Somewhere, over the rainbow

TL;DR: They probably didn't get all the cancer, back to the waiting game to find out the best course of option.

Greetings, blogsters!

Yesterday (Wednesday) was the day we had our first follow-up appointment with the surgeon. Well, not with the surgeon, because he's in, like, Prague or something. In Prague, while my husband has cancer. I mean, sure, at least one of his patients has cancer every day of the year, and if he waited until none of his patients had cancer to go on vacation, he'd never go on vacation. Still, I thought we were special. Turns out we're just patients. 😉

But I digress. Today we met with Jeannie Doyle, Dr. Song's physician assistant. Boy oh boy, was she awesome! Just super friendly and helpful and sweet. That's gotta come in really handy when she [SPOILER ALERT!] delivers bad news.

First we saw Anabel, the nurse. Anabel didn't seem to remember us, even though she just saw us three weeks ago and has only seen about 150 patients since then. But then Vic said something funny, as he does, and Anabel said, "Oh, I remember you!" And we said, "Of course you do." And she laughed. She then joked around with us as she reviewed Vic's history and took his vital signs. It was a great start to the appointment.

Then Jeannie came in. We took a cotton to her (young people, look it up) immediately—she was so personable and upbeat. She said she thought his speech was excellent, and then she asked him what he thought of his speech. I thought this was a great question, because doctors always evaluate your progress based on milestones, but people evaluate their progress on how things are going in their everyday lives, like whether they can eat or talk. You know, little stuff like that. Vic said he felt pretty good about his speech.

Moving on to the pathology report, she said there were no surprises: squamous cell carcinoma, 1.6 cm wide, 4.5 mm deep, staged at T2. Then this genial, lovely woman dropped the hammer. There was "some tumor present at the deep margin." Now, this could mean that they went EXACTLY deep enough, that the last of the cancer is in the part they excised, and there are no cancer cells left on the tongue.

But the more likely scenario is that they didn't go deep enough, and there is still a little cancer left. And as she said, even two cancer cells left are two too many.

Exhale deeply.

So the next steps are these:

• First, we wait. At least we've had a lot of practice at that.
• There is a "tumor board" that consists of the surgical staff, the radiation oncologist, the medical oncologist, and the pathologist. They meet next Monday, June 24, to discuss what they think the best option is.
• It is highly unlikely that the outcome of this meeting will be "let's do nothing."
• It is fairly likely that they will want to do an additional surgery on his tongue—which actually shouldn't be too bad. He may need a little reconstruction, but not as much as they had initially considered. The surgery isn't too scary. It's just a bummer to have to recovery from the same surgery twice.
• If they do an additional surgery, they will also likely do a neck dissection to remove the lymph nodes. This was never going to be the bad surgery, but still. Another surgery. Ugh.
• They may consider radiation instead of surgery, which Vic is not in love with. (Not that he's in love with the surgery.)
• And worst of all, they may consider radiation in addition to surgery because the cancer is stage 2—and chemo could be part of that. This would be the worst-case scenario for Vic.

Jeannie said she would call on Monday—probably in the morning. The tumor board meets at 7 a.m. (Really? Who schedules a meeting at 7 a.m. on a Monday? I hope they at least get food—nothing could be worse than a roomful of early-Monday-morning hangry doctors deciding your fate.)

Jeannie will help us coordinate all the appointments that come after that—another meeting with the surgeon and consultations with the radiation oncologist and the medical oncologist. This will probably happen the first week in July.

(And yes, Margeaux, I did tell Jeannie that we didn't want surgery in July because that's when all the new medical students start, and Jeannie said, "Don't worry. Dr. Song will be the one performing the surgery, with a fifth-year resident by his side." You gotta love that Jeannie.)

We had really gotten our hopes up. Vic's recovery hasn't been horrible. His worst fears were not realized—he woke up from surgery, he didn't have to have a breathing tube or a feeding tube, he doesn't have any problems swallowing, his speech is getting better every day, eating is getting easier. (Jeannie was impressed with what he had already started eating—including turkey, cheesecake and regular cake.) So we started feeling a little cocky, a little hope-y. Then this. To say we were disappointed is a severe understatement.

