I've been back from my last trip to the cancer centre in Calgary for a couple of weeks...it's taken me a while to summon the...I don't know...interest? motivation?...I'm struggling to find the right word.
In earlier posts, I outlined the issues I've had for the past two years with an area of necrosis in the side of my skull from radiotherapy. After all this time, I had high hopes that this latest trip would be the culmination of this latest "saga"...that the Doc's would have a date set for surgery, and we could get on with things.
"Hopes"...perhaps "pipe dreams" would be more appropriate. I'd had one last series of scans done in the past three months of a variety of flavors; CT, MRI, iCAT, x-ray, bone scans, etc. etc....you get the "picture". All intended to full quantify the extent of the necrosis and finalize a plan.
The intention was to remove the necrotic area, install an appliance in the void, repair the damage to my middle and inner ear from the bone spur, etc.
What the scans showed dashed my hopes. The area of necrotic bone is simply too large to address surgically. without complete absorption of the appliance edge fitting, it would simply be a disaster waiting to happen. One bump, any sort of trauma, even something as simple as biting something the wrong way could cause catastrophic failure with almost certain fatal consequences.
In short..the surgery is simply too dangerous to even consider. As an added bonus, the issue with my TMJ was also "quantified". My TMJ on the affected side is virtually destroyed by a combination of rads and arthritis. We've been discussing what to do with that problem as well; removal of the joint and placement of a feeding tube, fitting an artificial TMJ, or simply leaving it alone.
That choice has also been made; we have collectively been concentrating on the left side since that's where the cancer was, and all of the treatment occurred, all of the pain was centered, etc. We hadn't looked beyond that...we should have.
The scans showed that the problem with my jaw wasn't confined to the left side...the right TMJ is "problematic" as well. It hasn't really caused a great deal of pain...well, it probably has, but the pain meds I've been forced to take to deal with the necrosis and the left TMJ pain have masked the problem. The right TMJ is virtually fused due to arthritis as well, so I've gone from being a candidate to have an artificial joint implanted, to NOT being a candidate for anything.
They will not attempt a bilateral TMJ replacement due to the current catastrophic failure rate of artificial TMJ's. The only option open surgically is to remove both sides, reassemble everything for cosmetic purposes, put in a permanent PEG and call it good, or simply leave everything alone and treat it symptomatically.
To say I'm "discouraged" is a rather large understatement. "gutted", "appalled","devastated"...they would all work fairly well.
the pragmatic side of me says this is just another hurdle to be overcome or accomodated. The pragmatist in me says "at least it's not a recurrence"...the emotional side of me tore one of my Doctor's a new body opening when he made that same comment to me during our consultation. I am sick to death of hearing that...NO, it's not a recurrence...but the problems I'm having are a LOONG way from being inconsequential in comparison.
To be honest, I don't know what I'm going to do, or what options I have, if any. My cousin ( he's the oral surgeon in my life and has done numerous surgeries in the years since my diagnosis)forwarded all of my charts, scans and test results for the past 36 months to a former colleague who is now at the Mayo Clinic to get another opinion.
He heard back from him yesterday...they concur. There is currently nothing that can be done surgically that is safe and that will offer any meaningful improvement in the current situation.
So...that's it. For the forseeable future, anyway. As much as I detest the very IDEA of even one more pain pill, or anti-inflammatory, or steroid, or???...that's what I'll be doing...eating more pills.
Yee-friggin-haw.
