Chomping at the Bit

A debrief with my cool cat surgeon, and the news is basically good.

The operation was a lot less intrusive than the last one, in part because evidently the right side of my, uh, oral cavity is much more navigable than the left was last year.  This occurs, I suppose, afer years of talking out of only one side of my mouth....

What they found and pulled out were a couple of really small, 3-5 mm, lymph nodes.   Small, in this context, means they don't have a lot of cancer.  It may mean that they were found early but maybe not - in that maybe there is nothing left generating cancer cells at all, and that these are just the residual cancerous nodes left from the cancer that was coursing around before.    So, on that front, either good or better than good.

He carved out more of my neck than just those nodes, in order to try to remove any "surrounding" nodes.  (In quotes for an interesting reason.  Evidently there is a basic, well-established understanding of the plumbing mechanics - the drainage system -  of the lymph system in the neck.  So his view of "surrounding" is not necessarily x centimeters from the suspect nodes.  It is based on the system, and attacks those which are likely to be in the same drainage field.)  All that stuff had no cancer detected.  So it wasn't much in the first place, and it appears to be very localized.

Now I'm back to whether or not to get radiation and if so how much.  Which truly is deja vue, deja vue.  Dr. Haughey is not decided on what to recommend, and so I'm off next to the radiation ongologist for his view.  Which will be, as I said to my buddies at breakfast, like asking the candy man if I should eat candy.

It raises again the questions I struggled with before, and find that no doctor, even a brave one like Dr. Haughey, will weigh in upon with much firmness. Put simply:  what's the benefit, and what's the downside. The problem is that the question is simple at this level but harder when you get past the generalities.  At this point, I either have cancer that still threatens me or I do not.  If I do, will the radiation kill it?  Answer will probably be - probably.  If I do not have it, will the radiation hurt me?  Answer will probably be - yeah but not a lot.  And we can do less this time, so it may not be so bad.  Will it retard the ability to detect problems in the future?  Answer is yes.  Radiation is like leatherizing.  Would doing nothing put me in a position from which I can't recover i.e. that will kill me? Answer will probably be -  very probably not.

And after yes v. no on radiation, it will come down to calibration, as ever.

Today I feel pretty good.  Still a very sore throat, and there seems to be no way to process food or drink so that feels good going down - but unlike last time things don't taste bad.  I still have a wimpy and unsophiticated palate, however, which makes marriage to the world's finest cook a little tricky.  ("It's all lost on me," I'm sure, is not a favored reaction to dinner...)  Valerie the Westie, as a consequence, is dining better than ever, and I know she's grateful.

As am I.

Aphorism No. 2

When in doubt, tell the truth.

Always thought this one was mine. I only learned recently that Mark Twain said it first. Mixed emotions over that - sorry to lose the invention, glad it's one of the two greatest Missourians.*

I use the expression a lot in practice, when advising people how to respond to questioning. It's a cousin to the old maxim of lawyers - never ask a question to which you do not already know the answer.

Twain, of course, had a lot more to say about truth, much of it brilliant. My favorite is another cousin - If you tell the truth you don't have to remember anything.




*The other Missourian being, of course, Harry S Truman.

Aphorism No. 1

You ain't a veteran until you get a few scars.

Year of the Tiger

I'm back home, out from surgery, a lot less debilitating this time.

I'm not sure why. Could be that the first time, I awoke with a log-shaped air tube down my gullet and a feeding tube in my nose. Meds up the wazoo, especially heavy-duty pain meds. Just before this latest event, I was asked if I had any questions and I said yeah, was all that invasion necessary? Well, maybe not, we'll see. This time, I awoke with no tubes, and right now I'm on percocet.

Plus this time I weighed a lot less. That probably helped.

So if you're going in for surgery, I guess the message is get fit and speak up.

Also the omens were good. Mardi Gras. Winter Olympics. Valentines Day. And we are going into my year, the Year of the Tiger. Doubly my year, in fact, since 1950 and 2010 are the years of the Yang Metal Tiger. (The Chinese add one of their basic elements to the 12 "zodiac" signs.) (I have no idea what any of this means, but as usual Wikipedia has a lot to say.)

I don't really know the details of the surgery yet - exactly what was found, what wasn't found, what comes next. Right now I have a sore throat and a droopy thing when I smile, makes me look kind of sneaky.

But I'm back, and best of all, as ever, were the hugely-appreciated words of support. Thanks to one and all. The tiger is back, grateful, and ready to prowl.

Pre Op

Part of the industrial-strength medical world I now inhabit is a visit to the pre-operation screening department, where they nail your insurance, draw some blood, try to figure if you have sleep apnea, and let you know that You Can Always Say Stop.

Well, unless you're unconscious.

I did raise some of the crummier aspects of my last surgical adventure. There was some tut-tutting and at least one nurse who said if the air tube really is killing you, pull it out. If you're awake, you don't need it.

Mound City

At the beginning of the Civil War the Federals moved quickly to secure Little Egypt, the land between the Mississippi and Ohio rivers at the bottom of Illinois. Strategic border territory, even though in a Northern state.

Once secure, the area was a headquarters and provisioner of the River War. Cairo was a communications center and Fort Defiance was at the confluence of the rivers. Just up the Ohio was Mound City, where much of the Federal fleet was built, anchored and maintained.

Today Cairo is a wreck of an old city, like a set for one of those post-apocalyptic films. And its even poorer and more wrecked little cousin is Mound City.

But Mound City was once a great river port, as it says on a marker that is one of the best things left in the town.

"The Marine Ways - During the Civil War, the naval depot of the Western Fleet was located at Mound City. Here the keels of three of the famous Eads ironclad gunboats were laid, and a large force of workmen were employed to keep the fleet in fighting trim. The Marine Ways, still in operation, are 400 yards south of here. Erected by the State of Illinois, 1935."

So I navigated the Jetta 400 yards south, more or less, down some shabby streets, through a gate in a levee, to a desolate stretch of the Ohio River's bank, looking across to Kentucky. The Marine Ways may still have been in operation in 1935, but no longer. There is very little there. No signs, no markers.

But there is something.

Boat ramps. They have a certain dignity. There is nothing else.


Who knows if they are Civil War era. But this was Marine Ways, certainly. Now unattended. One big flood and I doubt anything will be left.

I know a little of the history, though, and it is grand. To you, Mound City, home of the ironclads.

Long Drive

Today a drive to Indiana for a meeting, and back. Just me, the Jetta, my thoughts, over about 400 miles.

Not a bad way to review the bidding. What is odd is that with each turn, the project falls a little farther away from the general pattern. You begin to hear a lot less of the stock patter from doctors - "so, what happens when we are in this situation is...." To really mix up the metaphors: we have left behind the blocking and tackling, and gone to signals called on the field and broken field running.

It's OK. I was never really enough of a jock to do much broken field running. Happy to start, it has a nice leather-helmet stiff-arm college backfield sound to it.

About a year ago, before all this cancer stuff kicked up, I did a similar drive and stopped at Carlyle Lake, in Illinois, where it was mostly me and a lot of gulls, geese, other big winter birds. Some in line formations, high in the sky.

They were back in the sky today, in greater numbers. Sheets of them. We were south of the lake, and I think they were heading for open water.