A Darkness Looming Overhead

(WARNING) This is not like any blog I have written before. It is NOT upbeat. In fact, it is very much opposite of that. I will be discussing my current state of depression, and well as my future medical procedures, which may scare some people. They scare me! 

Good evening everyone.

My apologies for not keeping you abreast on the most current information regarding this horrific cancer journey. I am not doing well. The fact I have cancer... a life threatening disease has really set-in. I felt as though I could stand tall throughout this battle, but the outcome of my surgery and knowing what I must face ahead has pulled me down into a pit of sorrow. I find myself holding back tears more often than sharing a smile with those around me.

It wasn't until I had cancer that I realized how embedded this heinous disease is on the world around me. It feels like every other commercial, billboard, and bumper-sticker I see has some connection to the fight against cancer. The reason for all the attention? Cancer kills people. I'm not usually one to hold a piety-party, but I think it is only fair that I share with you what is on my mind...

Ten years ago, I couldn't connect myself to any relatives known to have cancer. Today, the numbers seem to be racking up. My father died of a brain cancer a little while back. He was in his fifties, with two young sons. I am thirty-six with children of my own. My children happen to be very close in age to those two young boys. I am scared... SO scared that this crap will sooner or later get the best of me. If I get cancer at the age of thirty-six, what is the likelihood I will get it again some time down the road? Will this crap take me away from those I love before we're ready?

The treatment has sucked so far, and I've only scrapped the surface...

Over the last week, I have had numerous medical appointments with my three primary cancer doctors to discuss the road ahead. In fifteen days, I will start both chemotherapy and radiation. I will receive six treatments of chemo; once a week for six weeks. I will also receive 30 sessions of radiation; five times a week for six weeks. The hope is that the chemo and radiation will kill off any remaining cancer cells that may be left behind following the surgery. Think of it like this... the surgery removed the salt shaker, but there may be some bits of salt still laying around. We need to make sure the bits of salt are completely destroyed.

Chemotherapy is going to attack every cell in my body... especially the cancer cells which are more susceptible to the chemo drug. For my case, we are hoping for two outcomes. First, we need to kill any cancer cells that may have metastasized (moved) from the original point of origin. Second, the chemo will weaken the cells in my neck and tongue, allowing the radiation to do its job more efficiently.

For upwards of two to three months, the chemo will cause me to feel nauseated and fatigued. Imagine having the flu for three months. I will receive some pretty strong anti-nausea medicines, so there may be some relief there. Also, the type of chemo I am receiving should not cause me to loose all my hair... so there is a silver-lining to look towards.

The chemo is going to suck, but to be honest, it does not scare me half as much as the radiation does.

Radiation is going to be used to destroy all the cells in a particular area. Not just cancer cells... normal, healthy cells that have a close connection to all the nerves that run through your body. I will soon be fitted for a mask that is essentially designed to strap my head to a bed so that I can not move, and so that my head can be positioned in the same place every time. It will be made of a hard(ish) plastic-shaped to my face, and designed to be worn tightly. It is absolutely critical that my head, face, and neck be in the same exact place for all thirty radiation sessions. The radiation technicians will take an initial image of my head and neck. With this image, they will strategically position a collection of radiation x-rays to fire and hit very specific areas within my head and neck. These x-rays are accurate up to a single millimeter. The reason it is so important that I not move is to prevent a section of my body from becoming an innocent bystander. For example... we have many glands that help produce saliva-some towards the top of our mouths and some under our tongue. In my case, the ones under my tongue were ripped out of my body during the surgery. I am not reduced to the few towards the top, which I can tell you now are not enough to live without constantly needing water. I could not imagine what it might be like without the others. So... it is very important that when they dial in these x-rays... they do so in a way that avoids hitting those glands.

As I said, the radiation is going to destroy every cell in its path. These x-rays are a lot like the sun's rays, only much, much stronger. So, I will essentially receive internal and external sunburns everywhere those x-rays penetrate. Some of the areas that will be affected: the gums, mouth tissue, tongue, throat, esophagus, lips, and all the external skin from the lower jaw to the tops of my shoulders. Imagine trying to eat or drink while having the world's worst sunburn inside your esophagus. Swallowing will become so excruciating that I will sooner or later refuse to do so. Every taste-bud will be cooked off my tongue, leaving everything in the world tasting what many describe as a disgusting metallic, earthy flavor. The taste alone has led many head and neck cancer patients to stop eating all together.

