Meeting with the surgeon...

This morning I met with the surgeon who did all the work on my neck/throat to excise the oropharyngeal carcinoma in late November of 2007... about 16 months ago. The last time I saw him was in August of 2008, 8 months ago. Since then, he and his wife have had their fourth child... but this blog is about me, not him. Nice guy, though.

On we go...

The examination went well... aside from the fact that he produced that damned fibre optic scope that he seems to take great pleasure in feeding through my right nostril and down into my throat to have a look around.

The good news is that everything looks 'really good'. There isn't any bad news, only one area of concern.

I went in with a list of complaints/observations; thank goodness for G. If not for her, I would never track some of these things, let alone write them down for reference. The list today looked something like this:

1. swallow is changing; becoming more of a challenge
2. reflux and heartburn; recurring way too much
3. tongue issues; burning sensation, loss of taste, odd sensations
4. intermittent coughing
5. hiccups, burping (gas)
6. hearing; much better. The guy you sent me to was wrong!
7. joint pain, muscle pain/fatigue, especially in lower extremities when inactive for a time
8. swollen saliva gland; is it ever going to go down?

So, the basic exam went well. He probed and prodded and stuck his fingers in my mouth to feel around. Structurally, everything looks good. There is no evidence of anything new.

The list;

1. The swallow will continue to change as I continue to heal. He recommended that I follow the advice from the speech people at iRSM (once Compru). If, in three or four months the swallow is still problematic, I should be going back to them to get a fresh view on the situation.

2. Dr. Williams prescribed prevacid to get the reflux under control. We'll give that a try for a couple of months. If that doesn't address the problem, then he may need to 'scope me (or refer me to a gastroenterologist) to find out what's going on there. He, initially, thinks that its probably just a by-product of the new swallow challenge.

3. It sounds like the tongue issues are all part and parcel of the lingual nerve repairing itself. He seems quite confident that over time it will all be back to normal. Yay!

4. Intermittent coughing. He believes that it may be part of the reflux issue. But as he was talking about all of that, he wrote up an order for a chest x-ray.

5. Hiccups, burping (gas) he put down as part of the reflux issue as well. We had another discussion about the serious hiccups I had while in hospital (vegas nerve silliness), and he introduced the name of another nerve, which I promptly forgot... and I also have forgotten part of the conversation around the hiccups. But there isn't a huge concern there...

6. I did not tell him that the guy he referred me to was 'inadequate'. I just pointed out that my hearing is back to about 90% and let it go at that.

7. We had a 'light bulb' moment around the joint/muscle pain; I could be suffering from something to do with a hypo thyroid. I have to look this one up. Apparently, when we factor in a few of the other items on the list, the joint pain can actually point to thyroid issues. This little syndrome could account for a number of the other wee challenges that I've been facing, not the least of which is fatigue and some motivational issues. He has ordered a series of blood tests...

8. The lump in my neck which is the transplanted saliva gland will not shrink much more that it has already. Damn. We could start looking into cosmetic surgery, but what's the point?
Vanity?

So, generally then, things are in good shape. We'll get the reflux contained, and investigate the thyroid.

Healthcare System Complaints? Got none again today...

Shortly after 8:30 pm mountain time last evening, my surgeon, Dr. David Williams called to let me know what was happening with the pathology on the samples taken during the surgery on the 26th of November. Now, think about this. At 8:30 pm a surgeon calls a patient. This call is made at the end of what was probably a very busy day. In fact, knowing what we do about David, this call was probably made at the end of another surgery... Norman Cousins once said: "Nothing is more essential in the treatment of serious disease than the liberation of the patient from panic and forboding." This guy, this David Williams, he gets it.

Now, the substance of the call last night was this:
Of the 41 lymph nodes removed from the right side of my neck during the neck dissection only one was contaminated. And that one was the secondary tumour that sent me to the doctors in the first place. It was, when removed, 4 cm x 4 cm in size. And, of the samplings taken from the left side of the neck, none of them was contaminated. Tissue removed from the area surrounding the primary tumour, no additional cancerous material was found. In short, it looks like THEY GOT IT ALL!

We will, of course, still submit to the radiation and chemo therapy treatments that will be designed based on this new information.

There is a lot of relief around here. I, personally, have never doubted that the team would get it... this may be a silly attitude to take, but it just never occurred to me that they wouldn't.