Tuesday, March 4, 2014

Next Stop: Normal?

In the latter half of February we made our annual pilgrimage to the winter nesting grounds of the Grandparents. One species winters in Palm Desert, CA and the other species winters in Tucson, AZ.

It's always great to escape the chilly, snowy, icy winter weather of New England in February. This year we had especially good weather in both destinations: temps were in the upper 70s F the entire time.

After the bout of depression I had over the holidays, I was sort of grinding it out at work. But I knew I had this trip to look forward to just six weeks later. I made it! The vacation itself was fantastic.

Splendid.

Fabulous.

The Progeny enjoyed time with their grandparents and Wonderful Wife and I enjoyed some free time to see movies and be adults. We also did a bunch of fun things with The Progeny like ride horses, hike in the desert, ride go-karts and play laser tag. A perfect vacation. I didn't want it to end.

From a cancer point of view it signified that I'm approaching normality. I had a pretty good energy level throughout and felt happy and relaxed.

A few weeks ago I wrote that both of Wonderful Wife's parents were diagnosed with cancer in the fall. We thought that would mean that we wouldn't get to see them during our February trip. But their treatment schedules worked out such that they were able to be in Tucson after all. It was a real treat to see them and witness for ourselves that they are doing well.

My beard had started to recover in the past couple of months so I planned to try to grow it again over the break. That way I'd come back to regular life with a beard in place.

You can see the result in the photo.

Not too bad! It's symbolic for me to have back something visible that treatment took away. And I've had a beard more than not as an adult - it's a little bit more of my identity than I realized.

In terms of other residual effects of treatment, the main ones are taste and saliva. My sense of taste has been returning very slowly. I've had a few foods lately that retained flavor through an entire meal. It seems like highly seasoned foods do that best. One examples is marinated steak tips that are made by a local butcher. The past few days I seem to have had a weird bug that set my taste progress back a bit but I assume it will return.

Saliva is the bigger challenge, and is related to taste. Saliva contains a variety of enzymes that are the first stage of the digestive process. They serve several functions, including starting to break down some foods. In the process they also release flavors. So with insufficient saliva I don't get those flavors released.

The lack of saliva also makes some foods pretty unpleasant to eat. Specific examples are cheese and ground beef. Melted cheese, like, say, on an enchilada, resolidifies in my mouth into unpleasant globules that are hard to swallow. Ground beef gets chewed into a fibrous mass that is also hard to swallow. I expected the aforementioned steak tips to have the same effect, but the marinade seems to have done some of the work that saliva would do (that's the purpose of a marinade) and they were actually pleasant to eat.

Colloquially I say "I have no saliva," but that's not true. I just don't have very much saliva, and it doesn't increase when I put food in my mouth like it should.

Another result of sparse saliva is that my oral cavity doesn't get rinsed and I usually have pretty bad breath. I experience it as a sour taste in my mouth that is ever present. Wonderful Wife says it's pretty atrocious in the morning but she would have never told me if I hadn't asked! Progeny the Younger seems especially sensitive to it and dramatically gags if I get too close to her face.

On the plane to vacation Progeny the Elder took this unflattering photo of me. I have no chin! Or I have several!

Actually, that is the lymphedema - the swelling in the lymph nodes in my neck that will be chronic. I didn't realized it had "come up" (as the doctor describes it) so much.

I've since started using the compression bandage for an hour or so in the evening when I remember, and doing self-massage more often. The lymph system is less functional and flows less easily, so I have to massage downward from my cheeks to my collarbones to help the lymph flow. Otherwise it backs up and produces the swelling you see.

I mentioned previously that I started running. The warm weather on vacation was a great opportunity to run every day and build up some conditioning.

I started by following a "Couch to 5K" program. They are designed to take a total couch potato from no exercise to running a 5K in eight weeks.

I immediately grew impatient with the amount of walking. I've been athletic for a long time and I'm used to pain from exercise, so I pushed that schedule a bit.

After the first couple of days of run/walk outings I could barely walk. Going down stairs was especially hard. But I kept making the run portions longer and the walk portions smaller and on Day 17 I ran 5K without any walking. It wasn't very fast - roughly a 10 minute mile pace - but I did it.

I kept it up after we returned home, but after a few days I started to feel bad. I have a muscle/tendon tightness in the right rear corner of my head and neck. It feels like a tight guitar string from my shoulder to the top of my head. It gives me a headache. It also seems to give me some swallowing pain. Not the type I had when my throat was raw, but more a muscular pain. Although it seems to be associated with additional throat congestion, too.

I noticed when I first started running that my upper chest felt tight. The area above my collarbones was all in the radiation field so it has damage and scar tissue. I'm pretty sure that's where the tightness came from. My theory is that the guitar string is due to the combination of running and lack of flexibility in my neck. And the other part of my theory is that the throat irritation is due to running in very cold, dry air. It was 26F during my runs.

I'm taking a few days off to see if things improve. And stretching my neck. So far it seems to be improving.

I also had a bout of serious fatigue this past weekend. It felt like the fatigue I experienced during early recovery in the fall. On Saturday I took a two hour nap, then rallied to go to the neighbors' house for a casual dinner (those steak tips!). Sunday I did nothing all day but lay around and watch TV.

Wonderful Wife thinks I have/had a cold but I didn't really have other symptoms. It's true that cold symptoms feel quite different now with my modified pharynx. So could be. Anyway, I feel much better now. People (like my mom) tell me that those unexpected spells of fatigue can occur for years after treatment.

Oh, by the way: we also got a puppy.