Tuesday, February 19, 2008

Pre-Op Proceedures & Tests

One thing we all want is to put our trust in our those who treat us. And most of us do. There are occasions when a professional tells us something, it may make us feel uncomfortable. Questions pop up in your mind.

  • Have they done all the could have?
  • Are there other options other than what was discussed?
  • What is the likeliness of the side affects?
  • Are they after my money or is MY health and best interest their number one priority?

Doctor O'Malley and Doctor Weinstein of the Department of Otorhinolaryngology: Head and Neck Surgery at the University of Pennsylvania, are very through. How refreshing is that? I admit, getting all the information needed and getting all the tests arranged before my first appointment with them has been a lot of work. It is very comforting knowing they truly do have MY Health and Best Interest as their number one priority!

They have ordered a few tests before I make my trip over to Philly. If you are lucky enough to be considered a candidate here are some tests you may have to undergo. Each person may vary depending upon your medical history.

  • H and P
  • Blood work such as PT, PTT and Chem 7.
  • EKG, Chest X-Ray and CT Scan along with an MRI.
  • Normal first time paperwork listing allergies, family history ect.

H&P is your History and Physical... like that coversheet you fill out at the doctor's office every year. Asking you thousands of questions... I call them the "ever had" questions. PT and PTT is a "timed" bleeding test. It measures how quick your blood clots etc. etc. People taking blood thinners have to be very careful before a surgery... this is routine for surgery patients along with the Chem 7.

The liver functions probably is in conjunction with the PTT since the liver filter's your blood, they want to make sure everything is working properly. And my best guess about the Thyroid is they don't want any surprises when they get in there, like a goiter (benign tumor) growing on your thyroid. Since I am so slim and having such a high metabolism rate, I assume they probably suspect hyperthyroidism, but nothing to worry about there. Leave no stone unturned.

Even taking something as mild as aspirin or ibuprofen can affect the clotting of blood during surgery. Some vitimans and herbal product will counter act with other meds given during surgery as well, the way I understand it. Rule of thumb is do not take these things two weeks before hand Unless your Doctor approves of it. When in doubt.....ASK!

I will have to see a Doctor of Internal Medicine to get these tests done for pre-op clearance. MAKE SURE the Interest is willing to do so if you are in another state. I almost did not get one to help me with this because of that very reason.Save all your documents and records. You will need to bring them with you. If you do not have them, ask for them.Last thing I need to do is get a Gastrostomy Tube. Different types are available, You should research it and see what is best for you and make sure the Doctor can put in what you request. Some Gastro Doctors only put in certain types.

Why do you need it? So you do not starve! During some surgeries IE: Grafts of the tongue or during radiation, you may not be able to swallow on a lot of days since this is involving the mouth and throat. The G-Tube allows you to eat. Some patients refused this and lost over 100 pounds or more and became very ill from this. Do not be stubborn or a hero, you will wish you did get it done when you can not eat anything for days or weeks.

Sunday, February 17, 2008

Alternative Treatment Plan For my Oral Cancer

After receiving the news of the type of surgery I was going to have to recieve, I decided to do my own research. I was looking for anything that would cure or perhaps offer a safe yet alternative treatment plan for my oral cancer. What would it be or where would it be? I had no idea but was determined to find out.

After searching the internet and looking at articles that people would give me, I found a different plan of action. It was found at the University of Pennsylvania. That is right, good ol' Philly. It was here that I found out about the Transoral Robotic Surgery.

Also known as TORS, this offers the same outcome of the microvascular free flap without all the trama and longer hospital stay I was briefed on originally.

  • Reduced pain and trauma to the body
  • Less blood loss and need for transfusions
  • Less post-operative pain and discomfort
  • Less risk of infection
  • Short hospital stay
  • Faster recovery and return to normal daily activities
  • Less scarring and improved cosmesis
  • No Scar and no tracheotomy, all done within the mouth by robotics and little cameras
So I called the Department of Otorhinolaryngology: Head and Neck Surgery on my own. I got my file from my surrent ENT and faxed it to them. I talked to a nurse who talked to Dr. Bert O'Malley who reviewed my file and said I may be a good candidate for the new procedure. I am to have some tests done here and I am going up on March 10,2008 for an MRI and consult. I will have a minor surgery on March 11, 2008 so they can size the cancer and see if I meet the criteria for the Robotic Surgery. One disqualifier is that you can not have had any radiation or Chemotherapy treatments. Thank God I have not have had any of that as yet.

I never thought I would say this, but I am really excited about this surgery. I hope and pray that this is the answer to prayer. If I had to have a procedure done, this is the way I would prefer. I shall keep you all posted on the results of those findings.

I have also read about a natural product called Avé. A dietary supplement containing Avemar, a uniquely beneficial natural compound that has been the subject of more than 20 peer-reviewed publications describing in vitro, in vivo and human clinical trials, with such dramatic results, its hard to believe that it is all natural.

