During the fifth week of radiation therapy, I met with my surgeon and radiation oncologist to assess the efficacy of the radiation treatments. It was obvious that the radiation (perhaps with some help from the Essiac?) was shrinking the tumor. In fact, the tumor had shrunk from 3cm to about the size of a pea, if that. This was good. This was what was supposed to happen. But, was it shrinking enough to warrant not having to do further surgery - i.e., the radical neck dissection?

Kathy and I met with Dr. Gleich on 10/22/97. As usual, he was to-the-point about our next move. After a brief poke and prod of my neck, he announced that the tumor had shrunk significantly, but not enough. We need to schedule the neck dissection.

There. Said, and done. Simple as that. Nothing to it. Hit me with your best shot, fire awayyyy. I had a lot of different emotions at this news. I sort of had a feeling that it would come to this after all, but certainly didn't relish the idea of the neck dissection. To be honest, though, intellectually I knew this was the best thing. Surgery would certainly insure removal of the entire tumor and any surrounding cancer cells. It is a distinct possibility that once removed, any tissue may turn out to be just dead tumor cells. At least that is the hope!

To this point I have had 23 radiation treatments. I am starting to feel pretty lousy, in general. The radiation side effects are now well into the forefront of my consciousness. The prospect of finishing out the radiation course and then having surgery is not my idea of a good time to say the least! Nevertheless, you "do what you gotta do." So we scheduled surgery for 11/14/97. Two days after my last radiation treatment. Jeez.

With the decision made that the neck dissection would be performed, we discussed the remaining radiation treatments with my radiation oncologist, Dr. Redmond. Since we were now confident that the tumor would be removed, the treatment schedule should be recalculated. This would allow reduction of the total dosage to my clavicle and neck areas to 5140 cGy. The bad news was that instead of 35 treatments, I would now get 38 treatments! The last 10 were to be "boost" treatments intended to assure that the tonsil site was completely dosed. The total dose for the tonsil, after the boost, will be 7040 cGy.

The logic of these decisions and their timing was that once the 5140 cGy dose has been reached for my neck and throat, there would be 10 days of treatments left (for the boost to the tonsil site). Two days after the boost I would get the surgery. The area being operated on would have had nearly two weeks to begin healing, since it was out of the field of radiation during the boost. Make sense?

At the end of this day, I am exhausted. I feel emotionally drained, and wonder just where all this is leading . . .

On 11/10/97 I went in to University Hospital for pre-op testing. This was the same as the pre-op testing for the tonsilectomy, back in September. In fact I had the same nurses and everything. Pee in the bottle. EKG. Physical. Medical history. Standard stuff.

On Friday, November 14, 1997 (I'm thankful it wasn't Friday the 13th, not that I'm superstitious), I arrived at University Hospital at 5:45am. It occured to me that this is only the second time in 44 years that I've ever been in the hospital. I feel nervous for various reasons. One is certainly the procedure itself. I'm not looking forward to getting cut open . . . Other issues in my mind at the moment are more dark and foreboding. I can't help but wonder how all this will turn out. Will it be successful? If so, will there be a recurrance? Will I have to spend my life "looking over my shoulder" wondering if every little swelling or lump that pops up will be cancer? I hate these feelings!

I was taken back to the surgery prep area immediately, along with several other patients there for their own personal battles. Stripped down to "nothing," and put on one of those stupid gowns that tie in the back, and have your butt hanging out. What about dignity? Didn't even get to keep my wedding band on. Here comes the nurse. More questions - medical history. Here comes the nurse anesthesist. Same questions. Pastor Jarrett from my mother's church showed up about that time. He patiently waited until all the hubub died down, and then said a prayer for me before going under the knife. You see, this time there is no doubt about whether or not I'll get the neck dissection . . . Healing and peace. God made us. We should have the faith that God can fix us too!

