Thursday 24th January 2019

Not A Smooth Recovery Path For Me: Head & Neck Cancer. 2018.133.

Not A Smooth Recovery Path For Me: Head & Neck Cancer. 2018.133.

Update One: Monday 24 December, is that whilst it is always disappointing to have changes like this in recovery, I am actually able to manage the issue of pain, when it arises and am feeling better in general.

Update Two: Monday 14 January, the pain comes and goes but the news from my Head & Neck surgeon is that he was looking for cancer when I saw him on 8 January. This made me quite concerned. Whilst there was not cancer there as he could see, I do now know there could be another surgery this year. Sigh.

It’s Friday 21 December 2018 and not a normal blogging day for me at all.

But, head and neck cancer recovery is not ‘normal’ I guess!

My blog has been a great source of comfort to me as I can write down what is happening to me, and often receive support in return.

That is lovely.

Today I just need to share this story.

Since my last blog post here, I have continued to be back and forth to the great team I have at Westmead: my prosthodontist and nurse. Each visit since October – when I last saw my Head and Neck cancer surgeon and nurse – has been about:

  • checking the health of the skin which was added to my upper lip (under it) last May
  • checking I am keeping the metal abutments clean where they are attached to the upper teeth prosthesis
  • and fitting me for a partial lower denture to add to my remaining 8 teeth

Showing my mouth’s flexibility – reduced now.

I have had some pain. It is like a sharp nerve pain and each time I mentioned it I was told it is part of ‘re-modelling’ and I have taken that to mean, this will go on as my new mouth and lip settle into their space. I am pretty good at managing pain but earlier this week I needed to share what had been noted by me after seeing my G.P.

  • the pain, which initially we/I thought was from some abrasion of the new tender inner side of the lip against the prosthesis was not likely to have been only from there…because
  • when I tried to use my small micro brush to clean in between the gaps left at the top of the screwed in prosthesis there was  no gap 
  • where the gap had been was skin, resting and immoveable, onto the top of the acrylic prosthesis

After my G.P. saw it, I sent these photos to my Professor and the Prosthodontist. The prosthodontist rang to say, stop using the microbrushes and use the water pik only to clean. The professor emailed to say “come and see me early January for a closer look”.

Yay to having responsive professionals. Very grateful.

Not so happy for the pain it is causing, the lip tightening even more and the disappointment that things are not going as I had hoped. Probably as my team had hoped too!

On the positive side, I have overcome setbacks before AND I trust my professional team BUT this is not a situation I imagined.

Skin does its thing it seems. My post here is about how the stent being taken out too soon prevented the full healing and I needed a 4th surgery and then over 3 months with a new stent.

I seem to think….more surgery may be on the cards.

Sigh.

I am taking pain medication as advised by my G.P. I am doing all I can to treat myself more gently. I am looking forward to seeing the family on Christmas Day here but my eating may be even more compromised by then. Who knows?

Many I know in the Head and Neck cancer support groups are in quite different stages of healing, acceptance of many aspects of their recovery and managing things well. I am buoyed by them, and already support for me and my update has helped. I also know as an Ambassador for Beyond Five, that those of us with Head and Neck cancers are affected by treatments long after the five years.

I am just over 19 months since diagnosis. I am also less patient than some! I am, always very grateful for my cancer treatments and follow-ups in an Australian setting here:

Chris O’Brien Lifehouse

The late Prof Chris O’Brien. In the hospital named after him.

Westmead Oral Restorative Sciences

Thank you for your support, friends from blogging land and readers!

Denyse.

 

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Oral Health & More From This Head & Neck Cancer Patient. 2018.71.

Oral Health & More From This Head & Neck Cancer Patient. 2018.71.

I know!

Another post about Head and Neck Cancer!

But there is a very good reason why!

Not many people, including our “every day” health professionals are all that familiar with the signs of a possible Head and Neck Cancer. This is why, over the past month, there have been posts, tweets, instagram and facebook status from various people, including me.

This list of symptoms is from Cancer Council. Head and Neck cancer does not cover brain cancer.

On 27th July 2018 it was World Head and Neck Cancer Day. The 4th one ever. The first one held in 2015 after it was announced by former President Bill Clinton in 2014 and H&N cancer patient, actor Michael Douglas seen and heard here:

Do you know I disliked (hate is too strong a word) going to the Dentist?

