Why am I having surgery, you ask? Welp, I found out in August that I have a patch of oral squamous cell cancer on my lower left gum. Let me say first that it is eminently treatable, I have a top rate team taking care of me, I have an excellent prognosis of recovery, and nobody should be freaking about about this. I’ve got it handled.

The Background:

In 2001 my dentist put a crown on a molar in my lower left jaw (Molar 19 if you grok dentistspeak) that had been root canal-ed in Sweden. Shortly after the crown was installed a small patch of inflammation appeared on the gum directly under the crown. The dentist checked it, didn’t see anything concerning, told me to use salt water rinses, and said that he would monitor it.

The inflammation continued over the next twenty years, never really hurting or anything, just there. In July 2021 I had the bicuspid next to the molar crowned. The inflammation began to get a bit puffy. I was supposed to have it biopsied but the periodontist I was sent to … let’s just say that he didn’t inspire confidence. Fast forward to this spring’s dental cleaning when my dentist said, “This is growing. You really need to get this biopsied—I’m making an appointment for you with an oral surgeon.” The OS turned out to be the same one who took out Lyndon’s wisdom teeth so I knew he was good.

I went there, he looked at the inflammation and opined that I was having some kind of reaction to the dental cement in the crowns, but that we’d take samples and send them off to pathology anyway just to confirm. He numbed me up, snipped out five bits of gum, and sent me on my way.

A week later, he called. To his shock, it was oral squamous cell cancer, the most common form of oral cancer. Since I don’t smoke at all or use any tobacco products he really didn’t expect this diagnosis. But it needed to come out tout de suite so my August and September suddenly became filled with medical visits.

The Medical Visits:

The Oncology Surgeon: Doctor E (nice guy, very competent) x-rayed my jaw, palpated my neck (nobody, by the way, has been able to feel any swollen lymph nodes, nothing has ever shown up on my blood tests, and all the x-rays of my teeth including the ones taken at my dentist show no sign of cancer in the bone), scoped my nose and throat, and laid out a surgical plan. He would surgically remove the two molars and two bicuspids on my lower left jaw, remove the cancerous gum tissue and a strip of jawbone to make sure nothing had gotten in there, do some reconstruction on my jawbone, then wrap everything up by taking out the lymph nodes under that side of the jaw. Everything would be sent off to pathology, at which point it would be decided whether or not I needed radiation, chemo, both, or neither. In about six months or so I could be fitted with a partial denture or implants, depending on how well the jawbone healed.

Pre-surgery physical: That was done at my GP’s office and was a standard physical with an additional EKG and chest x-ray. Everything came back okay (I have a little bit of opacity at the bottom of my lungs, but so do 90% of people in the United States who had COVID so…) and I was cleared for surgery.

The Radiation Oncologist: Dr. D (very nice guy, also extremely competent, with a great scheduler and nurse) took my history, palpated my neck, and felt around in my mouth. He told me I would most likely need radiation and what I could expect from it. Treatment would take six weeks; every week day I would drive to their office where I’d lie on a table and a mask that had been fitted to my face would hold me in place while I got hit with radiation. I could expect loss of taste, a drop in saliva production, and increased soreness and pain in my jaw and throat as the treatments proceeded. It would become painful to swallow during the second half of the treatments and I’d probably go on liquids, at which point I would need to make sure that I was taking in 2000 calories a day as the pain and lack of taste would affect my interest in eating. That being said, they have good painkillers that are very effective for this sort of thing, and I have a Ninja blender that could turn a brick into soup.

Long term effects would be a permanent drop in my saliva production (he said I’d probably need to have a water bottle next to my bed, which I already do), but it wouldn’t affect my ability to swallow or speak, and my sense of taste would eventually come back. I can live with that.

The Chemotherapy Oncologist: Dr. T (also a very nice guy—really, everyone I met at the cancer center was a doll) had spent a rotation at the University of Chicago Medical Center so we commiserated on Chicago winters. He didn’t think that I would need chemo, but it would depend on the PET scan and the path results of the excised tissue. We talked a little bit about the effects of chemo and what I could expect from that. He also asked me when I was supposed to get the PET scan. When I said it was two weeks out he said, “That’s unacceptable,” made some calls, and got it for me the next morning.

The PET-CT scan: I showed up after not eating anything since midnight, got a shot of radioactive glucose, waited for an hour for it to make the rounds of my body, then spent a half hour with my arms over my head while the scanner did its thing. A PET scan finds areas of high metabolic activity, which can include cancer, incisions, infections, and recent bone breaks. Unsurprisingly, it picked up on some low-level activity in my jaw, more apparent on the side with the cancer and much spottier on the other side. The doctor who wrote the report said that the other side might be due to an infection; since I had an URI/sinus infection complete with sore throat, coughing, etc. at the time, that could explain it. Oh, and apparently I have a large mass on my right ovary, but it didn’t react to the tracer so it’s either a cyst or a fibroid. Quelle surprise, said the woman with PCOS. I’ll get that dealt with once the jaw is done.

