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.