Throat Blog — A Fast Start to a Slow Week

Ok, I should never say that I expect an uneventful week. It just tempts fate too much. After expecting nothing much to happen this week, Sunday night when I went to bed I started getting some upper right abdominal pain. Not bad…nothing like the pain from the blood clot last year. But, it was dull pressure/pain that just kept getting a little worse. So, at midnight I dragged myself out of bed and drove over to the UTSW ER, which was pretty busy for a Sunday night. After about 30 minutes out in the waiting area I got an exam room.

Pain-wise, it still wasn’t horrible…maybe a 3 or 4, which is enough not to ignore but not really enough to beg for morphine. It always seems to surprise medical personnel when I turn down pain meds…I must have been asked 4 or 5 times if I was sure I didn’t want something for the pain.

After repeating my medical history 3 or 4 times (I’m getting too good at that) labs were taken. Then, about an hour later, got an abdominal CT and a chest X-ray. Around 3:30 AM the pain started going down the scale…back to a 1 or 2 (if I thought about it I could feel the discomfort, but if I hadn’t been in the ER I could have slept through it). Finally, around 5:30AM and after finding nothing particularly remarkable on the CT (small gallstones but nothing in the bile ducts that would explain the discomfort) they sent me home.

Well, they said “we’re sending you home.” In reality, I went to Starbucks and had breakfast then drove the 10 minutes to my office, where I crashed on the floor for a couple of hours before getting up and working for most of a day.

So, after all that busy-ness on Monday…the rest of the week was pretty quiet. They did schedule me with a GI specialist on Monday, so maybe will get some clues as to what is causing my gut issues this week. And, my quarterly follow up with my Radiation Oncologist is Tuesday. I’m tempted to say “I don’t expect anything particularly eventful” from that appointment, but I’ve learned my lesson about tempting fate.

Throat Blog — It will be like Christmas in December

Well, I’ve not updated in a while since really not a whole lot has happened for a while. So, here is the big catch-up post. (mmmmmhhh. ketchup.)

So, the kidney stone did pass unremarkably. I’ve still got one small stone lurking in that left kidney, but don’t expect it to cause as much trouble as that first one. The only lingering effect is that some days I feel the need to go right after I go. Not every day. Not every time. Just when it will be most annoying, I think (like when I’m getting ready for bed).

Of course, since that is now in my rear-view mirror, something else has to crop up. And, this month the winner is…steatorrhea. I’ll spare you the ugly details of both the symptoms and the collection and delivery of 2 stool samples for analysis. Basically, I’m either not digesting fats (which would point to an issue with my liver, pancreas, or gall bladder) or I’m not absorbing fats (which could be some kind of small intestine inflammation). First stool sample ruled out clostridium difficile (aka “c-diff”). Now, they are checking my latest gift to the lab to see how much fat is there. Probably a lot, as I am currently a two-flusher. Fat floats…

My pancreas and liver both looked normal on the CT scan I got just about a week after the symptoms started (the CT was just a coincidence…was actually a follow up scan on the kidney stone). Pancreatic cancer can cause these symptoms, but the CT ruled that out quickly. And, my blood work did not indicate any particular liver or bile system issues. So, the hunt continues.

Until the root cause is determined, I’m just having to live with it. A little uncomfortable and very annoying, but hasn’t had a particularly huge lifestyle effect. If it continues for too long, I could start having some vitamin deficiencies (specifically, vitamins D, A, E, and K are fat soluble and rely on dietary fat uptake for adequate nutrition).

Cancer-wise, I pretty much recovered from the chemo bonus round. Hemoglobin, RBC, and Platelets were back up to the low end of normal on my last blood tests. The small tumors (all 5-9 mm) are still in various stages of destruction, but are not totally gone. So, I’m doing rounds of Erbitux every 2 weeks. This is the chemo that gives me the lovely acneiform rash. I basically look like I passed out in a fire ant mound. But, the rash doesn’t itch (except a little on my neck and head). No Efudex or platinum-based chemo, so the bad anemia side effects from the previous rounds of chemo aren’t expected.

I actually was walking and running a little before all the wet weather moved in. I credit that with contributing to how quickly my blood counts came back up. The first couple of outings I got pretty fuzzy if I pushed my pace at all much above a stroll, but after only a couple of weeks I could trot in 30-second bursts without feeling like I was going to run out of air. Aerobic exercise causes an increase in red blood cells…which I was quite short of after that last major chemo round.

I’ll get a CT scan the first week of November, then based on the tumor status we’ll decide either to keep on the every two week Erbitux or switch to monthly Keytruda or Opdivo.

Now to the “Christmas in December” update…I’ve scheduled the throat surgery to repair my glottic web. On November 27 I’ll go under the knife and the surgeon will slice my vocal cords apart. Then, she’ll insert a piece of plastic (called a “keel”) to hold the vocal folds apart so that they do not heal back together. That will stay in for 2 weeks, then she’ll do another short procedure to remove the keel…at which point I should have a voice again.

One concern that I have mentioned before is that the vocal cords are normally anchored by the vocal ligament to the thyroid cartilage. Well, my thyroid cartilage is only half as tall and twice as thick as it used to be, and for a while was not there at all. So, once she cuts apart the vocal cords she might also have to do something to re-anchor them to the front of my neck. She won’t really knows until she gets in there and starts cutting. So, fingers crossed that that does not present any major complications.

Other than that one thing, this is actually a surgery that is common for people who are undergoing gender reassignment. Man–>Woman the vocal cords are shortened and Woman–>Man they are lengthened. I told the surgeon that, if she had any control over the end result, I would prefer more Isaac Hayes and less Lisa Simpson. But, I’ll settle for whatever I can get. It has been about 15 months since I lost my voice. It will be nice to be able to yell at other drivers, again.

Other than that, I’ll have a visit with my radiation oncologist in a couple of weeks, but don’t expect that to be anything more than a quick review.

So, that is all the news that fits, for now. I’ll try not to let another month pass before I update again…but no update typically means good news (or at least no news). Ciao.