Thursday, May 24, 2012

For a Breath of Fresh Air, Go to Manhattan

The developments are coming so fast and furious, I'll put off finishing the second part of the last post. The part of the last post that I edited out can wait, since it does not further the plot. Meanwhile, the plot (or the snot) thickens.

Last Friday morning, I had an intake interview at the hyperbaric facility. It was extremely odd, since the intake appointment was with a doc who moonlights for my practice group, using my exam rooms and my literal office. A few hours later, Dr. Duchess of ENT, colleague to Hygeiea, Greco-Roman Goddess of Otolaryngology (my apologies to the Duchess that good goddess pseudonyms are hard to think of sometimes) installed tubes in my eardrums so my head doesn't explode when they're changing the pressure in the HBO chamber. That seems wise.

Things got really confusing on Wednesday. We took the long train trip to F'in' Famous Cancer Hospital to see Dr. The Fixer, plastic surgeon and man of mystery. Then, we took a walk uptown to Lummock Hospital, the new stomping grounds of Dr. The Coach. These men, along with Doctor Mister Rogers, performed the giant operation that saved my life and my right eye in 2005, plus a couple of other procedures. In March, when I had my clival cleaning, Dr. The Coach had been away on a 2-and-a-half month sabbatical/lecture tour before he settled into his position at Lummock.

Here is another odd medical fact I would like to impart from my adventures. Once you have had a lot of surgical procedures in an area as complicated as the sinuses and throat, your face is not just that of an okapi. As the various surgeons are telling me, it's like a game of pick-up sticks. A quick scrape-out back through the nose to the clivus as was just done to me is one thing, but it is another to squeeze a tissue patch back there that is big enough to cover my clivus and has blood vessels long enough to plug into good circulation. It would take a large incision through tissues that have been cut and irradiated and scarred many times.

Both Dr. The Coach and Dr. The Fixer have independently concluded that, with what the inside of my face has been through, a graft is a risky proposition, and everything else should be tried first unless I am on death's door from an infection. I am not sick enough to need such a drastic move. Dr. Mister Rogers and Dr. The Fixer as a team have done four or five similar procedures that ultimately went well, but they were nothing to be undertaken lightly. (Incidentally, they do like the HBO and nebulized antibiotics. They are inconvenient, but noninvasive interventions.)

Meanwhile, to further muddy the waters, the Medical Mafia were speaking to Dr. Proton, a grand old man of radiation. He thinks that the clivus must be covered some day, but not to rush it. I just hope I can wait long enough for someone to invent spray-on, vascularized mucus membrane.

He also told them that someone who has received as much radiation to one spot as I have in both childhood and adulthood is virtually unique. Oh. Good. It's nice to feel special.

As I was writing this, Dr. Treabeard, the Famous ENT Surgeon just sent an e-mail. As soon as I can be squeezed into his busy schedule, he wants to sit down with me and Kathleen and discuss surgery. He notes that he will probably have to go in though the old incisions. Oh. Lovely.

Are you confused yet? It means you're paying attention. I have top flight physicians in top flight institutions disagreeing throroughly with each other. Why? I wrote several paragraphs of speculation, but that's a waste of everyone's time, so I just deleted it.

This is my plan for now: This is life and death. I will give a respectful and attentive hearing to Dr. Treebeard. I will probably check with a couple of other leading lights at the nearby medical Meccas. I will talk to Dr. Hygeiea, who is a friend, a first class doc, and geographically the closest of them. Then, I will ask the 2005 team, now at F'in' Famous and Lummock to tell me what they think of what I have been told. I may ask them to speak with Dr. Treebeard directly. I have entrusted my life to these surgeons many times, and they have proven their worth personally to me as well as in multiple clinical trials. K and I will, at the end of the day, probably defer to whatever they recommend. B, being 8, has no choice in the matter. For now, it looks like no surgery, and what a relief that is!

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