Two Stupid Things in two days: a new record?

As I was leaving the doctor's office after my annual how-you-doin' checkup, he said, as a sort of by-the-by, "You've gained six pounds in the last year. You'll need to watch that."

This after a long discussion of what sort of cancer I'd had and how I'd recovered and what my further treatment would be like, if I had to have any. This after he'd asked how the psychosocial aspects of recovery had been, by querying "How's your social life*?" in his Muppety voice.

I turned around in the hallway after the weight warning and looked at him levelly. "I've been busy" I said, and walked out.

Because, really? The last thing on my mind since just about eleven months ago has been Weight Fucking Watchers and not eating too many calories.

The first Stupid Thing had come the day before, so maybe I was a little over-reactive.

A woman I work with very occasionally--maybe twice in three years--asked why I'd cut my hair. Before I could respond with something neutral and funny, another nurse said, grimly, "She had cancer and was afraid she'd lose her hair to radiation." Leaving aside whether or not it's quite sporting to scoop somebody on something like that, things got a bit uncomfortable.

Nice Lady I Barely Know had a lot of questions. I don't mind answering questions about what happened to me; very few people, after all, even think that head-and-neck cancer is A Thing, let alone that you can lose part of your palate to it. I answered as best I could, and then she said this:

"Well, at least you don't have anything to worry about any more!"

Nice Lady I Barely Know put her foot straight fucking into it with that comment. I *know* it was meant to be reassuring and optomistic, and I treated it that way, but really? I have more to worry about now than I know what to do with.

I have, for starters, a very much increased risk of developing another, different sort of oral or oropharyngeal cancer. Call it two to three times the risk of your average person: my mucus membranes have shown that they'll react badly to HPV infection, and that reaction won't go away unless my DNA gets reworked in the manner of a Time Lord's.

I also have, not to put too fine a point on it, a couple of surgical sites that will never heal any more than they've already done. That means that inhaling my food, wearing a big plastic or plastic-and-metal thing, and having to explain shit to people will never go away. I can't emphasize how much that's affected things up to this point: I wear a MedicAlert bracelet, I don't go out to eat as much (because I can never tell when something might decide to exit my schnozz rather than head toward my gut), I have to tell *every* medical person I deal with about the prosthetic. And then I have to explain. Again.

Which brings us to the Social Life aspect of the whole deal. I hadn't realized, until I'd talked to other young and young-ish cancer survivors, how much that can factor in to starting--or ending--a relationship. I've been on a couple of dates with a new guy, and now I wonder, every time he doesn't email or call, if he's flipped out either by my lack of anatomy or by the idea that he might be buying into something that could end Very Badly Indeed. I used to worry about my belly or my cellulite or that huge zit on my chin; now I worry about the fact that I have this thing in my past and this plastic thing in my present and future.

And, finally, I have something that normal people don't: An every-six-months reminder of what pure gutwrenching fear is like.

I have to get scanned in November. I'm dreading that, almost as much as I'm dreading the dentist visit I have in September, a year to the freaking *day* that Amanda the Hygienist found Lt. Lumpy. I'm dreading the chest CT I have to have next year, to make sure that the tumor didn't seed into my lungs. Every six months for the next couple of years I get to go back to the CT center, drink the barium, take the Valium, wobble out of the room after the scan, and go on to the MRI.

These things are just part of the deal, I guess. They don't make me any more special or tragic or brave or stalwart than any other person who had rogue cells cut out of her body. I actually had it easy by comparison to my pals like Lara and Nikki.

But. When my tongue, out of habit, traces the curve where Dr. Crane cut out my palate, or when I have to run for my prosthetic when the phone rings, or when somebody acts relieved because I only took a few days off and wasn't out for some health crisis, I remember.

I used to have a favorite dress. It was a double-layered thing from Gudrun Sjoden, a Scandanavian store, and it had tiny lines of ornate embroidery around the cuffs and hem and neckline. It's the dress I wore when I went to the dentist last year. It's still hanging in my closet. I haven't had the balls to put it on again. Maybe I will this year, when I go see Amanda.

It would be the first step in not worrying so much.

*"Social Life" meaning "sex life" to my doctor. Which, to give him props, was the first time I'd been asked about it by any medical perp involved in my care. But still: DO NOT WANT to discuss that with Dr. Muppet.

*pant* *pant* *pant*

I'm twisting my spine at a worrisome angle, checking behind me to make sure I still have a butt. I had thought I had run it off this weekend, but no, it's still there.