Once daily use is shown to support healthy immune system modulation and the regulation of cell metabolism, supporting the processes of cell differentiation and repair. It has not been apporved by the FDA because it is all natural and therefore can not be patened. However private studies show that it does reduce the Squamous Cell Carsonoma by up to 85 percent. It also is said to reduce the side affects of Chemo dramatically.

I not started taking this as yet, I do not want to hurt my chances with the TORS, plus it is 161.00 for a 30 day supply. I am investagating this more, so I will keep you posted as to what I may find and how it may or may not work in conjuction with regular treatments.

Green tea stops growth of oral cancer cells and breaks down and kills existing oral cancer. The polyphenols in tea areantioxidants, which work to remove free radicals (oxidants) which cause the mutation of genes which lead to cancerous growth. By drinking 4 to 6 cups of green tea a day the polyphenols can inhibit the growth and spread of cancerous cells. The results of research at the Medical College of Georgia in Augusta, USA indicated compounds in green tea selectively induced cell death only in oral cancer cells while ignoring normal cells.In China where green tea is extremely popular, oral cancer rates are 1/2 that of North America, even though smoking rates- a known risk factor for oral cancer - are 3 times higher in China

Reported by www.100percenttea.blogspot.com

Teatment Options for Oral Cancer

It was 6:00 AM when I crawled from the tent to make my first mornings coffee. I was excited today because we were going to take the 4x4 up one of the hardest mud bogging hills there was in the country. Very few made it up this hill and I knew with the new modifications made to my truck by McFarlands Off Road, I was going to be King, as I had proved to be so far this week.

That is the story I wish I could tell. Here is the Real story about my 4x4 Experience!

I was referred to another ENT who reviewed my file. He did his little examination and started to tell me of my options. OPTIONS!........ I like options. That means that I have choices. Must not be too bad, otherwise I would not have "OPTIONS". In the words of the infamous Bill Engvall, "That would have been a big ol' WRONGOH! Things could not have been further from the truth."

I sat in this chair that was fastened tight to the floor. It was very small, sat very upright and would not recline. He proceeded to tell me of my "options". Here they are.

1.) I can go through massive doses of radiation and chemotherapy for about 8 weeks. He described it as being very brutal. At first you won't feel too bad but by the second week, maybe the third week if I was lucky, I would not want to do anything or go anywhere. I would be very sick and feel like total crud! The treatments would be every day, 5 days a week for 8 weeks.

IF going through all of that did not work I would have to have surgery anyway. And then more radiation for a short time.

2.) The second option would be surgery. After surgery I would still require radiation and chemo , but milder doses and for only 6 weeks vs. 8 weeks.

Here is where that proverbial 4x4 came and smacked me right on the side of my head and knocked me cold! He described the surgery which I considered to be nothing less than barbaric!

The incision would start where the upper and lower jaw meet. Then it would kind of horseshoe down and go to the chin. Then they would cut the jaw bone in two. The red line in the picture to the left, indicates the flap that would be cut and the blue line is where the jaw would be cut. The reason for this is, they can not see down the mouth to do the surgery. Your tongue goes back and then down. It stops just above your adams apple. Yeah, I did not know that either. So in order to cut out the cancer they have to make these incisions, Swing the jaw out of the way in order to see to do the surgery. Then they would take some skin from my forearm and some vessels to make the graft for the tongue. The vessels would keep the graft from dieing out.

This would be a 6 hour surgery and then after all was done, they would sew me up like Frankenstein and insert a tracheotomy. Why? Because of the swelling that will occur after surgery. The swelling can get so bad that it would cut off my air and I would die. This also allows me to cough up the crud from my lungs that develops during long surgeries without messing up the graft on the tongue.

It was at this point I came to a full realization that I had Cancer!
I sat in that chair after hearing all he had to say. I was partly sick from the surgery description and partly stunned from the big 10 foot long 4x4 he just hit me in the head with. I sat there and was............well, I just was. I had no feeling, my mind was a blank for a minute. I could not speak , I did not move. I just sat there. And then......emotion took over. It was all I could do to muster up the "Manly Courage", to keep from crying my eyes out! I now realized I had cancer and more importantly , what that meant!

The Doctor says.....you all ready for this one? He says.....Are you ok Mr. Resner? Oh MY GOD. Can you imagine what my thoughts were at that time. My thoughts only took about 5 seconds and within that 5 seconds those thoughts were...... You just took my gonads and ripped them from my scrotum and stomped on them just after ripping out my heart and soul.... and you want to know if I am ok. My reply to him was simple, I answered in a weepy yet slightly muffled voice, NO!