To help combat some of this crap, I will be having both a port and PEG surgically inserted. The port will be used to hook up IVs for giving me chemo and/or saline fluids if dehydrated. The PEG is a feeding tube, which I imagine I will live with for quite a few months. The inability to swallow has made it very hard for some head and neck cancer patients to go back to eating again. Some just refuse the taste, as I said earlier, and prefer living off the PEG.

So, aside from my neck having horrific lymphedema and being extremely uncomfortable 24 hours a day, and no longer being able to enunciate clearly enough for others to understand me... I have much more crap to look forward to.

I can't promise that my blog posts will return to being the up-beat, comical posts they used to be. The honest truth is... I have allowed piety to overwhelm my thoughts. This nightmare has finally taken its toll on me. I have no doubt I will survive the treatments, but I am fearful to face what my future has in store.

I will continue to blog as I find the courage to face both my daemons and this disease, but not nearly as often as I have in the past few months. I will try to find the bright-side again, but I cannot make you any promises. As I've said before, I appreciate every, single one of you and welcome you to reach out to me anytime. If you need my telephone number, address, or e-mail, just let me know.   

Vampire Jugs

Buenos dias!

So, I've been trying to catch you all up, but a lot happened in the week of and following my surgery. I had a post-op appointment with my ENT surgeon on Thursday, but I don't want to loose out on sharing with you the "in-hospital" part of my journey. Without further ado, please allow me to jump back where I left off... in the hospital.

The first morning following surgery felt somewhat surreal. As many of you saw, I had sent out a selfie on Facebook, which should give you an idea that I was in relatively good spirits. Now, I don't know if it was the drugs, or simply my body not realizing yet that it had just went through a significant trauma, but I did not remain on this same "high" throughout my hospital stay.

I recall waking-up in the hospital room alone. It was quiet and peaceful, only the gentle snore of the patient next to me could be herd. I had been using my pain button routinely, so pain was not much of a concern. The night before was foggy, and I had a lot of unanswered questions on my mind. I didn't want to wake my neighbor so I left the TV off, and I had no valid reason to call a nurse in, so I just sat there quietly taking in my surroundings. I was trying to piece together what I could of my surgery the night before when I suddenly took notice to my cell phone plugged into a charger next to me. Jess must have set my phone up for me. She might have told me, but I doubt I was in any condition to remember anything.

I used my phone's camera to evaluate the surgeon's handiwork. The outside of my face was obviously swollen. I could see the staples surrounding my face, which came as a surprise to me because I would have thought the wound would have been covered. I could also feel and see the four drainage jugs hanging from my neckline. All four of them had a little bit of bright red fluid in them. I can remember chuckling to myself thinking the whole thing looked like a vampire blood harvesting farm. Like a maple tree with a syrup spike, only it was my neck and four tubes leading into these small jugs.

I then started to peak around in my mouth, which was a bad idea. I knew the swelling would be deceiving, but I couldn't help worry when I saw my tongue in the shape it was it. It had a tear drop-like shape, was twisted upward, and bent significantly to the right. Nothing about how my tongue looked gave me any hope of ever speaking normally again. Within a matter of seconds, I went from being in a peaceful state, to feeling a huge sense of stress and panic.

Just as I could feel myself beginning to slide into a state of depression, the door to my room opened, and in walked a nurse. The nurse was there to take my vitals. She was the same nurse that had been taking care of me throughout the night, but this was the first time she checked on me and I wasn't in a groggy, doped-up state. She was nice, and took her time taking my vitals, cleaning up my wounds, and emptying my blood jugs. I had a lot of questions, but she was only able to answer a couple of them. She informed me that the doctors would be in shortly to check-in on me.

The nurse left, and I was left there again to relax in the quiet room. I suppose the nurse's visit was more excitement than I was ready to handle, because as soon as she left, I fell asleep again.

I hadn't been asleep long before the doctors stopped by to see me. It was a team of four residents. My primary doctor (the ENT surgeon) doc nowhere to be seen. The residents were led by the same female doctor I had encountered in pre-op. She was just as pushy during this visit as she was prior to my surgery. The residents asked me a couple questions and looked at my numerous wounds. All-in-all, they were pleased with the way everything looked. The entire meeting with them happened so fast, and was so impersonal that they had left before I could even muster a single question. Clearly it was not their job to attend to my personal needs and/or concerns.

I spent the rest of the morning and much of the day slipping in and out of naps. Jess, my mom, and Jossalin stopped by during the morning hours to see me before they left for the airport. It was nice getting to see them, although it was heart wrenching to see my daughter cry when she saw me in my current condition. Getting to see her really helped me out of the slump I was falling into. Jossalin reminded me that there was more to this life than a tongue. No matter what happens from this point on, I always have my family to tent to, and they could careless how well I speak.

