One of the next appointments was with the Radiology Oncologist, Doctor Kenneth Hu. He works mainly out of Beth Israel’s radiology department at the hospital on 1st Ave and 16th Street, in the basement. They fit me in at 230 pm the Tuesday after Labor Day.
After sighing in, this time the wait was about 2.5 hours. First saw his assistant, who went through many years of medical school and was in her second year interning with Dr. Hu. Said one year was sufficient for her requirements, but she wanted to stay another year because Dr. Hu was one of the best. Another boost of confidence.
So in comes Dr. Hu and after asking me what I did for a living (sales, I say,…after all, aren’t we all selling ourselves non-stop?), he says “so I guess appearance and speaking are important to you?” I’m glad I was sitting for that question. In the nanosecond it took me to respond positively, I did a quick scan of human population to come up with someone (a group) who would not think appearance and speech was important. (I drew a blank, but may have needed more than a nanosecond).
He hears my story, why I’m there, looks through my chart(s), then starts exploring. Sticks, fingers, then the scope through the nose again. I’m glad for all of it. He tells me that the reason I may have this cancer is due to HPV and that biopsy pathology may show this once it’s complete. If so, it may be a good thing. Regardless, as much as he can conclude, I would need seven weeks of radiation, followed by seven weeks off, and then a brachytherapy boost (24 hours in solitary in the hospital with focused radiation implanted behind my tongue), and surgery on my neck to take out any leftover lymph nodes.
Then he starts the initial preparation of letting me know what to expect. Starting radiation, they would insert a feeding tube in my stomach. Yes, a hole is made from the outside into the stomach. The tube would be tapped to the outside of the stomach when not in use. He says that even though it’s not needed for the first couple of weeks, it’s important that it’s there and that I get used to using it. Why? Because after the first couple of weeks, apparently the throat gets fried and it becomes very difficult to eat. And, it’s important to keep nutrition flowing through this process.
Radiation, as focused as it can be, will kill good cells as well as bad. Therefore, it will more than likely kill the saliva glands on at least one side of my mouth. Afterwards, the mouth becomes abnormally dry most of the time. If the gland on the other side is not wiped out, then the good gland can make up for the entire mouth (kind of like the body can function on one kidney), but it would take up to a year or more.
I’d also need to see a speech and swallowing therapist. During the process, apparently, it’s important to practice swallowing so that one doesn’t loose the adams apple function (thyroid cartilage). In other words, I might be inclined to want to use the feeding tube, and in fact should, but I had better work on swallowing exercises so there is no problem later. There won’t be any motivation problems in this department I’m thinking.
Also, because the radiation is pointed into my face and neck, I would permanently loose parts of the hair on my face (where one shaves), which would not be so bad if it could be made in the shaving pattern. But, where the radiation comes out the back side of the head, I would likely loose hair there, but that would be temporary. And, because radiation enters the jaw, I’d need to see a dentist to make sure that all the teeth are healthy because extractions after radiation are dangerous and can fracture the jaw bone.
He did say that during the seven weeks of therapy, it is good to be active and that active patients do better than non-active. Although, I may want to plan on not working for a month or more.
Both Dr. Hu and his assistant are super nice, patiently answering all my questions, even though it’s evident from the waiting room outside that they are extremely busy. So they give me a book, “100 Questions & Answers about Head and Neck Cancer” (Dr. Kenneth Hu is one of its authors) and we shake hands and he tells me he will try to schedule me that Friday for simulation (getting fitted for a mask).
Outside the hospital, I unlock my bike and head home, trying to digest, without tubes, all the information I’ve just been given. Tomorrow I’ve got a PET Scan to look forward to.