Thursday, June 23, 2011

Lots of Info

Had a lot of information thrown at me today. I met with my Medical Ocologist, Dr Szewczyk (pronounced Shevcheck) today. Like everyone else I've met at Ironwood she was very nice and explained everything in pretty good detail.

This morning I looked in the mirror to see how the inside of my mouth was doing. I haven't really been doing this because it usually looks bad and it stresses me out that something is wrong. Today was no different. The graft that replaced the tissue that was removed in surgery was a rather sickly looking grey with what looked like wrinkles or something in places, and I was freaking out that it wasn't taking or the graft was deteriorating or something. The margins of it were rather horrid and damaged looking but it's been that way since the beginning.

Anyway, Dr Szewczyk is doing the preliminary examination and she looks in my mouth and asks "How you doing with that hair there?" So I asked her, "That is hair isn't it?!" and she says yes. So the graft in my mouth looks greyer than the nice pink mouth tissue because it's skin not tissue. This explains why my chest skin feels really tight. He used part of my chest skin for the graft in my mouth and had to pull the remaining skin tight to fill the gap. It also explains why my nipple is so far off where it should be.

Don't click for a larger image if you don't want to be grossed out.

This is now in my mouth...

So down to the nitty gritty. Dr Gorgeous (she's a tall thin beautiful blonde but she reminds me a little too much of Linda, my ex), sat down and explained, after commenting on how young I was, that I was going to be having a pretty intense session of chemo and radiation. She said the reason for this is that my cancer is curable and when they have a patient who they are able to cure, they push hard for that curative treatment rather than the palliative treatment they would give someone who's cancer is not 'curable' but rather needs to be managed. This might be the case if I was older, say, in my 70's, but since I was young and had done so well with the surgery, they were going to push. So my chemo will be intense and my side effects may be equally intense. Nausea and vomiting, though she said the chance of vomiting was less and they would be giving me plenty of anti-nausea meds and there's a good chance I might not have too bad a time with it. She explained that the reason they do the chemo with the radiation is that the chemo messes up the cancer cells and makes them more susceptible to the radiation. Chemo alone would not help me and radiation alone would not be as effective without the chemo.

I asked her about my PET scan and she said it all came back negative. She showed me the scans and explained what they meant, but to be honest, the things I saw all looked like cancer to me. She seemed pretty confident that I was clear though, so all good.

Then it was off to meet Shirley, for a teaching session. Very nice. She explained how the chemo process works, how long it takes (3 to 4 hours!!) and about the various drugs and IVs I would be getting. I have to take a series of 3 pills called Emend before the session. These will help with delayed nausea. Some people don't feel nauseous after chemo until 3 or 4 days later and these pills help with that. Then I will have a normal saline drip or some other type of fluids as well as a 'breakthrough' drug for nausea (she didn't give the name) and another drug, Deladol, which is a steroid to help with nausea and swelling. This is all in addition to the actual Chemo drug, Cisplatin. It's a common cancer drug and one that works particularly for head and neck cancer.

While explaining this, I was visited by Jennine Zumbuhl, director of research. She wanted to know if I wanted to be part of a study for a rinse that helps with the mucousitis. Basically the chemo and radiation will cause my mouth to be very dry since my salivary glands will be taking a hit from the treatment and this mouthwash (goofy name I can't remember) is supposed to help. It's already used for other treatments and the pharma company is trying to get its usage extended to cancer patients like myself. Ah yeah, I also have to have a shot in my arm of some junk. I hate shots.

Shirley continues, explaining the rest of the chemo session and I head over to the scheduler to try and figure out when I really need to be there. My radiation starts at 5pm every day, but on Monday and Tuesday I have to be there at 11:45am. It takes about 45 minutes to set up, apparently. Afterward I head over to Jennine's to talk about the research study, which means I need to actually be at the office at around 10:45am.

In addition to all this, I have to have blood work done at a different lab and it was too late to do it today so I have an appointment tomorrow at 2:00. More needles.


Sue said...

Nice to know that they believe it is completely curable. You seem to have got quite a few answers today.

Guy said...

Yeah, I've always gotten the impression that it was but no one's actually said it before.

Colleen said...

Fantastic news! Umm... what did she say about the long term prognosis of the graft in your mouth?

Guy said...

She didn't say anything about it really, though she was impressed with the work he had done. She hadn't seen the chest muscle to neck thing before.
It's weird to say, but I hope the radiation side effects make that hair fall out and stay gone lol

Spender said...

You are an incredibly courageous man and a born fighter, so I know that you will win.
My heartfelt and sincere thanks to you for being an honest and brave reporter. Those who are ill can learn and be inspired by you.
Those among us who are more fortunate just think you're a hell of a guy, a great friend and a genuine bad-ass.
Keep up the fight and know that I am right there beside you, sir.