The days in the hospital were long. I was receiving routine visits from the nursing staff, with the occasional appearance of one of the ENT residents. I spent a lot of time catching-up with the news and eavesdropping on the family next to me. He was a younger Hispanic gentleman, whose entire family remained at his bedside through-out the duration of the hospital's visitation hours. (from 8 a.m. to 8 p.m.)

I found much joy in analyzing the internal workings of the hospital's nurse staff. Like any organization, the hospital is challenged with personnel issues. It was easy to tell what nurses were new, and which ones had some seasoning. It was also easy to tell which nurses valued their jobs, and which ones didn't. I was fascinated to see how complacent some of the nurses had become in their jobs, and how those same nurses were the ones that appeared to value their jobs the least. Since I was in the hospital for six days, I had the opportunity to meet and observe numerous nurses at work, and after awhile, the nurses felt comfortable opening up to me when I asked them questions about their work-center. There were the same common workplace dysfunctions going on at that hospital that I can find within any military organization. As someone who studies the art of leadership, I find comfort knowing that leadership principles and theory are universal. It doesn't matter what type of job is being conducted... if people are involved, there will always be issues for leaders to address. The key is for leaders to keep an ear to the ground and constantly be aware of what is going on around them.






Six days in a hospital is a lot. I thought I could do more, but after the fifth day, I was going stir-crazy. In my six days, I moved rooms twice. The first time was because my room was needed for a special needs patient, and the second time was because my neighbor informed the hospital staff that their home was infested with bedbugs. There were times where I was alone and times where I had roommates. I can definitely say that having a room without a roommate is MUCH better.

The length of my hospital stay was being driven by those drainage jugs in my neck. The doctors did not want to send me home until I was comfortable to do so, and one of my demands was that I have those jugs removed for I left. They were a bit of a nuisance and if anything was going to get infected, it would have been those. So, I felt it was best I stayed until the jugs were removed. The first two were removed the morning of day four and the other two on day six.

The ENT residents were the ones to determine when the jugs would be removed, which was based on how much drainage each jug was producing. The first two were removed on the weekend. The resident that removed them was one of the guys. He was cool; very patient and willing to take my questions. He took his time removing the jugs, making sure the entire task went down with as little pain and suffering as possible. The other two were yanked out by the rude, female resident. She literally grabbed the jugs out of another resident's hands and pulled them out with the lease bit of concern for me as possible.  

I went home in the morning hours on day six following the initial surgery. It is kinda funny, because my post-op follow-up appointment was scheduled for a week after the initial surgery, which is the very next day. I couldn't help but to think what would have happened if I was left in the hospital for one more day. Would it really be a follow-up appointment? So far, there has been no word from the pathology department regarding my surgery results. Hopefully we will find out more tomorrow!

Does Polly want a Cracker?

Happy Hump-day and welcome back to my blog.

Yesterday I described to you the events that led up to me going under the surgical knife, in hopes of removing the cancer that has unwisely chosen my mouth to call home. Today I will continue sharing the story of my in-hospital experience, first by describing what medical procedures were conducted while I was under the knife, and then, what transpired when I first awoke from my surgical slumber. 

So, I had two procedures completed while under the knife. The first procedure is called a glossectomy, which in medical terms means I had a portion of my tongue permanently removed. Since it was not the entire tongue, and did not involve the base of the tongue, my procedure was considered a partial-glossectomy. As many of you know, the cancer tumor had grown on the bottom-left portion of my tongue. The hope was that the doctors could shave off the cancerous portion, cover the exposed tissue with a skin graft from my thigh, and all would be as it was. Unfortunately, my tumor had grown too deep. (Remember me telling you about the carrots?) So, instead of trying to maintain the traditional shape of the tongue, my doctor decided it would be best to fold what was left of the top-left section of my tongue, and stitch it together.

Now, my tongue looks like a sideways parrot tongue. Yes, it even has a tip to it just like this picture.

The second procedure completed that day is called a bi-lateral neck dissection. A neck dissection is a procedure aimed at taking control of all lymph nodes in an area to prevent cancer metastasis. Some head and neck cancer patients get away with having one side or the other done. Some patients may even have a single, or small group of lymph nodes removed and that's it. I'm sure a lot of this is driven by cost, which is such a shame. Since I am being taken care of  by Uncle Sam's insurance, my doctor decided not to risk my future and to have everything removed now. So, I had over sixty lymph nodes removed from all over my neck... to include the original six that were first mentioned what now feels like years ago.

