Second Surgery: Neck Dissection

April 2023 through May 2023

Oklahoma or Bust

We left in the afternoon on April 6 and headed for Oklahoma. Jolynn drove because I was on medications. I tried to keep her company as best as I could.

It was almost funny. She was taking care of me on the road. Making sure I was comfortable and rested. Making sure I was not hungry. Making sure I took my medications.

She is sweet and caring.

It was a long drive to Oklahoma. We informed my parents, who live in Texas, that we were definitely coming. They planned to drive north to meet us in Moore, just south of Oklahoma City. My niece, Jamie, from Tulsa, would meet us there too.

Puppy Named S’more

We arrived at a small farm northeast of Oklahoma City. I thought it would be flat with grass and maybe some cows. I was wrong. It was beautiful. Rolling hills with trees. Different animals surrounded the puppies in a small fenced section. A cow, goats, hens, cats, dogs, and maybe a few others.

But my eyes were on the puppies.

With one quick glance, I found the puppy I had been looking at in pictures for the last few weeks.

That one.

Brown and white. The white "V" on her head.

Jolynn picked her up at 5 PM on April 7. Eight weeks old.

I named her S’more.

We looked around and met her siblings, her mother, her father, and the other animals on the farm. It was a wonderful environment for S’more since birth. A small farm. A kind and sweet lady. Not a puppy mill. Just a family raising dogs.

We drove to a motel in Moore to meet my parents and Jamie. We stayed one night.

The medications wore off.

The pain increased.

It was painful just to drink chicken broth. My family watched me struggle to take small sips. Mashed potatoes were not much better. So I stuck with liquids. Sip by sip.

Worse than bone marrow biopsy number eleven.

The next day, we went to Braums. I was not eating, but ice cream? I could not say no. There is no Braums in the East, so I had to get one while we were there.

"It melts in your mouth," I told myself. It should be fine.

Vanilla shake. No straw. I was not ready to pull a thick shake through a straw.

Even with a spoon, I struggled. I did not finish it. I handed it to Jolynn.

If you have never tried Braums, I feel sorry for you. If you are ever driving through Oklahoma or North Texas, stop and get a bowl of ice cream.

We also met some friends at Braums. Just one day with family and friends was sweet and enjoyable.

We left in the afternoon on April 8 with S’more.

On the way home, we stopped at a rest area for overnight in Tennessee. We introduced S’more to a river. It was interesting to watch her observe, sniff, and step into the water for the first time. I had stopped at that same spot many times before.

We arrived home safely at 9:10 PM.

I was happy to see my parents and Jamie, even if it was only for a short time.

Second Surgery

I did not understand much about the neck dissection. I knew they were going to remove lymph nodes from my neck because you never know if cancer cells have reached the nodes and could spread to other areas of the body.

Again, on April 18, I was in the same prep room with the same process. Different teams came in and out. Papers to sign. IV line set up. Fluids running.

Dr. Pierce came in, still looking happy, and again he made me smile. He pulled out a marker and drew a line on my neck to make sure they were cutting in the right place. I am very sure he knows what he is doing and would not make a mistake. I assume marking like that is more for patients, so we do not worry about those rare stories you sometimes hear on the news.

This time, I did not have to wait long.

A nurse came in and gave me another sedative. I waved at Jolynn and Ando.

I was out as they rolled me away.

I never saw a 3, 2, 1 countdown again, if they even did one.

Am I disappointed? Not really.

Just another gap in my memory that I will eventually forget and move on.

I woke up feeling okay. I could feel pain when I moved or when someone touched my neck, so I decided to stay still.

Eye movements only, I told myself.

Then I realized the surgery must have been long.

Much longer than I expected.

Tube and a Bulb

I stared at a tube coming out of my neck that ended in a bulb. There was some red fluid inside the tube and bulb.

I learned that I would need to keep the tube and bulb in place for drainage for a while.

I got worried that something might yank it out by accident. The nurse did not seem worried at all. She swung it around while working on my IV line and checking my vitals.

I could not imagine it being yanked out suddenly. I kept staring at it and wondering.

Another nurse came in and noticed that the tube was loose. She clipped it onto my shirt.

"Keep it clipped," she told me.

Clipped to my shirt made me feel better.

Just a little.

The next day after surgery, I was scheduled to come back on Friday for a post-op follow up. They might remove the tube. We would see.

I decided to take both oxycodone and Tylenol to manage the pain. I was told I would be discharged later that day.

I hoped to eat Cream of Wheat before going home.

Heh.

Confirmed Stage 1

I saw Dr. Pierce on Friday, three days after the surgery.

He said the pathology report had not come in yet. He removed the drain tube and the tape. It stung, but it was still better than when I tried to eat mashed potatoes two weeks earlier.

He checked my tongue. He took another picture for future comparison.

"All is good," he said. He would let me know once the pathology report came in.

Just a few minutes after I stepped out of the office, I received an email from Dr. Pierce. The pathology had just come back.

Good news.

There were no cancerous lymph nodes.

My final stage was Stage 1.

The only concerning feature was nerve invasion in the primary tongue tumor. He would present my case at the tumor board conference in two weeks to determine whether radiation would be recommended.

I could meet with a radiation oncologist to discuss the risks and benefits before deciding.

For now, Stage 1.

Neck Dissection

Two weeks after the surgery, I was still thinking about the long hours they spent operating on my neck.

I knew they removed lymph nodes. In my mind, I thought they just cut open, took out a few nodes, and stitched it back up.

I was curious what it actually looked like, so I searched for a video of a neck dissection.

Yes, two long weeks of wondering.

I found videos on Mayo Clinic’s website. Several of them, showing different levels. The one I watched was Mayo Clinic's Level II to IV (YouTube). Please be advised that this video contains graphic footage of surgery.

I was blown away by how complicated it was.

They cut layer by layer, going deep into the neck. Careful cutting and cauterizing. Navigating through tissue, veins, nerves, and structures I did not even know were there. It reminded me of wood burning stencils I used years ago. Precise. Controlled. Slow.

It did not gross me out.

It was amazing and interesting to watch.

Deep enough to remove lymph nodes.

After watching it, I emailed Dr. Pierce and asked him what level of dissection had been done on my neck. I told him I had watched a video and found it interesting.

He replied: Levels I through IV, with some of Level V as well.

I responded, "I’m impressed with your ability."

Jolynn Broke Down

On May 9, I developed both a sinus infection and an eye infection. I went to Patient First.

While sitting in the lobby, I wondered why I was back there again after so many visits dealing with my tongue ulcers. I told myself that if this visit fixed the infections, then I would be fine.

Then Ando called me.

He told me that Jolynn had broken down and had checked herself into the hospital.

With infections and pain in my tongue and neck, I got worried and drove to the hospital to check on her.

They told me she would be transferred to the ER overnight and then to a psychiatric hospital.

I did not know where she was.

I did not know how she was doing.

No one would tell me anything.

All they said was that I would be contacted in a couple of days.

Shock.

Worried.