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Cancer Diary – Second Entry

Posted in Health - aging, mostly by EloiSVM42 on April 3, 2011

Cynthia and I drove to Phoenix the day before our appointment at the Mayo Clinic on Tuesday, November 10. We spent the night at a Residence Inn that is on the Mayo Clinic campus.  The campus is on the eastern outskirts (at least for now) of Phoenix, and there is nothing within a mile of it in any direction, so we infer that most of this hotel’s clientele probably comprises patients coming from out of town and the families of those staying at the hospital. 

We had two appointments at Mayo, the first at 9 am to get registered and the second at 10 am with the doctor. We arrived a little before 9 am and they began registering me immediately. They started asking the same questions that are on forms they sent us to fill out in advance. They seemed surprised and pleased when I told them I brought the forms and told us that not many people do. I also brought a CD of records and images from tests taken previously. They took the forms, and loaded the CD onto the doctor’s computer.

I remember scoffing at the notion that a lot of money can be saved with a system of centralized medical records, but the savings potential must be huge. I’ve filled out so many forms with the same questions that we might save a zillion dollars on me alone.

We finished registration and were sent to the waiting room. It occurs to me that what we may be waiting for is to learn how long I have to live and how uncomfortable my remaining time will be.

As we were early, I had time to consider the other waiters. Most, but not all, were my age or older. The women on average were older than the men. A few seemed fitter than I, but most did not. A couple of people were wearing masks. This could have been to avoid germs due to impaired immune systems. But it could also have been cosmetic, to hide the results of disease and/or surgery. Fortunately, we did not learn which.

We were now on typical medical office schedule, which means running very far behind. We were forewarned about this, because my doctor “likes to spend a lot of time with his patients.” Fine by me. Nearer the appointment, the quieter my mood. Inner tears and apprehension.

When we were shown into our consultation room we were joined quickly by a young doctor who is an assistant to our main doc. He was pleasant and obviously competent. He took some more information, did an inspection with a tube down my throat, and told us what to expect from our doc.

Our doc arrived. We had heard and read about him. He is a leader in his field, as are, it seems, most of the docs at the Mayo Clinic. This doc deserves his reputation. He is serious and thorough. He exudes gravitas. It seems almost impertinent to refer to him as a “doc.”

The doc made his own inspection, and told us more about this kind of cancer. Fortunately, a very small percentage of them metastasize below the neck. This doesn’t mean they aren’t dangerous, but the success rate in dealing with them is very high today.

The doc laid out my treatment options: surgery; surgery plus radiation therapy, possibly; radiation and chemo therapy without surgery. The descriptions were thorough, candid, and therefore unsettling. After hearing the options and asking questions, we concluded the best way for us to proceed is with surgery. The doc said this decision should be made by the patient, but he agreed, that, yes, in my case starting with surgery is a “no brainer.” The doc gave us a copy of a major research paper, of which he was one of the authors, which is reassuring about the procedure and the success rate.

When I describe the surgery it may be surprising that it is the best of the options. The cancer will be removed by “Transoral Laser Microsurgery.” Due to swelling, I may need a temporary tracheotomy. Then, the lymph nodes below my mandibles will be removed via conventional surgery, to see if and how far the cancer might have traveled. Finally, a tube will be inserted through my nose into my stomach, by which I will be fed for about a week.

Depending upon the condition of the lymph nodes, I will be finished, or I may need radiation therapy.

I will be in the hospital for about three days. Cynthia will be able to stay in the room with me. Thereafter, I will be free to return home, coming back a week after the surgery date for a check-up. Cynthia and I decided we will just check into the hotel on campus and stay there until the check-up rather than return home.

The doc reminded us that the throat is an extremely important part of our anatomy. We breathe through it. We eat through it. It is very sensitive (a fact of which I am all too aware). I will be uncomfortable for awhile, and the adjuvant radiation therapy is something we should hope to avoid.

When the doctors left I pulled Cynthia onto my lap and we began kissing, which seemed like the thing to do at the time. The scheduling nurse walked in and caught us. Actually, she was very pleased. She said she seldom sees kissing there, and it is in fact very good therapy and important in keeping a positive attitude toward the experience.

The surgery is scheduled for December 7, about four months from my first doctor’s appointment. They said they would move it up if they can, but it is unlikely, and in any event waiting won’t affect the outcome, just prolong our anxiety and my sore throat a little longer. Also, we will come in for a check-up about two weeks in advance of the surgery, and thereafter I will have to stop taking some meds I am now on.

After the appointment, we went to the Desert Botanical Garden, where I hoped to add a bird to my life list – the Verdin (Auriparus flaviceps). It is common in the desert brush, but I had never seen one. I found the bird after a couple of hours searching. As we were leaving, we realized that we will have to return, because it is a beautiful place, but between the stress of the medical appointments and my searching for the Verdin, we had hardly noticed and appreciated it.

We planned to try a Mexican restaurant we read about in Arizona Highways, but we decided to skip it this trip and head home. It was a good thing, too, because on the way home the car died, and we had to be towed home by AAA, so we got in later than planned. It was only a dead battery, fortunately.

It was a hell of an interesting day.

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