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.

A sudsy summit

Cancer wants to have a beer with me.

His invitation popped up as a text message on my cell phone while I was driving around town on Saturday. Creeped me out; it really did. Almost made me crack up the car! I pulled over and parked to make sure that I read the message correctly.

Seems fishy, coming on the heels of the fiasco in Cambridge and Obama's "teachable moment" with that cop and Skip Gates.

Does it sound like a trap? Is this some kind of clever marketing gimmick, a mass text message sent to thousands of people at the same time? City of Hope and Kaiser have been doing a lot of radio buys recently, so maybe this is Cancer's way of striking back. I imagine Cancer would have a hard time buying a spot on KNX-AM, even with the Fairness Doctrine and all.

Or maybe this text message was directly solely at me. I have been dissing Cancer a lot in this blog. Maybe Cancer wants to give me his spin on what I've been spewing.

Or maybe Cancer wants to go mano a mano.

Call me crazy, but I'm tempted to take the bait. It would be quite a beer date. I'm confident that I can handle any questions Cancer has for me, and this would give me a chance to get Cancer on the record about things that I want to know.

At the top of that list: Dude, are you still in me or not? And if you are still lurking in me, when are you gonna pack it up and leave?

Oh, and I would love to see Cancer's reaction as I unbutton my shirt to pour my brew into a syringe attached to my G-tube.

Still, I don't want to act hastily. After almost 20 years of kvetching publicly about HIV, I've never gotten invited on a beer date with AIDS.

So it just seems odd.

I sat in my car, reading the message over and over, while tapping my fingertips on the dashboard. I didn't want to blow Cancer off right away, and risk pissing him off. Cancer went to the trouble to text me; Cancer deserved a timely response. So I hit Reply, and texted back to him:

"OK with U if I bring along Joe Biden?"

I'll let you know if I hear back.

Under the knife again

Maybe Dr. B1 defused bombs for the Army in Baghdad before he took up head-and-neck surgery.

Because it could not have been easy on Friday in Kaiser's operating room for Dr. B1 to get his delicate instruments past my steel-trap jaws and deep enough into my kisser to capture some of the suspect tissue that lurks there.

If you want the Cliffs Notes version of today's post, here it is: T.G.I.Saturday.

I'd been jittery about how Friday's surgery would go ever since I learned early this month that another biopsy was in my future. While I won't know the results of my biopsy till next week, the procedure went well.

I remember the whole experience with Friday's surgery in stark, high-definition clarity —all the way up to the very beginning, that is.

What I mean is: I remember boarding the Red Line in Universal City shortly after 5 a.m.; I remember getting off the train at Sunset and Vermont; I remember trying to maneuver around a cyclist on the escalator ("I can't move!" he barked, a minute before he and his bike magically regained the miracle of movement at the top of the escalator); I remember walking through the doors of Kaiser's brand-new, $600-million medical center for the very first time; I remember checking in at the admitting department; and I remember asking a pregnant woman to move a sweater so I could take one of the last remaining seats in the waiting area.

I remember getting a plastic band wrapped around my wrist; I remember stuffing my clothes into a plastic bag and donning the standard-issue cap, gown and hospital booties; I remember the nurse unfolding a blanket fresh with warmth from the dryer over my body; I remember her thumping the back of my left hand so she could get a vein for an IV; I remember being interviewed by a steady parade of anesthesiologists and others on my doctor's team; I remember being asked for my name and birth date at least a dozen times.

I remember Dr. B1 stopping by my bed to greet me and review my charts, shaking my hand to say hello and squeezing my toes to say goodbye.

And finally I remember one of the nurses telling me that the medicine that she was feeding into my IV would help me relax. She then brought up the metal rails on my hospital bed and, with help from one of the anesthesiologists, pushed me down a series of winding corridors toward the room where my surgery would take place.

That last scene I've watched a million times on "E.R.," except the irony is, I've never seen a single episode of that show. (If I had mentioned "Ben Casey" instead of "E.R.," some of you might have clicked away to a blog by a younger, hipper cancer victim.)

I remember thinking that the ride in my bed to the operating room was taking too long, but maybe the nurses just push the bed aimlessly around the floor until they know that I am asleep. Because I don't remember entering the operating room. My next conscious memory is opening my eyes in the recovery room, having my vitals taken by the nurse who still thinks I resemble Ben Stiller. Maybe it's a Jew thing; that nurse kinda resembles Julie Kavner.

Dr. B1 says that he won't know the results from the biopsy till Wednesday, so I'm looking at several days of biopsy news hanging over my head.

I have plenty to do to keep me busy in the meantime. Seems like the anesthesia is affecting my ability to pee again, so baby-sitting my bladder and taking Flomax is priority No. 1 (I've used that pun before and I'm not ashamed to use it again).

Darning socks is the next task on my list.

The next time a doctor or anyone else feels like squeezing my toes, I may not be wearing brand-new baby blue hospital booties. I better be prepared.