Let’s take stock of what we, as a society, learned this year. The Higgs Boson still doesn’t exist, although deflections in the readouts make their nonexistence highly improbable. The oldest “animals” in Chinese fossils nearly 600 million years old turn out to be some kind of fungus (admittedly, it’s OLD fungus). Antioxidants don’t prevent prostate cancer. College graduates get better cancer treatment than those less well educated. And rats not only learn to liberate other trapped rats, they give them gratuitous chocolate treats.
Personally? What a year. The stuff “used to treat vaginal yeast infections” worked. The chronic pain on the deep left of my tongue is almost gone. I’m not generating nearly the volume of disgusting ropey throat mucous in the evening. My tongue rehab is making my voice at least marginally more understandable. And I can drink a 500 calorie breakfast product shake (made with whole milk, of course) in lieu of two of my cans of international emergency rations.
So, physically, I suppose I’m climbing out of the hole. Although I’m still unable to swallow anything more challenging than cream-thick liquid. I’m also still pretty nervous about the future. Which is a good segue for this New Year’s edition. We need some predictions about next year!
Prediction 1: aliens will not contact earth. Earth will not contact aliens. Despite Discovery Channel’s best efforts, Bigfoot will not actually be encountered. See http: //www.bfro.net/
Prediction 2: none of the present Republican candidates for President will be elected. Can you frickin’ imagine? See http://nymag.com/daily/intel/2011/06/god_caught_backing_multiple_go.html
Prediction 3: anomalous weather will not be blamed on sunspots. The sun is in a period of low activity, and those annoying spots are nearly gone. Don’t worry. They’ll be back. We’re climbing out of the sunspot cycle minimum, see http://solarscience.msfc.nasa.gov/SunspotCycle.shtml
Prediction 4: the price of high-quality flash-frozen Bluefin tuna will continue to rise on the Tsukiji wholesale market, making those Australian tuna cowboys (see http://scubachronicles.wordpress.com/2008/06/20/tuna-cowboys-playing-with-14ft-makos/ ) wealthy beyond reason.
Prediction 5: the world will not end on 21 December 2012, despite the close-out of the Mayan Long Count Calender (ending the 144,000 day cycle and wrapping up the entire Mayan 5,200 year creation story). For sensible debunking from NASA, see http://www.space.com/14078-apocalypse-2012-doomsday-predictions-debunked-nasa.html . For a rather more fun comprehensive compilation of web-based sources of hysteria, see http://www.december212012.com/ .
So there you have it. Fun as it would be to check in to The Restaurant at the End of the Universe next December, we’re all gonna wake up on 22 December one day older and just those few hours wiser. I’m working on staying optimistic for the coming year, despite my trepidation. I’m running low on Xanax, though, so we’ll have to see how that goes. One thing I do know—you all are motivation for working hard toward recovery. Special shouts this week to Linda for the great photo from “the good old days”, the update from Margaret and her family, and the note from Mary. Thanks all—talk to you next week!
Last February, I presented myself at my GP’s office with the swollen throat and tongue and impaired speech. He took one look and ran—actually ran—upstairs to the nearest throat specialist willing to look at me. Which the guy did. That guy subsequently panicked and called Greater Baltimore Medical Center and the Johns Hopkins Throat Cancer specialists to try to get me in that night. On my way out of his office, the throat guy said “just in case you want some hope that it’s an infection and not a malignancy, here’s a prescription”. I filled the prescription, started the course the next morning. A few hours later it was confirmed that it was cancer and I dropped the med. The stuff he gave me was an antibiotic called Fluconazole. I was reminded of this when my oncologist diagnosed my painful tongue as due to childhood favorite “thrush”. Which, it turns out, is a fungal—actually yeast—infection. Thus the new scrip my oncologist wrote this week for a higher dose tablet says “This medicine is used to treat vaginal yeast infections”. That’s pretty much it.
But it seems to be working. After two doses, my pain is less and the ropey throat mucous isn’t as bad. Dr. H is just smegging awesome!
Last night I had a dream that I ate a whole pizza. After I was done, I wondered how I managed it by mouth instead of feeding tube. Then I woke up to the reality that it was an Instant Breakfast shake and more UN emergency rations by tube. Sigh.
Also last night, I finished the Gospel of Luke. Now I’m into the Gospel of John. It’s a long one, and takes some slugging to get through. Ah, but there’s the big reward waiting—my annual foray into the Revelation of John. Psychedelia like the Grateful Dead could only wish for.