Time to go to sleep soon - they got the IV in my arm and wheeled me into the operating room. I remember hearing a radio in the distance announcing that the temperature is 37 degrees, and it's raining. Predicting the first snow of the season tomorrow. Great. A dismal day for surgery. Funny, the things that stick in your mind. Hustle, bustle. People running around. Making preparations. Clattering sounds. I'm going, going, gone . . .

. . . Waking up in recovery. It's 1:30pm. I thought I'd have been done sooner. Feeling very out of it. Groggy. Fading in and out. There were a lot of people recovering - sort of like planes backed up at the airport, waiting to take off. I was finally wheeled to a room. 5th floor. Looks like most of the rooms are taken.

Starting to feel a little coherent. Just a little. Enough to notice numbness in my left ear and side of face. Top of my shoulder too. At some point I remember a group of about 5 residents coming in. Still a little out of it, I asked if they were "here to change the light bulb." One actually asked if it was out!

It wasn't long before the pain started cutting through. And it was one powerful hurt, let me tell you. A very steady pain in my shoulder. Right where they put the "wound drain." Otherwise, everything was pretty much numb. Got some morphine. Ah, that's the ticket. Also got some roxicet, since the morphine won't last long.

My family was present most of the day (though I wasn't really aware of it). I can describe my state of awareness as foggy, at best. Dr. Gleich came in at around 5:30pm. He immediately spotted a nonfunctioning drain pump (that my wound drain was hooked up to). It provides vacuum for draining my incision. Got that fixed. And proceded to discuss how the surgery went. He felt it went well. He noted that there were some minor irregularities found on the tonsil site. They were biopsied, just to be safe. He also said that there were a few "spots" in the section removed from my neck. He said we wouldn't know if these were active cancer cells, and that they are gone anyway - so it doesn't really matter. That's why I felt this was the best route to go! We'll discuss the results on Wed., 11/19/97, when I go in for a follow-up with Drs. Gleich and Redmond.

After Kathy left at about 8pm, I had some time to experiment with trying to find a comfortable position. There wasn't one. I did, however, use the time to think about some weird things (must have been the drugs). I reflected on how during my radiation treatments, the transition between wakefullness and sleep (and vice versa), seemed to require a lot of time. I believe this was due to the fact that I had to adjust to the horizontal versus the vertical orientations (associated with sleep and being awake). And these adjustments were confounded by my need to get the phlegm cleared out of my throat (since the cilia cells in my throat weren't doing their normal job of keeping the phlegm moving, any more...thanks to the radiation). This resulted in an hour or two after first lying down (or getting up) being used to cough, gag, and spit my way to comfort! No fun, but that's starting to diminish now. Of course, now I have new pains to distract me from it too.

After about 9pm, things seemed to improve somewhat. Mostly, the problem was the pain in my shoulder. About 10:00p I decided to take a walk. It felt good to move around, albeit slowly. I had to roll the IV stand around with me. In order to turn my head, I have to turn my whole body. Things are either numb, or in pain! Strange sensation.

By accident, I discovered the source of my shoulder pain. And it wasn't a result of "surgery," necessarily. I found that when I disconnected myself from the drain vacuum pump, the pain subsided. When I hooked it back up, the pain came roaring back. I could definitely feel the "pull" underneath my skin from the vacuum.

I didn't really get any sound sleep all night. My throat kept telling me how sore it was - probably due to all the tubes that were crammed down it's radiation stricken surface! It hurts to swallow, and everything feels quite constricted. Neck and shoulder are sore and numb, as is my left ear. Hearing is also muted. My thought is that I certainly hope this improves! Left jaw is swollen, but my most painful complaint remains the drain tube in my neck. The drain is a plastic tube with holes in it, that runs under my skin from the top of my shoulder over to my neck, then up my neck to a spot behind my left ear. This is very irritating, and I wonder if it isn't the source of numbness of my left ear and cheek? It comes out tomorrow, so we'll see then.

Most of the day (Sat.) was spent alternating between resting and walking around. I am constantly trying to move my left arm around to regain maximum mobility. I know it will never be the same as it was, but I certainly want to get as much back as possible. So far, so good - I can actually raise my left arm above/behind my head already.

