The Dentist Weighs In

This afternoon Jeanette and I met with Dr. Linda Lee (what? no connection to Ireland?) in the Oral Medicine and Pathology department at Princess Margaret Hospital. We were expecting a simple examination and review of the teeth-cleaning procedures to counteract the radiation side effects. We got that, plus much more.

Dr. Lee gave us a comprehensive week-by-week breakdown of what to expect from the radiation treatment. Here it is, in a nutshell:

Week 1:

• skin in treatment area turns red.

Week 2:

• loss of facial hair in treatment area,
• open sores form in mouth,
• sore throat,
• taste is altered or lost,
• salivary gland is damaged resulting in thickened saliva,
• eating becomes difficult (meet with nutritionist to review caloric intake options).

Week 3:

• mouth and throat pain at its worst (painkillers subscribed to help with sleeping and eating),
• fatigue.

Week 4:

• mouth and throat pain plateaus (eating becomes slightly easier from developed coping strategies),
• fatigue.

Weeks 5 & 6:

• mouth and throat pain still plateaued,
• fatigue.

Weeks following treatment:

• pain and fatigue start to fade,
• taste begins to return.

Permanent side effects:

• some facial hair loss,
• right-side salivary gland damaged.

This last point is significant. In addition to requiring daily (5 minute) fluoride treatments for the rest of my life, the decrease in saliva would make breaking down food more difficult -- this means more chewing and always having a drink when eating chocolate. Also, the gums on my lower right side will lose some of their ability to heal -- I'll need to avoid ever having those teeth extracted or else risk serious infection.

As Dr. Lee pointed out, these side effects are particularly significant in a patient my age, who will potentially have to live with them for decades to come. She also pointed out that radiation treatment cannot be repeated -- it's a one-shot deal. All this to say that radiation is not an option to be entered into lightly.

She was encouraged that surgery hadn't yet been ruled out. Since a treatment decision hasn't yet been made, she kindly decided not to create the $200.00 fluoride treatment moulds today. Once I've decided which route to go, I'll return for the moulds, either for use as fluoride trays or as a guide for re-aligning my bite if they need to cut my jaw druing surgery (Dr. Irish indicated this wouldn't be necessary).

Finally, Dr. Lee recommended that we ask Dr. Irish why I haven't been booked for an MRI. She said it provides the best imaging of the tongue for spotting any further cancer.

Tomorrow afternoon it's back to PMH for my diagnostic CT scan. I'll ask about any package deals with the MRI while I'm there.