The Black Knight

The challenge of treating head and neck cancer is trying to minimize the impact on the functionality of the organs affected.    Traditional surgical methods, especially for advanced tumors result in major disruptions of normal speech, swallowing and other functions of the organs affected.  While it is possible to compensate with the changes, all survivors have found that their life changed after treatment.  For me the changes grew over time as every treatment resulted in further reductions in my ability to eat and talk.  Specifically my losses were s follows:

• 1997 - lost most of the functionality of my saliva and thyroid glans from radiation treatment.  I s subsequently required synthetic thyroid pills and pilocarpine to increase the output of the remaining salivary glans.   Talking was difficult for a while do to dry mouth, and nearly impossible with out the pilocarpine.   I also found eating anything citrus, mint, or with hot peppers too painful to contemplate.   I switched to children's toothpaste as adult toothpastes were too spicy.
  
  
• 1990 - after a hemiglosectomy, I had to relearn how to talk and swallow from scratch.   The surgery left me with a speech impediment that lessened over time and an inability to eat foods that required the tongue to move the item from one part of the mouth to the other. Also, I sometime found myself choking on food and chunks of hot dog, broccoli, or other items had to be massaged and coughed up as it blocked the esophagus. (Fortunately, I never found my windpipe blocked.)
  
  Over time, the muscle mass improved with use and tongue strength allowed me to lick an ice cream cone which was impossible right after surgery. The issue of choking on food remained. Finally at public dinners, I had to choose between talking with others and eating as eating was done much more slowly and deliberately to ensure that I did not choke.   Also the speech impediment made understanding me in noisy situations more difficult.
  
  

• 2007 -  After my last surgery, my tongue atrophied as it lost blood flow.   I both lost my ability to move food around my mouth and the ability of my tongue muscle to compensate for what may have been a week swallowing function.  The swallowing function is so week that I can no longer swallow my own saliva and instead it either dries up in my mouth or thickens on top of my larynx making talking and breathing sometimes difficult.    I left the hospital with a feeding tube and an even greater speaking impediment.   They have both remained for the past two years. 

The changes to my body made me think of the black night and his continuing williness to fight even as all of his limbs were chopped off.  I know it is rediculous but I have always felt that I have had no choice but to continue the fight as more and more of the functionality of my head and neck organs are eliminated.

So for your and my enjoyment here is an excerpt from Monty Python and the Holy Grail for inspiration.