Sunday, September 12, 2021

The cancer is back (or something equally bad): tongue surgery vs. COVID

Well, here we go again, folks. 

I've been having some pain when chewing - my tongue has felt sore, burnt, even like its been sliced open.

My tongue has been sliced open, of course. Sliced open. Go back to 2017, if you like - the early spring - and you can read on this very blog about my previous cancer surgery, which removed a strip of material along the left side of my tongue - a piece of tissue maybe around the size of my little finger (maybe a bit smaller) that was afflicted with squamous cell cancer. Like the recurrence, that involved visible, painful sores, though they looked different from the new ones and were in a slightly different place. My oncologist says that what he did in my mouth was "real ugly" during that surgery, that he was cutting into nerves and rebuilding them, so the fact that it has continued to hurt all these years has not been taken as a sign of anything - it was an expected side effect of a partial glossectomy. Of COURSE you never heal fully from something like that, and you learn to live with it; a little pain is a welcome trade for getting to have a tongue. 

And of course there are "shoulda coulda wouldas," now that he tells me I need another surgery. I mean, every time I went back there over the last four years to get checked out, and he looked and told me it was nothing - probably that might have led to my not being quite as worried about the alien in my mouth as I should have been this time, because I've been feeling wrong about the tongue, feeling like it's getting worse, for a couple of months now, and didn't actually rush to get it looked at, because, well, it wouldn't be the first time I was being paranoid about cancer coming back. You sometimes just don't know until it is too late that you weren't taking something seriously enough...

But eventually the pain got constant enough and bad enough that I went to see my GP; and my GP was worried enough by what he saw - the grey patches along the side in the photo below - that he sent me back to my oncologist, and... well, here we are. 

My oncologist is optimistic - we caught it early, he says. "We don't need to bother with a biopsy - it's either recurrent cancer or it's severe dysplasia, which leads to cancer, so either way, it's gotta come out. Why waste time on a biopsy?" 

He poked it with a tongue depressor, for the record, and it bled. It's that tender. 

And here's the thing: one of the reasons he's skipping the biopsy step (with my full assent) is that time is of the essence. There could be delays enough already, getting me into the hospital: I'm being told that COVID trumps cancer in terms of hospital beds. My cancer doesn't put anyone else at risk, but people with COVID could spread it to others, so they get priority. All of which is fair enough, but COVID numbers being on the rise again makes it very likely I will have delays getting into surgery. As my oncologist's assistant put it, "Well, if you know anyone who is unvaxxed, tell them to get vaxxed, because they are taking away your surgery time - COVID trumps cancer and everything else."

There is a whole universe of fear that opens up when you discover you have to have part of your tongue cut out, especially when they won't know exactly how MUCH to cut out. It's not made better by knowing that the key issue behind how much of my tongue I get to keep is tied to how long the wait is for a hospital bed. I mean, I know from long experience - my kidney stone ordeal, before that my mother's death, before that my reactive arthritis - how strained-to-breaking our medical system is. COVID creates an added layer of delay. 

...and here we are. Gives me a perspective to share with my vaccine-hesitant friends, I guess. The photo below is a bit gross, note. But see them grey patches...?

Wish me luck, folks - I might need it. 

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