I started when I was under 5. Apparently my teeth ‘came up decayed’ after an early childhood illness of mine and so a trek to a very painful experience at the dentist in Wollongong as a kid became part of my life. Urgh.

I had to have fillings and extractions (my 6 year old molars came up and were taken out!) without any anaesthetic. Thanks Mum and Dad (not) for never letting me know you could have a needle to dull the pain. Dad recently corrected me on this ‘fact’ saying he did not know either. The dentist, Mr Stone, worked in a surgery up some stairs in a  building in Crown Street Wollongong. Recently, at Westmead Oral Restorative  Sciences I saw ‘the set up from my childhood’.

My dental history, once we moved to Sydney (and I found out about injection for numbing the fillings!)  continued from 1962 until 2017:  with the usual fillings, removal of teeth in my latter years, root canal therapy and finally a bridge with a crown in 2011 was placed over my front teeth. I also had a partial denture in the upper gums and one on the lower gums.

Sometimes, in the past 5 years,  a “new to me” dentist would proclaim that I was not cleaning well-enough behind the bridge and candida was forming. I followed instructions, I bought products to help, I swallowed more fungalin than anyone needs to…and I had a biopsy on a white spot at the top of my mouth between upper gum and lip. Nothing but more candida was the response. Oh. the stuff I used….and still nothing really got better until late 2016 into 2017..read here for the details.

The people who are so kind and helpful to me at my local here, and oh so relevant Dental Surgery are the ones who understood my anxiety re travel to their surgeries, “got it” when I had to cancel at the last moment (IBS) and were just the best when it came to me having my HUGE challenge of all the top teeth & bridge removed in April 2017 BUT were “there” for me from the receptionist to the dental nurse to the dentist. It has been on of my life’s real blessings to find them. Here I am in June when I had a check-up.

Moving On…in more ways than one!

To have my cancer removed from my gums, allowing for margins, I had the ultimate extractions on 6 July 2017…my whole upper mouth! But, of course, the wonderful professional team I have, knew just how to replace what had gone. Use my leg! Good old right hand side leg had better blood supply so, it would be the agreeable donor of a fibula, some flesh and skin. OH alright then!

In recovery time: both in hospital and at home, learning to walk somewhat well with a boot protecting a very big and fleshy wound was hard. I had some physio & head & neck cancer nurse advice from Chris O’Brien Lifehouse before coming home. I had/have a very good GP and of course my husband on 24 hour call who knew I could walk and wanted me to be as independent as I could. Photos are of late July – 2+ weeks since surgery.

I also had (and still do) a very helpful and caring professional …my podiatrist Sean. He came to the house to give my nails some care and to check out what had happened. He keeps on eye on my gait as my walk is OK but sometimes I can feel like I might fall when I pivot. Memo to me: think before pivotting! Here’s where he works. 

One year on…thank you to Sean ( a new Dad now!)

How Do YOU Thank Someone Who Told You “You have cancer?”

In person, with cake. Yes, that IS my modus operandi. I come with little home-made cakes and a home-made card of appreciation. The moment I heard I had cancer held my attention  for a long while and will never leave me. However, even on the phone, from Wagga in NSW south west region, my Oral Surgeon, who had done my second biopsy in 12 May 2017, told me with care, compassion and a practical message!

She told me that she would be referring me to a Dr Clark in Sydney. I had no idea who or where but I took down the details then rang her surgery at Ourimbah  where I had my biopsy. Stef Calladine works in various places in N.S.W. and I am impressed by her work and her patient relationship. When I called the surgery, the lovely ladies there knew and helped me as much as they could, with a name (Dr Jonathan Clark), the place (Chris O’Brien Lifehouse in Sydney) and a phone number. More of the story itself is in the post above.

It was a couple of weeks ago I finally locked in a day when Stef was in and I could go to Ourimbah and what a delightful reunion it was. She has been following my progress professionally with follow-up letters and reports after surgery. I also got to ask the mystery (to me) question. How did Stef, someone who had trained and worked in the UK till a few years back, know to send me to Professor Jonathan Clark at Chris O’Brien Lifehouse? She didn’t but her nurse, Cathy, did! Oh thank YOU Cathy! That was the best decision.

About THE Teeth…when??

