Everyone Loves A Baby!

So, everyone’s been asking – well, close friends anyway – what’s up with the tongue thing?

I don’t want to overload the blog with personal stuff, especially somewhat distasteful (ha, I made a punny) personal stuff, but this is important to enough people to make it worthwhile. For which I am grateful. If you are looking for real estate stuff, skip this post.

Back in 2006 or so, my great dentist Pam Marzban became concerned about some white-ish material on the lower left back of my tongue. She suspected it to be leukoplakia, a possible precancerous condition, and sent me off to an oral surgeon (Dan Labriola) who could take a biopsy and ablate the area with a laser procedure, which he did. The leukoplakia was confirmed, but no cancer.

In 2008 Dr. Pam saw the leukoplakia again, but ran a new “Swish-and-Spit” test which came up negative.

This May, Dr. Pam saw a more dangerous looking red spot - erythroplakia. Back to Dr. Dan, who excised two chunks for biopsy and thought he got it all. The biopsy on one chunk was squamous cell carcinoma, with apparent negative edges; the other was negative but had enough interesting dysplasia that the area from which it was taken deserved careful monitoring.

Dr. Dan set me up for a C/T of head and neck to check for anything spreading, which I had done in mid July after the swelling from the excision was minimized. I went on vacation, and didn’t hear from Dr. Dan since we already had a followup set for October. The C/T didn’t show anything but a little swelling of the lymph nodes hanging over from the surgery.

Good ‘ol Pam (who insists I get cleaned at least 3x year – bad flossing habits) in late July saw the “bad spot” once again. When I got back to Dr. Dan in October, he took one look and said, “Kim, I want you to see Dr. Patty Lee [who is an otolaryngologist or ENT to most of us] because I think it’s back, and we need a broader view.”

I saw Dr. Patty right away and last Monday she took an even bigger chunk (under general anesthesia this time). Yesterday was my first followup and all looks “well.” The biopsy showed residual SQC at the prior site (not sure which one) but all the edges were clear. So once again, looks like we got it all. Next followup in mid-December.

Important things to think about:

• Oral cancer is nasty. Nasty-looking, nasty-feeling, and if you like to eat or drink (who doesn’t?), nasty to deal with. And, it can spread (metastasize). This most often happens when the cancer is in the back third of the mouth like mine, especially if you don’t regularly see a good dentist who looks for it.
• Using tobacco causes cancer. Don’t smoke or chew. I gave up the weeds in 1987 and got it anyway.
• Immoderate alcohol use can contribute. My use is moderate or less and I got it anyway.
• HPV is another known contributor. I don’t have it, but I got tongue cancer anyway.
• Cancer tends to run in families, so I understand. Not in mine, but I got it anyway.
• Tongue excisions hurt. I have Percocet (Oxycodone) and Lidocaine (in viscous form in a squirt bottle!) but it’s been over a week and the best I can do is sip soup or (with difficulty) slurp pasta that ‘s creamy enough and small enough that no chewing is required. No tomato sauce or citrus, please. It’s going to be another couple of weeks before I can bear to move my tongue and have it risk scraping my teeth without causing enormous pain. (I have sharp molars that tilt toward the “bad spot.”) I stopped using the Perc after 2-3 days because (a) pills are hard to swallow and (b) even if I put them in a smoothie, I can’t drive and it’s not good for the ol’ digestive system, if you get my drift. I can’t brush my teeth, but I can gingerly swish mouthwash (ProHealth, no alcohol) to keep the halitosis under some semblance of control.

OK, this evening I am seeing some new clients! I will take my little whiteboard and my Lidocaine squeeze, and try not to breathe on them. Hopefully they will understand my rather clipped speech pattern. Yes, I could’ve put them off another week or so, but even though the mouth doesn’t want to work that much, the head, heart and hands gotta do something productive.