I met with the radiation oncologist today to go over the CT Scan from last week and it came back negative. In this case negative is good. The lymph node the were tracking shrunk some more and there doesn't appear to be any signs of the cancer remaining. Of course the definitive test is a PET scan and I will probably have one of those some time this summer but at this point everything is looking good.
Of course it wouldn't be a visit to the radiation oncologist office without pulling out the scope and checking things out through my nose. This time it went easier than the last time. The CT Scan was for the neck area. With the scope the doctor checked out the nasalpharynex area where the main tumor was. As with the CT Scan there is no sign of the tumor. Yippee!!
Next he checked out the throat area. It is still red and swollen. The esophagus has narrowed. Some of that could be due to the lack of use and some from the treatment. We discussed my attempts at swallowing and what steps to take next.
Right now the swallowing has gotten a bit easier but is still far from easy. Basically it is still liquids or things that turn into liquids only. Any solids won't go down no matter how small and cause problems. I found that out today when I tried some shrimp bisque that had microscopic pieces of shrimp in it. It was a problem until I ran it through a strainer. Then there wasn't any problems. Another oddity is that food with fat in it goes down much easier than water. I had read this was the case and the doctor confirmed it. Another strange thing is that I decided to live life on the edge and try a bit of root beer today (what can I say, it was calling to me at the grocery store.) and that wasn't a problem. It may be the carbonation. Keep in mind all of this is done via small sips and a total of 2 ounces at a time.
After a week of my home brew swallowing therapy I can say that things have improved in areas that I hadn't thought about. For the past 6-7 months there hasn't been any liquid going down my throat and now I realize that helped contribute the the thick mucus that was plaguing my throat and nasal passages. (I have also learned through all of this how much your nose, mouth, throat are all connected.) Just by consuming the liquids that I have in the last few weeks everything has loosened up quite a bit. This has reduced the congestion and discomfort in my throat and made things like sleeping easier. It took a few days to have a noticeable impact but it has helped.
Next week I meet with the speech therapist and I hope to get some guidance on how to improve swallowing. I realize that I am not going to just jump in and start eating fried chicken (though some Seneca Farms fried chicken sounds really good right about now) but I do think there should be some sort of progression to slowly introduce semi solid foods. One thing the radiation oncologist suggested is to try egg custard. I may modify that and make some flan tomorrow. Home made flan tends to be a bit loose and could go down well but also have some characteristics of a solid. It also tastes pretty good and who knows, after that I could try creme brulee. Hey if this works out I could get used to this type of swallowing therapy. It wouldn't be too bad if I had to eat flan and creme brulee on a regular basis as part of my recovery. :-)
What's Up Next With The Recovery Plan
I am being patient with the recovery but do want to get started on a defined plan with goals to work towards. Just hanging out waiting for things to recover isn't really my style and I don't think its the best course of action. The doctor today did give me several exercises to start on that are designed to stretch the neck muscles and help me open my jaw wider. He even game me a stack of tongue depressors to use as a tool to help. I am hoping that the speech therapist will be able to provide an action plan to help move forward with the swallowing.
The doctor also gave me some samples to try to help with dry mouth. At this point I have some dry mouth. It manifests itself when I am talking and trying to eat. I seem to generate enough saliva to avoid dry mouth during normal activities and at night it isn't that bad. I do carry a spray bottle with me to spritz my mouth when talking for any length of time. Over time this should improve a bit but I have accepted that I will most likely have some permanent dry mouth. All that means is that I most likely won't be munching on saltines by themselves but that's OK because I was never much of a totally dry snack person. (I will miss some things like popcorn but I can live with that.)
One last thing the doctor today did was give me a prescription for the thrush infection. I am currently using miracle mouthwash but he feels based on what he saw with the scope that the miracle mouthwash may not be reaching far enough back in my throat to deal with the infection. This is a drug I have had before and it seems to work well. Getting rid of the thrush infection should also help as well.
On the physical therapy side I am continuing to use the Wii Fit and that is working out very well. My goal at this point is to focus primarily on the legs and balance exercises with a mix of the balance games and some basic yoga. In another week or so I will start to add in some of the strength exercises for the legs and the arm exercises. After a week of using the Wii Fit I have noticed a significant improvement in my legs. The Wii Fit isn't a silver bullet for solving everyone's exercise problems but in my case it provides a great way to slowly start to ease into exercising again at a pace I am comfortable with. I also think that even after I get by my cancer recovery phase it will still be an integral part of my exercise training. In another post later on I will provide a more detailed review of how it worked out for my recovery. At this point I would recommend it to any cancer patient that is looking for a way to get back into exercising.
Wednesday, May 28, 2008
Tuesday, May 27, 2008
Whats Up This Week
On Wednesday I get the results of the last MRI Scan. As always I am a bit apprehensive but don't think there should be any bad news. I think they are going to use the scope again to check things out and I want to ask them about what is blocking my throat.
