A Long, Hard Fight

When my “people-mover” van has a problem, I take it to the Chrysler dealership two hours away in Grand Junction, Co.  There’s a number of reasons for using this dealership rather than the one closer to home.  One –  we bought the Town & Country from them, two – they give incredible service as opposed to what we’ve experienced otherwise, three – it’s a chance to get to the “big city” and go to a mall.  But the biggest reason is that one of my brothers lives there. 

So on Monday, after observing that the van’s steering was sloppy, it hit bumps like a broken-down ’52 pick-up, etc. – and noticing the problems had accelerated during the previous weeks, Mom and I headed to Grand Junction.  The dealership had looked at the car a month previously and suspected something “big” was in the offing.  So they right away arranged for us to have a rental, and we met my brother for lunch and made plans to spend the night with him and his wife.  This brother (one of five of my brothers) is an identical twin, two years younger than I.

About six years ago, in the spring, I was visiting Jeff and his wife.  Jeff hadn’t been feeling too well, and his symptoms reminded me of when I’d had mononucleosis during my last pregnancy.  I urged him to go to the doctor, which he already had and been somewhat “brushed off”.  He had a smallish lump on his neck which the doctor thought was a swollen lymph node, fighting off the virus or whatever was getting him “down”.  As it unfolded, Jeff had squamous cell cancer of the neck and throat.  This type of cancer isn’t self-contained as in a tumor, but spreads quickly.  Jeff had a radical neck dissection, which involved removal of the right jugular vein.  At this time it was news to me that there are two jugular veins in the neck, a left jugular and right jugular vein.  After the surgery, Jeff  had radiation for five weeks.  He had 45 treatments in 30 days at a dose of 1,1000 units each, one of the highest administered.  Prior to the surgery and radiation he had a feeding tube put into his stomach.  His weight loss was minimal throughout the process, certainly at least partially due to the feeding tube.

When Jeff and his wife were informed of the cancer and the need to act quickly, side effects of the treatment regimen he would be undergoing were naturally explained.  But in the shock and panic of suddenly learning he had a potentially fatal condition, it didn’t all sink in.  And whereas he recalls being told to take care of his teeth, he remembers it almost as a side point.  Potential serious problems from having later dental issues weren’t highlighted.

Jeff has always been health conscious and takes very good care of himself.  He stays physically fit and at 53 was in excellent physical shape when he learned of the cancer.  Some past problems would always be a factor in his overall health.  He was in the Peace Corps in Africa when he was in his early twenties.  He contracted malaria while there, and for a couple years afterwards, had several  relapses.  When he was 27 he fell from a three story balcony while doing repairs on it.  The fall broke several ribs, puncturing his lung, which then collapsed.   He also broke  his arm.  After about a ten day hospital stay, he was getting ready to come home to our house.  Before he left the hospital his spleen ruptured and he was rushed to a neighboring town, as the surgeon in the hospital where he was wasn’t available.  After another couple weeks in the hospital Jeff came home with my husband and I.  That very night he collapsed and we rushed him back to the hospital.  This time there was a clot in his lung.  Hard to imagine one guy could have so many sequential serious health issues is such a short time.

Between the ordeal just described and his fight with cancer, Jeff had a respite from health problems.  And as the years accumulated after the cancer and he remained cancer-free, hope soared.  But five years after discovery of the cancer, Jeff learned he had numerous teeth on both sides of his bottom jaw that had to be removed.  Normally a family with poor dental health would handle such news pretty well.  But we discovered that radiation kills unhealthy as well as healthy tissue.  Jeff’s poor dental health was exacerbated by the fact, due to the radiation, he didn’t produce saliva, a major factor promoting healthy teeth.

 The jaw bone is dense, like oak, and when a tooth is pulled, leaving it exposed, if the gum tissue doesn’t grow over it to protect it, it’s susceptible to infection and disease.  This then leads to amputation of the jaw.  The situation was not merely a possibility, but a probability. 

