Sunday, January 18, 2009

The fight begins

As I laid in the recovery room at Kaiser following surgery on Wednesday, a nurse asked me if anyone ever told me that I was a dead ringer for that funny actor whose name she couldn't remember.

Here we go again, I moaned to myself. Unable to respond orally, I felt for my pen and notepad and scrawled, "Ben Stiller, maybe?"

"YES!" she shrieked.

Throughout the night and into the morning, it was The Ben Stiller Show in the Kaiser Sunset recovery room as nurses and other hospital staff fluttered around my bed and weighed the possibility that their new patient was the guy from "There's Something About Mary," "Tropic Thunder" and "Zoolander."

So if the tabloids this week feature reports that Ben Stiller just learned that he has cancer, well, I'll know how that rumor started.

I arrived at Kaiser Sunset early last Wednesday morning not knowing what was causing my tongue to swell, making it impossible to eat through the mouth or speak. Two days later, after having tissue removed from my tongue for a biopsy and getting a tracheotomy to facilitate breathing, my surgeon stood by my bed and told me that I have squamous cell carcinoma, a variety of cancer affecting the head and neck region.

I wasn't banking on cancer, frankly.

The timing was too suspicious. In May, I had oral surgery to remove all of my teeth. In June, I got fitted for dentures, and in July, after multiple attempts to achieve the right fit, I took possession of full upper and lower plates. Throughout the summer, I experienced increasing difficulty swallowing and speaking. By late fall, I was having trouble eating and drinking anything at all, and my speech was nearly unintelligible.

Naturally, I blamed the dentures, and sought a solution to my problem from my dentists and, later, my medical providers at Kaiser: my HIV doctor, the neurology staff, the head and neck surgery department.

That cancer was marching stealthily through my body throughout this time, and probably earlier, just was not considered. And when Dr. Birusingh, my head-and-neck surgeon, said he wanted to perform a biopsy on my tongue tissue to determine the cause of the swelling, I was convinced that the biopsy was going to show that a simply treated infection would be unmasked as the cause, not cancer.

Everything is moving quickly now.

My ensemble of artificial tube implants is expanding. On Wednesday, I got a plastic tube in my throat that allows me to breathe; last month, I got a G-tube that allows me to get nutrition and medication directly into my stomach. And in the middle of the night on Friday, I got a Foley cathether implanted into my urethra after it became impossible for me to empty my bladder, likely a consequence of being anesthesized for the biopsy.

We've got a heckuva fight ahead of us, my tubes and I.

The next step is to define a treatment strategy. A week from tomorrow, a board of clinicians at Kaiser will review my case and make a recommendation to fight the cancer with radiation, chemotherapy or by removing my tongue altogether.

I hope that last step won't be the board's recommendation, but I have to steel myself for that possibility.

If radiation or chemotherapy are recommended, Dr. Birusingh says that I'm looking at a treatment course lasting from four to six weeks. Of the two options, radiation seems the easiest and least complicated option; chemo would require longer treatments and possibly debilitating side effects.

I'm fortunate that the cancer appears to be localized, according to Dr. Birusingh.

I have a great deal to learn about cancer. To that end, Kaiser has already mailed a fat packet of information about its cancer programs and resources. Several friends have stepped forward to offer their personal experiences and those of their loved ones. And Dr. Birusingh continues to be patient and understanding by responding to my questions and serving as a resource for my friends and family members.

I'm well equipped to beat this thing, and my promise to myself is to make that happen. I may be naive about what I am up against, but my intent is to fight cancer with all I've got over the next several months or however long it takes.

Mr. Stiller, you're gonna be proud of me.

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