In order to complete this procedure, the doctors had to make a single incision from one earlobe to the other, following the natural crease in my neck. My skin was then stretched and pulled in all directions in order to expose everything inside my neck. It then took them hours of gently picking through the jungle of blood vessels, tendons, muscles, nerves, and other nonsense, weeding out all the know lymph nodes in both sides of my neck. The hope is that any and all lymph nodes impacted by the cancer have now been removed.

I remember waking-up somewhat combative. I can vaguely remember voices instructing me not to pull of any tubes. I can recall some very small snapshots in time where I was receiving a lot of instructions from people surrounding me. I don't recall being in a panic, so I suppose that is good.

My first actual memory is of Jess. I woke-up as they were wheeling me into my long-term recovery room. I'm guessing Jess had been allowed to follow us since it was her I recall taking most my instructions from. As the fog lifted, I can remember trying my hardest to determine the extent of my surgery. I could still feel my tongue inside my mouth, but I knew something was not right with its shape. I felt my thigh, trying to determine if they had taken a skin graft, but I could not tell yet. I remember rubbing my fingers across my neck, feeling what seemed like hundreds of metal staples in a uniform line. My mouth felt full. I'm not sure it was just a swollen tongue, but I remember it feeling very uncomfortable. I don't recall any pain.

I can vaguely remember Jess filling me in on some details. I remember she told me it was past 9 p.m. which I knew was a problem since my surgery was only scheduled to last 3-4 hours. I believe I tried to obtain additional information, but I'm not clear what all we covered. Even if something of value had been discussed, I probably don't remember now because I was slipping in and out of reality.

I can also recall the nurses giving me a crash course of my hospital bed and manual pain delivery button. Instead of being on a drip, I was given a button trigger like device that glowed green when a medical dose was available. When the button was depressed, the green glow went out and stayed out for ten minutes. After ten minutes, the green light would glow, I could press the button again, and would receive another hit of pain medicine.

All-in-all, I don't remember much of my first night. My biggest recollection was the frustrations of not being able to ask all the questions I had flooding into my head. I do remember Jess holding up a camera phone so I could look at myself and the work the doctors did inside my mouth. I knew my tongue looked twisted up an unusable, but I still had hopes that maybe things would be different after all the healing.

The last thing I remember before passing out for the night was a second person being wheeled into my room. It was really late... past midnight. An entire team of nurses wheeled in a patient of another bed. There was a lot of discussion about an emergency gall bladder removal. I think I was still under the effects of my own anesthesia because I was able to ignore all the hustle and bustle, passing out until I was awaken some hours later.

A Not-So-Good Start

Well ladies and gentlemen... we survived our first tour of combat together: "Operation Remove Cancer."

I was a complete wreck all day Wednesday. I didn't want to interact with anyone... in fact, I spend most of my morning sitting behind my computer playing a mind-numbing computer game. I was not ready for this surgery. I've had two prior oral surgeries in the past, so I kinda have an idea what to expect. This surgery is going to be WAY more invasive than my high-school mouth surgeries...and those sucked!

So, I spent a lot of time trying to find my courage. The fact was... I was scared. Really, really, really scared. I did not know what my life would be like in twenty-four hours, and I can tell you now... it is not the same. I am sitting here drowning myself in a pool of tears, knowing what I know now, but I will try to keep true to the story-line and not jump ahead.

Jess and I left the house just after 11 a.m. so that we had time to stop by Costco to fuel-up the truck. I wanted to drive my truck to surgery, not knowing how long it might be before I get to drive her again. I remember the drive being very quiet, almost uncomfortable. I hadn't eaten all day, so I could also feel myself getting "hangry." Jess tried her best to calm me down, but I think she knew my stubbornness enough by now that there was little she could do combat the chaos that was brewing in my head.

Parking at the hospital sucked as usual. I was particularly careful where to park my truck because I knew Jess would need to pull out and drive home later that night. We eventually found a decent, less compact spot, parked and headed into the surgical admissions building.

As soon as we walk into the hospital entrance for surgery check-in, you are immediately greeted by a receptionist. She sat at a small desk in the middle of this massive, very open and not at all private waiting area. This was the main waiting area from all families and friends with loved ones being worked on. The receptionist gave me a wristband and directed me to an administration office which stood directly behind us. The office was made of heavy-duty glass walls, had a single desk with multiple storage cabinets, and enough seating for the hospital administrator and two clients. Here, a lady made me sign my life away. The standard hospital, surgical admissions paperwork, splashed with a page or two releasing the hospital from any student liabilities since it is a learning hospital. I knew I was in good hands, but I was really hoping I hadn't just made a huge mistake. Who would really be doing all the cutting on me? I have no doubt my doctor is good at what she does, but is she good enough to fix some student's mistake following a sneeze, a hiccup, a hand tremor, who knows.... Maybe some kid will go rouge and just start chopping away because the girl next to him will not take him up on his offer for drinks after work.