"But what about the platelets?" I hear you cry. Well, after a frustrating week of going back and forth with the oncologist, I finally was able to get them to make an appointment for us by threatening a bad Yelp review. (Just kidding—I went all Shirley MacLaine from Terms of Endearment on them. "GIVE MY HUSBAND THE APPOINTMENT!!!!!") (Just kidding—I just said "I've been trying to get an appointment for a week. What is it going to take to make that happen? If I have to walk down to Aurora to get the paperwork myself, I will do it.") And that did the trick.

So we will get started on figuring out the platelet situation tomorrow (Friday).

Last week, I did a super mushy part at the end of the blog for our family and friends.

Now, I'd like to take a super mushy moment here to give a shout out to my company. When something is going wrong in your life, you don't need one more thing coming down on you. "Gosh, I'm sorry, Patty, but we're gonna need you to come to the office more often." or "We're gonna need you to take less sick time." or "We're gonna need you to work more traditional hours."

I don't know how people who work full-time are able to care for themselves or a loved one in situations like this without support from their office, so I am very very very grateful that I work for a company that has given me multiple days of bereavement leave, many sick days, many flexible hours,  many extra work-at-home days, and just multitudes of emotional support from the highest level to people I barely even know. I thank all of them from the bottom of my heart.

Now for the weekly picture. I was wracking my brain trying to decide what to show you. We took a picture of Vic's tongue with the sutures and everything, but I thought some of you might be reading this over dinner, so I nixed that idea. I have a great picture of Bella, but I put that on the Facebook, so most of you have already seen that. But then I suddenly got an inspiration while texting with a friend of ours, Squeak. (It's a nickname.) Something made me think about how I feel like we've just been standing under a dark cloud these past few weeks, and yesterday the clouds opened up and it started pouring. But in the words of the great Jim Croce, "nobody ever had a rainbow baby, until he had the rain." (Click to enlarge—it's worth the click!)

It's so rare to see a full rainbow arc, and rarer still to see a rainbow in the west in the morning—but the stars aligned yesterday morning when Vic was putting out treats for the critters who visit our yard, and he was able to snap this shot.

So I guess that's the message I'd like to leave you with. Yes, it's pouring right now. But eventually, we will have a rainbow.

We're on our way home?

Good morning, devoted readers!

After what we assume was a successful surgery yesterday, the doctor who came in to do rounds this morning said "I have to talk to [Dr. Song], but I don't see why you can't go home today."'

But I get ahead of myself.

Just a quick recap of yesterday:

• We came to the hospital at 10 a.m. to do bloodwork. The platelets were even lower than before. 😐
• Katie, our awesome nurse practitioner, ordered some more tests to be done on his bloodwork so that when Vic sees the hematologist next week, they'll already have some of the tests they need to start figuring out why his platelets are low,
• We went up to surgery check-in around 11, where we waited, and waited, and waited, and waited. They finally called us back around 4, where we found out that Dr. Song didn't really want to do too much surgery because of the low platelet issue. This was the most devastating part of the day, because we really wanted him to do as much as possible in one day, but ...
• ... it ended up being OK, because the surgery Dr. Song did do went really well. He took off all the visible cancer and sutured him up. No skin grafts, no neck surgery, etc., which means ...
• ... easier recovery, which means ...
• ... he may get to go home today! (More on that later.)

Vic is glad to have the cancer out, and even though it may not be all out (we'll know in about a week), the majority is out, and that's a relief. He was also quite concerned about his swallowing and his speech, but both are great. He sounds a LITTLE drunk (hee hee), but that will get better as he recovers.

