Just got back from conference with Dr Haakenslash, accompanied by friend's wife to be a second set of ears, take notes and also ask questions, which she did excellently.

Besides impressive credentials, the Doc has an excellent manner and thoroughly explained his recommended procedures which he will present to tumor board tomorrow.

Good news to me is the scans indicate I have cancer (Hmm, having cancer is good news? Yes, sorta...) only in tip of tongue (what's left of it...) in one-half of the forward two-thirds of my tongue (That 2/3 is aka the 'mobile' tongue) with no spread to lymph system or jaw.

I asked about possibility of more radiation and he said no; all it would do in my case is leave me with a shriveled, useless, tongue and probably not eradicate the cancer. He sees surgery as only option for me.

Plan is to remove that whole area, leaving the nerve center and the muscle, create a tongue bulk to aid in swallowing and talking and remove the lymph nodes under my jaw (not needed as such and are 'tumor cell repositories').

Then he will take a portion of skin and tissue from my left (non-dominant) wrist, along with blood vessels up my forearm a bit. This will all be sutured to the now-missing area of my tongue, with the blood vessels connected to the missing lymph node areas by microsurgery (eight stitches per 2mm vessel; total procedure will involve about 100 stitches).

Finally, he will take tissue from outside area of thigh to replace skin harvested from wrist (Robbing Peter to pay Peter...).

The procedure, which he does two to three times weekly, will take eight to ten hours, followed by a day in ICU, and then six to eight more days in hospital, with some speech therapy and swallowing therapy at some point. Nasal gastric tube for feeding, plus wrist/hand in splint for a week.

In tough cases with a lot of swelling, a PEG might be required, plus a tracheotomy, but neither is likely in my case because the surgery is to the front.

Surgery is scheduled for two weeks from today. That's it as I remember it so far.

On Edit: Since there is hair on that part of my wrist, it will survive the grafting. Friend's wife and I simultaneously asked about having to shave tongue! Doc pointed to electrolysis machine and said he will later use that.

Hang tough Pete. I'm sure it will be tough but I'm sure you will get through this. I firmly believe that for some people being empowered with knowledge like this helps us through the battle and it sounds like you are one that needs to know as much as possible.

Wow, long surgery but it sounds like you have a good doctor who does it often enough that you're in very good hands. I agree that for most people it helps to know excatly what will happen in detail ahead of time and I have to say that with every surgery I have had (and between the oral cancer, breast cancer, and esophageal strictures there have been about 8 of them done by 4 different surgeons in the past 3.5 years) the surgeons have been really good about taking time to go over exactly what they will do.

Try to put this out of your mind in the time you have ebfore the surgery and spend some time relaxing with loved ones if you can. At least that's what I think I would try to do. Of course, if you can't put it out of your mind, you can come here and vent, ask questions, etc.

Nelie

Hi Pete,

My husband had surgery at UW in April 2007 for tonsillar/base of tongue SCC with the same forearm reconstruction you will be having. It was certainly a very long day for him, and the eight days in the hospital seemed to last forever. But now 13 months out from surgery you really would never know that they split his chin in half and carved out huge portions of his mouth, as well as doing a left neck dissection. The scars have healed beautifully. If you are interested, you can check out the blog I kept during his hospital stay, as it has more details and may help you get a little sense of how things may go for you (realizing, of course, that everyone's course is unique). www.wickedsorethroat.blogspot.com
Like most blogs, it has the newest entries at the top, so it is best to check the archives for the earliest entries from March and read it from the bottom up so you get the info chronologically.

You seem to have a wonderful upbeat attitude, and that is sure to help you through the times ahead. If you have any specific questions you think I may be able to answer, please feel free to send me a PM.

Good luck with it all.
-Tricia

One more thing - yes, my husband still has wrist hair growing in his mouth. It makes for a bizarre party trick.

Tricia, I have two questions.

BTW, Dr Haakenslash is actually Dr F; for some reason I don't like to use real names (And Dr H is better than calling him Dr Fubar) My ex-wife (an RN) didn't get it at first but enjoyed the name when she did; I borrowed it from a guy on another group.

I forgot to ask if the would have a biopsy done while-we-wait to be sure before moving on with the detailed procedures. I guess the assumption is that enough stuf is being taken out that they are sure the will get it all (and the MR/CT/PET scans support that).

I live alone (on Bainbridge), and as a typical guy, I prefer to mend in peace rather than having people in and out -- Considering that I likely won't have a chin split or throat-cutting, and all the work will be at front, so less swelling in rear, likely I won't need a tracheotomy, can I expect to care for myself after discharge and being taken home? Lots of folks are poised to take care of me, but I know from previous experiences that I am more comfortable hiding under the bed or something like that.

David, our Doc also worked at the Moffitt.

Tricia,

I could have gone a long time before I read about the wrist hair thing but as they say, thanks for sharing...LOL

Pete,

All the best next week.

Rob J.

Pete,

What was your Moffitt docs name?

David, it's Dr Neal Futran, but I didn't see him at Moffitt, he just mentioned that he had worked there. Don't know when, and haven't seen it in the bios I read, but he told me that.

http://uwnews.org/uweek/uweekarticle.asp?articleID=42071