Cancer

Prior to leaving on our safari I had been experiencing a bit of a sore throat. Being stubborn I did not want to set of any bells, so I kept it to myself. Sometimes we do the wrong things for the wrong reasons. We had purchased trip insurance but if there is the hint of any pre-existing condition you are pretty much screwed.
I already had my annual physical visit scheduled for a couple days after we returned from Africa, so I let it fly.
At the physical passed all of the elements with flying colors and in passing asked Dr. Ficken to take a look at my sore throat. He takes a look and says “ let me get the big guy .” The big guy being Dr. Monroe, the head doctor at Healthy Life Family Medicine, comes in and says “that’s not good and it looks like throat cancer.” They managed to get me into an oncology otolaryngology appointment that same afternoon. This doctor takes another look and does a biopsy but pretty much confirms the original diagnosis, yep the big C. Turns out it was called HPV, human papilloma virus. It was stage 3 in my throat and neck lymph nodes. Lots of people carry HPV but only 1% turn into cancer. Lucky me. The good news was that after a full body PET scan it had not spread into any other parts of body.

Paperwork and Prep

Now it’s time to prepare: mentally, physically and emotionally. It brings Tim McGraw’s song “Live Like You Were Dying” into reality for you, real fast. I was fortunate to be referred to the Barrow Neurological Institute. I didn’t think so at first. Driving all the way into downtown Phoenix everyday for the next 7 weeks. I thought I was done commuting! But as things progressed I felt really privileged to have the doctors that I did. Dr. Jategaonkar was my primary otolaryngology oncologist. Dr J as he likes to be referred to, convinced Teresa and myself that with radiation and chemotherapy as opposed to surgery, the likelihood of successful treatment was high.

Then we were introduced to the radiation dr, Dr Kraus and the chemotherapy dr, Dr Yoo. Between these three doctors and the rest of the Barrow Institute I felt like I was being treated very well.
One of the first things to do was make a mask. If you look closely at my face in the picture below you can see the mesh mask they custom make for each patient. It goes on soft and then hardens to be fastened to the table and keep your head fixed in one position for the 35 treatments ahead.
That big machine rotates 360 degrees around, focusing its beam right on the affected part.

Treatment

The treatment plan is for 35 radiation treatments, 1 treatment every weekday except New Year’s Day. And 7 chemotherapy treatments, 1 every Friday for the duration of the radiation treatments. Apparently there is some symbiosis with chemotherapy and radiation treatments. The chemotherapy assists the radiation in doing its job.
The treatment called for me to put on a few pounds before the actual treatment started. I had about 3 weeks. I started off at 170 lbs. and gained 8 (you can do the math). By the time all of the treatments were completed I was down to about 145 pounds. They tell me that wasn’t too bad. The good news was that I did not continue losing very much once the treatments were complete. However, i had lost enough weight that I was on the verge of needing to have a feeding tube inserted into my stomach so I would not lose any more weight . Because of increased sensitivity, loss of taste and the ability to actually eat, these changes can make it difficult not to keep losing weight.
The treatments started off pretty easily, as I was told it would. But by the fourth week it was starting to take its toll on me physically.
I began to realize that this whole process wasn’t only impacting me, others, especially Teresa are having a hard time coping with it. About this time Teresa realized that she was having a lot of anxiety over the treatment and the expected results and really whether I was going to live or die. She made an appointment with Dr. Ficken to get something to take the edge off. Smart lady.

Angels All Around

If I’d known I was going to write this I would have, should have kept better notes. But here we are !
Our PC (Pebble Creek) friends are the greatest. About the fourth week I could only swallow soft things and in limited quantities. Anneka and Michael would invite us for dinner then send us home with dinner for the next day. Barb and Randy would drop off a soup. Ken and Nancy were especially supportive. Since radiation treatments were everyday, as time wore on the best I could do would be to come home and slide into my recliner and rest. Ken figured out soon not to even knock on the front door. He would slide in like a Ninja put some wonderful food that I could eat, a couple of times a week, then slide back out. Sometimes I didn’t even hear him. Teresa’s besty, Terri, would come in while we were in treatment and leave soups and puddings. Din and Ke dropped off a batch of homemade dumplings.
They were miracle workers for Teresa and myself, Angels All Around.

Back to Treatment

Radiation was first treatment in the day, five days in a row. During the first few weeks I hardly felt anything. The radiation treatments lasted about 10 minutes. Fridays are supposed to be fun days, right ? Well, for 7 weeks Fridays were torture. Fridays were chemo days. Chemo lasted about 4 hours attached to multiple bags of intravenous fluids. I don’t remember them all, but it started out with a couple of hours of saline. At about the same time a bag of something to prevent nausea. Then there were a couple of miscellaneous bags I don’t recall. Finally, the coup de grace, the actual chemo drug, Cisplatin. The “platin” in the name refers to the primary ingredient, platinum, which is radioactive. Of course all of the bags were refrigerated so my whole body lost temperature during the process. Fortunately they had nice warm blankets to keep you comfortable.
As if all of that isn’t enough they give you two different prescriptions for nausea prevention and send you home with a healthy supply of barf bags. If the first prescription doesn’t work quickly you’re supposed to move on to the second. How many times did I hear “keep ahead of the pain and the nausea.”
The first week was a piece of cake. I thought “what’s the big deal.” By the third week I was getting the picture. From the fourth week on, the symptoms seemed to start compounding. The Friday afternoon nausea started to get worse and the throat and mouth pain was getting really tough. Physically I was starting to get a bit on the frail side, losing weight and body strength
The good news was there was only three weeks of treatment left.
One of the many predicted contraindications of chemotherapy treatment is that the blood vessels carrying the Cisplatin through the body start to harden making it harder to get the IV started and the weekly blood draw done. One time at Sonora Quest for the weekly blood draw I got poked 6 times for blood and never gave it up. From then on they began to “hunt” for good blood vessels with an ultrasound machine.I. can’t say enough about the professionals at St. Francis Hospital and the Barrow Neurological Institute, I always knew they were the best and the results were going to be fine.

Treatment

It’s nearly nine months since the treatments have ended and I have several remaining impacts that I’m dealing with. First and most annoying is the fact that I still cannot create any saliva in my mouth. Saliva is where digestion starts and the moisture helps you chew and swallow. Anything particularly dry is really tough to get down and when it does it occasionally gets caught in the back of my throat causing a crazy coughing spell. I occasionally get cramps in the muscles in my neck caused by the scarring left behind from the radiation treatments. I have very little facial hair and none on my neck which is embarrassing because Mark has called for a no-shave November. I’m trying but what you see is what you get. Also, my upper and lower jawbones have gone soft as a result of the radiation therapy. So my teeth are tender and are prone to shifting.
Then there are the positives, HEY I’M ALIVE. My weight is still hovering right at 150 lbs. Teresa likes to say I’m too skinny. She’s just used to a bigger butt and Dr. Ficken says I’m just fine and I no longer need to take a blood pressure medication.
A couple of weeks after treatments finished I was determined to get back to the gym and regain my body strength. Wow, what an impact. On most of the weight machines I had lost 20 – 30 percent of my strength. But I started back determined. Going to the gym every day, working a little harder gaining muscle strength with every visit. I’m now about 95% back which I think is largely due to still being 25 lbs under my pre-treatment weight.
But I’m here and doing well and appreciate all of the support and love from family and friends, and especially all of the love, care and support from my loving wife, Teresa.