YAMDACTS

12:34pm

(Slowly the doorknob opens)

In walks Dr. Lai's Assistant in a white lab code (naturally!)

"How are we doing today?"

(I resist the temptation to use my standard reply: That is for you to know and me to find out!. Instead, Cheryl says:)

"You are supposed to tell us!"

"Well, I have the CT scan report, and it says 'No significant findings indicating a recurrence'"

(Sound of happy feet doing a dance).

Just what we wanted to hear! YEAH!

Wow, that` was fast. We had the scan late yesterday!

Driving over

Most of these three month checks take two days to do. I had to cancel classes on two days, which is tough for a teacher to do, but i have no choice. The scan has to take priority!

Our first appointment was at 9:30am, so Cheryl and I headed out of Austin at 5:00am. (No, the sun was not up, it is smarter than that!)

Surprisingly, there was not much traffic in Austin. That is very rare around here. We sailed out of town, through Bastrop (scene of a massive wildfire a few years ago), and got to La Grange for a kolache stop by 6:00. That is pretty quick, but we needed the stop, since neither of us had breakfast. The kloaches there are marvelous!

Another two hours and we are smack in the middle of Houston rush hour. We crawled along for quite a while, and finally made it to MDA!. Only this time, the line into the parking garage was huge, and going nowhere. Cheryl had a great thought: valet parking! That was something we did on our very first visit, but have not done since. Turns out it costs three dollars more to use that service rather than parking in the garage, so we decided to go for it and left the line and were in the hospital with enough time to make the first appointment just fine.

Plastics

The first stop was a visit with Dr. Yu, my plastic surgeon there. Dr. Lai wanted him to revisit my sagging mouth issue, which is causing me to drool excessively. Almost anything I try to put in my mouth immediately heads back out along the drooping side. I cannot feel it,! However, when my shirt gets messy, I do notice it, and Cheryl is constantly pointing out escaping whatever. The whole situation is very annoying, and I am actively seeking some kind of solution.

Dr. Yu, and my Austin plastics doctor, both agree that fixing the lips just is not going to work. They would have to steal ligaments from my arm to hold the lips up, and that would only work for a period of time and the problem would come back! So that is not going to be a solution.

I had an idea about building some kind of dam out of rubber or plastic that I could wedge between my lips and the artificial gum they built when they rebuilt my jaw during the last surgery. I visited with Dr. McMordie, who build appliances for my first two surgeries, to discuss this idea, and he thought we might be able to do something. He said he could build a dental plate that tied into the remaining teeth on the right side, and hung out into the area along my new jawbone. He said it would be an experiment and it might not work. I wanted Dr. Yu's opinion on that idea before trying it.

But, after thinking about it, the engineer in me got upset at one aspect of this idea. With nothing to support that new plate, any pressure in it would transfer directly to the remaining teeth on the other side (like a see-saw). That would stress those teeth badly, and I do not want to lose them!

The waiting area where we sit before visiting Dr. Yu is one of Cheryl's favorites. The fish tank there has very friendly fish, who always seem to come over to her when she gets close up.

For some reason, they were not a friendly as usual. Probably because they just finished eating, and they knew she had nothing to offer them.

We were called in to the small waiting room (with one of those door knobs) in short order, and were greeted by Dr. Yu's P.A, Brooke, who hails from Nebraska, so Cheryl and Brooke spent a few minutes discussing football! (Go figure!). Me? I just sat there waiting for my turn.

Brooke looked me over, declared that everything they had done looked fine, and wandered off to find Dr. Yu.

Dr Yu, in a blue bow tie, showed up very quickly, and also declared that all of his work looked fine.

Then we started discussing options to deal with my mouth. He came up with a different solution, Maybe we could construct implant that would replace the teeth they took out from my lower jaw. There is enough bone in there (thanks to my left leg) to support such a thing, so he suggested contacting Dr. Hofsted (who spotted my last tumor) and see what she thought!

Wow! We never suspected there might be a better solution!. So, we called over to the dental clinic to see if we could get a follow-up visit scheduled there.

We were out of Dr. Yu's area with new things to think about around 10:30.

My next appointment was at 3:40pm, so we had time to head to some place to get a bit of email checking done. We ended up on a walkway between buildings that spans the major road that goes by MDA. That gave us something to watch, in addition to people watching, which is always "interesting" at MDA!

We skipped lunch, since I was not allowed to eat before the CT scan. When it got close to time for the scan, we headed to the vampire feeding area. They needed lunch, so I donated a few gallons of blood! (Well, it seemed like that much!) Then we headed up an escalator to the CT waiting area and did just that, waited. After about 45 minutes I was called in to get the IV set up (no fun, as usual), and went back out to the waiting area to wait some more. Finally, I got called in and was taken to yet another waiting area, where i got to sit for almost an hour. At least in that room, they gave me a microwaved warm blanket. (Why are hospitals always freezing?) The scan itself was not any different from the others, but they use an automated IV push machine to inject a "contrast" die that makes things show up more clearly. When that thing kicked in, it hurt! No where near as much as a past one where I thought my arm was going to explode, but it was bad enough! I survived the injection, then the pain faded and was replaced by an internal heat stroke that extends from head to toe. That stuff is just weird!