This morning, Dr. Gonzalez came in (he works hand-in-hand with Dr. Song) with a bunch of fresh-faced medical students for rounds. Here's the recap of that:

• He looked at Vic's tongue, said it looked great. No bleeding, which is really great, given the low platelets.
• He repeated what Dr. Song said, which was that they took an area of the tongue that he thought would provide clear margins. (Dr. Song's concern was that he definitely went wide enough but wasn't sure he went deep enough, but the pathology would show that.)
• He said if it the margins were clear, maybe Vic would be done with the surgery. (Dr. Song also said that--maybe he won't even need to have the lymph nodes out.)
• He said the platelets were up to 97 after yesterday's infusion. This is excellent. (But we'll still need to find out why the platelets are so low.)
• He said that Vic's speech was fantastic, given that he'd just had surgery on his tongue, and he was swallowing just fine.
• The last thing he said was "I have to talk to the boss [Dr. Song], but I don't see any reason you can't go home today." This was very unexpected. Dr. Song said yesterday that Vic would only have to be in the hospital a day or two, but we expected "two." Vic is over the moon--so I sure hope Dr. Song agrees! It's almost worse to find out that you might be able to go home and then have to wait all day to find out. But still, HOME!!!

Next steps:

• Follow-up with Dr. Song's office--probably next week.
• Find out the results of the pathology--probably next week.
• Get an appointment with a hematologist to take care of that pesky platelet problem--probably next week. (I, too, was a little excited with the "go home" news that I forgot to ask about all of this. BUT I have now written it down, and rest assured that we will not leave the hospital until we know what the plan is.)

Now, let's see, what pictures do I have for you today?

This is post-surgery with the ladies in the PACU:

And this is us in pre-op, me with my Game of Thrones sign: What do we say to the god of death? Not today. That made a few people laugh, and the nurse even asked if he could keep the sign in their area. (I put this second so that a new picture would pop up on Facebook, hahaha.)

They want you to get up and around, so here's Vic walking the runway and also being silly:

(NOTE: He is only pretending to speak gibberish at the end.)

[begin really super mushy part]

Each and every one of you--whether you are a Facebook/blog "lurker" or someone who posts a comment or someone who clicks "like" or "love" or someone who texts or emails or someone who sends vibes, thoughts, energy, prayers and the like or someone who weeds or plants flowers or sends treats or offers any kind of help we might need--has lifted me up these past few weeks. You have enabled me to be positive and strong and resilient. You have been there for me so I could be there for Vic. You have been my cheerleaders, my shoulders, my rocks. My friends and my family, the people I love most in the world. I cherish you all.

[end really super mushy part]

Houston, we have a problem—maybe

TL;DR: We're still going to the hospital tomorrow (Monday) and still planning to have surgery.

Full post:

We went to the hospital on Thursday for a presurgery workup. It was not noteworthy, except for the fact that they took blood.

Our wonderful nurse practitioner, Katie, said someone would call us Friday with a surgery time, but if they didn't, we should call between 2 p.m. and 5 p.m., and she gave us a number to call.

When do you think I called? (Go ahead, think about it. I'll wait.)

Right. 2:00 p.m. I didn't even wait for 2:01.

The woman who answered the phone said the nurses were looking at the schedule now and would get back to us between 2:30 p.m. and 4 p.m. If you ever feel like time is moving too fast, I suggest waiting for a hospital to call you back. Time stops.

Around 3:30, Katie called—but not about the surgery. About Vic's platelets. They're low. Normal range is 150–400. Vic's were ... 53.

Subtopic: About platelets
Platelets are tiny blood cells that help your body form clots to stop bleeding.

Can you imagine what happens if your platelets are low? You bleed. If you're having surgery, bleeding is not desirable. Low platelets can scuttle a surgery. This was not good news.

Long story short (it's already too long), Katie ran around on a Friday afternoon trying to find out when we were on the schedule, what Dr. Song wanted to do about the low platelets, and generally just trying to get us squared away. We love Katie. She finally reached Dr. Song, who is determined to do the surgery. Vic's surgery wasn't going to be until the afternoon anyway, so they decided we would go to the hospital early, recheck the platelets, and if they are still low, they'll give Vic an infusion of platelets and check again. If they are still low, they can do an infusion during surgery.