It is not a $64 thousand dollar question but I do want an answer of course. From the work done by my amazing and caring prosthodontist and the prosthesis makers at Westmead here I am getting the idea I “may” have something like a set of top dentures added to the upper gum by the end of August. I have to add I am a bit nervous. Gosh, people, I have not had upper teeth for a LONG time. Here’s a series of pics to remind my readers of how much work goes in to seeing I eventually get a smile with teeth!

Is this nearly the end? No. Sorry.

I have no idea of the end…of the treatments and the addition of teeth. I know I have weekly appointments till the end of August. I know this is the start of helping me get teeth inside my mouth again. I will be given very explicit care instructions as this prosthesis will be screwed in so cleaning will, at the least, be challenging. I will be guided by my professional team about the progress. I have no follow-up cancer appointment at Chris O’Brien Lifehouse at this stage. I do believe the little ‘hole’ that appeared under my nose post stent re-insertion  in late May has closed over by itself. Phew. Or that would have meant a fifth surgery.

My prosthodontist talks to my Head and Neck surgeon often as they perform other cancer procedures. I also keep in touch from time to time with an email…and yes, they do know about my blog.

I was pleased to meet people from the local Head and Neck cancer support group recently and join a very active Head and Neck cancer Facebook group too.

 

There is more than one Head and Neck cancer…there are many. Mine was contained in the mouth, not spread and was not HPV. I say I am fortunate. I say that a lot.

Wishing you all the very best who read this.

It’s Dental Health Week here in Australia! Do take care of your teeth and mouth. Only 13% of Australians regularly see a dentist. I am one of those…and yes I had cancer detected but that IS not the norm! Just take heed & have a look here.

Thank you!

Denyse.

P.S. I have an update: Monday 6 August my prosthodontist took the stent out from my upper gums and fitted the wax model of my “teeth to be”. He was very pleased with the fit (all his work, over the weeks of my visits and his knowledge and skills) and we both smiled broadly at the result. In 2 weeks it is planned to fit the FIRST version of false teeth (prosthesis) in my upper gums. But on Monday it was the sweetest surprise for us all:

 

On Tuesday this posts links with Kylie here

On Wednesday this post links with Sue and Leanne here

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My Head & Neck Cancer 1st Anniversary. Pt 2. 2018.46.

My Head & Neck Cancer 1st Anniversary. Pt 2. 2018.46.

I recently wrote Part One of the Anniversary of my cancer diagnosis here.

The second part is actually a bit harder to write.

I am grateful of course for my cancer being taken via surgery but I seriously had no idea that to recover and be implant-ready would be up to and well over a 12 month period. This is because, as I understand it, bodies heal in different ways and react like that too. I also know that this mouth reconstruction of mine necessitates a lot of work by the multi-disciplinary team of medical, allied health and dental experts.

I am ever-grateful for this team.

With Prof Clark & Cate Froggat, Clinical Nurse Consultant & Surgical Assistant

I know that my Professor Jonathan Clark  leads the Head & Neck team and he is also working with the training of other doctors just as he learned as a resident with the late Professor Chris O’Brien at Royal Prince Alfred (RPA) Hospital. From the Westmead Oral Sciences comes  my Prosthodonist, Dr Suhas Deshpande and his colleagues including Dr David LeinkramDr Matthew McLachlan. Dr Deshpande’s Nurse, Ofelia has seen me through some emotional times and is a very kind person. Norma at the reception desk at Westmead Oral Sciences always has a smile for me and a welcome that’s bright.

Associate Professor Ardalan Ebrahimi was the first person I saw on May 18 2017 and who examined me and put together, along with Professor Clark what would be my BIG surgery in July 2017. A/Prof Ebrahimi was kind enough to respond to my 2 detailed emails pre-surgery and saw me post-surgery in 2017 along with  Justine Oates Head and Neck  Nurse Practitioner who re-dressed my wounds and ensured continuity of care once we were back home on the Central Coast.

In my 10 days post Surgery #1, I was cared for by a number of professional nursing staff firstly in ICU with Dr Tim  then on Level 9 North of Chris O’Brien Lifehouse where Jason was the NUM. I will single out registered nurse Roan as he cared for me most early mornings and made sure I got out of bed to get some sunrise shots!

