Wednesday, April 10, 2013

Osteoradionecrosis

   It has been quite a while since I have made an entry to the blog, and that is a really good thing. Over the last few years I have had several PT scans all showing some normal activity but nothing detecting any return of the cancer at the base of my tongue. But a subsequent issue has come up due to the cancer treatments. Osteoradionecrosis is a condition in which there is a significant weakening of bone structure due to high levels of radiation. This has been an ongoing problem but reached a critical point a few weeks ago.
       In May of 2012 an impacted wisdom tooth had to be removed and it was determined that antibiotics would take care of any of the infection. The tissue looked like it was healing OK but unfortunately the infection has remained in my bone for almost a year. Infections are nearly impossible to eradicate in highly irradiated tissue and bone structure. Over the course of last year, the infection would cause swelling and a great deal of pain and a round of antibiotics would calm the infection down but not get rid of it. This all reached a critical point a few weeks ago when there was another outbreak from the infection. A visit to my oncologist and a new X-ray showed a dramatic loss of bone structure in my jaw both from osteoradionecrosis and the infection. The diagnosis is stage three osteoradionecrosis.
         I was referred to Dr. John Coniglio in Rochester and he concurred that the situation has reach a critical stage and will be doing surgery on April 15th at Highland hospital in Rochester to try to improve the situation. The surgery is called a mandible resection, and they will take bone and tissue material from my left fibula and cut out the bad jaw tissue and bone from my jaw and replace them with the good healthy tissue and bone. The surgery is complex and will entail a 7-10 day hospital stay with 6 to 8 weeks recovery but the prognosis is good for a full recovery! The team of doctors perform this surgery 4 to 5 times a month and have really perfected it. Unfortunately if I wait any longer the infection could cause a life threatening situation. This surgery is the best chance I have to leading a healthy life with the post radiation jaw I now have!
          One thing that is a little alarming is how many head and neck cancer survivors are developing osteoradionecrosis ; somewhere around 15%. Dr. Coniglio mentioned that this is because many cancer patients choose not to have surgery to remove cancerous lymph nodes and therefore the radiation levels are higher to take care of everything. In my case I did have surgery but the primary site was the base of my tongue which is a difficult area to remove a tumor so higher radiation levels were required.
         We are keeping a positive outlook about the surgery and will be really happy when it is over. Peggy will post an entry after the surgery to let you know how things are progressing. Since I will have a trach tube for breathing for the first week, it will be impossible to talk with anyone but I will be able to send notes. As always I so appreciate all the positive thoughts that are coming our way from so many of you. It means more than you know. Here’s to a bright Spring !!

19 comments:

  1. As I'm sitting here listening to your dulcimer tunes, my positive thoughts are with you. Your music has helped me get through many difficult times in the past year.....here's knowing that everyone's positive vibes carry you through the next few months.

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  2. Thanks, Dan, for keeping us all close. Here's to you, and to your bright future! We are here for you and Peggy, for whatever you need. The positive energy is flowing, and it is endless. May that energy give you strength and bring you peace.

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  3. Oh my....another big time surgery. But it sounds like you will be in excellent hands. Plus, you and Peggy definitely have what it takes to get through it. Sending you positive vibes for a smooth surgery and recovery. Love you both.

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  4. Sending you positive thoughts and prayers for a successful surgery and speedy recovery. You'll be in our thoughts!! Love to you both!

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  5. Sorry to hear of your complications. My dental office is participating in a walk for Oral Cancer on April 27th at Otsinango Park in Binghamton, NY. Will be thinking of you as we walk. If anyone in the Bainbridge area wants to join us let me know. Michelle Gifford

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  6. Dan, you and Peggy were in my thoughts just now as I listen to the NCPR fundraiser that is about ready to give away a fancy guitar. I send good thoughts and positive vibes to both of you as you set forth on this latest part of your recovery. As always, just ask if you need anything. Love, Susan

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  7. Dan, you are most certainly in Kilo's and my thoughts and prayers. You reached out to Kilo and gave him your time and good thoughts and have helped strengthen him with your good advice, for that we are so grateful to you. Be strong and keep that wonderful attitude that is so contagious. You will get through all of this we are sure and the Lord is with you.

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  8. I like the part about the prognosis for complete recovery... wishing you the quickest and most comfortable recovery possible.

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  9. Dan - while I am sorry to hear that you need this surgery, I am glad the prognosis is good. I wish you the best of outcomes.

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  10. Lots of love and positive vibes for you both, from Saranac Lake! I'm visualizing that complete recovery! All the best, Sue (Grimm) Hanley

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  11. Dan,
    Bill and I are thinking good thoughts for you and Peggy. I too like the part about the prognosis. It does sound as though you are in excellent hands. We will be holding you close in our thoughts and prayers and hoping for a speedy recovery!

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  12. Sending you lots of love and well wishes from Willow and I. It seems to be a rough month for the both of us, with my heart surgery at the end of the month, but we are going to do great, I know it! A positive attitude is whats keeping me strong inside, along with wonderful support. You are in our thoughts, hang in there Dan and Peggy :) love Kels and Will

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  13. Good thoughts and prayers are in the air for you and Peggy!

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  14. Positive thoughts, prayers, and blessings for perfect surgery and rapid healing are coming from both Ron and I. And my cat is purring up a storm just for you!!!!

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  15. Lots of love and positive vibes to both of you. Sounds like you are and will be in good hands, but it must be scarey as hell to contemplate. Having had a few health issues myself, I've also found that once the crisis point fully arrives, you just settle down and trust your team and do what you have to do to get well. Last Friday, I marveled at the energy in that stringy Duggan body and trust it will bring you through yet again. I also saw the strength, compassion and love in Peggy's voice and my heart is with you too.

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  16. Hey Dan! Much love to help see you through this hurdle. Seems like a double 7am and 7 pm vibe for Monday. I'm visualizing you really enjoying a big piece of pie with your new,improved jaw. Love to you both. Debby and the Dawgs
    PS I heard a muffled voice from my closet. The Dirty Leprechaun wishes you a successful surgery!

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  17. Dan, I had followed your blog back in 2009, when I was undergoing treatment for Head and Neck cancer also. I, like you had had an excellent recovery. However in 2011, I did have some similar issues with impacted wisdom teeth. I had all 4 removed and due to the extremely slow healing process 2 of them became infected. My oncologist recommended hyperbaric oxygen treatments, of which I completed 45 of the 60 he ordered. It appears that it helped quite a bit. Did anyone ever mention HBO?
    best wishes,
    Brian

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  18. I love you guys very much and will be thinking of you always. See you soon.- Wint

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  19. You are both in our thoughts and prayer now and in the coming days. Klaus says this is the closest you'll come to putting your foot in your mouth! Love to you both! Lisa and Klaus

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