No one made it sound like a very big deal, so that's nice.

SO! Surgery is still scheduled for tomorrow, but no time has been set yet. Just keep us in your thoughts all day. Cuz what else did you have to do with your brain on a Monday?

And what did we do this week?

Well, Vic laid with Bella in the sun.

We went to Summer Lobster at The Palm on Thursday. If Vic isn't going to be able to eat decent food for weeks—or months—we're having lobster! (No, I know, this is not a picture of lobster. It's just me, dressed up in anticipation of the lobster. But now that I mention it, I wish I had taken a picture of the lobster.)

And, yes, more eating. I received a box with these goodies in it from my peeps at work. What was so meaningful about this was that people often send flowers when you're in the hospital. Fine by me—I love flowers! But again, if you're not going to be able to eat decent food for weeks or months, getting treats before you go into the hospital is just next-level awesome. Thank you, Ogilvy family!

And that's it for today! Thank you, as always, for your continued blah blah blah all the mushy stuff. 💖

We have liftoff!

TL;DR: Vic has chosen surgery! Surgery will be on Monday, June 10, somewhere in Aurora. (That Anschutz Medical Campus is huge, and they haven't told us yet exactly where yet—or for that matter, exactly what time. So, more details to come.)

Full story:

Today, we visited the radiation oncologist, Dr. Weeks. I know what you're thinking: "But at the end of your last very very very very long blog post, you said you were meeting with her on Tuesday!" That is true, but this morning, she said she had an opening today, so there.

Dr. Weeks is the radiation oncologist Vic had last time he had cancer, so it was "nice" to see her again.

Without so much as a how-dee-do, she said she agreed that surgery was the best first option. She said it would be more efficacious (having the power to produce a desired effect, I looked it up) and safer, given that he's already had full dose radiation. She said radiation would not be as effective as surgery.

We did talk about what it would look like if we had to do radiation after, and it's not great, so we're really hoping for clean margins on surgery with no follow-up. (That said, we still have an appointment with the oncologist, who may want to do chemo- or immunotherapy after surgery regardless of the margins. We'll find out more about that tomorrow (if we can get the Wednesday appointment rescheduled) or Wednesday (if not).

We asked Dr. Weeks if she knew Dr. Song. She did, and she loves him. She says there are four "head-and-neck guys" in Longmont who do surgery—and they all know their limitations. When they come upon a complex case like Vic's, they all call Dr. Song. And then she said, "He's the one I would go to if I needed this procedure." You can't ask for a better recommendation.

If you made it to the end of last week's very very very very long blog post, you know that we weren't in love with Dr. Song at the end of the appointment, so this really put our minds at ease. As we've said many a time, you don't need a nice surgeon. You need an expert surgeon. And Dr. Song is the expert. Patients all over the state come just to see him.

The last thing she said to us today was "Hopefully, you won't need to see me again." We like her a lot, but we couldn't agree more.

OK. So. Next steps:

• See Dr. Maymani Tuesday or Wednesday
• Get "presurgeried" on Thursday—this involves a visit with the anesthesiologist as well as ... I don't know. The stuff you usually do for presurgery—list of meds, what not to eat and drink the day before, what time to be there, what to expect, yadda yadda yadda.
• Surgery!

Super happy to be moving forward and getting the surgery scheduled so quickly (hint: start the process before you've even decided what you want—you can always cancel!) and in June (for those of you who do not know: Don't get sick in July. As my niece says, "With every new July comes new doctors, fresh out of medical school with a license to practice medicine.")

Now it's all on Vic's shoulders—he's the one who has to undergo the surgery and recovery. So take any thoughts/prayers/love/light/healing energy/etc. that you were sending to both of us and only send them to him. He needs all he can get!