The compression packing was removed this morning, revealing 30 nice shiny staples. Now I know where the term "zipper neck" comes from! It really does look like a zipper. Dr. Gleich did a real nice job of putting things back together, and wrapping it. He uses a compression technique (the residents said it was Dr. Gleich's own), that essentially wraps the incision area tightly to keep swelling at a minimum. Seemed to work - my neck looked great.

Saturday night went better than Friday night. I was able to sleep longer periods, but still had a lot of neck pain (from the drain tube). At about 9am, Sunday morning, the residents came by and removed that cursed drain tube! It hurt coming out, but once out it was much better. Now I can lay on my back without having irritation from the tube in my neck!

Strange how things come together sometimes. Here I am in the hospital for this cancer surgery, and we get the first snow and sub freezing temperatures of the winter! It looks cold out. Snowflakes seemingly suspended in the air outside, and sweat on the inside of the 5th floor window. Gusts of wind kicking up now and then. Yeah, the season is changing . . .

Neck is feeling much better now, with the tube out. The drain tube was stitched into place, and the doc said it may ooze a little. Supposed to take it real easy for the next week, especially. Left ear and skin around the incision are dead numb. Feels like I've had a megadose of novacaine. A lot of swelling too, that seems to manifest itself on the inside of my throat as well as the outside. And hearing is still muted - like I'm in a fishbowl or something - seems to "match" the numbness.

Going home shortly. Kathy just arrived (10:20am). Feel like a nap right now, though! Mr. Holland (70 yrs.) shares my room with me. He had a radical neck dissection also. His diagnosis is cancer of the salivary gland. I came into the room on his second day. We're both leaving today, however. Mr. Holland is very hard of hearing, so we haven't had much conversation. That is probably a good thing. He was a great roomate - we had quiet nights, even if we didn't sleep through them! Mr. Holland loves tennis. He was the KY (he's from Maysville) state champ for men over 50. He stayed active in tennis until stricken with meningitis a few years back. That's when he lost his hearing. And a long with it, his sense of balance - which you need if you want to play tennis. It sure seems like there are an awful lot of these sad stories around . . .

HOME! Finally made it home. It was great seeing Leah. My mom was there too. Kathy talked to Amber today also - filled her in on everything. I'm very tired . . . surgery and radiation take their toll.

Amber called from school later Sunday evening. So good to hear her voice. We only talked about 10 minutes, but I think we both needed to hear each other's voice. The only thing that would have been better, would have been for her to be here!

I've been trying to exercise my left shoulder while I sit around taking it easy. Rolling it around. Raising my arm as high as I can. Stretching it. If I'm not careful, though it can get painful. Dr. Gleich said the sooner I'm able to start doing this, the better - so I keep trying. The most difficult moves involve the neck. Up and down, and left and right are very stiff. The numbness is very aggravating, too.

Tuesday, 11/18/97: I've spent the last two days trying to rest. I really feel fatigued. I'm trying to figure out a way to get my hearing back, too. For about 5 seconds today, while in the shower, it came back! I was trying the old "swimmers ear" remedy of pinching my nose shut and blowing to build up pressure. My right ear popped, and then with a little more pressure, my left ear gurgled, and popped open too! Suddenly, the roar of the water splashing on the floor of the shower was bright, and very loud. About 5 seconds later, things plugged back up again. But, this gives me hope . . . The muted effect doesn't seem to be permanent.

EMOTIONS Physically I feel very drained. Like I've had enough, and my body can't take any more abuse. And I think this feeling is starting to carry over to my mental and emotional state as well. A sort of ominous feeling has settled in, leaving me with a sense of general frustration. I know we've done everything we can do to fight this cancer. But, I don't know if it's going to be enough! I pray that God will grant me peace. I sure need it right now. We'll see Drs. Gleich and Redmond tomorrow for the surgery follow up. "Irregularities" on the tonsil . . . "Spots" in the biopsied tissue . . . The ticker tape in my mind is flying right now. I pray that it goes well.

