Hi -
I hope this is how I start a thread.
I am having right marginal mandibulectomy June 17.
Symptom: Sore bump around Buccal molar with white patch.
Diagnoses (3 labs,2 biopsies):
Snip biopsy:
Fungus or Buccal Squamous Cell Carcinoma.
Larger biopsy:
Squamous Cell Carcinoma
Severe dysplasia (the final diagnosis from Yale-New Haven Hospital).
CT scan - normal.
However, between the roots is soft tissue, not bone, so something is going on.
All recommended removing the lesion.
But I have no idea what comes after surgery. I hope you can answer some questions for me:
Swelling - how long, how much?
Recovery time?
How long on liquid/soft diet?
Chewing ability?
Jaw strength.
Head/neck surgeon said something about implants later, but is it possible?
Basically, I'd like to know what to look forward to.
I take a blood thinner, so my healing may take longer, but the most unusual thing about my case is that I'm a ventriloquist. Not moving my jaw is the point - but how much will this affect my speaking ability?
Thanks so much -
Marlene

Marlene,
Sorry to read about your diagnosis, my thoughts and prayers are with you.
So...
What blood thinner do you take?
Have the doctors discussed changing or stopping it prior to surgery?
.."between the roots is soft tissue, not bone, so something is going on.
All recommended removing the lesion."
Have you had or do you have periodontal disease (gum disease)?
As for swelling, usually the most swelling occurs 24 hours post surgery and can last for a few days or weeks depending on the size of the area involved in the surgery and the degree of insult to the blood vascular system and lymphatics in the area. Simply, if arteries, veins and lymphatics were ligated or removed during the surgery the bodies ability to eliminate swelling is reduced in that area. Surgeons place drains as a rule when they have interrupted these processes to remove excess fluids causing the swelling. Discuss this with your doctors.
Recovery time depends on the severity of the surgery and a lot on the patient. If you have a "nothing brings me down" attitude then you will probably recover and cope much better than a person who assumes the worst and doesn't cope well. Some people have minor surgeries and are down for months others who undergo radical surgical procedures are quick to resume as much of a normal life as they can so surgery aside, your spirit, strength and perserverence has a lot to do with recovery.
Ditto on the soft diet and chewing, varies for different people.
Implants depend on bone. If you have good bone in the area then implants are a great option. I you are lacking bone then bone can often times be grafted into the area to accomodate implants. Once again talk to your doctors and make sure you get the specific answers to your questions. They may not be able to give you a rock solid answer until after the surgery.
Your speech will depend on the area involved in the surgery and if any nerves may be involved.
If your tongue and lips are not in the area and your throat and vocal chords are spared you should experience no changes barring some discomfort and muscle changes due to the surgery. Ask your doctors.
I always suggest to my patients that they keep a journal and write down all of their questions. Bring it to your appointments and ask the questions. Write down the answers so you can read it later. Don't be afraid to ask your docs to slow down or explain something they are used to this.
Please contact me if you need to.
I hope this is of some use to you.
All the best!!
Mike

Thank you so much, Mike.

Your answers are clear & concise & believe me, reading them is less anxiety-provoking than talking about them. Plus, I couldn't fine\d practical answers anywhere on the 'net.

I've never had periodontal disease.

Blood thinner: Warfarin. I will be off it for 3 days before the surgery, but I clot even when I'm taking it. I've been taking it since 1992 (pulmonary emboli). Had DVT in 2002 & retinal clot in 2005 that resulted in partial blindness. Was tested - got one positive & 2 negatives for antiphospholipid syndrome but no diagnosis - why I clot is a mystery to blood drs. So my dr. makes sure my INR (clotting time) remains 2.5 to 3. Going off makes me nervous.

Swelling: Dr. didn't mention drain, just breathing tube & an extra day in ICU in case tongue swelled too much.

After effects: Dr. said right side of my lower lip will be numb but didn't think anything else would be affected because he's going in through the mouth, & he didn't think he would be removing lymph nodes.

Anxiety - Fear of surgery is worse than the event. I'll blame that on my mother. Plus, all those what ifs - I'm uncomfortable when I don't have precise answers. Afterward - well, I'm no Scarlet O'Hara.

I am (was) supposed to teach and give a short demonstration of ventriloquism & do a short performance July 5 at a kids' magic convention. Surgeon didn't think I'd be able to do it. Luckily, we don't need to make up the program until a couple days before the event. (See Anxiety, above.)

Thanks, again!

Marlene

Marlene,
No thanks required.
I just hope the info was helpful to you. Keeping the INR between 2.5-3.0 is the best prior to surgery. I'm sure with your clotting history they will be monitoring you very closely and if the need arises put you on blood thinners as soon as it is medically feasible. With all the bad we here about some docs there are some real good and very capable ones out there and I'd probably say it's the majority of them who know their stuff. The unfortunate part is we don't hear enough about all the good ones and the bad ones make the mass media so automatically everyone assumes the worst.
You have a great attitude and a little anxiety prior to surgery is not always a bad thing just make sure the questions that bring on the anxiety are remembered and get asked prior to the surgery.
All the best.
If I can be of further assistance let me know.
Cheers,
Mike