Let the Fun Begin!

Monday, June 15

Today is dentist day. I have to get a clean bill of dental health before the radiation starts. Teeth and gums suffer collateral damage from radiation, so any dental issues need to be resolved first. Also, I get to have dental trays (essentially a mouth guard) custom made for me. During treatment I will do daily fluoride applications to keep my teeth strong. The dentist is great. I'm keeping him as my new guy. Had a full set of X-rays and a thorough dental exam. Got a clean bill of oral health. On too my next medical adventure.

Tuesday, June 16

First, a little background. Because I'll be having radiation treatment on my neck there is a chance that my throat will become so swollen and sore that I'll have a hard time eating enough food. As a precaution I'm having a PEG (feeding) tube inserted in my stomach. Barbara and I went to the hospital yesterday for this procedure. 

Whenever I put on the hospital gown and get hooked up to the monitors one of two things happens. Either my blood pressure goes sky high or my pulse starts racing. This was a pulse racing day. For safety's sake they ran and EKG and noticed the tell tale signal of atrial fibrillation. Oh joy! Yet another genetic blessing.  

Hold off on that surgery and call in cardiology to address the problem. By the time cardiology checked me out and decided on a recommended treatment I had "self-converted". In other words, my pulse rate dropped down to an acceptable level all on its own. I got an echo-cardiogram and learned that my heart was not damaged or abnormal. I now have yet another prescription med to take twice a day.

Enough excitement for one day. I'm going home.

Wednesday, June 17

Today I got a PICC line inserted. This is a catheter that runs from a vein in my right arm all the way to my aorta. This will be used for administering the chemo and any other meds I might need. Also it's a good port for drawing blood samples when required. The good news is that I only get stuck once. The not so bad news is that I get to live with this appendage for the next few months. 

Tomorrow it's back to the dentist to pick up my fluoride trays and get my teeth cleaned.

My New Appliances

June 27, 2015

The weather has been stinking hot lately. So, what better way to spend my time this past week than a series of visits to doctor offices?

Tuesday found us chatting with the cardiologist. He said I was good to go for all my future treatments.

Wednesday I met with a Speech Pathologist. Her job this day was to get baseline data on how well I chew/swallow and how flexible/extensible my jaw and tongue are. I got good scores on the chew and swallow parts. She was a bit astounded at how wide I could open my mouth and was again surprised when I could easily touch my tongue to my nose. There is a real risk of throat and mouth muscles and other tissues being scarred by radiation. This may limit their future range of movement. She taught me a few exercises to stretch the affected muscles, but said I had so much range of motion to start with that I should be fine no matter what.

Thursday we went in for a second, and ultimately successful, placement of  the PEG tube.

This is a "better to have it and not need it than need it and not have it" appliance to use in case trouble swallowing late in the treatment regime creates a situation where I may not ingest enough calories  to maintain my perfect weight.

Here's what it looks like from the inside.

They inflated my guts to poke around with the scope, inspect my GI health and insert the tube. The insertion went smoothly. Afterwards I was really gassy and farted a LOT.  Some of the air sneaks into the peritoneum so I had a big bubble pressing against my diaphragm. That was pretty uncomfortable until the gases were finally reabsorbed and things felt "normal" again.  I left the hospital feeling pretty good. Then the drugs started wearing off. Damn!. It felt like somebody had been punching me in the guts the whole time I was unconscious.  Had to lie down and nap for a few hours when I got home. Felt much better afterwards. But, the incision area is still tender. I do not recommend this accessory for folks like me who prefer to sleep on their stomach.

Friday was a big day that included three appointments. First was a post-op check of the PEG. That went really well.

Second was my CT Simulation. In anticipation of radiation treatment, they made a mask of my head, neck and shoulders by stretching a warm  thermo-plastic mesh over me and tacking it to the CT scan table. Once the mask cooled to its rigid final form I was firmly locked to the table. They attached a few reference tags to the mask to aid in alignment and then marked me with a tiny tattoo. It's so tiny that you probably couldn't find it if you went looking for it. But, nevertheless, Bridget is now the only tattoo-free member of this side of the family. Unfortunately, I didn't think to have them take photos of me during the process. But, here's what it looked like afterwards.

 

Once that was done they loaded me into the CT scan tunnel to make a digital 3D image of head and neck.

This will be used to calculate the strength and direction of the radiation to most effectively penetrate the good tissue and target the cancerous areas. Calculation and consultations should take about 2 weeks. The the radiation/chemo treatment combo can then commence.

Finally, we met with the folks at Home Care IV to get trained on the care and feeding of my PEG. It's simple. Inject 60 ml of water each day to flush it until the time I might need it. Then come back and they'll supply me with the dietary supplements I  might want.

Monday we return to the chemo oncologist. He had suggested a pre-dose of chemo if this whole process was going to take too long. Hopefully, we have made enough progress that he'll hold off until the anticipated July 13 start date for the complete treatment.