Friday, January 21, 2011

The Plan

We saw Dr. D this afternoon. I feel really good about where things are and where they are going. If I had to sum up my thoughts I would say we are in the best of the worst. By that I mean that we are dealing with cancer, surgery and recovery, but from where things stand right now it seems as though we caught this nasty disease early. For that I am thankful beyond words.

The plan...Within the next 2 weeks, Patrick will have surgery. During surgery they will do several things 1) Remove about 1/3 of his tongue 2) Remove his wisdom teeth 3) Remove several lymph nodes from his neck 4) Graft skin and a vein from his wrist and arm and use it to reconstruct his tongue

Science is amazing! I am in awe at what they are able to do. This is not Dr. D.'s first rodeo and that is very apparent. He sat across from us in an exam room and spoke to us as though we were around a coffee table. He took his time and explained everything. He patiently listened to our questions and gave answers. And now, I will do the same for you.

Why take out Patrick's wisdom teeth?
For two reasons. Having wisdom teeth in makes the jaw more weak. Having another surgery to take them out makes the jaw weak. We need Patrick's jaw to be at its best incase he ends up needing radiation therapy. Radiation breaks down teeth and jaw bones. Plus, if Dr. D. extracts them while performing the other surgeries he will deposit a mixture of blood platelets and bone particles in the socket before closing it up which leads to very rapid healing.

How will they remove the lymph nodes and how many?
We have about 700 lymph nodes in our body. 300 of them are in the neck and above. Dr. D. will make an incision along Patrick's neck from one side to the other. He will remove several (approximately 20) lymph nodes and a salivary gland.

Will Patrick have radiation or chemotherapy?
Maybe. We will not know until a week after the surgery. The lymph nodes will be tested for cancer and if the pathology report comes back positive Patrick will undergo Radiation therapy for six to seven weeks with the possibility of intermittent chemotherapy.

How will the skin graft work?
Dr. D. will work along side another doctor in the operating room who will attach the vein and skin taken from Patrick's arm to his tongue. It will immediately receive blood flow. The skin will appear white, but over time will take on a pink tone like the rest of his tongue.

What about recovery time?
Patrick will be in the hospital for 5-7 days. The first two days after surgery will be spent in the ICU. After that, he will spend another 2-3 weeks recovering at home. He'll have an NG tube or feeding tube for about two days after the surgery then will start a liquid diet. Talking will take some time too. He will be hard to understand at first, but as the swelling goes down, it will become more clear.

Why Patrick? What caused this cancer?
We do not have an answer to that. Dr. D. said tongue cancer is becoming more common in young men and women. Young men and women who do not smoke, chew or drink alcohol. He said he did not think it had anything to do with Patrick's occupation (radiological technologist).

Did I forget anything?

So, processing all this has been difficult to say the least. Surgery day will be bittersweet. The cancer will be gone, but recovery will start. Patrick will have scars. Scars that will forever be a reminder of this journey.


  1. sending so many deeply heart felt healing thoughts and wishes to your beautiful family... your strong, beautiful family.... you have a wide circle of love and support... do not hesitate to lean into all of us... wendy

  2. Laurel -
    Good for you for posting all of this information! I have no idea, but it seems like it would be great for processing...and you can look back on this all after a while, once this is just a memory, and be so grateful for the doctors of our world, and the technology they have mastered, and all the cool tricks they can do nowadays! I am so glad that he seems to be in the "best of the worst" category and that you have a plan. We are praying for his healing, strength, and for the strength of your family. We love you!
    : ) Sarah

  3. The best of the worst ~ so thankful!!!!! Give Patrick a hug for me (and he can hug you for me, too).

    All my love,

  4. God is good! Modern medicine is good! Your family was on my mind all day yesterday. Hugs & prayers from me.

  5. Hi friend~ I am happy to hear that it is the BEST of the worst. I am here, and am happy to watch those little sweeties anytime! So sorry that this is the journey that will take all your time, energy, obsessing, and praying for a while. Much love to you guys ~ Karen

  6. You are right. Amazing what they can do! I know this isn't easy and it will take some time to heal but I know you will all get through this! I pray God gives you strength each day!

  7. Science sure is amazing. I would have never thought you could reconstruct a tongue from an arm.