Anyways... I got all signed-in and was directed back into the waiting room, where I would stay until called back into pre-op by a nurse.

On my way to the hospital, I was contacted by my Fire Chief and a fellow Master Sergeant, wanting to say "hi" and wish me the best before I took the plunge. They both showed up minutes after Jess and I found our seats in the waiting area. I hadn't seem either of them for a little over a week, so it was nice to use work as a way to get my head off all the other bull I was overly obsessing over. The four of us sat there discussing random, meaningless issues... jumping back and forth between work related issues and questions directed towards my cancer treatment. Before not too long, a female nurse popped-out from behind a door and called out my name.

It was go time!

I said my good-byes. The Fire Chief informed me that he intended to stay with Jess thought-out the surgery (he is a very good man). My buddy had to return to base, but still wished me well. Jess and I grabbed my things and headed back to pre-op.

The pre-op staging area was pretty big. There had to be at least twenty beds lining two parallel corridors. I was escorted into my room, where I was immediately met by a couple nurses. They gave me very specific instructions on how to prepare myself for surgery. I had to disrobe to the nude, give myself a moist-towel bath, and equip the standard issued hospital gown and rubber bottom stockings. I then crawled under some warm bed sheets. The nurses had a bunch of standard questions for me. One took notice that I was under a bit of anxiety and assured me the anesthesiologist would have something for me very soon.

After a couple minutes of sitting there, a couple of young doctors came peering around the curtain. They both introduced themselves, explaining that they are two of the ENT residents that will be assisting in my surgery.  The young female doctor was to the point, almost brash and definitely lacked bed-side-manor. She immediately began pushing a release form into my arms requesting that I sign. She explained they may need to take a tissue sample from my thigh to use under my tongue. Then went on to inform me that it will hurt, but my pain medications should prevent the area from becoming too much of a nuisance. So far, she was not my favorite. The male doctor was more laid back. He was more concerned with how I was feeling and if I had any concerns they could address before I headed back into surgery. My only concern was whether or not I would get to see my assigned doctor before being placed in the hands of the residents?

A team of anesthesiologists came back to prepare me for surgery. They ran a couple different IVs and explained that sense work will be done in my mouth, my breathing tubes would be inserted through the nose. So, they had me huff a bunch of nasal spray that was meant to constrict the blood vessels, thus opening up the airway and decreasing the likelihood of bleeding. Jest before leaving, one of the anesthesiologist informed me that he would get me some medicine to help me relax very soon.

Just as they walked away, my primary ENT doctor walked-in, still dressed in her business clothes, and looked nothing like one might expect from a doctor that was about to perform surgery. She admitted to be running slightly late, but assured me she was well-rested and ready to rock. Jess asked her to confirm how long she would anticipate the surgery taking. Her response was 3-4 hours. The plan was to do the tongue first, that way they can send the tissue samples to pathology to ensure ALL the cancer had been removed before sewing it up and moving onto the neck.

The surgery was due to begin at 2 p.m. It was already past that and my doctor didn't appear to be ready. Not only that, we were told I was being moved to my third surgical room. The first surgical room I was assigned to still had someone inside receiving care. The second room I was assigned to had a sudden loss of ventilation. I sure hope the old proverb, "third time's a charm" holds true today. So far, I was not getting the sense of ease nor encouragement I would have hoped for.

 It was go time. Jess was told to say her good-byes. I could see she had started crying. I tried not to, but I'm sure my eyes welled-up. By this point, I had become a mute. I decided the next work I spoke from my mouth would be with a new tongue. It was either that, or I was literally in shock, scared to death. I was rolled into an operating room. I just stared up, admiring all the fancy lighting and chrome fixtures. I could hear a lot of talk going on around me, but I was drowning it all out. I was trying desperately to find peace. A voice called down to me and asked that I take a couple deep breaths. Those were the breaths I needed to finally put my mind at ease...

The Last Supper

Hello everyone. Today is April 11th, the eve of my surgery.

I had an appointment with my medical oncologist yesterday to discuss everything that had or had not transpired over the past twenty-one days. If you recall, I had been accepted into a drug trial, but had randomized into the control group. This means I would receive the single dose of chemo and the basic oral medications, but I would not receive the test drug.

