Hi All! Just thought I would keep everyone apprised that my husband (John) has been doing pretty good overall since I last chatted with everyone. His appetite is getting better - he even managed to tackle a small (5 oz) steak just a few days ago! He ate most of it - but he said the "taste" was still lacking - which still hold true for a lot of different foods that he eats. I suppose that still just takes more time. There seems to be more mouth dryness now - but he has been using the "Orajel" which definitely helps. On Friday (1/24) my husband has an appointment to meet with his surgeon. I am hoping that perhaps, with any luck, he may not even need the surgery for the neck dissection that is part of the original treatment plan for him. But if it turns out that he does have to get this procedure done - what I woulk like to know is:
1. Does a neck dissection effect your eating abilities? I guess what I mean is, since my husband is finally starting to get an appetite back to some degree - will this procedure cause him to start from "ground zero" again?

2. Does a neck dissection effect speaking ability afterwards? My husbands voice is back to normal after all that radiation treatments which had him talking like the "Godfather" for awhile!

3. On average, what is the length of time for a procedure like this? Is it a lengthy surgery?

Thanks for taking the time out to read my question, and please forgive me if this has been answered a "thousand" times already in the past. I want to especially thank Joanna and Rosemary for their recent and re-assuring responses. I will be unable to meet with the surgeon tomorrow with my husband since I cannot get out of work - so I'm hoping to fill in some of the blanks on this procedure by anybody who has been there before. Any information you can give is always greatly appreciated.

There are a variety of types of neck dissections, with a variety of names such as radical neck dissection, modified radical neck, etc. Each type involves different amounts of tissue removal and different types of incisions. For the most part, unless there is a tumor in the neck which has invaded the muscular structures there, neck dissections are done just to remove lymph nodes and associated tissues. These types are often referred to as modified radical neck dissections and leave only a few problems afterwards. But these residual issues do not involve appetite, voice, swallowing, and the things that you have mentioned. Pretty much everyone ends up with some numbness as a final result, as major nerve which transverses the area has to be cut in most cases. While this feels a little funny at first, you get used to the fact that one side of your neck has no feeling, and personally I do not even notice this anymore. If muscle tissue is removed there can be range of motion limitations post surgery. Since my surgery was done post radiation, it was more difficult for the doctor, and therefore took longer to perform, about 4 hours. Compared to radiation the surgery was a walk in the park. I had lymphedema for about 6 months afterwards, but that finally resolved with constant massage, and even while you have it, it is primarily an esthetic issue, (unless it refuses to go down, and then there is a danger of sepsis in the surrounding tissues). Your husband has done the worst already

Donna, I have to agree with Brian, the neck dissection is a walk in the park compared to the radiation. I had about 1/6 of my tongue removed along with the radical neck dissection, and about 10 days after leaving the hospital the surgeon was miffed that I hadn't returned to work. Did wind up with some shoulder and left arm mobility problems, which causes some issues with airport security (raise your arms--I can't) Also the swelling Brian talked about.

Have some intersting things going on with the nerves to/from/through the neck, but suspect either I"ll get used to it or they'll go away in time.

Bob

My husband John had the neck dissection in October. His attitude is and has been one of a great fighter and positive. The neck dissection seemed to put him back alot. It may have been that the radiation was continuing to work and we did not realize it. Like your husband, John was starting to eat and his voice was coming around. After the radical, he went backward alot. His attitude stayed good but he was not able to eat and his voice got worse. It is now January and he is doing much better again. He is trying to eat but has epiglottis problems (caused by the radiation not surgery).
John's surgery was radical--22 nodes, juglar vein and the large muscle in front. Most people don't have that. We were told that it was because the radiation had made the area a mass and the surgeon did not want to cut through to take out the node thereby possibly releasing any remaining cancer. He chose while in surgery to take it all. The biopsy came back negative. John has never looked back. He is ok with the surgeon's decision.
I did post in another section a problem we are currently having with increased intracranial pressure. We are waiting test results but it may be from the removal of the juglar vein.

Good luck and don't look back.
Meredith

Thanks to all of you who responded. My husband found out today that he is having the "Modified Radical" type of neck dissection. The surgeon told my husband, just as you have mentioned Brian, that eating should be "OK" and will not have any effect on speaking abilities. As far as neck/muscle movement - he was told that he will need physical therapy afterwards. (I think he said for 3 days a week). The recoup time the doctor mentioned is "3-5 days in-hospital". The doctor also told him that there "should not be" any more radiation treatments post-surgery. He did mention something about taking out the Jugular (not sure if I spelled that right) vein just on the one side of the neck. Is this common for a "modified" dissection? Are there any major risks for this type of procedure? What are the chances of infection? My husband is scheduled to have this surgery in a few weeks - and although I'm still apprehensive about it, I do feel better knowing that most everyone considers this to be a "walk in the park" compared to the radiation. Thanks again for the info - it's been very helpful.

donnajean, just one more thing that might help you. I, too, had the modified radical neck, and although I was hugely swollen with drains in place when I awoke, there was never any pain. None. So although I was uncomfortable with a head that listed to one side, I had plenty of energy because I wasn't fighting pain. Your husband should do just fine. Oh, another thing, nine months out from the surgery, I am finding that a good deal of the original numbness has receded or vanished all together. Now if my neck itches, I can feel it when I scratch.
Joanna

Meredith...I think that what your husband experienced was related to the radiation and not the surgery. The negative effects of radiation really don't get to their worst point until about 2 months out from treatments. Then you are in full blown radiation sickness. As to the jugular involvement, check out the post today http://www.oralcancerfoundation.org/cgi-bin/ultimatebb.cgi?ubb=get_topic;f=3;t=000090;p=1#000007 Even though it is titled sleep apnea, at the end there is some discussion that you may find helpful.

Meredith,
I had a moderate neck disection on November 19th. My range of motion was not effected at all. I had 28 lymph nodes removed. My neck was very tender after surgery. I took Roxicet meds to relieve the discomfort. The discomfort does not last long. My neck still feels numb at times. Your husband should do very well with having a neck disection. I never had Radiation, but from what I here that is way more challenging.

Hi again, By the way - in regards to the Modified Neck Dissection - after the person is in recovery and awake after the anesthesia - are they able to talk right away or are they too sore and bandaged and swollen to speak? What about by the next day? And has anyone had any problems as far as driving a car after this procedure? I know the doctor told him he will be getting Physical therapy afterwards - but is the limited range of motion so severe he may not be able to operate a vehicle? I know that would be on the "intolerbale" list if that's the case, just as the PEG tube was too. As far as the length of time of surgery - is that about 4 hours? Thanks.

DonnaJean, I had other things done at the same time as the neck, so I cannot speak to length of surgery, however, if he does not have a trach, he will be able to talk when he wakes up, although his throat may be sore from the intubation. But he will be able to communicate. As far as driving, I was perfectly capable of it, but for the most part played princess and let myself be chauffeured around (grin). I saw a physical therapist once, who gave me some exercises that I did for a few weeks, which eliminated a small pain I had experienced in my shoulder. A minor matter, but the exercises were easy and worked great. I know you are going to surprised at how well your husband does.
Joanna