Click to go back to table of Contents

 

 

Part III, Chapter 3:

Always Something

There to Remind Me

 

 

Sent/Uploaded: July 9, 2007

Subject: Radiology is the Spice of Life (kinda like habaneros)

Hello, everyone.

I am now almost a year and a half out from chemotherapy, but since I have had three different tumors in quick succession, those pesky doctors won't let up on the screening. (Don't they know things come in threes?) Every fewe months, I catch up with my friends in the radiology department while they scan me from yin to yang.

Well, this time around, there's some action. There's something funky going on at the site of my bone graft in my face, and the graft itself seems to be sinking backward. Before everyone gets all worried, let me assure you that the likelihood of recurrent tumor is very low. By far the most likely cause of these changes is a chronic wound infection (How comforting!) which would make sense, since I have been feeling a little under the weather for the past few weeks.

The movement of the bone, creepy as it may sound, is probably irrelevant. My plastic surgeon said months ago that it's probably dead after being exposed to the air for so long, and my right eye is now held in by scar tissue. (The body's own duct tape!) Nevertheless, I do find the phrase "can't rule out local recurrence" to be a bit of a downer.

So now, I'm popping antibiotics like candy (Don't do this at home. It's only worthwhile if you have a festering surgical wound that's been irradiated so much it has the consistency of Jello.), and I am waiting to hear from my ENT surgeon the Coach at F'in' Famous once the films are sent to him. I hope he'll say what he always says: "Hey, I don't know much-I'm just a surgeon, but I don't see anything scary on your scans. These internal medicine types can be a little jumpy. You're a rock star!" at which point everyone will breathe a sigh of relief.
 

 

 

Sent/Uploaded: July 9, 2007

Subject: Also Sprach the Coach

It has been over two weeks since my last scan. I did not mean to keeping my friends and family in suspense, but for various bureaucratic reasons, my scans did not make it from Wicked Famous to F'in' Famous until the 11th. The Coach, whose word is soothe on the matter, was not in on the 12th.

I was never worried. Since the last scan, I had lost my cell phone and my iPod, and I smashed the back window of my station wagon while taking off a bike rack, but I was never worried. Nope. Not me.

The Coach called on the 13th. He was not his jovial self-deprecating self. He was annoyed. "Look, I know you're an internist, and I don't want to offend anyone, but this is post-surgical changes, and it's going to look abnormal. I don't know what these internal medicine types think they're scanning for. Every time they do it, they get upset, your family gets upset, you get upset, and I get upset, and it's nothing. Tell them no more scans for at least six months!"

Thus sayeth the expert.

I was never worried. That old window needed changing anyway.

--Tom

Sent/Uploaded: September 11, 2007/September 12, 2007

Subject: I'm having a bypass!

Not the way you think, though.  Heart surgery would be just my style, but I'm trying to change my wild ways.  I'm just having a tear duct bypass.

Here's a little background for the nondoctors or doctors who slept through this part of anatomy:

Tears are formed by the lacrimal gland in the upper eyelid and flow across the eye until they get to the corner next to your nose.  The tears drain through two little holes into the lacrimal sac and then down the lacrimal duct into your nose.  (That's why your nose runs when you cry.)  Think of it as a sewage system for your eye.  Mine is clogged.  The duct has been sliced through twice during surgery and has gotten more radiation than the Incredible Hulk.  Instead of draining into my nose, the tears either slide down my cheek (I weep for the children.) or accumulate in the lacrimal sac, forming a little cess pool that causes frequent infections.

Radiation has left that part of my face just one step up from aspic, so not a great spot for surgery, and surgery has lost its charm for me anyway.  However, my periodic infections have gotten nastier and harder to treat with antibiotics until one a few weeks ago made me look and feel like I had lost a cage fight.  I considered Draino eyedrops for a while, but that's bad for the environment and therefore politically incorrect.  Surgery is now inevitable.  So last week, I saw Dr. Roto Rooter, self-described eye plumber.

Dr. Rooter is a cheerful, chatty guy who spent much of the visit cracking jokes.  According to him, tear ducts are so badly made they disprove intelligent design.  Instead of trying to fix mine, he'll tear me a new one.  On October 18, he will make a small incision next to my eye and make a big passage from my lacrimal sac to my nose, bypassing the tear duct altogether.  The whole thing should take an hour or so, and I should be able to go home the same day.  No fun, but not bad as bypass operations go.

The Good News
Despite all of the complications and recurrence scares, life is good.  From the neck down, I am as healthy and fit as I have ever been.  I took the medical boards on August 22 (Results come back in 3 months.), and I am slogging through bureaucracy to get my full license.  I am on a research team that is finally in the last stages of institutional approval to research a device that could greatly improve diagnosis of TB.  I am working on a couple of writing projects for one of my mentors, and I am talking to people at  Dana Farber about carving out a job seeing cancer survivors.  (I hear they can run into complications.  Go figure!)  When life gives you tumors, make tumorade.