Kathy took off work to drive me down to the Barrett Center for a 12:30pm appointment with Drs. Gleich and Redmond. I face this meeting with not a small degree of trepidation, because we will be presented with the results of pathology tests of the dissected tissue, and tonsil biopsies. There is potential for bad news, and I just can't stand the thought of more bad news. My body can't take any more "bad news." After taking our place in one of the now familiar examination rooms, we waited for the doctors . . . A knock on the door. It was the always smiling Dr. Bott-Kothari. She looked at my incision, and commented on how good it looked ("Really"). And brightly asked, "how did it go?" meaning the surgery. She seems so young and uninitiated - so full of hope and promise. Like she hasn't really seen the horrors of oncology, or maybe if she has, they just haven't sunk in yet. But, wouldn't it be great if she could stay bubbly and optimistic!? I really appreciated her at that moment. I discussed it briefly, and she asked if we got the pathology results back yet. We said no, and my stomach sort of rolled. She went and found the paperwork. Came back in with that beautiful grin, and a thumb up! Thank God. Again. Everything was negative, and she "proved" it by letting me read the results. Neck dissection tissue was negative for cancer. Tonsil tissue was also negative. We really needed to hear this good news.

Dr. Redmond came in shortly afterward, and we discussed my current condition relative to the radiation treatments. And a minute later, they were called away for an emergency. Said they'd be back . . .

We were taken across the hall to wait for Dr. Gleich. He came in after a few minutes and appologized for running late. As typical, we got right to business. He explained the pathology report again, but took some of the excitement out of it that the rad-onc docs had injected. Dr. Gleich is, after all, a surgeon.Things are black and white. He said there were some "spots" in the neck dissection tissue. They appear to be noncancerous, or dead. But, he said it really wasn't important either way, because they have now been removed. And I agree with him that it was a good idea to take the safeguard measure. The tonsil site looks clear, and that is what we want. Black and white. I like Dr. Gleich. You know where you stand. And he is a great surgeon. He removed the 30 staples from my neck with no discomfort to me. He was impressed with the degree to which I could already move my left arm. He said I didn't need to go over the rehab instructions with him, since I can already move my arms normally (albeit slowly, and carefully). All in all, everyone was very pleased with my rapid recovery from the surgery, and the great appearance of the incision.

We talked about my hearing loss, and numbness also. The hearing should return to normal, and the numbness should go away as the nerves reestablish themselves. This may take up to a year, however, and there will be small areas (i.e., lower ear lobe, and parts of the cheek where the incision is) that will remain numb permanently. If the cancer stays away, I can deal with that . . . Dr. Gleich said, "make an appointment for next month, and we'll see you then." Any questions, call. Black and white.

Dr. Redmond came back for a few minutes just before we left. He poked and proded a little bit, and said everything looked fine as far as he is concerned.

I spent the next week or so just resting up and letting my body heal itself. I took the doctors' advice, and didn't do a whole lot of strenuous activity. My main goals were to try and get rid of the throat pain and dryness. The swelling in my throat is still very taut, though not real "big." Not much has changed in the last week, though. I still get tired fairly easily. It's been almost two weeks since my last radiation treatment, and I'm really hoping that the ulcers in my mouth will soon start to fade, along with my taste loss! The surgery scars continue to heal. The tight skin really is evident when I try to turn my head left or right, or up or down. I certainly don't have the mobility I used to have. I sometimes get needle-like pains out of nowhere that cause me to twitch, because I don't know they're coming until they've already passed! I must look like an afflicted person at times! The numb areas have diminished by about 10%. Some of my lower chest, upper left cheek and left shoulder are near normal feeling now.

This pretty much covers the surgery, up to about two weeks afterwards. Check out Chapter 4 for post surgery / radiation issues. That is where I will be posting updates as time goes by, so check back if you're interested!