Of course, I first saw a young resident, who stuck a camera down my nostril and made me squeak "EEE! EEE!" like a startled porpoise as he examined my vocal cords. I felt like I was trying to swallow paper clips. My mother, bless her heart, held my hand; what a wuss I am. Anyway, the guy seemed very confident and competent, and told me that my right vocal cord was paralyzed, which was causing the difficulty swallowing, and that it was very likely because a cancerous lesion is pressing on the nerve that supplies it. He added that that nerve would be in the top portion of my lungs.
I had been told in September that I had no metastatic disease in my vital organs, so the thought that it had spread to my lungs was, shall we say, dismaying. Young doc backed off a little when I told him about that scan, and went to get his boss, while my mom and I had a tearful little pity party in the office, with the door wide open to all who passed.
The actual specialist was also friendly and competent-seeming, but much more upbeat. She said that only the nerves to the left vocal cord went through my lungs; the ones on the right are in my neck somewhere.
Now, I can't explain why I find it less alarming that I might have metastasis in my brain stem than in my lungs. Perhaps because I was prepared for the idea it had spread up my neck, but not prepared for the lungs notion; perhaps because the radiation oncologist had suggested that radiation in my neck has a good success rate. I don't know. It was like the doctors were playing "bad cop, good cop." In any case, I was, perversely, slightly relieved.
I was more relieved when she stuck the scope down my nose, examined the vocal cord and announced that it wasn't actually paralyzed, just partially paralyzed. At this point I wanted to slap Young Doc.
Then she said that lots of people get this condition, which is called vocal cord paresis, for no good reason at all, just like some people get Bell's palsy for a few months and then it goes away. Sometimes the other vocal cord compensates, sometimes they have to perform a procedure that trains the bad vocal cord to work again. It's not necessarily an indication of cancer spread.
Still, what are the odds that I would get this out of the blue by coincidence, when in fact I have cancer progressing up my spine. I am having an MRI of my head on Saturday and a CT scan on Monday, and on December 2 I'll see Dr. ENT to get the results. Until then I just have to keep my fingers crossed and continue to croak, and to eat very, very slowly.
In the meantime, tomorrow I will have a planning session for radiation to my spine, which begins on Monday and goes for five days in a row. I may get a sore throat as a side effect, and the spine pain should subside within two to three weeks. If the cancer responds to treatment. And if all the pain is really coming from the cancer and not just my mechanical problems.
It does seem likely that the rib pain is from cancer, since it feels just like Dr. Lee warned me it might: like an increasingly tight vise around my middle. However, they are not radiating the ribs, just the spine (vertebrae T1, T2, T3, C6 and C7), in case the rib pain is simply radiating from the spine. I seriously believe there is a bone met right on my lower left rib which is causing the miserable pain just below, possibly pressing on my spleen (the nurse practitioner agreed), but when I tried to tell the radiation oncologist that, she rather patronizingly explained that she had other patients to see and in so many words suggested I should not go on about my pain.
A wonderful, accomplished friend was with me, and at that point she started to cry, possibly because she thought I was being dismissed, but I'm so used to that attitude from doctors I didn't even notice it. My friend said earlier, "You know, I'm not smart enough to get cancer," reeling at how much information I have to sort through and keep track of. And her father was a doctor.
I also have a metastasis on my lower sacrum near the left pelvis (that's where they took the bone biopsy sample, which was malignant), but they won't radiate that yet because it's not causing any discomfort whatsoever.
So...my mood has been shaky. It does feel like the rest of my life will be like a macabre game of Whac-a-Mole. I have experienced loss of hope for the first time since this all began, and trying to control the pain hasn't helped. Last Thursday the nurse practitioner agreed to refer me to the pain management clinic (readers of this blog may have noted that, despite my GP's commiserating with me recently about my not having been referred to pain management, he still allowed me to leave his office without referring me!). She said she wrote a dire letter because the waiting time can be quite long -- and suggested that in the meantime morphine would be better for me than Tylenol 3s. I guess she doesn't want me taking so much acetaminophen because it's hard on the liver and kidneys. I tried the morphine for three or four days, and it didn't really provide much pain relief, and left me feeling foggy and weak. It made the constipation worse, too. It certainly made me sleep -- like I was in a coma. I didn't like it at all, but I didn't have any Tylenol 3s left, only some pure codeine pills, which should be better for me, too, but they didn't seem to do the trick, either. So I managed to get my hands on more Tylenol 3s, and feel pretty good for about two and a half hours out of every four, plus I have to set my alarm to get up and take pills every four hours in the night. The T3s make me dopey, too, but it's a nice dopey rather than an "I'm dying" dopey.
Pollyanna moments:
- My friend Liz brought over, among other yummy goodies, a homemade banana cream pie, which went down very well.
- Diane took Mom and me to Rosetta McClain Park and the Scarborough Bluffs during that lovely fall sunshine on Sunday.
- I did not beat Liz at Lexulous, but made a good comeback after her 99-point EPOXY!
- Mom came along to my seniors' writing group, and also helped me rehearse some of the exercises.
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