Something happened last week that I forgot about until yesterday, one of those once-in-a-lifetime moments that nurses hear about happening to other people but don't believe will ever happen to them:

I had a sensible, intelligent, well-informed patient leave AMA and I totally agreed with his decision.

This particular patient had some pretty complex, chronic problems that had been exacerbated by a combination of dehydration and missed medications, and he ended up in the emergency room at Holy Kamole with weird symptoms. The fine folks at HK sent him to us for definitive diagnosis and treatment. Turns out he had missed some meds and gotten dehydrated.

So we ran a few liters into him and titrated his meds back up to therapeutic levels and were getting ready to get him on out when one of the new attendings on service decided we needed to do a much more thorough workup for stroke, something that did not actually happen to this patient. That would've required he spend several more days in the hospital, according to the doc, even though everything could be done as an outpatient.

So he asked about checking out AMA. The attending covering for Doctor Overreactive is a rational sort, but was worried about officially discharging somebody else's patient. So we did everything we'd normally do for a discharge except fill out the official paperwork, and off he went with a smile.

I'm still not entirely sure that this doesn't signal the End Times. Usually, if a patient checks out of our facility against medical advice, it's because they're either angry about the treatment they've gotten or are peevish because they're out of drugs. People who leave in the middle of treatment for whatever landed 'em in the hospital are not in the best of headspaces. This guy? Totally fine.

In other news, the appointment with Dr. Crane went fine. I got poked and squoze and told to make appointments for scans in November. Nothing's swollen in my neck, thank God, but he still wants a CT and an MRI to make sure I'm good on a radiological level. He dithered for a couple of minutes about whether to do both a with-and-without contrast CT *and* an MRI this time, saying he didn't want to "scan me to death," until I said "Dooood. I had CANSUH. Scan me all you want, okay? Just make sure it hasn't come back." So: scans in November, chest and abdominal CTs sometime next year, and then on to regular follow-up in perpetuity.

Next time I'll tell you about the Stupid Thing somebody said to me regarding having had my mouth hacked on. For now, I'm due another cup of coffee.

Bizzy Backson.

(Does anybody else remember that bit from "The Tao of Pooh"? I can't believe parts of that book are still taking up space in my memory.)

Today I have an appointment with Dr. Crane. I'm not sure what, exactly, is going to happen, except that I'll get my sinuses scoped (ohboy) and probably get an appointment set for yet another MRI and PET scan later on in the fall. No matter how big a pain in the ass being a CANSUH patient is, the follow-up is a bigger pain in the neck.

Speaking of pains in the neck, Dr. Elf started the molding process for The Final Bug yesterday. Here's what happens when you're having a Bug molded to the Giant Hole in your head:

First, the doctor will inspect your teeth and decide that, like a large farm animal, you need to have bits ground off of some of them. This will make it easier to hitch the wires on the prosthetic to your teeth later. If you're like me, with a relatively good set of teeth, the doc will have to grind quite a bit (WHEEEEEEZZZZ goes the dremel tool) to make the wire grooves. It doesn't hurt, but it is annoying, and leaves you feeling like you have bits of things stuck in your teeth. It also takes a surprisingly long time to do, as he's going micrometer by micrometer.

After that, as you're still in the comfy dentist's chair, you relax--until you hear the doctor say "We're going to need rope. Lots of rope." You wonder what "rope" is, and why they'd need a lot of it, and are relieved to find out that it's wax rope, meant to take impressions of your teeth for the obturator mold.

The rope goes into a metal widget that's shaped like a horseshoe, but hollow. That gets shoved into your trap and held there for a few seconds, so that your teeth can make a good impression.

Then comes the alginate molding. This is the truly annoying part of the process. Alginate is this pink stuff that's made, I think, of seaweed. It's sticky as hell, has to be very, very cold when it goes in (in order to hold a clean impression), gets *everywhere*, and tastes foul. Seriously: I had it in my ears before they were done.

The doctor cranks the chair back until you're lying feet up, head down at about a 25-degree angle, then instructs you to tip your head back as far as possible. Then he goops alginate all over the front and back sides of your teeth (mmph) and shoves another horseshoe thing into your mouth, full of a shockingly huge amount of alginate. This is meant to take an impression of The Defect.

The effect is like being gagged with Play-Doh. Luckily, the surgery left me without much of a gag reflex, so I was able to lie there without panicking and meditate on the wonders of medical technology. Once Dr. Elf waggledwiggledyanked the the mold out of my mouth, I was much happier.

