Thursday, May 19, 2005

That C Word

As I said, yesterday was my first visit to the dentist in a while.

If you haven't met me, I'll tell you right now that I have fucked up teeth. My folks had me in braces for a while when I was a pre-teen, but for some reason, they decided to have them taken off before the treatment was done. This seemed like a win-win situation at the time - my Dad got to save money that he was spending at the orthodontist, I was rid of the bane of my existence at that time, and both my folks got to stop listening to my belly-aching.

But the treatment wasn't done, and the teeth were still crooked, but what didn't bother me as a young boy didn't bother me in my drug-addled teens, and made me only mildly self conscious in my 20s. In my 30s, the crooked teeth were a definite liability, but nothing that kept me down, but by my 40s they became a downright embarrassment. So I neglected them even further and often avoided the dentist for years on end at times, which, of course, only made the situation worse.

So anyway, this year I finally resolved that I was going to deal with the whole situation and get the teeth cleaned, straightened and healthy, be it by appliances or by replacement, and I made an appointment last month at a dentist that L. had recommended.

Now, as you can imagine, I'm self conscious enough about my teeth in front of lay people, but showing them to professionals like dentists, dental assistants and dentist office receptionists is just unmitigated hell for me. But you gotta do what you gotta do, and the pros were, well, professionals and treated me well through the reception, through the x-rays, and through the cleaning.

Then came the consultation with the dentist himself.

Now, first of all, he was great. Nice manners, nice style, nice guy, but that's not the issue. The problem was, as he was examining me, looking from the x-rays to my mouth, he was concerned about the wisdom teeth, and feeling my neck and throat, he found a lump on my lymph gland.

"Is it sensitive?" he asked as he pressed on it.

It was - not painfully so, but I could feel a tenderness. So I asked the obvious - what would that mean?

"Well, it could be an infection from an abscess or something beneath the wisdom tooth" he said. "Or it could be cancer."

The "C" word. Damn that Bermuda triangle!

The doctor seemed fairly concerned and said he was going to make me an appointment at an oral surgeon. "It's not urgent," he said, "but I want you to go this week."

Well, that was impossible, because at the time, I still thought that I was going to be driving to Brunswick later in the day, but the doctor insisted that I go no later than Monday. So, now I have an appointment to go to the oral surgeon at 2:45 p.m. on Monday and let her see if she can determine the cause of the lump. That should make an interesting blog entry.

So here's what I'm looking at - according to the dentist, if it's an infection, I'll probably be facing wisdom tooth extraction and some gum surgery. Regardless of that outcome, he wants to replace a bunch of my old fillings, sees a potential root canal or two, and wants to pull my four lower front teeth and replace them with a dental implant. The upper front teeth will probably be capped.

No one's saying anything about cancer yet, but here's what I've found on line: "The lymphatic system is a series of microscopic vessels that drain fluid away from the tissues and return it to the blood system. Throughout this system, there are small organs called lymph nodes and there are clusters of these nodes around the body, especially in the neck, groin and armpits. The spleen is also part of this system. The lymphomas are divided into two main categories: Hodgkin's disease and non-Hodgkin's lymphoma.

Hodgkin's disease is most likely to be diagnosed between the ages of 20 and 40. The cause of the disease is unknown but there is some evidence that it may be caused by the same virus that causes glandular fever. The first sign is usually firm but painless swelling of the lymph glands. Swelling of the lymph glands is a natural response to infection, but in this case the glands are also tender to touch. Other symptoms include tiredness, weight loss, severe night sweats, fever and generalized itchy skin."

Well, that describes me pretty well. I had no idea of the presence of the lump, never felt it, but it was tender to the dentist's touch. And maybe the recurring fevers and fatigue weren't residual symptoms of the flu after all.

"Hodgkin's disease affects the lymph glands and may be hidden in deeper parts of the body as well. Your doctor will want to know whether these lymph glands or nodes are involved as this will influence the kind of treatment required. Common tests include: removal of an affected gland for investigation, a bone marrow sample taken from the back of the hip bone, X-rays and CT Scans.

The treatment of Hodgkin's disease normally involves radiotherapy, chemotherapy or both. The type of treatment depends on the number of clusters of lymph glands and the types of cells involved. For some patients, radiotherapy may be all the treatment they require to be cured. The patient will attend a specialist center as an outpatient for six to eight weeks. Chemotherapy is usually given as injections into veins and tablets may also be prescribed. It is usually given on an outpatient patient basis at three to four weekly intervals over a period of four to six months. Chemotherapy may make patients lose their hair but it will grow back over the next few months. Chemotherapy may cause sickness but doctors will give additional medicines to prevent this."

Well, nothing to worry about there - I already shave my head bald, so how bad could it be?

Then finally, here's the good news: "Even though this is a serious disease, there is a good chance that patients will be cured, especially if the disease is detected early."

So maybe I have Hodgkin's disease and maybe I don't. I will face either possibility with equanimity. In the meantime, there's nothing that I can do about it so I might as well enjoy my life and not worry about things that I have no control over.

It's a Zen thing.

My magnolias still aren't blooming but now the ones near my office are.

The Atlanta Water Department is still digging up the leaky water line on Peachtree in front of my old karate studio.

Saturday, I'm off to the north Georgia mountains for a little recon prior to the June 11 hike with the Zen Center.

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