I'll close today with a picture of Vic having one of his favorite desserts: pineapple upside-down cake. This delicious one courtesy of our niece Margeaux, who had us over for dinner last week. :-)

"Aaaaand, you are holding"

If you've seen "The Way Way Back," then I'm sure you remember the scene where Nat Faxon keeps a PYT from going down the ramp by asking her for about a minute to "hold."

If not, watch this. I'll hold while you do it.

Also, if you haven't seen "The Way Way Back," go get it. Get it now. Watch it. Watch it again. Have tissues at the ready.

OK. Back to us.

So, we saw the surgeon today, Dr. Song. He and his staff were awesome, until you could tell that he had other things to do and he stopped listening to us, but I get ahead of myself.

First the nurse came in, took all his vitals and history. Then the physician's assistant and speech/swallowing therapist came in. The P.A. took more history and talked more specifically about the cancer. Then he decided he needed to do a bunch of unpleasant things, like sticking a tube up Vic's nostril to deaden the back of his tongue, then stick a camera up that to look inside, only to decide that he should have done all that on the other side. So he stuck another tube up Vic's other nostril to deaden his tongue more, then stuck another camera up his other nostril and root around in there to see what he could see. Vic didn't like this tube-nostril thing.

Then Dr. Song came in. First he reviewed the video from the tube-nostril thing. As the camera progressed through Vic's various body parts, he talked about what we were seeing. That was pretty cool.

Then he decided he needed to stick his finger in Vic's mouth to feel around. He used a numbing spray that he said would taste terrible, like a "funky banana." Vic said it wasn't that terrible. Then he put more numbing stuff on the cancer side of the tongue. He really didn't want Vic to feel anything as he was rooting around in Vic's mouth. Then he did a lot of feeling around, much of which was painful despite all that funky banana numbing. He said he didn't feel anything on the left side, and what he felt on the right was broad (2.5 cm, about an inch) but it didn't seem very deep. When Vic accidentally bit the doctor's finger, the doctor decided to stop feeling around. He said his finger is very important to him. I'm thinking if his finger is so darned important, maybe he should tell patients not to bite it before he puts it in their mouths. But I digress.

Then he reviewed the PET scan. Again, he showed how different things were "lighting up" on the scan. First, the brain, which showed normal activity. Vic made a brain joke, which the doctor did not appreciate, because he had a brain joke of his own ("So, Mrs. Love, he has a brain, and it works.") and thought Vic stole his thunder.

As he went through each layer of the PET scan, he described what it was showing--some inflammation in the back of his neck, noting in the lungs, nothing in the heart, nothing in the liver, nothing in the kidney, nothing in the bladder. We heard all that from Dr. Maymani (the oncologist), but it was nice to hear all that from a second doctor.

Based on what he can see on the PET scan, it's early-stage cancer, probably T1 or T2, for those of you familiar with the tumor grade classification system of cancer. This, too, is good news and was nice to hear.

After all this, Dr. Song started describing the surgery, which he said would remove a portion of the tongue (a "partial glossectomy," for those of you who like to look things up). (Again, this is good news—Dr. Maymani couldn't say whether Dr. Song would even perform the surgery.)

In the drawing below, there is a shaded circle on the right side—this is the cancer. (The shaded circle at the back is where the previous cancer was.) Then there is a solid line around it--this is the part the doctor would remove.

While Vic is still under anesthesia, a pathologist would examine the specimen to determine whether Dr. Song got all the cancer. (This is called having clean margins.) If he did, Dr. Song would close the wound, procedure complete. If not, Dr. Song would remove more of the tongue. This is the area shown by the first dotted line outside of the solid line. The pathologist would examine the specimen again, if it still didn't have clean margins, Dr. Song would remove more. Lather, rinse, repeat, until the margins are clean—that is, all the cancer is gone.

The next step depends on how much of the tongue Dr. Song has to remove. If he removes a bunch, then he'll also perform reconstructive surgery at the same time—taking a bit of flesh and tissue from other parts of the body to use as "filler" for the tongue.