He excused himself and a nurse came in to discuss things more. Well, there was no discussion, she had the consent papers to sign. That was her mission, to get me to sign the line. She did not have answers to my 10,000 questions. She did not know much of anything at all. Kind of a dumb cluck actually. But she knew how to shove those papers in my face!

So I took the papers and told them that I need a few days to digest all of this and I would call them back to let them know what I had decided.

First Tonsil Cancer Surgery

All I could think of was Ohhhh, ! Now I realize that this is not the Christian thing to think. Nor is it proper to put into print. What you need to understand is the frame of mind. It is different and anxiety can bring out a lot of things that normally would not be indicative of your normal thinking. That is exactly what I thought though. As I was removing my clothing in preparation, I dern near chickened out! But...I " Manned Up" and donned the gown of shame and embarrassment. The nurse seem to read the situation well. She asked if I needed something to calm my nerves. My reply was short, quick and to the point. YES!! Thank God for valium. It makes you feel very mellow! Pretty euphoric I must say. You just do not care about much. So I went into surgery for my first time. I remember thinking that the lights were BIG, the table was small and the tools on the other side of the room looked scary! So I closed my eyes and they stayed that way. The less I know and see the better it is for me.

I used to be an EMT. I would do CPR on people whom were lying there dead. I would scrape people off the street who were badly hurt and in need of surgery or they would breathe thier last breath right under my nose. Something we would term as " The last Sigh". But that was them. This was me this time. Tis a different story now. Percentages are no longer an issue. When It is you, it is no longer 70-30. It is 100%!!!! Starting to understand the frame of mind yet?

I was deeply scared. But even this I found, would be nothing to what I was about to experience in the very near future. All in all, the surgery went fine. I woke up what seemed to be a few minutes later and had a mouth that felt like the Mohave Desert. I was denied drink but finally offered ice chips which can seem like a real treat. I later found that they removed one tonsil and the biopsy revealed cancer. Recovery was a BEAR! They removed the tonsil and what is called a reasonable margin. Means what ever they feel is necessary to try to get all the cancer in that area. Recovery was long and hard. They older you are the harder it is to get over a cold much less the pain from a tonsillectomy. But after the third week I was better.

I had Squamous Cell Carcinoma. A common cancer for the oral region. It was in my tonsil and in a portion of my tounge. I was now being referred to another ENT who specializes in Oral Cancer. I thought ok, Surgery it is not that bad. I have after all, one under my belt now. Little did I know what was entailed in this surgery. The options to surgery seemed bleak!

Diagnosis of Tongue and Throat Cancer

My first visit to the Otolaryngologist, AKA ENT, was not that bad in my perseption. He thought I may have cancer but was not sure. Or at least he was telling me at that time. If he was 100 % sure at that time he was not expressing himself that well. I think he knew then. I think he like any professional could not say, YES you have cancer. Not yet anyway. He left me with the hope that it could be a puss bag behind the tonsil causing this. At the time I thought he was not sure of anything. What I was hearing was, You have a small yet hard tonsil. You need some tests. You need a Cat Scan to determine this. I was ok with that. It is just a kind of Xray.

Then I heard the most awful word I had never heard of in my 47 years of life. SURGERY! Never had surgery before. Did not want to either. This was after I went to his assistant to get the "Tests" arranged. I said to her, " What are you talking about? the Doc did not say I needed surgery. "I thought..... Get those dern papers out of my face Woman! I am here for a C-Scan and that is it! She then told me this was only if the test proved I needed surgery. We can always cancel. Little did I know. Part of the test was surgery. To do a biopsy. The C-Scan was a mere formality. I thought Kasey Chambers was singing to me the song titled, "I got you now". Only it was not love she was offering me, it was more of a form of torture.

Early Signs of Oral Cancer

At first I thought I was just having problems with a bad case of Strep Throat. I went to the Prompt care on the weekend and got some antibiotics. After taking a round of that for a couple of weeks I still felt bad. My throat was sore and still had a swollen gland. Pain resinated in the ear on one side. I knew the Prompt care Doctor had to have misdiagnosed my problem. Even though I am not a Doctor, I knew something else was wrong. But who do I see next? I mean, this does cost me money. How do I spend it wisely? What professional should I ask next?

I went to the Dentist thinking it may be some gum disease acting up again. In the past I have had simular symtoms just not this severe. It did seem reasonable to me. Swollen glands, soreness, maybe it was because I had let it go for so long. My Dental visit is where I found out I had a leasion on the tounge. He dismissed any idea of cancer think it was caused by some sort of blunt force trama. Jabbing a toothbrush back there accidentally or swollowing glass and not realizing it. I could not remember doing any of those things. You would think that you would have some pain associated with such trama. Would you not? So he sent me home with an anitbacterial mouth wash. I used this for one week and still had little or no difference in my symtoms.

After a week or so I decided to see an Ear, Nose and Throat Doctor. Maybe he could shed some light on why all these symptoms were increasing rather than going away.