It Might Get Messy

The thing about cancer is, it’s forever. This is, of course, literally true. It’s a simple matter of probability that a genetic error will coincide with other physiological conditions to cascade down the road of runaway cellular misconduct. This can happen any time, anywhere, at any age. 

But it’s also true in a more immediate and frightening sense. Once you’ve had cancer, you have the nagging discomfiting feeling that it’s coming back. Or starting anew. Or both. There is a constant chipping at the edge of your consciousness, loose shards of paint and plaster around cracks where the tumor of your nightmares gains entry and proliferates.

I went to see my new “palliative care” specialist this week. Dr. S has been assigned the complicated task of keeping track of, adjusting, juggling, and prescribing my medications. He is being very sensitive regarding possible intrusions on my other doctor’s turf. I assured him that the medical team is not generally turf-conscious, and also that they are more-than-happy to be relieved of responsibility for the volume and diversity of my meds. 

Dr. S is streamlining the anti-depressant and anti-anxiety components of my pharmaceutical program. We’re cutting back to one of each, and experimenting with doses to find the best balance between blissful sailing on the gentle waters of life and being passed out face down in muddy bilge scum under the storm-slammed decks of a trawler off Tierra del Fuego. 

But I still had that “holy shit, we’re goin’ down, all hands to the boats, women and children first, get the band playing “Nearer My God to Thee” and signal the Carpathia” feeling when I started getting a new ache at the base of right mandible. It started as a single point of pain, about where the cheek meets the jaw. Over a few days, it grew and stretched along a line from up under my earlobe to down near my throat. Now it’s a constant dull ache, running along my Eustachian tube, feeling rather like a childhood post-swimming earache. 

Anyway. First thing that popped into my mind, of course, was that there was a new malignancy sprouted and blooming in my throat behind my jaw. I emailed the doctors to appraise them of the pain and inquire about what to do. But, that was the first of the week of Thanksgiving, and perhaps unsurprisingly, the docs didn’t respond. Admittedly this is unusual. They’re ordinarily quick to reply. But I’m thinking they were just busy running between work and family, like most Americans at the holiday kickoff. When the pain stabilized, I figured it wasn’t some new issue. It feels more like an artifact of the surgical reconstruction of my face. There are a number of sliced, diced canals and suture lines in my neck. I think one of them is stretched, or maybe inflamed. 

In any case, this pain is easily controlled with a half-dose of dilaudid twice a day. So I gave up trying to kick pain killers and resigned myself to one in the morning and one in the evening. Dr. S is onboard. He re-upped the scrip. Now I’ll be happy, not to say calm and relaxed, for the foreseeable future. 

As to the potential for new tumors, that is, of course, reality. And for a number of reasons—baseline sensitivity, heavy doses of radiation therapy, massive application of diagnostic X-rays—I am more liable to sprout new malignancies than your average joker on the street here in the Year of Our Lord 2013, assuming your “Lord” goes by the consensus calendar we’ve all been using for the past few hundred years. We’ll be doing big threshold diagnostic tests the week before Christmas. I’ll have a PET (the one with the radiolabeled sugar uptake) and a CT (3-dimensional computer registered imaging) scan later in December. The results will be in my hands that day, in my doctor’s hands that evening. Since I am only able to read the imagery if there’s a massive crystal-clear tumor slurping up radiotag, it’s unlikely I’ll be able to tell anything at first glance. I’ll be seeing my covey of doctors the week or two after Christmas. That’s when we’ll really know if I’m cancer-clean, or if there is more painful marching to be done in 2014. 

Until then I’ll be chirpily optimistic. Or maybe hazily optimistic, depending on how much pain medication I need to soothe my aching jaw. But in either case, I intend to have a slammin’ holiday season. 10 months ago, it was pretty clear to all concerned that I wasn’t going to be alive to celebrate these holidays. But here I am, candying orange peel, baking the family pan duce Christmas bread, watching football on TV, and reading Genesis, the 4 Gospels, and the Revelation of John in preparation for one more Christmas and New Year and birthday season. 

I hope you are all having a great run-up to the holidays. Keep your stick on the ice and your aquavit in the freezer. With a little luck—and pending those upcoming diagnostics—I’ll be around to celebrate many more with you. Rock on, everybody!