Dr. Song also wants to remove the lymph nodes on the right side of Vic's neck. That's less of a problem—it's just an incision on the neck, remove the lymph nodes, close it back up.

Dr. Song does not believe he would need to take part of the mandible (jaw) as Dr. Maymani suggested—Dr. Song says the mandible doesn't seem to be involved at all. That is great news, because Vic was really worried about that.

Vic may also need radiation after surgery, but the dose would be much smaller.

Vic could do radiation before surgery—try to kill it that way, making surgery unnecessary—but the radiation would be a higher dose (with presumably higher side effects) and the surgery would be more difficult after radiation.

AND FINALLY (for this part of the story), Dr. Song also discussed what it would be like if Vic chose to do nothing. He said he couldn't say how long it would take to kill Vic, and it's a horrible way to die. "I urge you to get treatment," he said. We had talked about "doing nothing" when Vic was initially diagnosed, but Dr. Maymani also said it would be very painful and awful, so we took that option off the table at that point.

Then we asked some questions:

• Best-case scenario—the surgery where he takes the least amount of the tongue and Vic has no radiation after—what does that look like? He'd be in the hospital for three to five days, get some speech and swallow therapy, some follow-up visits, and he'd probably start to feel better in about four weeks.
• Near-worst-case scenario—the surgery where he takes the most amount of the tongue but Vic still has no radiation after—what does that look like? He'd be in the hospital for about a week, but he wouldn't start to feel better for months instead of weeks. He wasn't more specific about how many months.
• As for what happens if you add radiation to the surgery, we won't know until Tuesday, when we see the radiation oncologist Dr. Weeks.
• What effect will the surgery have on Vic's everyday life? None—he'll still be able to drive, walk, eat, swallow (although obvi the last two are with therapy), etc. The only problem would be if he had something go wrong during the surgery, such as a stroke or major cardiac event on the table. Dr. Song really felt that Vic has a good chance at a high quality of life with treatment. (Although his definition of "quality of life" might differ from Vic's.)

This was the point where I feel Dr. Song was starting to get frustrated with us. He kept asking if we had any questions, but he also kept looking at his watch. Vic was trying to ask good questions, but Dr. Song got a little fixated on thinking that Vic wanted to refuse treatment—like Vic was trying to decide whether he was going to even have treatment. And he kept saying "You should really get treatment." But Vic was just trying to get more information about what the recovery would be like so he could make an informed decision about which treatment to get. I get it—there are still so many "what-ifs" that it's hard for Dr. Song to give specifics, but I still feel he wasn't fully listening to Vic.

We finished the round of questions, and Dr. Song left us with Liz, the speech/swallowing therapist. She was wonderful. Here are some of the things we talked about with her:

• The base of the tongue (in the back) is the "powerhouse of swallowing." Dr. Song is not going to touch the back of his tongue, so he really shouldn't have any long-term swallowing problems. Obviously, the early days after surgery could be difficult—but long term, he should go back to normal.
• She was the one who told us that any reconstructions would take place during the initial surgery. I know we were thinking that he'd get the cancer out, and then he'd have to wait a while for reconstruction—but nope. It will all be on the same day. For me, this was more comforting.
• She also said the most common outcome is that the first piece he takes out is enough. It is uncommon that he would have to take a whole lot of the tongue.

The unfortunate thing is that we just can't know what is going to happen until Dr. Song gets in there. An MRI would make all of this more clear, but Vic can't have one because of his defibrillator/pacemaker. So at this point, we just have to make a blind decision.

After we finished with our appointment, we drove back through Denver to get home. (The doctor is in Aurora, people. AURORA.) And I thought it was kind of cruel that, in stop-and-go traffic, we had to follow this:

I mean, at one point, I thought, "I'm just gonna stop the car, run up to the van and ask if they have any cupcakes." But common sense prevailed, and I did not get out of the car on I-70.

