by Bob Brecht
– Part One
In the last 10 years, I have had four head and neck surgeries for malignant tumors, two courses of head and neck radiation and one lung surgery to remove two nodules, which turned out to be benign. I had two face and neck reconstruction surgeries, too, and 30 hyperbaric oxygen treatments for a broken jaw due to osteoradionecrosis. They wired my jaw closed for six months to try and get some healing. But it is the details of the first surgery that stick in my mind.
In my Philadelphia hospital, they allowed me to walk with my wife Susan from the prep area to the elevator for the ride up to pre-op. The nurse escorted us. I pulled along the wheeled stand that had my IV bag swinging to the rhythms of our steps. I held Susan’s hand and assured her that everything would be OK. She was allowed to come with me into the elevator. When we arrived at the O.R. floor, though, she had to stay put.
I kissed her and walked out of the elevator and turned right toward the doors to pre-op, pushing the IV pole along. I heard the elevator doors close behind me and, for the first time, I was filled with fear. I felt alone and scared witless. I choked up. But I pulled myself together by thinking, “It’s O.K. It’s time. This is right. Do this.” The nurse opened the doors to pre-op and I walked in. I climbed onto a gurney and became another sheeted figure in a room full of sheeted figures, each with an IV tree standing nearby like a stainless-steel sentinel. I awaited my turn.
That was in November, 2002. About three years before this event, my internist, whom I saw annually for a physical, was so concerned about my lively drinking and smoking lifestyle (even though I had quit both in 1995) that he recommended an otorhinolaryngologist for me to see twice a year. He knew I had the classic profile for head and neck cancer. And so began my long relationship with the head and neck surgeon who saved my life numerous times.
In January, 2002, one of our adult sons, Ben, died unexpectedly. It broke my heart and Susan’s too. Our other son, Adam, was devastated. It changed things forever. My internist told me that carrying a heavy burden of grief can sometimes stress the human system in difficult ways, and he encouraged me to be especially vigilant for anything going wrong in the coming months.
In the spring, around the time of my 61st birthday, I found two swollen lymph nodes in my left neck. My surgeon needle-biopsied both and found that the swelling was caused by infection. He prescribed a course of powerful antibiotics, and the swelling subsided. But that summer, I never really felt well. It was as if I had a low-grade fever. My energy was sagging. In October, the two nodules swelled up again, and open biopsy was recommended.
The November, 2002, surgery was fairly straightforward. The surgeon removed the nodules, and while I was still open, they found that the infections in both of them were encased in malignant shells. The needle-biopsy had pierced through the shells and had extracted only infected material — missing the malignant cells in the casing around the nodules. With this information in hand, he continued the surgery by removing a dozen nearby lymph nodes to make sure the area was clear of cancer. Then he sewed me up: a neat, now barely visible six-inch scar on the left side of my neck. The diagnosis was squamous cell cancer of unknown origin.
Thirty radiation treatments were recommended, and I completed them on Jan. 31, 2003. I was asked if I wanted to have a feeding tube inserted because the inside of my mouth would be burned and irritated by the radiation. I said no, and for weeks I ate nothing but a liquid product called Resource 2.0, which provides perfect medical nutrition. I lost my sense of taste, and for a few months I ate no solid food other than ice cream, scrambled eggs and smoothies. It hurt to swallow anything and everything. It was, I am told, a very heavy dose of radiation. The fatigue I experienced for months after the treatment was unlike anything I had known before.
That spring of 2003 my energy was limited, but I had an idea for a good project. My wife and I bought a deteriorating 30-year-old, 19-foot sailboat. We named her Moonshadow. And while I lacked the wellness to be on my feet working for hours, I found that I could work on her quite well on my hands and knees: sanding, painting and varnishing. I had never done anything like this before. It’s amazing what you can learn by reading the directions on cans of paint and varnish. It gave me a real sense of purpose and accomplishment and made me feel alive. How I loved Moonshadow. She was beautiful when she was finished, and I sailed her every minute I could that summer.
The burns in the lining of my mouth and esophagus healed in about six to eight months. It is odd how that happens. The eating disabilities diminished so slowly that I often did not recognize how much progress I was making. One day late in the summer I realized I was pretty close to normal again. My energy was much better, and I knew that some working out would get me back to where I had been. It was still hard to tolerate hotly spiced food, but otherwise I knew that I had recovered well. My sense of taste was back. I could swallow solid food with only occasional difficulty by lubricating it with water. Meat was always difficult, though, so I gave it up. I was already used to carrying a water bottle with me to help with the dry mouth, and I was eating a fairly healthy diet.
I was cancer free for what seemed a long time except that I had many early stage skin cancers removed. It reminded me that all of those wonderful shirtless, shoeless summers I spent along the Toms River in New Jersey when I was a boy may not have been quite as healthy as my mom thought. But I did learn to sail a little eight-foot boat, and that led me to Moonshadow and more adventures later on. What a great gift from those summers.
Three years after that first surgery, I was diagnosed with a squamous cell tumor on the right side near the parotid gland. Surgery was scheduled for Dec. 23, 2005, which included a partial parotidectomy. The diagnosis was the same: squamous cell cancer of undetermined origin. No further therapy was recommended, and recovery was less arduous, but I had a greater saliva deficit because my parotid was partially gone. I knew what to do about that. Never forget to bring the water bottle.
Bob Brecht was born in Glenside in 1941 and graduated from Abington High School in 1959. He graduated from Brown University in 1963 and taught German, Latin and English at schools here and in Puerto Rico. He worked for the Philadelphia Urban Coalition, ran his own live lobster company and helped start the International Technology Exchange Center at the University City Science Center. He is now retired and living with his wife of 42 years on the Toms River in Pine Beach, N.J. Bob’s father, Raymond C. Brecht, was a reporter for the Philadelphia Bulletin and was Time Magazine’s White House reporter during World War II.
Part Two next week…