The Surgery:

The surgery was scheduled to happen on last Monday but there was a scheduling miscommunication between my surgeon’s office and the hospital so the event has been moved to 7:30 AM on Monday, October 9. Once I’m out of surgery I’ll spend between 2-5 days in the hospital (I’m hoping for two but it’ll be whatever they recommend), then go home to recuperate and heal for 2-3 weeks before they start the radiation and/or chemo.

Pretty much every medical professional I have spoken to has gone out of their way to reassure me that they can handle this and I have an excellent prognosis. I choose to believe them, so I’ve been doing my best not to panic. I probably won’t be bringing my laptop to the hospital but I’ll load my login details into my phone and hopefully I can update you tomorrow. Think good thoughts for me, please, and if you would like to support me in a more material way you can always join my Patreon. The most basic tier gets a free short story from me every month for $3, plus updates on my work and sneak peeks at the current WIP. Higher tiers will get bonus material, a free ebook, print book, or hardcover book, and all proceeds will go towards paying off my medical bills. And if you can’t swing that, totally cool—I will be happy with prayers, healing vibes, and any good thoughts you can shoot my way.

I had an interesting experience last night. I finished my word count for the day, I’d vacuumed the living room and put a load of laundry through the machines, and I didn’t have anything else needing my evening time for once.

So I got dinner and spent the rest of the evening watching movies (2001 and 2010, to be specific). And … it was really, REALLY hard for me to relax. I was comfortable, I had two cats sitting with me and a glass of pop at my side, and yet something in the back of my mind kept asking me why I was just sitting there? Shouldn’t I be knitting, or crocheting, or doing SOMETHING?

I think I have lost the ability to relax and do nothing. Assuming I ever had it in the first place, of course. But I am so used to multitasking even when I’m relaxing that the idea of just sitting there, watching a movie, and doing nothing else felt alien and weird and wrong.

I already know this isn’t good for me. I do need downtime where I can relax, recharge, and gather enthusiasm for the next day. But apparently I’m going to have to have a long talk with my subconscious before that can happen.

Had an extremely long appointment early this morning which meant that I got next to no sleep because my OCD brain kept waking me up to make sure I didn’t oversleep, staggered home afterwards and tried to take a nap but knew that Lyndon needed me to drive him to pick up his truck from the mechanic’s (turned out to be a broken wire attached to an important switch) so I couldn’t settle, Lyndon finally came in and asked me to take him to pick up his truck, at which point he discovered that his GPS wouldn’t give him instructions on how to get to the South Side Ballroom so that he could see BABYMETAL (Japanese heavy metal band fronted by three female performers) tonight.

So we both headed home to see if we could print out a map (which was not helpful) or rig up a mount for his phone (didn’t really work), and I finally said I would drive him because I’m much more familiar with Downtown Dallas, he’s been looking forward to this concert for months, and I didn’t want him to get lost and frustrated, give up, and come home.

And yes, I know the Ballroom is right off the intersection of I-35E and I-30 so why did we go through downtown? Because this was at the height of rush hour and the North Dallas Toll Road was bad enough. I did not want to be screaming out the window at perfect strangers as I tried to merge onto I-30 whilst figuring out how the hell to get onto Lamar.

All of this is to say that I have had one hell of a day, I am exhausted, still need to go back downtown to pick up Lyndon, and afterwards I am going to get well and truly smashed because man, I deserve it.

I have had better Augusts.

On 8/7 our downstairs AC unit went out hours after I got some rather unpleasant news (which I will not discuss at the moment—I’ll explain once I have more details) which pretty much kept us running around like headless chickens for the last three weeks. Repairing the AC unit is just not in the budget right now so we have two window units keeping downstairs tolerable (I am very, very grateful that temps have dropped back into double digits here in the clavicle of Texas), and I have had three meetings regarding The Unpleasant News and have three more to come.

If that wasn’t enough, last night Lyndon’s truck decided to crap out. We tried jump-starting it and putting in a new battery (which it needed anyway—the old one was leaking goo), neither of which worked. Lyndon can hotwire it so it’s not the starter motor. At this point we’re not sure what’s going on so he’s trying to research garages in the area in between calls, and once he makes his choice we’ll get it towed over there and let the Pros from Dover take a crack at it.

On the plus side this is the first time we’ve ever had serious trouble with the truck, and it’s 17 years old so that’s pretty damn good. On the minus side, we really didn’t need another expense right now. Last night he said, “We’re good people, right? We haven’t pissed anyone off, have we? So why is all of this happening to us at once?” I said I didn’t know why, but apparently five planets are retrograde right now so maybe that’s futzing with the ether.

So, yeah, things are a little hectic here in Casa Fletcher at the moment. If I owe you a project, you will get it. It will just take a little longer than I expected.

I’m not going to keep bitching about the heat because nobody needs to hear that and places like Phoenix have it worse, anyway.

I just wish I felt better. I have a metric buttload of things to do but yesterday I was so damn drained I begged off from making dinner, and today I’m waiting for some serrapeptase and decongestant to kick in so that my head stops feeling like a concrete balloon. On the plus side we have everything in-house that I need for dinner so I won’t have to run to the store for anything, which is nice, and once I swallow enough caffeine I’ll see about knocking out today’s word count. I actually wrote 3K yesterday, the first time I’ve hit my daily word count since May 14 of this year.