As always, Jessica accompanied me on this appointment. The appointment was set in the morning, which is nice because the cancer center is far less crowded in the earlier hours. We didn't have to wait long before I was being called back by the nurse. As always, she led me into an examination room where I had my vitals taken. I have gained ten pounds in total since beginning this journey, but that is about all that had changed. My heart still looks great and I am still 71 inches.

One of the trial coordinators stopped by to gather the medication log I had been recording and the unused medicines. She asked how the trial went, which I responded by telling her that everything went well with the exception of that "food poisoning" incident. I had annotated all the doses I had missed, so she was happy.

Shortly after she left, the medical oncologist popped in with her two assistants. The last time I saw her she had a mask covering her face because she was sick, so it was nice to see the doc at her best. She asked me a couple questions about the drug trial and conducted a condensed physical exam. Like the ENT surgeon, she seemed taken back by the fact I had not experienced any ill effects from neither the chemo or the pills. She inquired about the stomach bug "food poisoning" I had battled, but agreed that my self-diagnosis was the most likely cause for illness.

My daughter Jacee and brother-in-law Oscar had both comedown with the same 24-hour stomach illness a couple days after my bout. Since two other people in my household shared identical signs and symptoms, I ruled out food poisoning and assumed I had received the same stomach bug that had been reportedly going around. I am hesitant, but have decided to remove that bistro from my kill list.

So the doctor was pleased with how I had responded to the medical trial. Her next concern was preparing me for surgery. She assured me I was in good hands and that I would be seeing her soon to discuss the post-surgery plan of action. She said I will fall into one of three options: radiation only, radiation and chemo, or nothing at all... just monitor. The later will only occur if they find no cancer cells in my neck. Considering I have at least one necrotic node... that last option is not likely to happen. BUT... we shall keep our fingers crossed.

I have been instructed to stop taking Ibuprofen (Motrin) 72 hours before surgery.  The only medication the hospital wants me to take is Tylenol. Well... let me tell you, Tylenol does nothing to my pain; it doesn't even dull it. So, I asked the medical oncologist if there are any other pain management options for me that are acceptable before surgery. She prescribed me some Hydrocodone, which only makes me nauseous. The past three days have not been fun.

After my appointment at the cancer clinic, Jess and I stopped for an early lunch before heading to the medical imagery clinic to get another CT scan. The wait at the imagery clinic was a little long, but I was super early, so that would be expected. From the time I was called to the back, to the time I was walking out the door was only fifteen minutes. Since I had been through this process before, the nurse was able to zip through the procedure without the drawn-out explanations and such. I think the nurse lady had a thing for me because she was totally digging my killer veins. She even made a comment on how she wished all her patients were as easy as me. It was a good thing Jess wasn't there, because I may have had a cat fight on my hands!

So... yesterday was pretty uneventful. There is nothing new to report. My anxiety is still lurking around and I still have cancer that needs to be eradicated.

Having my mom and daughter in town has been a blessing. The two of them have been a welcomed distraction; preventing me from lounging around feeling sorry for myself. Today, we went to the Sonoran Desert Museum. If you ever find yourself in Tucson, I highly recommend this awesome day-adventure. As the name alludes to, the museum is a learning center for all things Sanoran Desert. It has all the plants and animals one might expect to find within this beautiful desert landscape. Today was particularly cool because all the animals were in view. Jossalin got to see her favorite animal: the wolf. This wolf is a Mexican Wolf. I asked Joss if she knew how the Mexican Wolf sounded... she said she didn't. I told her a normal wolf goes, "Ahhhhooooooooooh." The Mexican Wolf goes, "Ahhhheeeeeeeeeey." She didn't get the joke, but my mom did... which made me laugh.

On the way home, I called the hospital to check-in and receive my reporting instructions. I am to report in at 1300 tomorrow with a 1400 surgery time. I must stop eating by midnight and cannot have any liquids past 1100 tomorrow. Between my current mouth pain and not eating tomorrow, I should be a ripe "A" hole by the time I get to the hospital.

We decided that for my last meal, we would get tamales from the Tucson Tamale Company. This place has been voted the number one eatery in all Tucson. I love tamales and couldn't think of anything else I would rather have that I hadn't already eaten numerous times over the past month and a half. My mom and I purchased two of their family platters with an assortment of their best flavor combinations. With the tamales, we received all the side fixin's one might wish for!

On the way home, I had to explain to Jossalin that tonight would be my last solid meal for awhile. I went on to tell her how I may never experience food the same way again. My daughter is such a kindhearted individual. She wanted to make sure my night was filled with my favorite things, so she convinced my mom to make some of my favorite cookies. During dinner, she made it a point to tell everyone, "Tonight is daddy's last supper." I know what she meant, but I could help thinking of Jesus. I hope the day following his last super and the day following my last super are nothing alike.

