This is my first entry on this message board. My wonderful husband Jack, 60, had surgery last Monday (August 11, 2003)to remove a squamous cell lesion on the floor of his mouth. He had a skin graft taken from his upper leg and placed where the tissue was removed on the floor of his mouth. His dentist found the lesion during a routine teeth cleaning. The ENT surgeon feels he removed all the cancer, which was 3 millimeters in size. Good News!! A little background information - oral cancer (T1,N0,M0)is the third cancer my husband has had during the past ten years. First, he had colon cancer and had 14 inches of his colon removed, 4 years ago prostate cancer whereby he opted for brachytherapy seed implantation and now oral cancer.
My question is this, Jack has had really smelly breath since the second day of his surgery - so much so that I can tell when he's been in a room even after he's already left. He had also developed a nagging dry cough. I would like to know if this is normal after having oral cancer surgery.

I can only speak from our experience, Packer never had smelly anything after any surgeries, but one, and that was dead tissue.......As a nurse, I am obsessed with smell, if it has a foul odor I would have it checked out, just to be safe, of told more than one doc it stinks, and after 2 years of dressing changes I still smell everyone I change........Dee

Packer brings up a good point. You want to be sure that the graft is taking well. Some grafts fail due to lack of sufficient blood supply or other causes, and necrotic dying tissue does smell bad. If you have not seen the doctor recently, I would go in and have him take a look and mention this to him. Oral hygiene after these kinds of surgery also can be a problem, as patients don't want to mess around in there too much because everything is sore, but it needs to be maintained. It wouldn't hurt to get in to see the doctor just to be sure what's what.

Thank you Packer 66 and Brian for your quick response. Jack called his doctor's office (doctor just left to go flying-fishing for two weeks in Alaska. His doctor's nurse said that the smelly breath was normal and should go away in a couple of weeks. That's just the news Jack wanted to hear because he doesn't want to believe there's any problem. He's quite the optimist, which has come in handy especially when he's had three different types of cancer. I am still concerned that since the foul oder did not go away once the doctor took out the gauze he had sewn into the floor of his mouth to the bottom of his tongue to hold the newly placed skin graft into place that this clearly could be a sign that the skin graft is dying. Right now, I cannot convince Jack to get another opinion because he heard the answer from the nurse that he wanted to hear. Right now I'm frustrated and concerned. Is there any other signs that the tissue is dying other than a foul oder? Fever? What other problems might a dying skin graft cause? Can an infection develop and travel through one's bloodstream if left unattended? I really appreciate the responses to my questions as I am new to this forum with a newly diagnosed husband.

I think that for nothing else than your own peace of mind that you insist on the doc taking a look. You really shouldn`t have to be looking for other symptoms, you should have the doc take a look........I`ve learned the past couple years to be really pushy, and I`ve also learned to trust my instincts, if I think something is not right. Abcesses can develop very easily with grafts. The nurse may be right, but she can`t make a judgment without a look.........I would insist on a visit...........Dee

Packer is again right. For sure this doctor has an associate on call to see his patients while he is out of town. I would not wait 2 weeks. A dying graft can set up an infection that could make matters worse all the way around. If Packer and I are wrong, the worst that has happened is that some time has been wasted going to see the doctor. If we are right, it could prevent additional problems. Failing grafts sometimes can appear grayish in color, but this in not a very accurate indication to judge by. A trained set of eyes needs to look at this. We probably could use a couple of posts here from people who have had both successful and failed grafts, about their experiences. I didn't have one, so I am giving you what I have seen and been told, but am not speaking from personal experience

As a person who has had a failed graft just recently I agree with Packer and Brian. Do not wait.....get in to see someone else. I had an infection that did not want to clear up along with a sore throat that lasted for 3 weeks. I did not have the bad breath or so no one mentioned......Hummmm very curious, maybe that is why people stayed away from me and here I thought it was my nasty streak.........LOL.
David

This is for Carol's husband:

Get yourself to a doctor NOW! I had a foul odor in my mouth and not wanting to offend anyone, and being incredibly stupid for an otherwise smart person, covered it up until I landed flat on my back in a hospital for 8 days, very, very sick with a roaring infection throughout my system. You will most likely not be that sick because I had just finished rad and chemo and had no white cells to speak of. However, that does not change the fact that foul odor equals infection, if not of the graft, of something else. You need to keep it from getting out of hand. Two weeks is way, way too long to wait. Tomorrow is when you must get that checked. This is nothing to fool around with.

Thank you all for your insightful respones to my concerns about Jack's problem. Since he is quite stubborn when it comes to seeking out medical attention I decided to print out all your responses for him to read tonight. I'll keep you posted! Thanks again!

Hooray! Thanks to everyone's insistance - Jack went to the doctor this afternoon. The doc found that some of Jack's skin graft was dying off around the edges. He also said that Jack had developed an infection in and around the skin graft where his cancer was removed. Doc trimmed the dead skin graft and prescribed strong antibiotictics for Jack to take - one every 12 hours. Jack is sure glad I insisted he check it out. Thanks to all who shared their own experiences with me, which made it easier for me to get Jack to that point!!