My Chin is Shrinking!
Sunday, December 18, 2005
We have settled down to a routine, sort of. However, new developments seem to arise.
The strap that has been holding the right side of my jaw to the left side has started to poke through on the left side at its end. Also, it has appeared that my chin has been shrinking. About a week ago, something appeared that looked like the head of a screw. As the days went by, it became apparent that is, in fact, what it was. The surgeon had told me that there were three screws holding it into my chin, so this was obviously one of them.
I asked Dr. Kumar if he knew of a good medical doctor with whom we could consult about my concerns. He did know an excellent one and, it turns out, it happens to be near the large, Ayurvedic hospital in which he practices. He suggested we meet him there and he would make sure we were shown where to go.
We arrived at the appointe time and alighted from the auto-rickshaw in front of a very large and busy hospital. We stood there wondering how we were going to find Dr. Kumar, when we were joined by his assistant who is always present in the consultations. We were standing in front of the office in which Dr. Kumar was working! Coincidence? We don’t think so.
Then, we were off to see the surgeon – down the street, past the canopied shrine (where those who worshiped on the sidewalk in front of it take off their shoes, but those walking directly in front of it don’t), around the corner, across the street, up a few steps and into a small, pleasant office. In a few minutes we were ushered into the even smaller examining room with a typical examining table and a desk, behind which was the doctor.
Dr. Victor is pleasant and well-spoken and appears very familiar with my situation. “When I practiced in Mumbai at one of the top cancer hospitals of India, I saw many cases of oral squamous cell carcinoma, as many men in India smoke and chew tobacco,” he said.
He examined my face and mouth and said there were no obvious signs of cancer, but he did agree there was deterioration. He listed the possible cause as: 1) some cancer still active in the bone, which he felt unlikely, given my otherwise- good health, 2) a constant, low-grade infection causing the bone to break down, 3) the bone has had its blood supply cut off or restricted due, perhaps, to the radiation or tumor; or 4) a combination of the other three. He recommended doing what would essentially be a pre-op workup to determine what is going on. That includes an MRI of the jaw, chest x-ray, ECG, and full blood analysis.
Once he determines what is going on, he will be able to treat it, he says. If it is an infection, then antibiotics should do the trick. I am not sure of the options in the other two cases. He did say that, once it is appropriate, he can take bone and skin from my rib-cage and rebuild the jaw. This would be a different approach than the first surgery, where Dr. Anderson took bone and skin from my leg.
In any case, once we know what the options are for reconstruction, we will have to decide whether to has it done here or back in Vancouver. I will be sharing the information with Dr. Anderson, in hopes of getting his recommendation as well.
We are pretty confident in the abilities of the medical profession here. We have read very positive things about other North Americans who come here to have elective surgery done, because it is so much less expensive and there are no waiting lists. The doctors are trained in England or North America but, as Dr. Victor said, the test equipment, such as CT scanners, are one or two generations behind. The important thing will be to make sure the hospital facilities are good and sanitary.
I plan to complete the tests Monday and get in to see Dr. Victor as soon as possible after that.
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