Dental oncology and a delay

A few days ago, I had no idea there was such a thing as “Oncology audiologist” or “Oncology dentist.” But radiation treatment can have real impacts on both hearing and dentistry, and they need baseline measurements and preparatory conversations before getting started.

The audiology visit came first. They led me into a soundproof room with thick walls, and inserted a series of earbuds into my ears and played long series of clicks and tones at high and low tones, with progressive degrees of quietude. Also, tests where I was asked to repeat words back. My hearing is normal, with typical falloff at the high end correlated to my age. Potential effects of radiation would probably be either tinnitus or mild hearing loss. Possible future hearing aids if that does come to pass, but it’s rare. Not much to say here.

Artifacts of a 2018 visit

The Dental Oncology visit was more intense. I’ll definitely need fluoride trays, and to fluoridate nightly during treatment (loss of saliva during treatment means a much higher likelihood of cavities). But why is there less saliva? Because my salivary glands will be irradiated too, and damage to them could be permanent. I should expect a drier mouth for the rest of my life. Apparently, these days they are able to do a better job of targeting radiation so that it has minimal impact on salivary glands. And some people even have pre-surgery to move the glands! That prospect did not come up in my case.

The really scary/new information was that the radiation will also affect vascular flow in the jaw, which will make it impossible for it to heal in the future. That, in turn, means I will not be able to have teeth removed or implants done in years to come. So it’s important to get everything removed now that looks like it might be a problem down the line, and the doctor did find one tooth that seemed to have borderline future prospects. So, on top of everything else, I now have to have emergency dental surgery to have another molar removed, which means it’s going to get even harder to chew and swallow.

Not the news I wanted to hear, but I do appreciate the wisdom of it.

The next morning was to be my final CT scan – the “mapping and planning” one. Unfortunately, when I got there, they told me that we’d have to delay that because the tooth removal would change the structure of my mouth. So now I need to get the tooth extracted ASAP, give it 7-10 days to heal, and then do the final CT scan. Not great.

So Many Appointments

Hi everyone – 

Physically, I don’t feel that much different – I need a bit more sleep, my throat feels kind of “thick” with just a bit of difficulty talking sometimes. The hard part is yet to come. 

Emotionally, I’m coming to terms with what’s coming down the road. I’ve learned a ton in the past week, and all of the information has helped turned a big scary mystery into a big scary plan. But I no longer have “fear of the unknown.” I know it will be uncomfortable and then painful and I just have to be here for it. 

On a boat in Kauai, 2022. I miss feeling this healthy – time will come again. Photo by Ward Ruth.

The number of appointments and scans involved in planning for cancer treatment is just ridiculous (but everything has a reason – no complaints). Trying to fit all of this into my work schedule has been a challenge, but work has been really supportive – no one is complaining that I’m missing half the time. I’m keeping a log of appointments I’ve had or that are coming:

Continue reading “So Many Appointments”

Treatment Ahead

Hi friends – 

Today the doctor told me to try and get through my hot sauce collection quickly, because I probably won’t be able to enjoy it after the radiation treatments begin. That gives me a few weeks to get through ~20 bottles. Not going to happen.

A few weeks ago, a persistent “thickness” in the throat and a visibly swollen tonsil led me to see the doctor, who felt suspicious and sent me to a specialist, who surprised me by doing a spontaneous biopsy on a lymph node in my neck and an order for a CT scan. A few days later, I got the call – I have Stage 2 Squamous cell carcinoma of the throat. It was the last thing any of us saw coming, and suddenly things are moving really fast. Yesterday I met with a surgeon who delivered a mix of good news and bad. 

The good news is that the marker I have — P-16+ — is the good kind, which responds very well to radiation and chemo, and which will allow me to avoid surgery which would probably have life-altering side effects on speech and swallowing. He gave me a 100% chance of survival (not 80-90%, as the first doctor had reported), which immediately lifted a huge stress load. 

Continue reading “Treatment Ahead”

Honoring Martin Luther King

“If you can’t fly then run, if you can’t run then walk, if you can’t walk then crawl, but whatever you do you have to keep moving forward.” -Martin Luther King

Martin Luther King
We had a choice between a woman of incredible intelligence, qualification, and character, or a twice-impeached convicted felon, rapist, pathological liar, and lifelong grifter. We chose the latter, and will pay the price together, as a nation. Today I am proud to honor the life of one of America’s great leaders, Doctor Martin Luther King. May he continue to inspire us to be better.

Contradictions in Photography Advice

I’ve watched a lot of photography youtube and listened to a lot of photography podcasts and read a lot of photography articles, and one thing has jumped out at me: For every piece of loudly-spoken advice, there is a piece of equal and opposite counter-advice (The First Law of Photodynamics). I finally got around to gathering up as much of the conflicting advice as I could think of and putting it together in a single article – hope someone finds it useful.

Contradictions in Photography Advice, at Medium

Foggy fishing at Moss Landing

Grateful for Billboard Bans

Vermont was the first of four states, along with Maine, Hawaii and Alaska to ban billboards – Vermont voters did not want to disrupt the natural view of their state, and I assume the other states had similar reasoning. We owe so much to people and politicians who put a stake in the ground to protect natual beauty when it was still possible, for the sake of future generations.

Joshua Tree 2024

Amy and I spent the first days of April in Joshua Tree, and had an amazing time exploring the boulders and cactuses (monzogranite and cholla). 

The hikes there are mostly short – pull over, do a mile or two, get back in the car and find another. But some are longer, like the day we veered off the Split Rock trail to find the Miners’ Boulder Cabin, which gold rush miners created by finding a natural confluence of boulders and patching in smaller ones, sticks and boards, and making a hammered tin roof – some of their leftover gear is still present to this day.

On our very first hike, we were visited by a beautiful coyote, out looking for dinner. 

Setting out on the trail to Arch Rock, we spotted this leggy Kit Fox loping through the brush without a care in the world, a harbinger?

We had another amazing evening watching desert stars from “Star Box” – a property out in Wonder Valley that the owner granted access to for a small fee. We had some fun doing light painting while waiting for full darkness and the stars’ own light show. Such a peaceful, beautiful evening.

In Twentynine Palms, we visited the “outsider art” sculpture gallery “Glass Outhouse” and wandered through the array of odd things planted in the ground. 

We watched the sun go down from Cholla Cactus Garden and Keys View. 

In Wonder Valley, we happened upon the Plane With No Wings, and finally found The End of the World.

I’ve been through the desert on a plane with no wings

Just wanted to share some of the pics from the trip, here:

https://adobe.ly/3JoppiV

Exploring Vintage lenses

My first vintage lens, recently arrived from Ukraine. This is a 1976 Helios 44mm f2 M-style screw mount (I recently overestimated its age, sorry). Verified not to be radioactive. Amazing how cheap these things are on eBay, but still perfectly serviceable with the right (cheap) adapter. Loving the slightly soft focus, if I can nail it. Some neighborhood shots of Magnolias in bloom.

Arrow

Paddling near some broke-down pilings at Rodeo, I suddenly realized there was an arrow stuck into one of them, probably shot from shore who-knows-when. I turned around and there was not a soul on shore, so I was fine, but then imagined what would have happened if I’d been there at the right time, and this sucker had gone through me. And that reminded me of the lyrics to Wings’ “Arrow”: “Ooh, baby, you couldn’t have done a worse thing to me / If you’da taken an arrow and run it right through me. Oooh.” And I love that song, so everything was fine.