At times, the persistent mouth infections had a comic aspect. When I did the oral comprehensive exam for my master’s degree, I had to keep a bottle of Listerine (the brownish stuff thick with eucalyptol, not a sweet “breath freshener”) on the desk and beg frequent bathroom breaks to swish the accumulated microbial mess out of my mouth. The committee assured me they gave me no extra credit for such a bald-faced attempt to garner sympathy. Although, in retrospect, I suspect they did.
Actually, the comedic nature of that incident stretched out for quite a while longer, and narrowly missed appending a tragedy to its etiolated life span. As was the academic custom at the time, we planned a major party that evening (the fact that it was a school night, a Tuesday I believe, be damned) to celebrate (presumptively) my passing the examinations, or, conversely, to provide an emotional buffer in the event of failure.
Of course, I passed. I say “of course”, but I had an unconventional boost from more than my oral hygiene. When we convened for the exam, one of my committee members was missing. My major professor, the much esteemed Dr. W, called the MIA faculty member’s office a couple of times as we got underway. Dr. D’s phone line was busy. After a few attempts, we gave up on Dr. D and completed my exam. When I walked across campus heading for the state-of-the-art party facility, Dr. D burst out of his building, shouting questions at me as he ran. I gave him the formal definition of salinity which, at the time, was 1.8065 times the chlorinity (I believe it is defined differently today). At that point, Dr. W showed up to distract Dr. D, taking him back to discuss the exam with the rest of the committee. I continued to the SOTA party facility.
Where there were, per usual, a keg of beer and buckets of steamed crabs. Later in the evening, I discovered an unopened bottle of Sloe Gin, a sweet, highly alcoholic cordial based on the flavor of the “sloe”, a small species of European plum (once when I was hiking around the borderlands between Belgium and the Netherlands in the vicinity of Maastricht, I stumbled upon a hedgerow hanging thick with ripe, sweet sloes. Needless to say I stuffed my face, and was refreshed to finish my hike back to the very nice boutique hotel with the outstanding restaurant). Of course I cracked the bottle of Sloe Gin and swigged some. Then swigged some more. Much later, I had consumed most of the half-liter bottle. By then the discomfort of my infected mouth was accompanied by a disgusting build up of syrupy, sugary goop in my throat from the cordial. To cut the latter, I started drinking the Listerine. Which is not a safe, sane thing to do. Fortunately, I ran out of Sloe Gin before I could consume enough of the Listerine to do any real damage.
Anyway. Back to that month prior to my cancer diagnosis. During that period, I purchased and swished my mouth with gallons and gallons of Listerine. Took handfuls of over-the-counter pain killers. Finally, I met an old and dear friend for dinner. I was helping esteemed Ms. W celebrate her own triumph over breast cancer. Between funny stories and reminiscences, Ms. W convinced me to take my month-long mouth pain to my doctor (Cathy, of course, had been bugging me to get my butt to the doctor for weeks). Kicking off, the following Thursday, my cancer wars that are now entering their fifth year.
Anyway, as I mentioned last week, I’ve recently started to bleed a lot more frequently and intensely than I have been. My damaged, rebuilt, re-damaged, and re-rebuilt oral cavity and throat started to run with thick clots of fresh, red blood. And pain, which has generally been under control, returned. So we saw a doctor last week, one of the head and neck cancer experts at Greater Baltimore Medical Center who have saved my life twice (so far).
Characteristically, he squeezed me in for a late afternoon appointment on an already full day, and one on which most of his staff and nursing support was MIA by the time I arrived. Not a bit disturbed, the Doc was his own assistant, suctioning away blood and mucous while manipulating the endoscope to peer into my bronchi and along my throat. There was nothing obviously associated with bleeding. Big chunks of my thoracic infrastructure remain, and will forever be, comprehensively trashed by the two rounds of radiation treatment. But otherwise, there were no sores, no visible masses, no inflammation, no cuts, scabs or scars.
Absent the naked facts of the blood and pain, this would all be good news. But, lacking something visible to blame for the bleeding, his conclusion was ice-cold and scorching at the same time. The blood is coming from a recurrent tumor somewhere deeper in my plumbing. He’s apologetic that there’s nothing he can give me for the bleeding. He did the rough-and-ready check for anemia by observing my fingernail color. Says “ahh, your anemia isn’t all that bad”. I had not even considered the potential for my bleeding to be sufficient to cause overt anemia. But apparently it is.
Dr. S, a Walter Reed Army Medical Center alum, immediately starts the diagnostic process that will ascertain whether I’ve got something trivial, something terminal, or something at one of the many stops in between. Next week, in lieu of the long-scheduled and cherished trip to the Outer Banks to photograph cottonmouths and roust out a rattlesnake, I’ll be heading to the lab for a PET/CT scan to reveal where and what this presumptive tumor is.
Dr. S was careful to prepare us for the likelihood that a third major malignancy in my throat is likely to be difficult or impossible to treat comprehensively. He repeatedly used the phrase “palliative response”, meaning, of course, that we can treat the symptoms but not the underlying disease. When I pressed him, he did say that “we can surgically remove pretty much anything”. Then he suggested that if they were in my throat cutting anyway, they might as well remove my now-useless voicebox. Dr. S says if they do, I’ll be able to pour liquids directly into my gut. Man, I would love to ditch this peg-through-the-stomach wall in favor of thick shakes dumped down my throat. If this new tumor proves to be recalcitrant or even terminal, at least I’d have a major bump in my quality-of-life for whatever time I have left.
But we don’t need to go there yet. Tuesday I’ll have the PET/CT scan. Dr. H will have the radiologist’s report that afternoon, we’ll have Dr. H’s interpretation on Wednesday. Unless the PET/CT output is unusually clear, the likely next step is a lights-out scoping and biopsy. From there, if they think they can cut to some purpose or believe I could take more radiation treatment, I’ll probably have to battle claustrophobia in the MRI tube. It seems, though, that they may use more approximate treatment planning this time. We’re running out of methods to fight malignancies, although apparently there are some chemotherapeutics that could at least reduce tumor size, and as I say surgery and radiation remain at least theoretically on the table. So, we’ll just have to let this play out, while I continue to mop up liters of blood and phlegm here in my Recovery Recliner.
This week’s entry is pretty much a complete downer. To offset at least some of the bummerly nature of things, I leave you with some midsummer photos. Remember, my friends, my pain can be your gain. Live ‘em while you got ‘em. Because you can see, from my example, that they ain’t forever. Rock on, everybody!!!
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