Wednesday, April 19, 2006

* Throat Cancer Free *

Today was my quarterly visit with my ENT (ORL) doctor. I had been preparing myself psychologically for quite some time now. We were up late last night so I didn't get up until around 08:30, had breakfast and tried to get at least a couple of hours of work done before preparing to leave. I spent at least 2 hours just going through e-mails and bookkeeping and filing. It's amazing how it all piles up after spending just one (entire) day away from the computer.

At 14:00 I took a Xanax as per my doctor's instructions, to try and start calming me down, especially my reflexes, before his examination. I took the bus, and then the métro, to the doctor's office. I didn't want to drive as I didn't know what condition I would be in afterwards.

He was actually reasonably on time (15 minutes late) and we started by discussing the evolution in my situation since we last saw each other. I had to admit there wasn't a lot of change. My voice is still not working properly albeit slightly better than the last time. My swallowing is much better. But my mouth is still as dry as ever without any saliva. My taste buds are still not great, although they're reasonably better than the last time, and I can drink beer and wine. He immediately reminded me not to "abuse" the wine and beer.

I then sat in the dreaded examination chair. He checked out my ears and started in on my nose. I thought he was going to clamp my nose open or something with the weird thing he shoved up there. Finally he sprayed the anaesthesia up my nose and down my throat. I had to gargle with the anaesthesia for 30 seconds before swallowing it. He then had to wait a bit for it to take effect so he made a phone call while I sat staring at a mirror worrying about what was coming next. He now has a huge flat screen on the wall with the video setup so you can't avoid it. I closed my eyes the whole time so as not to have to watch the inside of my throat in amazing technicolor and the size of the wall. The exam went much better than last time and I didn't cough or gag half as much. He shoved the camera up each nostril and down the throat and looked around and made me make noises with my throat (ehhh, eeeee, ehehehe) and count. He would make comments as he was looking around and was actually silly enough to ask me a question of two. If you think it's bad enough when a dentist asks you something while your mouth is full of cotton or such you can imagine how ridiculous the situation is when you've got a video camera twirling around down the inside of your throat. He had to wait for an answer. Finally came the part I was dreading: I stuck out my tongue, he wrapped a Kleenex around the tip and held on to it while he stuck his finger down my throat and felt around inside. I only gagged two or three times and didn't actually spit up this time. He did the other hand as well and then it was over.

We sat down to "talk" about the status. He used a new anaesthesia which is apparently stronger and I could not speak for about an hour afterwards. The rest of our conversation took place with him speaking and me writing on paper. Apparently I still have bruises and burns in the back of my throat and just behind my vocal chords. The bruises are from the surgery and the burns are from the radiotherapy and they have been aggravated by the chemotherapy. My vocal chords appear to be in good condition. But they don't approach each other when I speak. He is sending me to an "orthophonist" for some vocal re-education work so that I use my "new" throat correctly when speaking. The bruises themselves are from a combination of the surgery, the radiotherapy and the chemotherapy. They will be absorbed over time. But, as usual, he can't say how much time.

We also spoke about the skin and the muscles. I mentioned the difficulties I have in the morning moving my left arm and shoulder and such as well as the pains I get during the day over the scar area and along the shoulder. He is sending me to a physiotherapist for some massages and heat treatments.

He palped all around my throat and neck. He explained that the solid bits were scar tissue which had been hardened by both the surgery and the radiotherapy. He said that, although massaging twice a day was good, I need to be massaging longer to break it down more.

Finally we spoke about the cancer surveillance aspect. He gave me the good news first that from everything he had just checked in my throat is completely cancer free. I will be seeing him again at the end of July. Two weeks before seeing him again, in mid-July, I will go back to the Clinique Hartmann for a full chest x-ray and an ultrasound exam of everything from my thorax down to my genitals. Then after his examination in July we'll book me for a complete PET scan for September prior to seeing him again in October. September will be one year from the beginning of treatment (surgery). Apparently there are not that many PET scan machines in the Paris area and I'll be going to Sarcelles for mine.

We discussed the evolution I could expect in the future. He used quite often the phrase "it's the ransom to pay for cancer" in that most of what we discussed he said would never be 100% again. My swallowing will continue to improve and, once the bruising and burns have been reduced, should eventually reach a normal level. My voice will never be 100% again. But, with re-education, should get much much better than it is now. The depressing prediction was that my taste buds will never be 100% again. They will get better and better, very slowly and over several years, but they will never achieve the level of fine tasting they had before. The chemotherapy has permanently destroyed too many of the buds themselves. Eventually I will probably look in to alternatives for this situation as I refuse to believe that I can't get my taste buds back. The dry mouth and lack of saliva will always be a problem. This I knew even prior to the treatment as they had explained this to me at the clinic. This too will continue to improve but it will never be 100% again and I'll be spending the rest of my life with a bottle of water next to me. The tasting situation and the swallowing situation are directly linked to the lack of saliva. I will be looking to alternatives for this evolution as well.

I left feeling pleased. Pleased that the examination itself had gone much better than last time. It certainly was still extremely painful and uncomfortable. But it was better. Pleased as well that my throat is completely cancer free and anything which I may have felt along my throat is not a problem.

I got home, wrote down on paper to Desney that everything was fine, crawled in to bed for about 3 hours, and I have just finished eating dinner (fish and rice( without any difficulty.

Onward and upwards...

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