Ultrasound

Another weekend has come and gone, and things are very much still the same. It’s funny, we hold the end of treatment as such an aspirational milestone, and it certainly is, but I am quickly learning that it does not equate to the finish line. I recently read a blog post that said the “last day of treatment is the first day of the next chapter - survivorship.” It is easy to feel discouraged now that treatment is over and I don’t feel any better, but the key seems to be to continue to take things one day at a time, little step by little step.

All that said, I am pleased to report two small improvements, namely, my nose no longer bleeds and my gums are no longer agony when I brush my teeth. Small wins! Sadly there is no change yet in the agonising burning pain at the back of my mouth, so eating continues to be a challenge. 

Fatigue is still very much dominates my life. I am still not managing to do a great deal beyond walking the dog, laundry and taking care of myself (meds, rinses, gels, etc.). Friday morning I got to road test the new waterproof trousers Rich had bought for me. I can confirm they are indeed waterproof! It absolutely poured down on my walk, but I was bone dry in a waterproof coat (borrowed from my daughter for DofE), waterproof trousers and wellies. I was, however, absolutely baking, so lesson learned is to wear lighter clothing underneath.

It was back to Oxford on Friday for my check up with my oncologist. I have not missed that drive! Thankfully this time it was Rich driving so I could sit in the front seat like a big girl. I am also still on my anti-sickness meds for the opiates, so these came in handy for the journey. I also haven’t missed the hospital. I saw two of my radiographers at reception, who thanked me again for the chocolates and told us a story about one of them removing the seal from around the tub, taking out all of the Snickers bars, and then putting the seal back on, so the others thought they had a dud box with no Snickers! I probably could have just bought him a few Snickers bars if I had just told me! In a strange way, it was nice to see them again, probably only because I was safe in the knowledge that I didn’t have to go back into the radiotherapy room and put the dreaded mask on again. They were very patient and kind to me and for that I am very grateful.

The appointment with my oncologist went well. She was pleased with my progress, in the sense that I didn’t get any worse after treatment ended, when the majority of patients do, and she assured me that in another few weeks I should gradually start to feel better. I was signed off from the Speech & Language team as they are pleased that I have managed to keep eating, my jaw opening is good (it clearly pays to do the daily exercises! Although I will admit I forgot some days, and others it was too painful, but I mostly tried), my saliva looks okay (a bit lacking, but nothing catastrophic) and my swallowing function is fine. This was all very pleasing, both to the doctor and to me. I also asked a critical question – when can I have spa treatments again. She estimated December, which is something to look forward to. She also said my taste should return fully in the next 8 weeks or so. Hopefully in time for a full Christmas roast!

She examined my neck and felt the palpable node I had mentioned. She said she wasn’t concerned about it, but she would refer me for an ultrasound, more to put my mind at rest than hers. I was extremely lucky to get an appointment same day, but it meant we had to wait an hour. We decided to leave the hospital to get some lunch, so headed to the nearby M&S Food Hall. Such a treat! It is so hard to browse the aisles and look at all the tempting food, knowing I can’t eat most of it. I did manage to stock up on a few ready meals that I think I can manage to eat at least some of, as well as some delectable custard-filled choux buns and cheesecake. It is going to be a challenge to wean myself off these delicious puddings when I’m back to eating normally again.

It was then back to the hospital for the ultrasound. The sonographer was a head and neck specialist and was really helpful in explaining the reason the node might be swollen. Apparently, we have 600 lymph nodes in our body, 300 of which are in our necks, because this is the main point of entry for infections (mouth, nose, etc.). I had 19 removed during my neck dissection, so the one that I can feel is likely doing the job of the missing 19 in terms of fighting infection, which is why is it a little swollen. Like my oncologist, he also said it was probably nothing to worry about, it’s very small (3mm) and he couldn’t see anything untoward on the scan. He also mentioned something called a ‘hilum’ which is normally seen on a non-cancerous node, but he couldn’t see one on this particular node. The lack of hilum can, but does not in itself, indicate metastasis. However, in this case it is more likely to be because the node is so small.

I was told to let them know if I notice it getting any bigger, otherwise my MRI and PET scans will be in January and they will check it then. I felt very ambivalent about the outcome as I left the hospital. The doctors were nothing but reassuring, but having just been subjected to two rounds of brutal treatment for a stage 2 cancer, it's hard to not worry when something isn't right. I suspect my takeaway from the scan was very different from Rich’s. I’m guessing it’s something like this:

What Rich heard: The node is likely to be reactive to the inflammation in the oropharynx but it’s currently too small to tell. It’s very likely nothing to worry about, but keep an eye on it. It will be fine.

What I heard: It’s too small to tell, so it is possible that it could be cancer, especially as it doesn’t have a hilum, but we won’t know until it grows bigger, by which time it might have spread to your lungs. Come back in 3 months.

Of course, he didn’t say any of this, it was all in my mind, and I am, of course, going to try very hard not to think about it over the next few months. Easier said than done though. I just wish there could be a definitive test they could do now to truly rule it out.

In other news, Halloween is fast approaching so Lily kicked off the horror theme this evening by making a Halloween cake. She did have a bit of an accident while making it though, as a piece of the glass mixing bowl shot up and lodged in her cheek - ouch! Makes a nice change that it's not my blood I see! 

(NOTE: no children were harmed in the making of this cake)