Then it was over.

Dinner

On this trip, we decided to stay with Cheryl's high school classmate, Sharon, and her husband Dan, who we often visit on these trips. I got to bond with Little Bits, their wired little doggie, who is a ball of energy. She remembered me from my last visit, and was my best friend immediately.

We ate way too much food at Olive Garden and I crashed for the evening fairly early. Sharon and Cheryl were talking about their upcoming high school reunion, so they kept at it a bit longer.

Back to MDA

Next morning, we took Sharon to the airport so she could go back to Nebraska for a visit (that seems to happen with folks from Nebraska a lot. They seem to need to return for a fix of some sort periodically. The best of all fixes involves going to a Cornhusker football game, but that is VERY hard to do! They have sold that stadium out for every home game for centuries, (or so I am told!)

Next thing I know, we are back at MDA. In the parking garage this time. On level 11 (a new record). That place is busy!

This appointment, with Dr. Lai, is the most important one, since he normally looks over the CT scan images, and gives us his "unofficial" opinion. This time, we got the official reading right away, which was great news.

New Issues

The CT scan showed a few issues we had not been thinking about. It appears that the main carotid arteries going up my neck, where the radiation occurred, are showing signs of closing down a bit. Dr. Lai said things like this are common, but he suggested that I get a Doppler scan of my neck to get a better look at this. Great, more stuff to worry about. The CT scan report also noted the damage caused by my stroke. I expected that, but I was hoping it might magically clear up. No signs of that happening, so this may well be the new me permanently! Oh well, I am getting used to it.

Dr. Lai was done very quickly. We told him of Dr. Yu's suggestion, and he was eager for us to explore that idea. Fortunately, we managed to get an appointment set up for right after this visit, so we left Dr. Lai and that evil door knob, and headed to the dental area.

Dental Plan

We got in to see Dr. Hofsted pretty quickly. One of her lab technicians took me into an X-Ray room for a 360 degree image of what is left of my head (including the few teeth left there). Then it was back into another small room to wait.

Dr Hofsted came in and we talked a bit about how I was recovering, and she inspected my "flap", the skin they put inside my mouth to replace my gum.

Then we got down to business. She had looked over the X-Ray and decided I was a good candidate for an implant. She suggested installing two metal posts into the bone (my leg bone) and waiting a couple of months for that to heal. Then they will rework the flap to expose the top of the posts, and bolt on a row of teeth! No of that denture stuff, this would sit there full time and give me back my left lower jaw. She even proposed a removable plate that would add back in a few of my upper teeth. All in all, that would restore my mouth to what it was before the jawbone surgery - almost.

It will take two out-patient surgeries to get all of this done, and we discussed doing the first one after classes end in mid-December.

I got a good look at what they did to replace my jaw, and I really am turning into a bionic man!. The entire left lower jawbone is gone. Where it was, they put in what looked like a bicycle chain, really a piece of titanium with places to put screws as needed. They can form this chunk of metal as they like, and they curved it to match my old jaw line.

On top of that metal, they took the leg bone and cut it into three pieces and bolted them in place to form a line of bone that looks like the original bone. On top of that bone sits the flap, pretending to be a gum. Only thing missing is teeth. It looks pretty amazing. It is also easy to see what they are planning. Just insert the posts into the bone, which is still "alive" and it will grow around them, locking them in place. Then they will form the dental pate they will bolt onto those posts. It will not move at all, so it might just work well enough to stop (or minimize) my drooling issues. Time will tell!

Hey, this is a HUGE improvement opportunity, totally unexpected. Both Cheryl and I were pretty happy with the prospects!

We left with a plan for my doctors to discuss this, since the surgery will involve both plastics and dental work, but it looks like we will be going for it!

Microcenter

We left MDA around 3:00pm, and headed for the requisite stop at Microcenter so I could buy a few new toys for my students to play with. After that, we headed for home.

Oh yeah, we did stop at Dairy Queen for blizzards to celebrate. We also stopped in La Grange for a kolache resupply!

Then we were home, around 7:30pm.

We had a long two days, and were both crashed as the stress of the trip faded.

It takes me a while to adjust to the new situation. I believe that every patient who sits in those evil waiting rooms, waiting for test results, actually expects the worst. You almost have to, so you are prepared if it turns out bad. I have actually been OK with the news, even when it was bad. Knowing is far better than not knowing.

When the news is good, it still takes a while for it to settle in. I went to bed last night just starting to feel like things were going to be fine. At least for another three months, then we do this all over again!

Such is the life of cancer patients. No fun, but something that must be endured!

Prayers

As usual, Cheryl sent out a flurry of text messages to all those who have been praying for both of us during this trip. She got over thirty replies almost immediately! That is amazing, and we both thank all of you. I have said it before, and will continue to say it again: this journey would be almost impossible to survive all by yourself. With Cheryl's help, and all of those out there" supporting us as well, we are doing pretty well. We have all of you to thank for that.

Oh, and God, of course. He was pretty good to us on this trip. We thanked him especially for that!