Only a millimeter?

In my last post, I talked about the possibility this would be a pivotal week. This week has been filled with good news and several changes that will lead me toward a more normal life.

On Tuesday, I had outpatient surgery to stretch my throat. The procedure was done with a fluoroscope. This allowed the surgeon to watch a live x-ray on a monitor as he operated. As I waited on the operating table I described for the surgeon my experience with swallowing. As I did this he turned to the nurse and requested she retrieve the infant instruments. After surgery, I learned why. The diameter of my esophagus was only one millimeter wide. Yes, about the size of a pen tip. He was able to open it to a diameter of ten millimeters. To eat solid food, additional surgeries will be required to achieve a width of 18 – 20 millimeters. For now, I am able to drink smoothies and eat food up to the consistency of apple sauce. I intend to replace one of my daily tube feedings with a smoothie or soup eaten by mouth.

Learning the remarkably small opening at the top of my esophagus explains what I’ve experienced since I began sipping fluids in late February. If I sipped too much water, I would have to wait until a gurgling sound and minor discomfort stopped. On one occasion, I was sipping some chicken broth made from Campbell’s Chicken and Stars soup. I tried to chew and swallow a single piece of rice. I could not swallow it, which now makes sense given the narrow opening of my esophagus.

I am told I will have multiple procedures to normalize my esophagus. The procedure, which only takes ten to fifteen minutes, uses an instrument to mechanically stretch the scar tissue from the radiation. Between procedures, the esophagus will narrow slightly. The narrowing lessens over time, and in many patients stops. In others, the narrowing continues and the procedure must be performed one or two times a year to maintain the normal esophageal opening. I don't think Theresa will mind If I have this done often. She gets a kick out of my anesthesia induced jovial behavior after I wake up from the procedure. ;-)

On Thursday, I had an appointment with my radiation oncologist. He was very pleased with my progress. The lymph node continues to shrink, and his examination led him to say there is nothing he found to concern him. He schedule me for a PET scan in early May. This test will scan my entire body for cancer, and I hope will be another validation my treatment was successful. Additionally, he recommended me for speech therapy to advance the mobility of my tongue.

Finally, we discussed my return to work. I had hoped to gain approval to work 30 hours a week, but received his support for up to 20 hours a week. This is probably best. On the few occasions I have ventured out for more than a couple of hours, I’ve found I tire quickly. So beginning next week, I will travel into work on most days, instead of working from home. This is one more step in my journey to return to a more normal life.