From the Head and Neck team who were part of my first surgery was a team of doctors including Dr Laura Wang & Dr Rahaul Jayaram who saw me most days in hospital.  Allied professional staff  at Chris O’Brien Lifehouse were physiotherapist Leah ensured I could walk post July surgery after fitting my right leg with the boot, dietitian Jacqueline gave me lots of guidance for eating post mouth surgery and the speech therapist Emma made me drink a cup of water (ahh!) and speak ( not a hard task given my propensity to talking!) to ensure I was going well before leaving Chris O’Brien Lifehouse last July.

I thank the wonderful anaesthetists and anaesthetic nurses who ensured not only that I went to sleep  but that I woke up with no dramas. One was Dr Murray Stoken and another is Dr Paul Goonan. On 16 May I was cared for by Dr Stephanie McInnes. 

Of course I have the excellent and fabulous Cate Froggat, my Clinical Nurse Consultant & Surgical Assistant who is the gentle and smiling person looking out for me in the operating theatre and in post-op consultations.

How could I not mention Julie and Priscilla…a hug and smile each time I see them, those who keep all of us seeing Professor Clark organised with compassion and care.

Once I was home, as I have outlined before, I was also in the care of the Central Coast Public Health Community Nursing Team for around 2 months and Eileen was amazing with her knowledge and advice.

My dentist Dr Alistair Brown saw me for a mouth check last October and to clean the remaining ((and oh so important to me) 8 bottom teeth. He was the person who initially referred me to Dr Stef Calladine, oral surgeon,  who did the biopsy last May and broke the news to me over the phone that I had squamous cell carcinoma. I will always be grateful for her caring manner and more importantly for referring me to a place I had heard of called Chris O’Brien Lifehouse and to a specialist I had not, Prof Clark.

My GP. Dr Owen Greene. What a caring and understanding man he is. I saw him sometimes up to 4 times in a week when I was recovering from BIG surgery #1. He reassured, he checked on me and he continues to do so, letting me know you are doing really well. His office staff and pathology people ask how I am going tooIf I pop into the chemist next door, Tim the pharmacist is always asking how I am going too.

There are those that I cannot mention all by name but have been integral to my diagnosis, surgeries and recovery times:

  • staff at the various Imaging places in Sydney and on the Central Coast
  • staff at the Admissions Desk and Pre-Surgery Desk at Chris O’Brien Lifehouse
  • the nursing staff pre- and post-op in the recovery areas
  • my psychologist from the READ clinic in Erina saw me a couple of times and was most kind in her assertion that I was doing well without any more need for her services.
  • the social media account for Chris O’Brien Lifehouse @chris_obrien_lifehouse & the art programs at COBLH @arterieatlifehouse (Instagram)
  • those lovely people who welcome me to their coffee shops like Randa at Fibonacci Wyong  and ask after me, along with my fabulous hairdresser Tiffany, our great podiatrist Sean who came to the house to treat me when it was easier for me, and our Property Manager, Naomi, who was delighted to see me recently. Kyla who makes the most delicious cupcakes always asks how I am going when we catch up. In fact, I won a generous voucher recently and as cupcakes are something I CAN eat, this is just the best!
  • the Beyond Five Organisation: Nadia for her reaching out for me to help with publication of my story written by Kirsty. Check my photos here to see the fundraising ribbons. World Head and Neck Cancer Day in July 27. I wear my ribbon and blog about Head and Neck cancer because not many people know about this cancer. I do now!

Then definitely NOT last nor least are my friends and family. Those who connect on-line too. My blogging friends, my instagram friends and those from Facebook and Twitter. I love connecting!  To know of so much love, concern and care being out there for me after the diagnosis and through recovery in the year it’s been is marvellous. Thank you for reading my posts, checking out my Instagram pics and ‘liking’ the blog Facebook page.

Each day in 2018 I made a commitment to myself to do at least these three each day:

  • get dressed in an #outfitoftheday and go out – for a coffee, a browse, a shop or just to look at a view
  • go into nature or observe nature and then capture this in a photo
  • make something creative, be it a mandala or a pattern or just so art fun.

I cannot single any one person out from family and friends….other than this person:

My husband. There for everything for me. Always. Love IS what keeps us together…and has done for over 47 years.

Sending everyone my love and gratitude.

Denyse.