On the swallowing front I can swallow ice cream and soups a teaspoon at at time. I have also tried this ice cream called Dibbs that is essentially small bite sized chunks of ice cream covered in chocolate. These I eat in very small quantities. Its better than ice cream because it forces me to chew it a bit but still melts completely. This is getting my jaw muscles working. The first time it was hard to even open my mouth. Keep in mind that it has been 6 months since I had to chew anything. One interesting thing I have noticed is that swallowing thicker soups like cream of mushroom is easier than thinner liquids like water. I still can't consume anything solid but just being able to get down a few spoonfuls of soup at a time is progress. The way I am approaching this is the same way I am approaching my physical rehabilitation. Take it slow one step at a time. With swallowing the goal is to just use those muscles in some manner a few times a day. It isn't a lot of fun at this point but I think it is a necessary step to go through.
On the physical side I don't think I have talked about this much but part of the result of 6 months of inactivity and the weight loss is that my muscles, in particular my leg muscles, have really diminished. With my legs it was at the point where just standing up from a kneeling position was difficult as was climbing stairs. This week I started doing some training with a Wii Fit. I have only been using it for a few days but I can say this is just what I needed to get started. The balance exercises actually do work your leg muscles and in my case it allows me to do a little or as much as I can handle at the time.
One of the things that kept me from starting other exercises for my legs is that most of them involve some sort of motions like knee bends and such that I just couldn't do. With the Wii Fit and the balance exercises and games there are activities that I can do that benefit the leg muscles without worrying about starting something like knee bends that I can't finish. I have already noticed some positive results just after a few days of using it. Right now I am doing 20 - 25 minutes a day. At first I just did the games to get my legs used to do any type of activity. The games may seem simple but after 20 minutes you do start to break a sweat. In the last two days I added in some of the most basic yoga poses. One, the warrior I could do OK. Another, the tree I think its called, would have been a good candidate for America's Funniest Home Videos. You have to stand on one leg and needless to say I wasn't able to hold that pose in any type of balance position at all. One of the nice things about the way Wii Fit works is that you can choose the activities you do. So for most of the workout I can keep focused on the simple exercises that I can do but I am able to add in one or two that require more effort every now and then to see how I do.
After this week I have a few more appointments. I meet with the medical oncologist office for a status check and then with the speech therapist for an evaluation later in the week. The radiation oncologist office was able to get that appointment moved up a week. I will post more information on how those appointments went next week.
On the swallowing front I can swallow ice cream and soups a teaspoon at at time. I have also tried this ice cream called Dibbs that is essentially small bite sized chunks of ice cream covered in chocolate. These I eat in very small quantities. Its better than ice cream because it forces me to chew it a bit but still melts completely. This is getting my jaw muscles working. The first time it was hard to even open my mouth. Keep in mind that it has been 6 months since I had to chew anything. One interesting thing I have noticed is that swallowing thicker soups like cream of mushroom is easier than thinner liquids like water. I still can't consume anything solid but just being able to get down a few spoonfuls of soup at a time is progress. The way I am approaching this is the same way I am approaching my physical rehabilitation. Take it slow one step at a time. With swallowing the goal is to just use those muscles in some manner a few times a day. It isn't a lot of fun at this point but I think it is a necessary step to go through.
On the physical side I don't think I have talked about this much but part of the result of 6 months of inactivity and the weight loss is that my muscles, in particular my leg muscles, have really diminished. With my legs it was at the point where just standing up from a kneeling position was difficult as was climbing stairs. This week I started doing some training with a Wii Fit. I have only been using it for a few days but I can say this is just what I needed to get started. The balance exercises actually do work your leg muscles and in my case it allows me to do a little or as much as I can handle at the time.
One of the things that kept me from starting other exercises for my legs is that most of them involve some sort of motions like knee bends and such that I just couldn't do. With the Wii Fit and the balance exercises and games there are activities that I can do that benefit the leg muscles without worrying about starting something like knee bends that I can't finish. I have already noticed some positive results just after a few days of using it. Right now I am doing 20 - 25 minutes a day. At first I just did the games to get my legs used to do any type of activity. The games may seem simple but after 20 minutes you do start to break a sweat. In the last two days I added in some of the most basic yoga poses. One, the warrior I could do OK. Another, the tree I think its called, would have been a good candidate for America's Funniest Home Videos. You have to stand on one leg and needless to say I wasn't able to hold that pose in any type of balance position at all. One of the nice things about the way Wii Fit works is that you can choose the activities you do. So for most of the workout I can keep focused on the simple exercises that I can do but I am able to add in one or two that require more effort every now and then to see how I do.
After this week I have a few more appointments. I meet with the medical oncologist office for a status check and then with the speech therapist for an evaluation later in the week. The radiation oncologist office was able to get that appointment moved up a week. I will post more information on how those appointments went next week.
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