Tomorrow night (I’m writing this on Friday evening), after the crowd leaves from the crab balls, shrimp, ravioli and ham dinner, I hope to have everything wrapped and under the tree so I can settle in to watch the Midnight Mass from the Vatican. It’s fabulous. They have a creepy little porcelain Jesus that is apparently by some famous post-medieval porcelain house. It’s frightening.
Finally, I hope all of you have a wonderful, wonderful holiday with whatever family and friends you’ve got around. I know I’m just glad to be here for this one, having come through disease and treatment, either of which could have, with a slight miscalculation on anyone’s part, especially me, have seen me not here to send my love to you this holiday. But I’m alive. And I’m damned grateful for it, and for all of you out there, giving me strength to fight through the darkness. Thanks all. I love you. Talk to you around New Year’s!
It Might Get Messy
Friday morning at the hospital, fine-tuning my rehabilitation with Therapist Bethany. Friday afternoon with Dr. K, my GP, gentlemen who saved my life by recognizing my Stage 4 tumors last February. After the exam, he said “May I ask a question? What was the worst part of the whole experience?”
I had to think about it. I thought hard about the emotional strain, the panic over my professional life, the night I was certain I was not going to survive.
The latter was the key. I had gone through the whole seven weeks of two-a-day radiation and weekly chemotherapy treatment, and while it grew increasingly painful on my throat and jaws, it didn’t disable me. I was chirpy and optimistic on the last day of treatment, a Friday when I got the last two doses of radiation. It was that Saturday night that the shit hit the fan. That was the night I dehydrated in nonstop vomiting and had to be shuttled to the ER next morning, where I was admitted, packed into a room, hooked up to an IV and an automatic vacuum throat drain, and given two units of blood for anemia. It was the physical exhaustion and pain of those first few nights after treatment ended that were by far the worst of the worst. As a scientist and at least amateur practitioner of Zen acceptance, I knew going in that cancer is like auto accidents, lightning strikes, and jet engines falling from the sky onto beds. It can happen to anyone. There’s no sense being personally affronted by it when it shows up. You’re gonna spend enough of your physical and emotional strength fighting the battle for recovery. Don’t want to dilute that focus by worrying about what you’ve done to insult the gods.
Dr. K is only a few years younger than I am (his daughter played double-reed instruments in her youth, as did Molly). He said he’s had cancer patients who didn’t have the strength to fight their way through the physiological wasteland of radiation and chemotherapy.
While it did cross my mind that Saturday night that I might not survive the experience, that just kind of pissed me off. Weak as I was then, and horrified as I was at having to go to the emergency room (4th time in my life, once as a kid for a cut on the head, twice for my stone-packed gall bladder), it made me mad that I’d been forced to it and steeled myself for getting through it. I was, in short, enraged (along with being pretty much prostrate).
So there you have it. Turns out I lied to Dr. K, and misled you a few paragraphs up. I DID end up emotionally vested in the process, angry, frustrated and out for vengeance. Which latter, with some hard work on this physical therapy, may come to pass. I may yet beat this and come out scarred but whole.
Speech therapist Bethany ran a scope through my sinuses to check out my throat yesterday. Turns out my epiglottis actually still exists. It’s twisted, misshapen, and dysfunctional. But it’s there. Hopefully I’ll have a picture for you next week.
I hope everyone is having a good runup to the holidays. I sure as hell am thankful this Christmas. Just glad to be here!
In case you haven’t thought about it lately, your epiglottis is an important piece of plumbing. As the (reviewed and referenced, despite missing the “a” in the first sentence) University of Maryland Medical Encyclopedia online puts it:
The epiglottis is flap of cartilage located in the throat behind the tongue and in front of the larynx. The epiglottis is usually upright at rest allowing air to pass into the larynx and lungs. When a person swallows the epiglottis folds backward to cover the entrance of the larynx so food and liquid do not enter the windpipe and lungs. After swallowing the epiglottis returns to its original upright position.
In other words, your epiglottis sorts solids and liquids from gasses and makes sure each gets down the correct pipe. A major problem with people whose epiglottis fails to do this sorting correctly is pneumonia due to crud (i.e. solids and liquids) running into the air passageways.
My General Practitioner, Dr. K (who saved my life last year by recognizing that I not only had throat cancer, I had acute Stage 4 throat cancer that needed immediate attention) last week prescribed a new medication for me. It’s a pretty big pill that has to be taken in the morning. I figured I’d just dissolve it like I do with the rest of my meds and pump it into my feeding tube. No go. Not only did that pill not dissolve in a glass of warm water, when I dumped it into the sink it got stuck and took an entire week (in a heavily-used bathroom) to dissolve.
Nor could the pill be crushed. It has a sort of semi-moist texture that makes it squash but not fragment.
