Tuesday, August 18, 2009

Hunkering down for the long haul

Got a close-up look on Monday at the creepy underbelly of last month's biopsy results.

In Monday's visit with Dr. B1, the head and neck doctor who has had to put up with me more than any other Kaiser provider, he handed a copy of the surgical pathology report from the July 31 procedure to me.

The headline news from that report —that no more evidence of cancer was found in me— was joyfully disclosed here almost as soon as I read it in an email from Dr. B1.

On Monday, Dr. B1 shared additional findings by the pathologist.

I didn't really learn anything new, but the terminology that was used in the report to describe my condition sounded so much scarier than I imagined. (If the pathologist who wrote it ever decided to leave Kaiser, I bet he could earn a lucrative salary from the GOP spinning the Obama health care plan to the electorate.)

According to the pathologist's report, "granulation tissue with extensive necrosis and inflammatory cell debris" was found on both the left base and the deep base of my tongue, and "bacterial colonies" were found on the left base of my tongue.

I knew that there was extensive cell damage resulting from radiation therapy on my tongue —I'm reminded of that every time I try to open my mouth— but the way I had been privately describing the situation was that my tongue simply had an "owee" and just needed time to heal.

"Necrosis" sounds like an arch-villain of Spider-Man, or a death-metal band opening for Marilyn Manson. And a cluster of bacterial pup tents on my tongue would give me plenty to be nervous about, but entire "colonies"?! I only hope that those bacterial Ben Franklins don't take steps toward full statehood.

The bottom line is that if my tongue is healing at all, it is doing so at an extremely slow pace.

After Dr. B1 and I reviewed the pathologist's report, he outlined the next steps for me in my treatment plan: another visit to the Radiation Oncology Department at the end of the month, more imaging studies and possibly more surgery.

So Monday's visit in the Head and Neck Department wasn't the victory lap I had hoped it would be.

For one, my fingers had been crossed that Dr. B1 would tell me that he would agree to begin divorce proceedings between me and my trach. Instead, it looks like I'm going to be saddled with my trach for some time. Dr. B1 doesn't want to remove the tube until a clearer picture emerges about what's happening with my tongue and jawbone.

"Wait and watch" were the doctor's orders.

As far as the cancer is concerned, Dr. B1 said that the risk of recurrence becomes very low after five years. That means I'm going to be having cancer heebee-jeebies well into President Obama's second term or President Palin's first.

Don't get me wrong. I'm still kicking my heels and flashing "V" for Victory signs about beating cancer, at least so far. As Dr. B1 reminded me on Monday, the challenges that I'm facing now are annoying but they are not life-threatening.

There's a huge chasm between life-threatening and quality-of-life threatening, and that gulf is my buffer zone against cancer.

To twist a cliché, this opera ain't over until the guy with the trach sings.


  1. Paul - if you ever write those two words together again, I may have to stop reading your blog. (You'll have to figure out which ones I'm talking about because I can't write them together).

  2. Uh oh! I've been called on the carpet and I don't know why!

    Could the two words be "President Palin"? They may be the most offensive words I've ever written.

  3. good news, some not so...... love ya AMA

  4. Dear AMA

    Has the American Medical Association ever tried to shake you down for copyright infringement? They were established in 1847; you were established after that.


  5. I am encouraged by what you are writing and keep praying for a full recovery. Having no signs of cancer is good, but lets get the tongue fixed. I want to have more debates over the best rock n' roll band ... the Beatles!

    BTW, did you see Aunt Mary Anne's picture she has for her follower. Isn't that the ugliest cat you have ever seen?

    Love ya
    Mike (the brother)