Surprise Surprise

The side effects of radiation can be described as short term and long term.
Or, rather, the effects might be seen as on a scale from short term to long term.1
And, while Yogi Berra didn't say it, he should have: With Stage IV throat cancer,
anything can happen . . . and it does.
The very short term effects of throat cancer treatment, which for me was
mostly pain and addled brain.2 So many times I have heard survivors tell of the
gift that keeps on giving.3
So, what a surprise in June 2015 fifteen months after the end of
Radiation One and six (plus) months after Radiation Therapy Two, to have
liquids begin to gratuitously come out of my nose. Here, I take a drink of thin
liquids, swallow and half, logically, goes down my esophagus into my stomach,
my intended target. Partial victory. Then the other half, illogically for me and
most of the non-cancerous world, comes up and out my nose.
As I told my docs, it's surely irritating, but is downright embarrassing at
small formal dinner parties when the borscht rushes out of my nose and down
my starched white shirt to my cummerbund making me look as if I'm a victim in
Agatha Christie's Then there Were None.
When you drink red Gatorade or a
beet smoothie, you'd better move fast with a napkin when the your drink is
shared between your shirt and your throat. 4
Disconcerting is an understatement. How can this be happening after
months . . . a year and a half? My nose bleeds not blood, but my drinks. Well,
every patient is different. No shit.
After a week or so of this nuisance, I emailed my MD Anderson oncologist,
Dr. Merrill Kies about this little affliction, dutifully copying my surgeon and my
radiation oncologist. I registered not so much my disappointment, but more my
confusion and consternation. I asked, Should I: a. ignore this new
development as just another of the multitude of crappy events that befall the
cancer inflicted and wait to see him on my regular update visits to Houston in a
couple of months; or b. wring my hands in anger and disbelief and curse the
gods; or c. consult a local physician. And if I should see a local Memphis doc,
who should I see . . . a general practitioner, oncologist or ear-nose-throat doc? 5
Kies is a professional and since he's begun to care for me he has
1 The American Cancer Society says Radiation can damage normal cells, and sometimes this damage

can have long-term effects. No shit.

2 At least more addled and I think a lot more addled - than that with which I ventured into the world
of cancer.
3 Which actually describes primarily radiation, but is a propos for chemotherapy, too.
4 I haven't been invited to a small formal dinner party since I got cancer. I think people still regard it as contagious.
Anyway, it doesn't matter, because I wants invited to small formal dinner parties before I got cancer either.

5 At least I gave my primary Houston-based doctor a list of good choices.

consistently refuses to rise to my bait. See an ENT at once, he deadpanned

back.
So, I made an appointment to see Dr. Thomas Long, a Memphis ENT who
had a year earlier treated me for debilitating pain in my left ( cancer side and
radiation side, of course) ear and Eustachian tube, the latter named for
Bartolome Eustachi, a famous Italian anatomist who very much liked cutting up
bodies and studying them before it was common practice.
Dr. Long offers up a great bedside manner, punctuated by avuncular,
knowing and slight smiles. He looked in my ears, cleaned out about two jars of
wax6 and, after administering some anesthetic, proceeded to first look in my
mouth. He quickly muttered uh huh or hmmmm a couple of times, took a
slight step back, looked at me and said, Wow, that radiation is really hell on
your teeth, isn't it? It was a rhetorical question.
My teeth were ecru before cancer, and the lower incisors now stubs,
remnants of teeth really. My daughter tells me they look like baby teeth. 7 Why
is the radiation(s) and post therapy fluoride treatments have produced
something more of a taupe, which the Internet tells me is the color of the fur of
the French mole. and a brownish gray which may contain hints of yellow,
purple or green That's my teeth, for sure.,
I've spent much of my life, since around age six anyway, when they started
to arrive, abusing my adult, or permanent, teeth 8, though I never repeatedly
opened coca cola bottles with my teeth, as did a six-foot five Samoan rugby
opponent9 at one of our more raucous after parties. But cigarette smoke, red
wine, coffee and the incessant gnawing of countless pens and pencils stained
and wore out my teeth badly, if not beyond repair. 10
After expressing his opinion about condition of my teeth, allowing a few
minutes for the anesthetic to take effect, Dr.Long performed a laryngoscopy, or
scope, of my throat. He poked around, presumably, my mouth (oral cavity)
and throat (oropharynx). This scoping was a painless, albeit uncomfortable,
procedure that I'd undergone a number of times since I'd discovered a large
lump under my jaw in November of 2013.11
6 Long's nurse, a real talent, took the wax and quickly sculpted a torso of Eustachi, which I've had
bronzed. And so far unsuccessfully offered on EBay
7 During her upbringing I insisted that she be honest and forthright with her observations and insights.
Why I did that remains a mystery to me.
8 As much as anything can be permanent. My friend E.W. tells me that permanent means it will last
longer than I will which is as good a definition as any.
9 I knew I was wise to avoid him during the match, but avoiding him during the beerfest I regarded as
an essential life-prolonging strategy.
10 Beyond repair in this case means beyond my budget, as the cost estimates to fix my teeth have
come in at around the cost of a San Francisco one bed condo with a Lamborghini in the package.
11 In fact, the asstute (sic) ENT doc who examined me three times throughout 2013 - without seeing
my cancer - had done three endoscopies on me.

False alarm. When Dr. Long finished probing the depths of my throat, he
pronounced that there was noting really unusual about what was going on with
me, at least nothing that he thought unusual under the circumstances.
Or, rather, As I guess you know, you've got major scarring in your mouth
and throat. It's obvious from looking down your throat that you've had an awfully
hard time.
Uh . . . yeah, I replied.
But I don't see anything that is not inconsistent with your having
undergone very heavy radiation therapy on your mouth and throat.
Physicians, even the best, are subject to using euphemisms, I conclude.
Translation: Wow your mouth and throat are really fucked up. What a mess.
But this shit that is going on, whatever it is, it's not a recurrence of cancer.
What a relief.
_____________________
Perhaps there was a time when I wanted to be Nietzsche's Ubermensch,
some great prototypical leader creating a new way for the world to think and act.
Now, I am reconsidering even being George Bernard Shaw's Man and
Superman's Unreasonable Man:
The reasonable man adapts himself to the world: the unreasonable one
persists in trying to adapt the world to himself. Therefore all progress
depends on the unreasonable man.

So, long after my radiations have ended, the side effects not only persist, but
worsen and rise anew Such is the manner of the gift that keeps on giving.
But amidst and along with the pain, it gives life, too.