He came in to the examining room where we were waiting, said his hellos, shook hands, and told us that the tumor was on the base of LD's tongue. How the heck did he know that without examination and looking at the CT or PET scan? The not so friendly and negative Dr.N said it was on his voice box and had they tried to remove the tumor it probably would have taken part of his vocal cords which can't be duplicated and replaced. My husband would have had an electrolarynx, which is a handheld, battery-operated device the patient places on the throat to produce vibration and make speech. I know he wouldn't have wanted that, we joked about it a little and I told him that if he got mad and tried to yell, I'd take the batteries out and we wouldn't be able to hear him at all!
Back to Dr. Z, (amazing man with an amazing resume,) he put a scope through L's nose to look at tumor, VB, and Esophagus. I was excited that I got to watch on the screen while he was doing it!! Sure enough, tumor was at the base of the tongue, VB is clear as well as the Esophagus.
Dr. Zafereo's plan:
1. L will talk with his "team" Radiologist, Dr. Chronowski on Tuesday, 13th.
2. Anesthesia Assessment, which includes an EKG* and Echocardiogram**, & Stress Test***. Blood work and repeat CT Scan of Neck and also of Chest this time is scheduled for Wednesday, 14th.
3. a Laryngoscopy****--biopsy Scheduled for Thursday, 15th.
4. speak with his "team" General Oncologist, Dr. Jassani on Friday, 16th
5. Insertion of a port***** put in on Tuesday, 20th.
6. Start treatment....chemo or radiation, whichever the Head and Neck Surgical Team decided on scheduled for Friday, March 23rd.
In case you didn't know or remember, here is an explanation of some of the terms:
*Electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart. An EKG translates the heart's electrical activity into line tracings on paper. The spikes and dips in the line tracings are called waves.
**Echocardiogram is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain x-ray image and involves no radiation exposure.
An echocardiogram allows doctors to see the heart beating, and to see the heart valves and other structures of the heart.
***Stress Test leads (wires) to an ECG machine attached to your chest, and a blood pressure cuff is placed on your arm. A clothespin-like sensor may be placed on your finger to measure the amount of oxygen in your blood. After a baseline ECG is obtained, you will be asked to begin performing a low level of exercise, either by walking on a treadmill, or pedaling a stationary bicycle. The exercise is "graded" - that is, every three minutes, the level of exercise is increased. At each "stage" of exercise, your pulse, blood pressure and ECG are recorded, along with any symptoms you may be experiencing.
****Laryngoscopy--biopsy: A special flexible scope will be inserted through the mouth and into throat. Through an eyepiece on the scope, the doctor will examine the larynx. The doctor may then collect specimens (biopsy), remove growths, or retrieve a foreign object trapped in the throat. This method is often done in the operating room under general anesthesia.
*****Port (sometimes called portacaths or subcutaneous ports)
is a small medical appliance that is installed beneath the skin with a tube inserted into a vein.....They use this port instead of sticking a vein each time to deliver chemotherapy to cancer patients who must undergo treatment frequently. Blood can also be drawn by using this port.
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