Someties I feel like my throat is achey, or I feel like I might have some pain when I swallow and I think, "Is this cancer? Has all the dipping I did caught up to me?" As a health care professional - I'm an RN, former Corpsman specialized in aerospace medicine and combat medicine - I know the risks and I ignored them for a long time.
Yesterday I received a patient and before I went to see him I was already dreading it based on the report I received. They said that he had not been seen since August of 2013 when he had gone in for a lump on the underside of his tongue and had been told then that it was suspicious and that he needed to go to the ENT specialist and have it checked out. Night before last he had come back to the ER stating that he had terrible pain and trouble swallowing and breathing. The record went on to clarify that the pt communicated this in writing as the pt was not able to speak clearly enough for the physician to understand what he was saying.
I went in to see the pt. Rarely is a man who is 6 feet tall supposed to weigh 116 pounds. I introduced myself and had trouble keeping eye contact - my eyes kept wandering to the jaw that looked 3 times its normal size and the masses on the left side of his neck. He nodded in response to my introduction and listened quietly as I explained my role as a care manager. When I finally began asking him the questions of my assessment, he tried to speak. I don't know what disturbed me more, the gutteral and garbled sounds he produced in an attempt to respond, or the smell of rotted cancerous flesh that came out with each attempted word. His daughter was angry. She said, "No, he never followed up after last summer when they told him it looked like it coulod be cancer." She was obviously holding back her tears by staying angry and hardened against the pain of seeing her father in such a state.
Today I found out that the surgeons here aren't able to do surgery because the damage is so extensive that they cannot secure a safe airway for him for surgery - even with a tracheostomy. At this point they say the destruction of his lower jaw is almost complete, the tongue is necrotic, the muscles for swallowing are hardened and essentially non-functional. We have begun looking for surgical specialists in the area willing to take on such a high risk patient. And we treat his pain as best we can.
He smoked and chewed until 5 months ago. for tha past 40 years. He's 56. He looks 86.
Sometimes I still wake up afraid that I have already done too much damage to myslef and that this could still end up being me. It could. But I know that by quitting, I have improved my chances significantly. All the crap I went through during the SUCK, all the dealing with cravings and the rage, it was all worth every second of it in order to help reduce the chances I would end up like this fellow I now get to assist in planning for the remainder of his life.
Ironically, it was just a little over a year ago that I had a similar experience at a different hospital with a different patient. That is actually over in the Words of Wisdom section...
CoachDoc
Day 1514