So, where are we now? Well, we still need to gather a bit more intel first. Dr. Song wanted us to see Dr. Weeks and Dr. Maymani again, find out what they recommend, now that they have Dr. Song's opinion. We see Dr. Weeks on Tuesday next week, and Dr. Maymani on Wednesday.

So once again, we are in a holding pattern until we get the final tidbits of information and Vic decides precisely what treatment he wants to get.

Thanks for "holding" with us!

P.S. If you are concerned that you might miss a blog post, you can subscribe to the blog or you can ask me to add you to my mailing list, and I'll send you a link to the blog whenever I post one. Just send me an email, a text or a DM on Facebook!

PET Sounds

TL;DR
PET scan shows just one small speck of cancer on Vic's tongue—nothing in the lymph nodes, nothing of significance anywhere else. Next stop: What will the treatment be?

Full blog post
When last we met, I was writing the blog and Vic was taking pictures of birds at our feeder, particularly our beautiful Western Tanagers.

Taking pictures and watching the wildlife that comes to our yard (a wide variety of birds, squirrels, a skunk, a raccoon [or two], a fox and our neighbor's cat) are two of the activities that help Vic feel normal and take his mind off the cancer —even if only for a moment.

OK. So. The PET scan. It went about as expected—it took a long time, but at least it was boring. No need to dwell on that, except for these pictures Vic took while he was there:

You know how people always take pictures of their feet?

The dreaded donut.

We saw the oncologist, Dr. Maymani, Friday. He is a genial fellow who nevertheless uses big words that I continually had to say "Ummm, what does that mean?" Note to all you medical professionals out there: It's OK to use big words, but do please follow-up with "What that means is ..." Thank you.

• The PET uses a "radio-labeled glucose" that is attracted to areas with high activity, such as the brain and the organs—and cancer cells.
• The PET found a teeny-tiny dot on the right side of the tongue 👅near the mandible (jaw). Vic said, "Wow, that cancer really is small. Dr. Maymani said, "That's your brain. The cancer is over here." It's so small that it basically only shows up in one of the many, many views of the PET scan.
• The PET did not find any dots—teeny-tiny or otherwise—in the neck (lymph nodes).

Bottom line of the PET scan, the cancer has not metastasized. For those of you who do not watch Game of Thrones Grey's Anatomy, what that means is (medical professionals: see how I did that?) that the cancer has not spread. This was the absolute best news we could have gotten from the PET, other than "The biopsy was wrong. You don't have cancer. Sorry!" 😉

Now, here's where the news from the PET scan goes a little downhill: Treatment.

• Surgery is Dr. Maymani's preference.
• Pros:
• Surgery removes the cancer. If there is no cancer left, it can't spread.
• If the surgeon (Dr. Song) thinks he got all the cancer, there would likely be no follow-up treatment (radiation and chemo- or immunotherapy). For those of you who remember the last round of treatment, you know why this is a pro.
• Cons:
• Any surgery is risky.
• While emotionally, Vic's heart is big and full, physically his heart is not strong. Surgery will take a toll.
• Even though the tumor is small, Dr. Song may have to take a large area of the tongue or even the jaw to make sure he gets the whole thing. This would require a much more extensive surgery as well as reconstruction later on.
• The medical team (Dr. Song, Dr. Maymani and the radiation oncologist Dr. Weeks) may decide he needs follow-up treatment in addition to the surgery.
• If surgery is not an option, the next best treatment is radiation therapy.
• Pros:
• Radiation kills the cancer. If the cancer is dead, it can't spread.
• Cons:
• Radiation therapy sucks. Just read past entries of this blog.
• He may still have to do chemo. (This would be decided by Dr. Maymani and Dr. Weeks.) Radiation and chemo? That's a low blow.
• If surgery and/or radiation are not options, the next best treatment is chemo.
• Pros:
• Chemo shrinks the tumor (but doesn't kill it, which is a con, obvi).
• There are newer versions of chemo that weren't available last time around and may have fewer side effects.
• Cons:
• Chemotherapy only keeps the cancer at bay for awhile—so it could recur.
• Side effects, side effects, side effects. Even the newer version of chemo will have side effects. The last round of chemo was not great for Vic.
• And if all of the above are not options, the final possibility is immunotherapy.
• Pros:
• Immunotherapy targets your T cells, which boosts your immune system. If it works, you're immune to that cancer for life.
• Cons:
• Immunotherapy doesn't work for everyone.
• You have to have repeat PET scans. Vic doesn't like repeat PET scans.
• More side effects! In this case, immunotherapy also targets other organs and can cause colitis, pneumonitis and other inflammation—all treatable, but still ...