On Tuesday this posts links with Kylie here

On Wednesday this post links with Sue and Leanne here

On Thursday this post links with Leanne here.

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It’s More Surgery For Me. 2018.40.

It’s More Surgery For Me. 2018.40.

In the overall scheme of things (OSOT as my husband says) this up and coming surgery is “just what it is”. My mouth has not healed the way it might have – nothing to do with my health. Apparently the previous stent, added during surgery in early February 2018 just was not on for long enough I was told last week by Professor Clark. I was also told, that some more skin will need to be harvested from my fabulously (my word!) giving right leg for that to happen. OK. Sigh.

My right leg is such a good one: here’s a collage of how much it has helped….and healed! I am one lucky lady.

But I still found the news harder to absorb because of the details. I knew the surgery was necessary after the Professor and my prosthodonist talked then let me know before Easter. What I did not know was that I would be having ‘the stent, the stinky stent’ in for MUCH longer than before. I had a little weep about that on the way home because I know how that felt in my mouth for the few weeks last time.

So…what’s a blogger to do? Write about it and add a photo or three.

On Tuesday 1 May, following that visit in the afternoon, I wrote this post on Instagram and I admit it was to write it out rather than let it sit inside my head and I received the love, support and care from many. I have always been buoyed by this because I am socially and physically isolated here on the coast, and having friends on-line helps greatly!

Of course my husband is the best listener and advisor. My extended family gets concerned about me too but I like to think I am confident about how things go for me.

Today I was here at Chris O’Brien Lifehouse, Camperdown in Sydney, for my pre-4th surgery consultation with my lovely Professor. This is the view down to the ground floor from Level 2 as we were waiting. We heard the piano being played beautifully later & I got to meet the lovely art-making person & make a card. It is a most welcoming and caring place to be even though why most of us are there is not for a reason we choose.

Today I learned that I will need more surgery, the addition of a stent (mouth guard) as I had in February for only weeks …will be in my mouth for months this time. This is not a pleasant thought but without it, the gums and mouth area will not stay in place for my (future)implanted teeth. . My memories of this last time was that it is uncomfortable, gets stinky & will impede eating even more. And it hurt at times. I will need more visits to Westmead in the weeks following the surgery for the prosthodontist to take the stent off & clean around it & put it back.

Additionally I learned that my lip will need more skin. My right leg will be the source of a second skin graft from the thigh. This experience last time meant a bandage on for 2 weeks, no showering and after that time, to have a bath and over time the bandage and the healing patch will come off.

To say that I am a bit disappointed is true but…… surgeries such as mine are new, they require skills and knowledge gained each time a patient is presented. So, wondering how to manage my thoughts and feeling about this, I decided that writing it helps; as does showing appreciation for all that has been done for me so far and helped me recover from the nasty news last year that I had Squamous Cell Carcinoma in my upper gums.

The day I have my 4th surgery at Chris O’Brien Lifehouse will be Wed 16 May 2018 (day surgery)

That is one day short of the first anniversary of my cancer diagnosis on Wed 17 May 2017.

Read about that here if you are new to the blog

I was on Level 2 (where I stood today)  the very next day, 18 May 2017 to meet both the Professor and Associate Professor who would be doing my major surgery in July 2017.

That it is almost one year is both scary and amazing.

Thank you friends here and on FB for your support, kindness, messages and love.

This is what I know I will be looking like again. I guess it helps me to understand more. I am disappointed but I also trust my professional team implicitly and know what they learn each time they do this kind of complex reconstructive surgery is likely to help others.

I am dealing with this positively and with courage. I am going to wear this more, I think!

I will be spending more time batch cooking as I know I have to eat as well as I can but I also know the restrictions.

Thanks for reading thus far! I know this cancer story of mine is quite dominant at the moment which I believe is linked to The One Year Since Diagnosis coming up.

Do you remember certain days/times of year for different reasons?

I sure do.

I have always been like this.

I know there have been quite a few posts about this cancer and surgery but I am grateful to be able to blog about it and hope that you can have patience with me as I continue to get towards my goal of…..implanted teeth!

Thanks to all who read and comment. I am buoyed every time as I said in that Instagram post last week.

Denyse.

On Tuesday this posts links with Kylie here

On Wednesday this post links with Sue and Leanne here

On Thursday this post links with Leanne here.

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