Thank you Auditie, I manage, and do everything by myself, sometimes preferring that, but I will get a ride to surgery.

Paul, I just wanted to check in and say Hi. What an amazing treatment plan they have developed. I am beyond impressed that you even are able to understand all that well enough to then describe it. I am glad to hear you are recovering from the recent bout of infection. Good luck with everything.
Best,
Mary

Thank you Mary. I had it done last year too, but never heard of it before that either, and did a crash course to get educated. My Radiologist wrote a book on it, so I read it. They had fun one day asking me questions to see if I knew the answers. Good luck also with the upcoming PET.

That is a lot of stuff going on. Best of outcomes, Hopefully you will have enough space in your Sig. line. And hopfully it will be one of your last additions. Incredible that you have come this far.(radiation, Surgery and a cure. Oh my).

Shawn u.

Thanks Shawn, I left out a lot, and ran out of space already lol, but have some room for NED. Just trying to keep my infection at bay for surgery, trying to relax, getting sick from the occasional Oxycodone, missing my bucket list foods before surgery, due to my teeth, is all in a days work lol. That is one of my favorite movies, Wizard of Oz, believe it or not. Once, long time ago, at work In presented some employees certificates for courage, knowledge, heath etc, so they would leave me alone lol. We used to have fun in those days, but took care of buisness when we had to.

This procedure has risk for carotid blow out, others, and read somewhere could be around 17%, but that's over time, 3-24 months. This is my second IORT, and two prior IMRT in the same area. A neck dissection is 1-2%. Usually, pre-surgery, I reflect how I got here.

My surgey/radiation day is finally here on Wednesday, and it was a long wait, and not relaxing at all, which is no surprise. I've been busy trying to keep a mouth infection, and a jaw abscess at bay with antibiotics, salt water rinses, the heck with adding baking soda, which tastes like fish, and biotene mouth wash, the past three weeks, which could have delayed surgery. This prevented me from eating certain foods on my pre-surgery bucket food list, but I did alright with a few meals.

During this waiting period, I tend to reflect back from diagnosis to present, and prepare myself mentally for battle. It's also good because sometimes you are asked the same things over and over by other doctors, staff, and my situation can be confusing, even for myself. I can't believe I had 8 recurrences in 4 years, and feel lucky somewhat, although it was no picnic to get here, and more than paid my dues. My radiation oncologist said he has a lot of respect for me, and few could do what I did, and modesty aside, maybe he's right, but we do it because we have to, and anyone would in the same situation.

As mentioned, surgery will be a RND, along the same surgical lines, but after three neck dissections, two radical, there is not much left, so I don't know how radical it is, but they are to take out the cancer, so you never know, and they don't really either until surgery is done, and hopefully this point does not effect the carotid artery, being it was close two months ago. After the dissection, before closure, radiation will be done directly on the tumor site with an applicator, 5mm away, and everything else protected by lead shield or clamped out of the radiation field, and dosage will be equivalent to 45Gy or more, continiously, less than and hour, instead of 4.5 weeks with IMRT. Having already had 130Gy to this area, it will be 150Gy total, my 4th radiation treatment, but is really like 210Gy. At that time, the whole surgical team, including my radiologist, the physicist, leave to the adjacent leaded control room, the OR is leaded too, and continue monitoring me by CCTV, and other life support monitors remotely controlled from there. Then when all systems are go by the physicist, the radiation oncologist presses the radiation button, I don't know if it's Red lol, to administer radiation, and authentication seems like sending off a nuclear missile, which mabe is what my cancer needs, and my thought is, "On My Signal, Unleash Hell." From Maximus in "Gladiator."

Strength and Honor

Again Paul, you are simply amazing.
I will be keeping you in my thoughts and looking for your updates.
I think that as you really have done your research regarding your treatment options, all will be well. You are a Pioneer aren't you.
You certainly do have Strength and definitely Honor.
Take care, be well ,
Tammy

Thank you Tammy. All will be fine, and like another doctor of mine said, I'm like a cat with 9 lives lol. Anyway, I have to go back to get another hug from my doctor in a few weeks, makes it worth it

Good luck Paul!

Thanks David.