What a mouthful.  Literally, in my case.  It’s a disease caused by a therapy treatment used to get rid of another disease.  And I’ve got it.

I had another PET/CT scan this past week.  The benefit of this scan is the visualization of any hyper metabolic activity from the brain through the entire torso (and below).  Cancer cells light up during this test.  The first PET/CT scan I had in September 2010 showed abnormal metabolic activity carpeting the base of my tongue and in level II-III on the left side of the neck.  That was all consistent with what I was feeling.

The PET/CT from this week showed no such activity.  In other words, results are negative.  A good thing.  The scan did show in my brain that my stupid gland is wholly intact.  Also consistent with what I’ve been feeling, the scan shows compromised integrity of the mandible on the left side indicative of osteoradionecrosis.  Easier said when broken as osteo-radio-necrosis.

What’s that mean?  Basically, I’ve got dead jaw bone which is seriously complicating matters.  Don’t know how I got so lucky, but only a small percentage of patients who have neck radiation get this.  Radiation has killed off ends of very small blood vessels that feed tissue and nerves.  The lack of nutrients at the micro level leaves the bone compromised.  The process (so far) is irreversible.  And the pain is non-stop.

If there is a good side, I guess it’s that I caught this condition between stage I and II.  There are only three stages.  Hopefully I’ll be able to avoid a titanium plate, harvesting bone from another part of the body and a complicated operation (stage III).  However, I’ll loose a couple of teeth and need to have bone cut out.  The bummer is that I’ll be wasting a couple of well done root canals.

How much bone will be cut out and how to protect what is left is still to be determined.  In any case, I’ll need to be hospitalized for the process and the options will be laid out in about 5-6 weeks.

In the meantime, the other benefit, if there can be a benefit, is that I’ll be starting 20 daily sessions of hyperbaric oxygen tank treatments this week.  Each season is about 1.5-2 hours — high pressure oxygen.  It’s a pressure chamber that a diver with the bends would go into.  The idea is that the increased oxygen will stimulate small blood vessel growth.  In other words, stop the process in its tracks.

As if the negative effects of the radiation treatment are not enough, the frigged up tongue, dry mouth, swollen throat, stiff neck, ringing in the ear, restricted diet, now it’s the jaw bone that is deteriorating.  The positive side?  My head is still connected to my neck.

And of course I can walk, talk, run, peddle, and shovel mud.  All stuff to be extremely thankful for.  So what the hell, as much as I hate taking anything synthetic, I’ll keep popping ibuprofen and be glad that the neck, tongue and eyeballs are still in place.  With lots of luck and good fortune, I’m hoping a good part of my jaw will be also.

What I’ve realized through this ordeal is that I thought I was stronger than I am.  I’m anxious for self pity and “why me” garbage thoughts.  I’m not able to put this out of my head like perhaps I should.   So I’m really much more of a wussy than I let on to be.  I’m OK, sure.  But I can’t let myself climb up the p factor scale 1.   It is what it is.  And I’m thankful that the medical community has developed creative ways of dealing with most of these ailments.

On the other hand, maybe I’m a little mopey because I haven’t gotten in any good century rides so far this year, another heightened p factor indicator given our extremely warm winter.

HBO here I come.

1. p factor scale is a measurement of a man’s fearlessness.  p, short for pussy, has its origins from Latin.  It was (is) a false cognate, meant as an insult to a man.  Calling a man a pussy means that man lacks a certain determination or courage.  As every man has some degree of pussyness related to certain events or areas of his life, the p factor scale was developed to help measure a man’s metal in those areas.  In general, a man wants a low(er) p factor measurement.

4 thoughts on “osteoradionecrosis

  1. Mother

    What a grand dose of intelligence you have. Your ability to lay out the course of your challenges has got to add important data to the benefit of others. Relative to your P factor, Rudyard Kipling would say you are in the process of living every 60 seconds and [so you are a man my son] as is your brother D. I’d like to be the Master of the Universe and absolve you of your challenges. I cannot but I can admire your continued use of time through the act of productive living. Yes, this mother sees in her adult children–entities who make the Greek mythical Gods pale in your presence.

  2. Anonymous

    Fred: No “p” factor whatsoever in you; rather the very opposite. “P” with you represents “pissed-off philosopher”, “pro-active pragmatist”, “protagonist peddler”, “philosophical intellectual philanthropist”, . . . and, of course, “phlegm prognosticator”. . . and that represents only the beginning should Martha wish to weigh in with compliments as well. You are one tough hombre with more fight in you than most, and a guy who clearly rises to the occasion. An example from which we all should learn and benefit. So while in your hyperbaric chamber sing “Thriller” and moon walk to “Billie Jean” as a tribute to mister hyperbolic hyperbaric hypochondriac. . . Wait, I see Martha’s comments from earlier. How “on point”; “that simple!” as Susan Marie is want to say. Love ya mon and ready to visit NYC to provide you and G some distractions, swjr


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