 

Sent/Uploaded: September 11, 2007/September 12, 2007

Subject: I'm having a bypass!

Not the way you think, though.  Heart surgery would be just my style, but I'm trying to change my wild ways.  I'm just having a tear duct bypass.

Here's a little background for the nondoctors or doctors who slept through this part of anatomy:

Tears are formed by the lacrimal gland in the upper eyelid and flow across the eye until they get to the corner next to your nose.  The tears drain through two little holes into the lacrimal sac and then down the lacrimal duct into your nose.  (That's why your nose runs when you cry.)  Think of it as a sewage system for your eye.  Mine is clogged.  The duct has been sliced through twice during surgery and has gotten more radiation than the Incredible Hulk.  Instead of draining into my nose, the tears either slide down my cheek (I weep for the children.) or accumulate in the lacrimal sac, forming a little cess pool that causes frequent infections.

Radiation has left that part of my face just one step up from aspic, so not a great spot for surgery, and surgery has lost its charm for me anyway.  However, my periodic infections have gotten nastier and harder to treat with antibiotics until one a few weeks ago made me look and feel like I had lost a cage fight.  I considered Draino eyedrops for a while, but that's bad for the environment and therefore politically incorrect.  Surgery is now inevitable.  So last week, I saw Dr. Roto Rooter, self-described eye plumber.

Dr. Rooter is a cheerful, chatty guy who spent much of the visit cracking jokes.  According to him, tear ducts are so badly made they disprove intelligent design.  Instead of trying to fix mine, he'll tear me a new one.  On October 18, he will make a small incision next to my eye and make a big passage from my lacrimal sac to my nose, bypassing the tear duct altogether.  The whole thing should take an hour or so, and I should be able to go home the same day.  No fun, but not bad as bypass operations go.

The Good News
Despite all of the complications and recurrence scares, life is good.  From the neck down, I am as healthy and fit as I have ever been.  I took the medical boards on August 22 (Results come back in 3 months.), and I am slogging through bureaucracy to get my full license.  I am on a research team that is finally in the last stages of institutional approval to research a device that could greatly improve diagnosis of TB.  I am working on a couple of writing projects for one of my mentors, and I am talking to people at  Dana Farber about carving out a job seeing cancer survivors.  (I hear they can run into complications.  Go figure!)  When life gives you tumors, make tumorade.

 

Sent/Uploaded: October 8, 2007/September 12, 2007

Subject: I'm having a bypass!

 

Hello, everyone.

 

I have several things to report.  First, I apologize, but in trying to avoid spam filters, I messed up my mailing list.  Many people were unintentionally dropped and missed updates.  I think I have retrieved the old list, but if you do not receive this e-mail, please reply to it immediately.

 

This is not an exclusive listserve.  If you want to forward updates or ask that someone be added to the list (especially to well-moneyed publishers who want to make books by cancer surviving doctors), please do.

 

Second, the entire Tumoriffic saga (thus far) is now on the web.  You can catch up by going to tumoriffic.org.

 

Third, the update:

 

As of last time, I had been scheduled for an operation on October 18 to bypass my damaged right tear duct.  Shortly after I sent my update, the duct got infected again.  Antibiotics took care of it, but it was time to act before another infection started.  The surgery was moved to October 4.  It was like getting to move Christmas to an earlier date.  Except not.

 

Although this was to be a short, almost recreational operation, there was one very unfun aspect.  I couldn’t argue my way out of general anesthesia.  I would have to be intubated (get a breathing tube) and put on a ventilator.  In my case, that’s a particularly difficult proposition.  Radiation fibrosis has left me with the ultimate W.A.S.P. jaw--unable to open more than a centimeter.  For my February surgery, they gave me a tracheotomy (they cut a hole in the base of my neck to insert the breathing tube).  That sucked (and blew).  I dreaded a repeat.  Luckily, for this simple operation, there was a Kama Sutra of more pleasant ways to intubate.  (OK, actually, just one.)  The anesthesiologist did a nasal intubation (which is as gross as it sounds).  It was reportedly very difficult and involved half-an-hour of me gagging.  I wouldn’t know.  They gave me the ‘date-rape’ drug, and I don’t remember a thing.  Good stuff.

 

Aside from that, though, the surgery was quick and easy.  I have had less pain than expected, and there is now a wide open hole in my lacrimal sac that allows the tears to drain into my nose instead of stagnating.  Oddly, the inflamed pouch that sat under my right eye for nearly two years deflated almost completely (I don’t know why.), and despite all that jabbing around, I don't have a sore throat.  To top it off, my medical license was waiting for me in the mail when I got home that evening.*  What more could a tumoriffic doctor want?

 

So ends, I hope, another tumoriffic aftershock.  Perhaps, I can finally return to being more doctor than patient.

 

--Tom

 

*Long, painful, bureaucratic saga perhaps to be told on the website one day.

 

 

 

Finally, check out the Latest.

 

All comments, suggestions, compliments, insults, and hate-mail should be directed to Tom@tumoriffic.org.