Dig your trenches and prepare for battle!

Hi. Welcome back to my blog. As promised, I've returned to share with you the outcome of today's medical appointment with the otolaryngology (ENT) surgeon. To be honest... this has not been the best of days.

Jessica woke me up at 0510, which is ten minutes BEFORE my normal wake-up, and an hour before I had planned to wake-up. I was annoyed at first, but later grateful for having spent an hour drinking coffee and watching the news along side her without the kids yelling and screaming. The youngsters awoke just in time for me to get ready to leave for my medical appointment at Banner. Jess went with me, and on our way out, we dropped the kids off at school. It was nice getting to see them off, considering I am usually at work by that point in the morning. 

The wife and I headed to the University's main hospital where I was scheduled to meet with my ENT surgeon for the first time. I assumed parking would be easy since it was only eight in the morning, but "BOY" was I wrong. We ended up on the roof of the parking garage...again! There were no signs pointing us in the right direction this time, so we had to stop to ask for directions. When we found our way to the right place, we entered into an empty waiting room. I felt as though this was a good sign that I would be seen quickly.

I had to fill out some forms before I could be called back. It was four pages, mostly asking me specific questions about certain parts of my body. Jess watched over my shoulder, correcting me when I miss-marked some of the responses... largely due to my inability to slow down and read the questions rather than assuming I knew the answers.

It wasn't long after I turned in the questionnaire that I was called back by a nurse. Jess and I followed the nurse a short way down a narrow hallway before arriving at the examination room. The room was small-smaller than most exam rooms. It was filled with fun toys that looked more like torture devices. I quickly identified a laryngoscope, which was a medical procedure I had yet to experience. The scope looked fancy. It was high-definition (HD) and attached to a monitor via some cables. I sat on the traditional patient examination bed/chair while Jess took a seat in the corner next to the door.

The nurse took my vitals. I must have been feeling well rested and stress-free because my blood pressure was looking good... 128/78. Now that I think of it... there is a high probability that my relaxed state was largely due to the killer massage I had received the day before.

I was also given a couple sprays of numbing agent in each of my nostrils. It was meant to numb my nose and throat in preparation of the laryngoscope. After the nurse had taken my vitals and set me up for a scoping, she left... never to be seen again.

The wait for the doctor felt like forever. I'm sure she was seeing another patient, but I couldn't help thinking the worst. I told Jess that I wouldn't be surprised if my CT scans from the day prior had not made their way into the hospital's database. Maybe the doctor had just received the scans and had just begun looking them over. Maybe my case was more complicated than I thought. I was anxious... I knew this medical appointment would reveal the true extent of my cancer dilemma.

There was a knock on the exam room door. Almost immediately, the door opened and the doctor and two assistants entered the small room. The doctor was very nice. She was pleasant, yet direct, which I find welcoming. The doc didn't beat around the bush. I was asked a couple questions, but it didn't take long before she had her fingers in my mouth feeling around. She asked me to lift my tongue... revealing the dirty culprit.

"Aw... It's so cute!"

Cute? Did she just call my tumor cute? What in the world is cute about cancer?

The doc informed us that the tumor on my tongue was small. It was insignificant and would be easy to cut away. Whew, what a relief!

She reached for the laryngoscope. Wait... I thought it was cute? She wanted a look in my throat. The medicine I had been given earlier made everything numb, so inserting the scope wasn't a problem. I told her I was sure my nasal cavity was messed up because I had issues inserting a nasopharyngeal airway during Combat Life Saver training in Iraq. She was quick to point out that there was a high probability we didn't know what we were doing. I felt silly...

The laryngoscope didn't hurt at all. The entire procedure only lasted a couple minutes, and the worst part was having the scope removed.

The doc looked over to one of her assistants and made a comment about my left tonsil. She then informed me that she was concerned on the way my tonsils looked, especially the one to the left (the same side my tongue tumor is on.) I proceeded to tell her of my history with tonsil issues, to include the many strep throat tests I received as a kid.

Next, we took a look at my CT scan results. The doc began by first educating Jess and I on what we were looking at on the scans. She started at the top on my skull and slowly worked her way down. She pointed out my brain, eye balls, sinus cavities, and upper pallet. This was all great, but I was only interested in my lymph nodes. She continued down... past my teeth, and eventually to where my tongue was located. She pointed out where my tongue tumor was, but still seemed very unimpressed. Just below the tongue are six lymph nodes, three on each side. Five of them looked like jelly beans, but there was ONE... One of the lymph nodes looked like a jelly bean that had given birth to a butter bean. Our conversation took a turn. Everything became very serious, very quick. I was informed the growth on the one lymph node was concerning. Without a biopsy, we could only assume it was also cancerous.

I immediately fell into a temporary state of shock. I felt the same way I had when first learning of the results of my initial pathology report. We were hoping my cancer was isolated to the tongue. If it was anywhere else... my treatment would be more invasive than we would have hoped. The worst news I could have received had just been given to me. The cancer has spread. Not only is it on my tongue... there is a good possibility it is on a lymph node and possibly a tonsil. I was crushed, and by the look on Jessica's face, she was also!

I began asking about the treatment. The doctor informed us that I would definitely need surgery, most likely two. One for the tongue and lymph nodes and the other to address the tonsils. The first surgery will require an incision around the crease in my neck, as if being cut from behind by my worst enemy. She planned to go in and remove everything. I don't even fully understand what those lymph nodes do, but it doesn't matter... she is going to remove all of them. As if it would make me somehow feel better, she went on to inform me that I would have a "cool" Frankenstein looking, stapled wound around my neck. If this were going down around Halloween, I might be okay with this, but it's not!

After the cancer, I would most likely get radiation, and possibly chemotherapy. Wait...what? The Radiation Oncologist was almost certain I would not need radiation. This is the type of misleading information you can expect when you don't see the doctors in the right order.

DISCLAIMER... although upset, I do NOT hold anyone responsible for the change in prognosis. The RadOnc had no idea the cancer was anywhere other than my tongue.

Because the cancer has spread into my lymph nodes, I would most likely need radiation following surgery. So just to recap, I am now looking at two surgeries and the possibility of radiation.

The doctor also informed me of a clinical trial that was going on she felt I was a good candidate for. It was specific to mouth cancer and was in its second stage of testing. The trial was testing a new medicine, designed to shrink tumors associated with oral cancers. It was in support of the University of Arizona, so I agreed to be a guinea pig.

I'm in total disbelief. I had prepared myself to hear good news. Although the tongue tumor is cute, the intervention needed to knock this crap out will be much more than I had hoped for. I was hoping the cancer could be cut out in a matter of minutes, followed by a couple days of healing, and maybe some speech therapy to get me back on track. Instead... I am faced with having all that oral cancer has to offer. I am happy that the cancer on my tongue is small. This means the likely-hood of losing my ability to speak is very slim. I am also pleased to hear the doctors' affirmation that this was 100% curable.

I was hoping our blog relationship would end after a month or two. Not that I don't enjoy out time together... I just value my health more than my story telling. It looks like we are glued to one-another for much longer than anticipated. We are looking at a six-month treatment plan. I hope to continue this blog for the duration of this journey. I guess we should all dig-in and prepare for the long battle ahead. Bare with me as I am certain the next couple weeks will be hectic. My surgey is scheduled for mid to late March. I am hoping to take a trip to San Diego in the very near future... before continuing on with this cancer trip. If you are in SD and would like to hook-up, please let me know. I have no agenda and no plans as of now. I need to get away... at least for a couple days.