I will try to keep you all posted following my surgery. I would expect Jess will post something on Facebook. I will be "out of it" for a couple days, so don't expect a blog anytime soon. I will write again as soon as I can. Thank you all for being in my corner. I have no doubt I will have your well wishes and prayers protecting me tomorrow.

I love you all!

Return of the Pickle

Greetings everyone! My deepest apologies for not have another blog post up sooner, but I've run into many distractions over the past week. I had been working diligently to finish-up a project at work before beginning my extended time-off. Now that I have started my time-off, my mom and daughter Jossalin are in town. To top things off, I am recovering from a bout with food poisoning. Anyways, we will get this story back on track over the next couple days.

So, I had an appointment at the cancer center last Thursday. This appointment was meant for me to meet with the clinic trail coordinators, as well as my ENT surgeon. I wasn't sure what to expect from this appointment other than additional information regarding my upcoming surgery. Wow... time is ticking away quickly. And to think, only two weeks until I go under the knife. The thought overwhelms me with anxiety just thinking about it.

Jess accompanied me to my appointment. We were both dressed in our Air Force fatigues, so needless to say, we were sticking out like trees in a concrete jungle. We drove separate since I was coming from home and Jess from work. As soon as I pulled up, Jess met me at my truck window... ready to assume her role as the assistant. She reached for my medical files, which she has taken ownership of. Together, we walked toward the cancer center. I can only imagine how official we must have looked to all the on-lookers.

Cancer has been a constant reminder of the perks I graciously receive from Uncle Sam. The uniform I wear is on loan from my country, and I wear it proudly. I am reminded of my service commitment every time I am thanked for my service while walking among the pubic. Jess and I were welcomed and thanked on numerous occasions on this particular day. It was humbling to have patients go out of their way to receive us with such kind words.

It is heartbreaking to overhear the overwhelming struggles people are having with medical insurance. Because all of us in the cancer center are there for the same reason, it makes it easy to stir-up a conversation with the person next to you, since everyone has a commonality they can connect with. Almost every conversation I overhear in the cancer center ends-up discussing the trials and tribulations of medical insurance. I am fortunate. The United States government pays 100% of my medical expenses. I do get to see the price breakdown for medical treatments because Tricare sends me a copy of every invoice, and let me say...cancer is NOT cheap. So... there I sit overhearing the horror stories of cancer patients unsure as to how they will continue to pay for their life saving treatments. This is not acceptable. The stress and anxiety of having cancer alone is enough to send someone into a tailspin. Now we add-in the stress of medical bills... Cancer is not an optional disease. If you get it...the only solution is to eradicate it from your body. There is only one path to survival, and unfortunately, that path comes at a great financial cost to many. I cannot thank my country enough for the support I am receiving. If allowed, I would do another twenty years... happily!

After Jess and I checked into the clinic and had a seat in the waiting room, we were greeted by a little Chihuahua. It was cute, well-mannered, and very sociable. The lady walking the dog explained that she was a support dog. The dog's job was to bring a smile to the faces of the patients roaming the busy halls. I would say it worked; I felted a little better getting to pet a friendly dog...

At two different times, both of my medical trial coordinators approached Jess and me while we waited in the "Diamond Waiting Room." Both gals wanted to know how I was doing and whether or not I was staying up on my oral medications. I had nothing but good reports to provide each gal; I had taken all my medications and had not experienced any ill side-effects. I did inform the one gal that I had some questions that I would like to discuss with my surgeon, which she assured me I would have time to do. The other gal wanted to make sure I was aware of my appointment for the 10th. Aside from that, they had very little information to provide me and simply informed me that they would be in touch at a later time. I told Jess I was confused as to why we were there. It was too soon for my surgical pre-op... or was it?

After waiting twenty minutes past my scheduled appointment time, I was called back by a nurse. She brought me back to an initial examination room where the nurses first obtain the patients' vials. I had gained about 10 pounds, but my heart was still looking good. My heart-rate was 68 and my blood pressure 128/78. I hadn't gotten any taller or shorter, which was something that had been weighting heavily on me. Still 71 inches...

