July 19th continued

While at the hospital today I asked whether or not my doctor had meant what she said about seeing me at least once a week. After some discussion I was told that in the past appointments with the doctors had been included in the appointment sheets that are created for the radio therapy but since this process has been abandoned there are sometimes slippages. In other words the nursing staff advised the doctor that I was there and she came and saw me and of course asked how I was.

I explained that I had found (so far) that contrary to expectations, I was still able to swallow without much pain, but that I had discovered that swallowing cold liquids was more difficult that any liquid that ranged from luke warm or better. The doctor was surprised that I had not yet experienced the pain she felt quite sure was going to come and suggested that I do not get too confident that I had escaped this side effect just yet.

She also explained that difficulty with cold liquids was due to a reflex action which somehow was triggered by cold liquids and not by liquids at other temperatures. Since I have learned a coping mechanism which involves tucking the neck down before swallowing I explained that this was what I was doing to avoid getting things going the wrong way and she smiled and told me that speech therapists usually teach this technique that I seem to have discovered.

I felt quite chuffed that I had managed to discover something on my own.

At this point we started to discuss the speech issues and I told her that while I had been practising I sounded quite odd in that the register was a lot higher than normal and that I found it difficult to speak and not clog my nasal passages which I thought meant that I was doing something wrong with the breathing. I expected that the meeting I would have with the speech pathologist would assist with uncovering what I was doing wrong and set me on the correct path. My doctor then suggested that part of the likely reason for this change in register was that in order to get at the tumour the doctor/surgeon may well have had to stretch the laryngeal nerve and that as a consequence the situation would not really normalise for some time until the stretched nerve recovered. She agreed that the breathing was an issue and asked if I had been able to produce a sound that was lower in the register. I indicated that depending on how I turned my neck and how I projected air towards the upper palate I could in fact get a louder effect and at a lower register but that this required considerable concentration and effort. We agreed to let the speech pathologist deal with this matter that in the interim I should continue to practice with the voice and see what did and did not work and then report on the outcomes at my first appointment.

She then asked if I was feeling any pain in the shoulder and chest areas and I advised that this was becoming more painful but not yet at the stage where I had to take pain killers to minimise the effects.

We then discussed my need to get blood taken in preparation for the meeting with the Chemo therapy oncologist and the need to change some of the appointments towards the end of the treatment regime to ensure that the required time between the chemo therapy and the radiation therapy was enabled.

I think that at the end of this discussion she was pleased with my progress to date and we met with the staff and arranged for both the blood test and also how we could best manage the combined treatment regime.

Managed to get home, tired as usual and after watching the old French movie "A Man and a Woman" I gratefully fell asleep for a little while. It's funny how simply getting some rays for a minute or two can make you so tired!