OK, what's early stuff? Let's assume this is your first biopsy/surgery.

When done, you will NOT be a complete wreck, although someone else should take you home from the hospital. However, after about two days you will be more than capable of driving. So before you go in, make sure your vehicle is full of fuel. It's better not to be at the self-serve at 25 below in a howling wind. This goes for any other things that will need doing like making sure any bills that could come due are paid. Try to save your recovery time for recovery (and surfing this forum)! So use the laundromat, get some groceries ahead, and do as much as you can to avoid contact with people after the surgery.

Sorry socialites. We told EVERBODY to stay away over Christmas, and that we were visiting nobody, neither my wife, nor me. That goes double for snot nosed grandchildren and others such as handshakers. Those of you who like to kiss dogs on the nose and pull your lips back so the dog can lick your front teeth and gums, well you're on your own. If you are taking any sort of public transportation, buses, trains or aircraft (as I did, my Lear Jet was in the shop over Christmas...yup honest, and I have some land...), then acquire a couple medical masks to wear while travelling. I forgot to do this for the flight down and used a black scarf instead. This got me some serious attention from the airport hero-complex security pretenders. If you have a choice, get the style that has four attachment points and goes behind the ears. You do not want a cold or strep-throat during your recovery.

Although this may be obvious to most people, you should have clean teeth. For a day or two before surgery, get your teeth as clean as possible, brushing and flossing. The problem is that if they are going to work on your tongue, as in my case, your tongue will be swollen for most of the first two weeks to almost half again as large as normal. In my case, I still have my four wisdom teeth, so my tongue tries to sit over top the molars. Biting down on one's tongue is a very real possibility. Your best bet is to pull your tongue down, close your jaws carefully, and keep your mouth shut. You will catch on. OK, but how do I eat? Answer: carefully. More in another post. Returning to cleanliness, you will also not want to be manipulating your tongue much in the first day anyway. On surgery day have a paper pad and pen available to communicate with. Talking could be very painful, especially if you talk too much immediately post surgery, and then the anesthetists drugs wear off. If you are still on mostly liquids the second day you probably won't want to brush your teeth then either because of tongue pain. If you're absolutely determined to brush your teeth, I suggest an electric tooth brush as it moves your tongue less. I have always used regular Crest toothpaste. Even the traditional minty ones like Pepsodent bothered me, and I love the hottest, spiciest, foods on the planet. What some of these new whitening formulas might do on open wounds is for somebody else to report.

As soon as you can move your tongue a bit, hopefully even on the first day you might consider flushing your mouth with salt water to keep any infection at bay. One half teaspoon of table salt in a tall glass of warm water will work good, as often as every three hours. Gargle it, don't swallow it. Now if like me the damage is to most of the right underside of your tongue, then you will have to blast the salt water in there. I obtained a 2oz (60ml) syringe, made by the BD company in New Jersey, from my local pharmacy. It has nice long tip on it with about a 1/8" hole in the end. Now a popsicle stick or tongue depressor to shove your swollen tongue out of the way and your cleaning in style (preferable over the sink with your sleeves rolled up!) This will be very handy when you start trying to eat food. This surgery not like your worst trip to the dentist. It is even WORSE YET. I doubt many have left the dentist with a swollen, incapacitated tongue. You have no idea what your tongue does in your mouth until you have had oral surgery. While you're eating, your tongue brings food back into position to be chewed again. It goes up between your teeth and cheeks and pulls out stray bits. It also cleans out the area beneath itself. All this goes on pretty well subconsciously. After surgery you will find out that those "backwater" areas are too painful to use your tongue to clean out. This is where the syringe comes in. Another item to prepare ahead of time is good flashlight that can shine a focussed beam inside your mouth. Try several and make sure the batteries are good. For food planning then, stock up on the smoothest, non-grainy things you can think of.

Thanks Tony. I mentioned the VELscope to several people around here and it is creating interest. The northern part of BC, where I reside, has far higher rates of smoking than the south. We know the implications. Also, many of the younger generation have bought into the lung health benefits of smokeless/chew/dip tobacco, oh great. It would be interesting to see if your dentist worries about false positives when her oral parts start getting red, white, or painful.
N.

Carpe.... Instead of a 2oz syringe (which is given to automatically PEG tube users) try a waterpik on the lowest setting. This works the best at getting every tiny particle out from between teeth and also would work great with the saltwater rinsing.

Thanks Christine. I don't own a Water Pik, but have seen them over the years in stores. I can just imagine a tool with a pump forcing water through a small orifice would be ideal, and combined with curved plastic pipes getting stuff between the teeth should also be easier. Sounds like we are plugging the product doesn't it?!!

Greetings Newbies if you are following me. This time I want to mention food stuff. If you've been surfing around you likely have found the food list. For those with their first biopsy/surgery the calorie requirements are not so critical. Basically you want a near liquid diet to get over the first week or two. The hospital juice, Jello, and tea will get old fast.