I was led back to one of the same examination rooms I had occupied in the past. Before we could even sit-down, one of my medical trial coordinators walked in to inform me a phlebotomist would be in shortly to take my bi-weekly blood draw. Without missing a beat...enter the phlebotomist. The guy taking my blood was the same guy that had done so in the past. He was cool, and even shared my name. Last time, I told him how I had been a medic in Iraq and had a lot of experience stabbing people with needles. He reminded me of my killer war stories, which I decided to one-up by informing him that I had once ran my own IV. This guy is easily ten years my junior, and I can only imagine this guy's impression of me is similar to those I have toward the old guys down at the American Legion: crusty, old war heroes. I can't wait to have my combat veteran ball-cap with millions of lapel pins attached to it.

Shortly after the phlebotomist left, the ENT surgeon entered. She was accompanied by her regular posse of assistants. After some very brief salutations, we got down to businesses. I was asked how everything was going since starting the clinical trial. I told her it appeared the tumor under my tongue seemed to have grown a second tumor toward the left side of my tongue. Almost as if happening simultaneously, she grabbed my chin, tilted my head back, and asking me to open my mouth and left my tongue. Again... she described my tumor as being cute. She was flabbergasted. The doc went on to explain the tumor had NOT grown, nor had it developed a second tumor. In fact, she insisted the tumor had shrank considerably. It had shrank to the point it looked as though it had spread. I was hesitant to believe the hype. She asked if I had been told where I randomized within the drug trial. I informed her that I had, and knew I was in the control group. Her reaction was nothing but positive. The doc went on to explain her hypothesis that the single dose of chemo I received was to thank, and that the IRX-2 injections people were receiving might not be as effective as the inventors may have hoped. I asked her if there was any possibility I was a "ringer" in this study. I am easily fifteen to twenty years younger than the average age of most cancer patients. I am also a fit-to-fight Airman that has been vaccinated against everything to include Anthrax. She admitted I did not fit the normal patient profile and could very-well be an anomaly among those in the drug trial.

The conversation quickly changes directions.

The ENT surgeon asked if I had any questions about the up-coming surgery. I admitted to reading the horror stories of others and proceeded to inquire about feeding tubes, ports, and the lose of many other eating and speaking functions we take for granted. She answered each question as honestly as she could, ultimately concluding that each patient reacts to treatment differently. It was vague, but true. I will have no way of knowing for certain what my future status looks like until that day comes. 

She went to describing again what procedures I would be having done to me on the day of surgery. My tongue tumor will be removed. She suspects the removal of the tumor can be done without having to perform any type of reconstructive surgery. This could be GREAT news! No reconstructive surgery would mean my speech would more than likely return to normal.

I will also have a bilateral neck dissection. This means I will have an incision made from ear to ear, across the fold of my neck. The skin will be pulled back in both directions. The surgeons will then begin the process of removing all the lymph nodes they can find. Now... originally I told you about the six nodes we looked at in the CT scan. Those six node pale in compassion to the number they will actually remove. The number could be upwards of 30 or more. She went on to explain that each of those node will be sent to pathology to be individually tested for cancer. The results of those tests will help determine the extent and type of radiation I will receive six weeks post-op.

My doc asked if I had any other questions. I asked her if the pathology reports would reveal what caused my cancer. Was it HPV?

"HPV...?!? Your cancer was not caused by HPV. We ruled that out from the initial biopsy."

What?!? So, apparently the cancer board at Banner requested Travis AFB conduct a second test on the initial biopsy to determine if HPV was involved. Those results came back negative! So what caused my cancer? The doc went on to tell me that there would be no way of truly telling what caused my cancer. Based on my limited smoking and drinking history... her best guess is "dumb luck."

Dumb luck... that's the best I'm going to get? I looked at Jess... she looked at me, then we both looked at the doctor again. I was thrilled that HPV was ruled out, but I was left perplexed as to how I got this cancer. How can I avoid getting cancer again if I don't know what caused it in the first place? My initial thoughts were of the burn pits in Iraq and Afghanistan. As firefighters, we are called to those toxic nightmares from time to time to suppress the fire when the winds were unfavorable for operations. We hardly ever wore out breathing apparatuses because we were young, dumb, and thought we were invincible. Maybe the exposure to all those chemicals caused this cancer! Maybe it was...

I started laughing. The doctors and assistants looked at me like I was crazy. I told the doc I knew what caused my cancer... dill pickle sunflower seeds. I wish I would have had a camera because her expression was priceless. She had SO many questions... I told her the entire story, which she then assured me was absolutely asinine. She was interested in getting her hands on some of those sunflower seeds, but not at all interested in entertaining the idea of a sunflower induced cancer. But, like an expert salesman, I had her bought on stopping at the first convenience store she could find to grab a bag of those delicious seeds. I figure if all else fails, I can always turn to sunflower seed distribution as my post military career, career.