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Cancer Diary – First Entry

Posted in Health - aging, mostly by EloiSVM42 on March 31, 2011

On Sunday, March 27, we threw an open house to celebrate the anniversary of my first year of  survival from a bout of serious cancer (The actual anniversary date, when I returned home from the Mayo Clinic, is March 23).

Discovery of the cancer actually occurred about six months before the treatments began.  I chronicled the entire experience in a series of nine journal entries, which I am going to post sequentially over the next two months.

Most of these entries were written after the fact, because as I was going through the treatments I was too addled to think, and far too enervated to write. In fact, at the nadir, I was too weak to lift a telephone, and could barely lift a toothbrush. The first entry begins below:

About a year a half ago, I started noticing troubles with my throat, most particularly, trouble swallowing. Everything seemed to go down the wrong pipe. Also, I seemed to be coughing frequently, particularly at night. And finally, I developed a mild sore throat that felt like a cold that had gotten into my left Eustachian tube. 

I spoke with my doctor about these symptoms (August 12), and he sent me to the best ENT specialists in town. The ENT doc performed an on-site inspection of my throat by sticking that tube with a light and a camera down there (August 14), then put me through a number of tests at a lab, including x-raying my throat as I swallowed barium (August 19).

The ENT doc said he found nothing in my throat, and that my swallowing difficulty is no more than is to be expected for someone my age. He prescribed something to fight acid reflux, an affliction also typical for my age, and which may be causing some throat irritation.

The diagnosis was reassuring, and the medication seemed to help my acid reflux. But the sore throat continued, and a couple of weeks later I called for another appointment and told him things just didn’t feel right.

He gave me another on-site inspection with the tube (October 7). “I see something there this time I didn’t see before,” he said and took a biopsy of a nodule on the base of my tongue (October 12). The biopsy required putting me out mildly so he could work in my throat without triggering a gag reflex.

The biopsy happened the Monday before I left for an eight day trip to Texas and Kansas on Wednesday. I asked the ENT doc if I should cancel the trip, but he said whatever it was could wait until I returned. He said he would call me with the biopsy results in Texas on Friday.

But the doctor called back the very next day (October 13). Apparently he sensed a problem and asked that the biopsy results be expedited. I was away and Cynthia took the call. “It’s a cancer,” he said. “But it’s treatable; it’s curable; we’ll save his life.”

When I returned home, Cynthia told me about the call. When she began, she was clearly upset, pacing and starting to cry. In a confirmation of the theory that when we don’t have the facts we assume the worst, I thought she was about to tell me she was leaving me or something. I was actually relieved when Cynthia told me I had cancer.

Cynthia had made a follow-up appointment with the ENT specialist, and, upon his referral, we also made an appointment with a specialist at the Mayo Clinic in Scottsdale, Arizona. The soonest he could see me was November 10, but the ENT doc said this was no problem. The cancer is not a fast moving one. For the same reason, he said I should take my trip to Texas, which I did.

I told a couple of my close friends about the diagnosis, one of whom gave me an article to read about throat cancer, which was considerably less rosy than my doc’s prognosis. I resolved to stop reading about it and not to think about it until I saw the Mayo Clinic specialist on November 10.

There’s a fanciful formula for turning lead into gold. You melt the lead without thinking of the word “hippopotamus.” It’s never failed because it can’t be done. Not to think about a cancer diagnosis, if you have one, can’t be done either.

The first thing I thought about is how it might affect my immediate plans. If I have an operation, which seems likely, will I be unable to talk for awhile?  If not, for how long? Would this affect my teaching schedule; my ability to eat; my ability to taste? How long will it take to rehabilitate?  Will I be up to the cruise we were planning next June?

Then I began to think how gruesome the treatments might be, and from there, of course, to about whether and when this might kill me.

This thought had a dramatic effect on my priorities. Most of the items on my personal “bucket list” dropped off. I stopped reading as much, and I put off the idea of learning Spanish, because there may not be much long term benefit to improving my mind. And I put off some scheduled dental work, because I don’t see the sense in spending money on something that could be incinerated shortly.

I thought of how much of our retirement savings I might spend on myself in “last things” activities, and how much to leave, considering that my life insurance policy will kick in. Macabre.

On my follow-up visit to the ENT doc (October 26) he gave me the official diagnosis – “Squamous cell carcinoma, moderately differentiated, ulcerated and tumor infiltration. No vascular penetration identified.”

This last phrase is apparently a good thing, meaning that the cancer had not gotten into my bloodstream to circulate elsewhere, though perhaps to the nearby lymph nodes in my neck.

Also during the follow-up, the words “possibly fatal, but unlikely” were spoken, which were completely ignored by Cynthia but not by me. My sense is that the ENT doc felt we dodged a bullet by my insisting to come in for a second look at my throat.

But that meeting heightened my sense that my clock is ticking. I was eager and anxious (two words often confused and misused) for my appointment at Mayo on the 10th. It would be almost three months to the day when my doc sent me to the ENT guy.   

I thought some about how the stress of this may be affecting my heart and blood pressure, something Cynthia seemed to be worrying about constantly. Our plans until the 10th, based on recommendations from the ENT doc and guidance from Cynthia, were to exercise, eat healthy meals and avoid the flu. 

Until then, my two fears were:

1        That I will undergo an operation and radiation and/or chemo therapy, and then learn that it was all unsuccessful, but has left me too enervated to be able to do anything much with my last days, and

2        That even with insurance, the expenses will be so great that they will wipe out our retirement savings, something I have promised myself I will not let happen to Cynthia. This would cause me to have to choose whether to abandon treatment to keep a nest egg – a whole new twist on the line, “Your money or your life.” As Jack Benny said when confronted with this threat by a robber, “I’m thinking. I’m thinking.”

Since there was little more to learn until the 10th, I stopped making diary entries until after the consultation. Cynthia and I drove down to Phoenix the night before, and planned a trip to the Desert Botanical Garden in Phoenix after the appointment.

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