So the search for alternatives and answers began.  It ended with hyperbaric oxygen therapy.  Jeff went to St. Luke’s in Denver, Co. that used this type of technique.  It involved, for Jeff, entering a chamber with several others getting the treatment.  Within the chamber, pressure slowly increased to the same as would be experienced 40′ under water.  Each patient wore an oxygen mask and breathed as pure oxygen as the body can tolerate.  The infusion of such pure oxygen into the body would induce, hopefully, the production of new capillaries in Jeff’s mouth so his teeth could be pulled, new tissue would cover the holes and he would avoid the probability of bone disease destroying his jaw. 

 St. Luke’s had two chambers, one holding four patients and one with a capacity of eight to ten.  Some chambers are designed for one individual.  Every 10 minutes the oxygen would be turned off for one minute.

Hyperbaric oxygen therapy is used for athletes trying to increase their skills, people who have suffered carbon monoxide poisoning, diabetes and amputees as well as others with conditions that benefit from increased blood flow which capillary production induces. 

Typically each individual treatment costs about $350.  If Jeff’s situation had been considered “dental” as opposed to “medical”, his sessions wouldn’t have been covered by his insurance.  But fortunately, for him, his expenses were limited to travel to Denver, lodging, meals, etc.  He initially had twenty treatments, six days a week until the full twenty was achieved.  He then went home, had the six teeth pulled and afterwards went back to Denver for ten more treatments.  Now, one and a half years later, five holes are fairly well covered.  The sixth only has a thin layer of gum covering it, so Jeff uses extra care in cleaning food particles out of it.  During this time, he used Biotine gel in his mouth to compensate somewhat for his lack of saliva.  He also had to drink lots and lots of water, especially while eating.  In addition he used a humidifier at night and still does.  Now saliva production is beginning to return as is Jeff’s sense of taste, which was gone for several years after the radiation. 

The saga should end here, but regrettably hasn’t. The radiation created scar tissue around his esophagus as well as stiffening the muscles and the esophagus itself.  This situation was discovered as a result of numerous unexplained pneumonia episodes.  The flap at the back of the throat at the top of the esophagus was destroyed by the radiation as well.  These situations combined to cause the food Jeff ate to enter the lungs as well as the stomach.  When food entered the lungs, it caused pneumonia.  In all these experiences involving the side effects of radiation, we learned those effects continue for two years.  So when one is considering the damage the radiation does to healthy parts of the body, the fact that those consequences continue to accumulate for two years are sobering.

Meanwhile the problem of Jeff’s repeated bouts with pneumonia had to be addressed immediately.  Keeping in mind he’s spleenless, has malaria lurking in his body somewhere, and he was approaching a winter with a flu that is notoriousfor attacking the lungs, worry among us all was pervasive.  He began a physical therapy program to strengthen his esophagus and teach him to swallow in such a way that would send the food to the proper place – his stomach.  He began twelve sessions of electric shock and physical therapy.  Four patches were attached to his neck and he was “zapped” with electricity when he swallowed.  The idea was to stimulate the muscles around the esophagus, and give the esophagus greater elasticity.

Never one to miss an opportunity for a laugh, Jeff arrived one day in the therapist’s office with two electric dog-training collars tightly fastened around his neck.

The physical part of the therapy consisted of swallowing techniques designed to strengthen his esophagus.  One exercise involved putting his tongue between his teeth and swallowing repeatedly.  This is called the masako technique.  He’d be given some type of food, at first soft things like applesauce and gradually working up to denser food like pieces of meat.  He’d try to swallow hard and strongly.  Another exercise was called a “double swallow” and finally neck lifts twenty to thirty times throughout the day.

At this point, Jeff hasn’t had pneumonia since August and is feeling pretty confident about the success of all the therapies and treatments he’s had.   It’s probably pretty obvious that my brother is one optimistic person who is positive in his outlook, loves life and is a fighter.  No wonder I continue to take my Chrysler to the dealership in Grand Junction!

This entry was posted on Thursday, December 10th, 2009 at 8:06 pm and is filed under Ones Mom Sometimes Remembers. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

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    Hi there,
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