Well, I thought to myself, this’ll be an adventure. I cracked open a (full calorie) A&W root beer, sat on the bed, and took a mouthful of soda. Then I tilted my head back. I used to take pills by dropping same into the liquid in my mouth, then releasing the whole mess via my epiglottis into my gastrointestinal tract. In this case, I was surprised to find that the soda did not stay in my mouth—it drained all by itself into my GIT. None entered my airway (thankfully). Turns out, I can take the pill by being quick about getting it into my mouth during the head-tilt routine. Score one for experimentation.
I spent much of Friday at the hospital having further diagnoses and getting equipment and specifications for physical therapy for my crippled tongue and throat. The therapist set it up so I would start in radiology, where a doc would do real-time radiobarium imaging of my swallowing. I started with a small sip of the icky white liquid and swallowed as directed. “OK, let’s look at this” she says. “See, here’s where your epiglottis used to be. It’s not there any more—the radiation destroyed it.”
Nobody (except me) seemed the least bit disturbed at the fact that I am now without such a critical item of gastrointestinal plumbing.
We went on from there. I got a new set of tongue exercises, which we ran through at the therapy session. Between sticking my tongue out, over, and around, and doing isometrics (anybody remember those Royal Canadian Air Force isometrics booklets? My parents were big fans, albeit doing isometrics between cigarettes and glasses of beer) against a tongue depressor, the (now weak and badly scarred) back of my tongue was cramping.
And that’s a good thing. The only way I’m going to be able to eat “normal” food is by making my tongue strong enough to take over some of the function of my now-missing epiglottis. I assume such exercise will also help my voice recover. So now I’m deeply vested in squishy physical therapy with my tongue several times a day. I go back next Friday to check progress.
I’ll let you know. Thanks for stopping by. Y’all are a big chunk of why I’m still here, so thank you again!
In 1897, Winston Churchill [1] wrote “Of all the talents bestowed upon men, none is so precious as the gift of oratory. He who enjoys it wields a power more durable than that of a great king. He is an independent force on the world. Abandoned by his party, betrayed by his friends, stripped of his offices, whoever can command this power is still formidable.”
I shuddered when I read this. It has only just occurred to me that I have made my living and my life based on public speaking. From teaching remedial summer school in Wayne, New Jersey in 1976, through graduate school, academia, government, and consulting, my ability to speak effectively has had my back. Which is a good thing—I’m not swimming in talent, and skillful oratory has been my one true core competency.
I shuddered because the aftermath of my cancer treatment is that my speaking voice is badly impaired. I no longer have the gift of oratory. This scares the crap out of me. There is nothing else I’m really able to do except talk on my feet. It seems to me it’s now a race—my professional life against the recovery of my voice. It’s certainly not a gimme. For one thing, my voice will always be different from its pre-malignancy self. Will it be as persuasive, as sharp, as effective? Beyond that, will I even have a job when it does finally recover?
At my series of checkups at the hospital last week, it was made clear that it will take on the order of a year, maybe two years, for my voice to recover. It’s not at all clear to me that I can survive professionally that long. Of course, I’m not sure what the alternatives are… .
On the positive side, the nutritionist gave me some very useful eating advice. I told her that just a bite or two of food by mouth makes me feel full, which is part of why it’s taking so long for me to get off the feeding tube (although recurrent surgery through a few weeks ago also played a role). She says that’s to be expected biochemically. What I have to do is eat a little bit by mouth before I eat via tube. This will prep my system for the big change-over.
And you know what? It seems to be working. I’m still pouring my 8 cans of emergency rations a day, but eating some real food first (well, except for first thing in the morning. I’m barely able to get the two breakfast cans down in the a.m., much less try to prepare and ingest some sort of gruel first). And the past couple of days, I’ve been eating more and more by mouth. I may get through this yet. At least physiologically.
Oh well. Today I put up holiday lights in the cul-de-sac and some in the front yard. Busy work week coming up. Tonight, I’m going back to read a little more of this history of World War Two. And also the gospels and Revelation. Every year between Thanksgiving and my birthday, I read all four gospels. And then, as a reward for the slogging that requires (the lists of “begats” alone is intimidating), I read Revelation. As psychedelic as anything Philip K. Dick, or even the Hindu holy books, can offer. This year, I have a brand new Oxford revised standard edition to replace the rather stodgy King James paperback I’ve used for decades. This is much more readable!
Thanks for checking in, my friends. My love to you all, and I hope you’re having a nice start to the holidays!
Notes
[1] My source is an excellent and very readable recent history of World War Two, The Storm of War, by Andrew Roberts, Harper Collins 2011. The quote is on page 46.