It was a little hard to feel hopeful after this appointment, even though the overall news was great. If the cancer had spread, this would be a very different blog post. But now it's been a couple of days, and we've had more time to process. We definitely are grateful that the cancer has not spread, and we are not putting the cart before the horse (translation: we are waiting to freak out until we know what, exactly, to freak out about).

Next steps: We have an appointment with Dr. Song on Wednesday, May 29. This should give us most of the answers we need to determine what to freak out about decide on a course of treatment. We are "looking forward" to that.

I asked Vic if he wanted to say anything in the blog. He said, "I gave you a whole sentence already when I let you use that joke about my brain."

He's a joker. Also, an excellent photographer. When he can't sleep because he's worried about his cancer, sometimes we are the beneficiaries.

Thanks, as always, for all of your support and love and yadda yadda yadda. 💓

The Waiting Game of Thrones

OK, to be honest, I only threw in "of Thrones" because tonight is the series finale of Game of Thrones. Game of Thrones really doesn't have anything to do with this post.

But as an aside, did you notice no one ever gets cancer on Game of Thrones? They either get murdered or ... nope. That's it. They only get murdered. All in all, not the worst way to die. Unless you cross Cersei, and then it will probably be long and painful.)

So, here we are in the waiting game. As you may remember, before Vic can do anything to treat the cancer, he has to find out more about the cancer, and to do that, Vic needs a PET scan and visits to the doctor. As of the last post, we did not have any of that scheduled. But now we do!

First, we are waiting for the PET scan, which is scheduled for Wednesday, May 22, at 7:30 a.m. (Yawn.) It's a fun affair where you have to drink something super gross tasting, and then you sit and wait in a room that feels a lot like a gas chamber—albeit with a comfortable chair. And there's only gas if you provide it yourself. You can't do anything while you're waiting—you can't play games, read, or even blink. (OK, maybe you can blink.) You can listen to music, but don't even think of tapping your toes! Then they come and get you to lie down in a tube-y thing for, like, a thousand hours and you have to be perfectly still the whole time. Fly lands on your nose? You can't shoo it away. Got an itch? Too bad. Back hurting? Sorry, Charlie.

Next we wait for the visit to the oncologist, which is scheduled for Friday, May 24, at 4:30 p.m. If he gets the results of the PET scan—which he should, because it's his group that did the thing—he should be able to tell us where the cancer is, how much it has spread, and what stage it's in. We might get some treatment options from the oncologist, so this is a big day.

Then we wait once again, this time for the super fancy ear, nose and throat guy, which is scheduled for Wednesday, May 29, at 11 a.m. This is probably the guy who would do the surgery, if that is an option. At this point, we should know everything we need to move forward. I assume we'll also start breathing again after this appointment.

In the meantime, it's life as usual for us. Last week, I went to the Colorado Chocolate Festival and got a little chocolate. (Yeah, I eat my stress—so what?)

Also this week, my friend Margo came over armed with a variety of flowers and greens and planted my outdoor pots. That is probably something I wouldn't have gotten around to this year, but it's something I really love, so I really appreciated this gift.

And that's all the news of the week. Thanks for keeping us in your thoughts and prayers and for sending all your love and light and energy.

(Final note: Vic was unable to contribute to this week's blog post because he was busy taking pictures of Western Tanagers. Stay tuned for those pictures in next week's blog!)