The mask of doom

The first ENT, who did the biopsy and also broke the bad news, recommended radiation followed by surgery if necessary. As I mentioned, the reasoning behind this was because surgery can be so disfiguring.

While we were doing our research, we went ahead and got a recommendation from my primary care doctor for a radiation oncologist, and headed over for an appointment.

The doctor is a local boy – went to school here in town, then headed to Harvard, and came back after finishing a residency at Stanford. Very, very nice guy. Young, too.

Like all the others, he poked and prodded the lesion on my tongue, then stuck a tube down my nose into my throat to take a look around and see if anything looked off. Fortunately, after peeking in there and making me say “eeee” while he looked at my vocal cords, he said things looked fine there.

His question, though, was why radiation first in this instance rather than surgery. We explained the answer given by the first ENT. He told us that in this case, since the lesion is accessible (i.e., on the oral tongue, the part that’s mobile, rather than the base, which is at the back and doesn’t move), his first inclination would be surgery. He spoke to the ENT, and they didn’t really come to any definitive answer, since they’re both experts in their fields but not the other’s.

So we asked for the name of another ENT, and made an appointment with him to get yet another opinion.

In the meantime, we went ahead with the mask of doom.

The mask is one made for patients with head and neck cancer. It’s a form-fitting mesh apparatus used to keep the head in one place during treatments. The form is heated slightly, then pressed down across the face and shoulder area while the patient (me) is lying flat on a table.

For those with claustrophobia – like me – this is an anxiety attack inducing experience. The mask tightens and goes solid as it cools. It is not a fun procedure for people like me, and I thought I might hyperventilate myself into unconsciousness at one point. The techs were very kind though, kept talking to me, and tried to cool it faster by placing cold rags on it. I am convinced that if I do have to undergo radiation treatments, I will need to be slightly drugged while I am in this mask. Did I mention that it bolts to the table right about the ear area on either side?

The radiation oncologist ordered a PET scan. This uses a glucose formula with a radioactive substance contained within it to “light up” areas that may have cancer activity, since cancer cells tend to use more energy than normal metabolic functions. All of this would be more fascinating to me if it weren’t for the fact that I had to wear my new mask during the procedure.

It took three tries and a compromise to get the mask in place – the compromise being that I would only need to wear it for about six minutes rather than 30, because I was having too much trouble having the mask in place. With a little help from one of the techs, though, I managed to get in the most comfortable position and the calmest state of mind I could, and was rolled back and forth through the scanner. With the mask off, and with me being almost motionless, they also did a longer scan of about 20 minutes.

And then I was freed from the mask, and once again, we waited for results and our next appointment, this time with the new ENT.

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