Dr. Elf showed me on a plaster mold what he wants to do with the final, definitive obturator. In order to cut down on the bulk, he wants to make the front of the thing metal, and smallify it by about two thirds. He'll do that by leaving the area immediately behind my front teeth free of obturator: I'll have a sort of hourglass-on-its-side bit of metal that hooks to my back teeth with the speech bulb attached.

This is good for three reasons: First and most importantly, the whole contraption will be lighter. It won't fall down on the back of my tongue and make me sound like a retainer-wearing kid with a bad cold. Secondly, it'll take up less space and thus theoretically be more comfortable to wear for long periods of time. And third--and more important to him than to me--it'll be hooked to teeth further back, so nobody will be able to see the wires unless they're really looking. I don't mind the wires, but he wants a good aesthetic result as well as a good functional one. *shrug* Whatever, dude. You're the perfectionist.

Dr. Elf also sprang what could be a fun thing or a wearing thing on me: He's giving a talk to some otolaryngologists later this fall and wants me to come be a show-and-tell for people without palates. I told him I'd be happy to sit up straight, mind my manners, and let doctors shine lights into my mouth. He said he'd let me know when and where this thing is happening.

So! Three weeks until the TerminatorMouth comes back from the molding company, then more fittings and filings and grindings of plastic. I was a little disappointed that I won't get a glittery My Little Pony Palate, but TerminatorMouth is a good second choice.

Had a bad day? Have some sleeping leopard cubs.

First they play a two-step, then a Cajun waltz. If you don't dance, then it's your fault.

La Belle Dame Sans Merci, Der Alter Jo, and Heidi The Goat-Girl and I (along with respective spouses) went down to the river this weekend. We stayed in an elderly farmhouse with wavy floors and an entire batallion of mice, ate tons of smoked sausages and bratwurst and potato salad, and floated the Comal for a record five hours. The Comal wasn't much lower than I'd ever seen it (and I've seen it once about four feet higher, which is a story in itself); we just hung out in the shade under a bridge for about an hour.

It was a good weekend. There was plenty of food, plenty of beer and tea and coffee and bottled water, plenty of cold spring-fed river to tube down, and I only lost a couple of things in the chutes.

For the uninitiated, the "chutes" are places where the city fathers and various engineers have decided that the river is too dangerous (second chute) or the bridges too low (first chute) to be safely navigated by crowds of semi-drunk people in big rubber innertubes. Years ago, you had to haul out of the river and walk around one particular bridge, but the more moronic segments of the population didn't, and got stuck under the bridge and drowned horribly. Hence, the chutes were put in--one at the low bridge, and one just above a small waterfall that's much more treacherous than it looks. I nearly drowned going over Stinky Falls once.

Anyway, here's how it works: you're sitting in an innertube, thoughtfully provided with a drink holder and handles, and probably tied on to other innertubes containing either people or coolers or both. Right before you get to the chute, you untie from everything except your cooler tube and manuver yourself into position so that you're (ideally) going down the chute feet-first.

As you enter the chute, you're going slowly. Then things begin to go very wrong indeed, as you spin around, lose sight of your companions, and eventually get spat out of the chute going remarkably quickly, into a surprisingly strong whirlpool-like current. That was where Der Alter Jo rescued the tiny baby snapping turtle, who was as dizzy and confused as she was.

The second chute is a bitch. It doesn't help that the signs above the river warn you that a "Tube Shoot" is coming up--it makes it sound like rednecks with guns will be taking potshots at your sunburnt self. It was at Stinky Falls that I managed to get the cooler tube (with water, not beer, in it) and my own tube safely over the edge and down into a companion's hands, then fell over the edge of the falls and lost my hat and the bottle of sunscreen.

The River Gods got a full set of clothing from us that day: La Belle Dame's shoes went first, followed by two T-shirts and a cute little cover-up, and then my hat. Nobody lost their sunglasses, their mind, or consciousness. We all got vaguely, patchily sunburned in weird places. We all stayed well-hydrated.

And then we finished Saturday night at the best damn dive bar I've ever been to. A band called The Chubby Knuckle Choir played, we ate cheeseburgers and drank Maker's Mark, and wrote our names on the wall behind the table. It's the only dive bar I've ever been to with a haunted flush outhouse.

Back to work this week, with a follow-up with Dr. Crane and His Band of Merry Sinus-Scopers and a remolding appointment with Dr. Elf. I wish I could move the river to my front yard.