I had my first appointment with the head and neck surgeon today, Dr. Netterville. A resident, Dr. Sarah (last name escapes me) and a nurse practitioner, Patti McCarver also worked with me. They were all compassionate, articulate, and thorough. I feel so blessed to have such a stellar crew of caregivers.
Unfortunately, I can't offer a complete picture of what lies ahead. Much is yet to be decided. Here are the highlights, though. Dr. Netterville's first impression is that surgery is the best option in my case (I won't go into the reasons for this now, but bottom line is that he thinks it would improve my long-term survival rate). He made the comment that if he were going to have cancer anywhere on his tongue, he would pick the spot where mine is located. I am fortunate that the cancer doesn't involve the back or tip of my tongue, in which case a resection would cause more problems with swallowing and speech. He does anticipate having to take a fairly large section, but does not anticipate causing a severe speech impediment. When asked how it would affect my singing, he simply said he didn't know. If surgery is chosen, I will also have a sentinel lymph node dissection, in which the node/s where the cancer is most likely to travel to first would be removed. If the node/s are positive for cancer, I will have to have radiation. If there is no nodal spread, I will not have to have radiation.
However, Dr. Netterville was quick to point out that he will be presenting my case to the tumor board (a group of oncologists, surgeons, etc.) on Monday, and they will collectively decide what is the most appropriate treatment plan to ensure eradication of the cancer. He stated that if they believe chemotherapy and radiation are the best options, he would defer to their decision. If chemotherapy and radiation are chosen, there will be no surgery involved. I will have a CT scan of my head and neck tomorrow at 1pm to help them determine the best plan for me.
Since I found out that some oral cancers are treated without surgery, I have been hoping my case would qualify for that option. I know it seems strange to want chemotherapy and radiation, but surgery has seemed to be the more overwhelming route to me. Since a fairly large portion of tongue would be resected, I would have to have reconstruction using a skin flap from my forearm. When I think about the recovery time involved, I am very apprehensive. Dr. Netterville seems to think that surgical recovery is less difficult than the effects of chemo and radiation, though.
More daunting than the recovery process is the possibility that my singing might not ever be the same. Of course, to the doctors and probably most of you, it seems trivial to consider singing a higher priority than living. And, I don't really, but I must admit there have been moments where I've wondered if I would want to live if I couldn't sing. That must sound so dramatic and just downright stupid to some of you. But, I've thought it more than once.
Also concerning is my speech. Although Netterville assures me that I would still be able to practice, I wonder what the true impact would be. Many of my patients have a hard time hearing anyway. Hearing loss in patient + speech impediment in provider = very long work days. :)
It's funny how we refer to God as the Great Physician all the time, but the meaning can't seem to permeate our dullness. Terrah and Doug went with me today. After the appointment, Terrah and I were discussing my concerns about surgery when she reminded me that Netterville said he prays for wisdom with each patient. She said she realized that if he is praying for wisdom, God is my doctor. And, if He is my doctor and I require surgery, He will restore my speech, singing and work abilities to the state He desires. That may not look like it looks now, but His plans will not be thwarted (Job 42:2), and they are always good plans. Back to Great Physician ... I use that phrase all the time, but it didn't really come to life for me until Terrah said, "God is your doctor." That struck me with such fresh meaning. God is my doctor! God is my doctor! God is my doctor!
Thank you all so much for praying and please keep doing so. Next week will be really busy as I will likely meet with a couple of oncologists after the tumor board has discussed my case. Then, I imagine decisions will need to be made quickly. Pray for wisdom, pray for my voice, pray for my pain with eating, but most of all ... pray that in the midst of this I will live my life in a manner worthy of the Gospel of Christ and that He will be glorified as He deserves.
"Praise and glory and wisdom and thanks and honor and power and strength be to our God for ever and ever. Amen!" -Revelation 7:12