Need some calm.

So here I sit, just a couple of days away from yet another unpleasant surgical experience, desperately searching for a state of calm.  I have never had panic attacks or anxiety much that I am aware, but somebody just flipped on a switch and I feel like I am going to lose my mind!  I honestly don't know what is happening and I am having extreme difficulties focusing on anything.  The world around me is not making much sense anymore...I wanted the last 7 weeks of treatment to help me and lead to this moment where I could still possibly get it all, and put this saga behind me, but my future does not comfort me.  What is it going to feel like, waking up from yet another surgery but this time I will not have the luxury of speaking?  Granted, I don't talk much anyway, but I have always had the ability to talk...just not the desire.  Tuesday, that will all change.  What will the desire to talk feel like when one lacks the ability to do so?  There have been many unpleasant experiences over the last 3 years as I have always plunged head-first into whatever treatment option gave me the best chance for long term survival.  As my available options have dwindled, the decisions have become more and more difficult.  I hate that I have to make them.  I hate that my family has to watch me go through this again and this time is likely to be much worse.  I know that I can have this surgery and eventually adapt to my new life, but the interim recovery/adjustment period absolutely terrifies me.  I am an emotional wreck right now and probably not the greatest person to be around.  
In lighter news, we had an awesome Stobb Family Thanksgiving celebration the last few days that helped distract the mind.  The San Francisco contingent made the trip in on Thursday and then we had a number of days of very pleasant meals and visiting.  I do better when surrounded by people that I care about, but all good things must come to an end and everyone headed their separate ways.  This is when the sadness and doubts start creeping back in.  Ultimately, I think it boils down to fear.  I am afraid, very, very afraid.  Afraid of the actual surgery, afraid of the recovery, afraid of the changes to my body, afraid of life after the surgery, and the list could go on and on.  I hope that I can hold it together well enough to face this next hurdle and make it out the other side with my sanity.  I have my doubts currently, but time will tell.
Maybe I am about to go over things that everyone knows already, but I feel like I need to lay out what is about to happen.  Tomorrow I will finish with my pre-operative appointments and meet with the plastic surgeon that will be putting me back together.  After that, it's one more night of sleep (if that is even possible) and then I report first thing Tuesday morning for my next body modification.  There is a long list of procedures that I signed my consent to last week.  There will be a complete laryngectomy and I will lose my voice and all ability to speak.  In addition, there will likely be another bi-lateral neck dissection and the insertion of my new breathing apparatus, a hole in the base of my neck called a stoma.  The separation of my lungs and my mouth will then be complete.  There will be a feeding tube inserted while I am out this time and I will have that for 8 weeks or so.  My surgeon thinks there will be lots of carnage in the area where they are working and that plastics will have some considerable work to do.  That could mean I lose my one remaining pectoral muscle or have a free flap from another part of my body.  It's not clear and they won't know exactly until I am on the table.  My surgeon tells me that the probability of me dying on the operating table with this surgery is very low, but I have had lots of radiation in this area and they have to be extremely careful with everything.  She plans to be in there at least 6 hours and then turn everything over to plastics to rebuild the area.  In all, I am told it will likely be a 10-12 hour surgery, so hooray for me!  I am afraid for the wake-up after surgery.  Very afraid for where my emotions are going to be when I wake up.  Again, I hope that I can hold it all together.  Likely I should be out of the hospital by the weekend and will probably stay in Houston for a week or so to get through all my follow up appointments.  Then it will be back to Lago Vista for some rest and relaxation (aka recovery).
My only option for communication after surgery will likely be the electrolarynx.  Eventually, after I heal and everything settles down a bit, I can have a follow up procedure that will give me the best chance for more natural like speech.  This link gives you some further reading on this type of procedure.
Maybe this was coherent enough that you were able to follow it.  Just trying to keep it together in the face of insanity.  What we need to happen is for this surgery to remove any and all traces of residual disease from my neck and I skip gleefully away into the sunset.

Been here before, sort of.

So here we are again in an all too familiar situation.  It has been quite some time since I have written anything, mostly because I had very little to say.  I could have chronicled all the crappy days of laying in bed with no energy to get up, an awesomely annoying rash all over my head, chest and back, and a mouth full of sores that make talking, eating and drinking a rather unpleasant experience.  I opted not to bore everybody with these happenings, but now I am headed down the next path towards what hopefully is many more years of life ahead of me.
To recap, I just finished a 6 week cycle of chemotherapy with infusions of Carboplatin, Taxotere and Cetuximab on weeks 1 and 4, and then Cetuximab only weeks 2, 3, 5 and 6.  The three drug infusion was the worst and led to about a week of really crappy existence, but we all made it through and can now talk about it in the past tense.  The Cetuximab gave me a rather bothersome rash that persists even today, but we are only 9 days out from my last treatment.  The goal with all of this was to stop the growth of the tumor that is near my larynx, and best case would be shrinkage of the tumor prior to another surgery.  Scans were yesterday, results obtained today at a visit with the surgeon who would perform my laryngectomy.  The tumor did indeed respond to treatment and has actually shrunk in size and measurable intensity on the PET scan.  In addition, there is no evidence that the disease has spread anywhere else in my body and this leads to the chance that one more surgery could possibly cure me completely.  Again, it is a very slight chance, but it is still a chance.  And so we are now in a similar situation to what we were in earlier this year.  I am now headed for surgery #4 to once again try to rid myself of my squamous cell carcinoma.  Difference is this time there is no post surgery radiation or chemo to help clean up any surprises they find once they are in there.  The surgery will either work or it won't but this is the choice that I have made and feel like this gives me the only chance for a cure and the best chance to maximize my time in this world.
This surgery will remove my larynx, thus disconnecting my mouth from my lungs and rendering me unable to speak naturally.  I will have a hole in the base of my neck (properly called a stoma) from which I will breathe for the rest of my days.  It will have a little filter on it that I change every day that keeps bad out and helps humidify the air before it reaches my lungs.  Initially, I will communicate with an electrolarynx held up to my neck when I need to say anything.  There will also be plastic surgeon involvement to reconstruct the area as need, how extensive this will be is unknown at this point.  Time will tell, I suppose.  I have speech options available, the best of which is a TEP (tracheoesophageal puncture) where they connect my trachea to my esophagus and put in  a voice prosthesis that I can, with a little extra effort, force air into my throat and speak quasi-normally.  The only thing I would never be able to do again is swim.  I would have a feeding tube inserted during surgery and likely would have it for a minimum of 8 weeks.  This is what I have to look forward to in about a week and a half.  December 2nd is the day.