To digress a bit, my "last supper" was on Monday night, Dec.30/2013 at the Raga up Broadway from the Holiday Inn where we stayed on a nice medical rate. I recommend them. Supper was Prawns Vindaloo with rice and lots of cold water. It was great, really sets your face on fire. They do have less zippy fare; it's a great place to eat. Anyway, my surgery was on Tuesday, New Year's Eve. Supper that night and breakfast Jan.1 morning was juice, Jello, and tea. Ugggghhhhh. I got discharged shortly thereafter and we went back to the Holiday Inn to regroup and prepare to stay a couple more days. I did not want to fly back immediately for two reasons. One was germs etc., but the other was aircraft cabin pressure. I find that if I can't swallow well, and with force, my ears do not pop properly. Who needs a painful flight just to save a few bucks? Next we went food shopping. (I'm not sure why, but on long posts this thing slows down making typing a chore. Need new post.)

Newbie Food continued. On either side of the Holiday Inn close by are a Shoppers Drug Mart and London Drugs. Grab some bottled water and either Ensure or Boost for meals. Just down the hill from the Broadway and Cambie Skytrain station is Whole Foods and across the street is a Save-On. At WF I got a small tub of mild guacamole, another of hummus, and to get adventurous, a tub of tapenade. The tapenade is small chopped olives of several varieties, and some oil and spices. These bits can and do get under the tongue and up in the cheeks, but it tastes so good! Across at S-O some Freybe fine Liver Suasage with Herbs, and a couple bottles of low sodium V-8 juice rounded out my first post hospital meal. I'm an omnivore and this liver sausage is about the only meat ground finely enough to get down in the first few days. Even then it's easier to eat washed down with the V-8 juice. There you go, meat, and veggies in a semi-liquid form. We came home two days later on the Friday. Now I am able to smash up hard boiled eggs, then add some guacamole, hummus, and olive oil. This should keep anyone powered up. Tonight I plan a baked cauliflower and broccoli recipe. You will survive, good luck.

Hello Carpe:
A page or two back on your thread we discussed the Velscope and other early diagnosis tools currently marketed and that were planned to be used in your surgery (ie blue light). This morning I was re-reading some of our websites literature at the link below.

http://oralcancerfoundation.org/HPV/ocf-hpv-opinions.htm

From what I read, unless I misunderstand, our own foundation doesn't place much faith in any of these technologies. Now, it seems to me this information is circa about 2010, so maybe changes have occured since time of writing.

Also, if memory serves, at the time all this stuff was written for publication on the website an exhaustive process was used with confirmation by multiple experts in the OC field to insure that everything said was very accurate.

I would love for Christine, Paul and Brian Hill to opine on this.

Tony

Greetings Tony. Although the powers that be may not have faith in the screening technology, someone is paying attention. On the OCF home page, right side, Cancer News, there are two screening related articles. The first is "Abstract B05" and the fifth is "LED Medical...." Dr. Poh, mentioned in the fifth article is one of the doctors who worked on me in Vancouver. Considering the stats on new Dx all over the world, let's hope these low tech, low cost, devices work.

Tissue auto fluorescence technologies have some value and as we learn to interpret what they reveal, (there is a bit of a learning curve) they are in some cases more useful than others. OCF was a funder of this technology long before there ever was a device on the market, when we recognized its potential. The work in those days as being done in cervical cancers, but I and our board saw the idea as useful in oral as well if it proved out. We funded research at MDACC, and later when devices appeared, I was a consultant to the manufacturer. Canada was the home of LED who made the first device - the VELscope, and it is also home to the BC Cancer Agency who has worked (Dr. Miriam Rosen) on the science for over a decade.

There have been wild marketing claims made by companies selling various devices these days about what it will and will not do. At the end of the day it can (not always) reveal dysplasia and cancerous cells that may be difficult to visualize with the naked eye. This is particularly useful in advanced cancers to determine/define surrounding tissues that while not yet malignant, but are dysplastic and on their way to it. Where it has not proven very useful is in HPV+ cancers, as they develop deep in the basal cells, and do not produce surface based lesions that the device can be used for (nor can they be seen by the naked eye). HPV in the tonsil very seldom ever produces a surface lesion or color change and it has metastasized through the normal lymph drainage passageways into the cervical nodes of the neck so fast, that in most cases a surface lesion never appears even in stage 4 disease.

So while it is highly useful, it is not the second coming, nor able to find everything, and it is highly non specific. It finds all tissues in which the fluorophores in the cells are non functional, indicating cellular damage, and more often that not this damage is NOT cancer. It can be benign things, even hyperkeratosis which is just the formation of a thickening of tissue from chronic low grade trauma. So this is where the "art " of interpretation of understanding what it is revealing comes into play. Everything that goes dark when you are using the light is NOT cancer, and most things are even just natural anatomical occurrences, such as any blood vessels that are close to the surface of the tissue, like under the tongue. The hemoglobin in the blood has the same reaction under the light as tissue abnormalities. Useful device/science yes, completely game changing device, no.

Brian thank you for putting the screening device matter in perspective. As possibly the luckiest guy on the site with OC, I want as much early detection as possible for everyone. They tell me that my OC was caught early, and the December 31, 2013 surgery is all I will need. It's tough to read the stories posted by folks diagnosed late. Worse yet are those whose cancers progress while they mistakenly relax with a benign diagnosis, because their samples weren't analyzed by labs properly experienced with this horrible disease.

You are right to express caution about wild marketing claims. The internet has allowed all the old scams new life with a greater audience. Separating the unscrupulous from the promising behooves us all.