.”The family is paying out $600 a month in medications, not counting the every-three-weeks shot that Oma needs to keep her white blood cell count up, at $5,000 a shot, not subsidized by the manufacturer. Gateway Hospital has hit the limit of their involvement, according to Shawnna, balking at a needed colonoscopy because the family can’t afford the deductible. And the calls from the bill collectors now come nightly. The bills make a small mountain on the kitchen table. All told, they come to nearly $200,000. In the midst of it all, a cancer treatment center called Tennessee Oncology has provided a glowing ember of hope. “They’re treating Oma, regardless,” said Shawnna, finally giving a smile, “and trying to find charity money as well. A lady from Tennessee Oncology called the other day and said, ‘Shawnna, I can’t find a single charity to help,’ and I was like, ‘Yeah, I know.”The odyssey told, the smile grew defiantly wide on Shawnna’s face as she waved away the shadow.

Finding faith

Oma/Ingrid looked with unbridled love at this daughter of hers who won’t give in or give up. “God makes you meet people for a reason,” she said. “Sometimes you don’t even know why for years. You have a connection like this, if you’re lucky, maybe once in a life. “A lot of people, you try to tell this story, and they don’t get it. They think I’m the nanny, they think I’m just here to…” Shawnna broke in as Oma teared up. “They think that us using our savings…” She broke a moment and recovered. “Our children are well taken care of. We’re in the military. We are very well taken care of. The money, it was nothing compared with the value of (Oma’s) life.”If there’s a reason to have faith in life, in God, this is the reason. (Oma) gave me faith in something I didn’t even believe in. So I know that He’s real, because I’ve literally watched Him keep her alive.