Hello my name is Adam, I’m 48 years old and about to celebrate one year since finishing cancer treatment for a squamous cell carcinoma in my left cheek.
It all started in early 2021. I noticed something was wrong when I felt a sharp pain when I put my head on the pillow. At first I thought I had been bitten by a bug while out walking in the forest over New Year.
When the spot on my face became more of a bump I went to see my GP but he was away and I saw a locum. I was prescribed antibiotics. That was a total waste of time.
After finishing the 2 week course of antibiotics prescribed, I went to a different GP and told him my history of having a squamous cell carcinoma removed from my left temple back in September 2017. I felt like this was the same thing. He gave me 2 weeks of antibiotics but also made a request for me to see the Ear Nose & Throat Department at Auckland Hospital.
By this time the area had swollen and was starting to close my ear canal and there was a messy discharge from my ear. My ENT consult with Louise in March 2021 confirmed there was nothing wrong with my ear so she referred me to her colleague in the cancer department.
My next consult was the most productive from my point of view, I was examined by the specialist who also video-conferenced with some of his peers around the world I think. They all agreed that it was a very aggressive and fast growing cancer.
Off for a biopsy, CT scan & MRI then back in for a meeting. This was when I was told it was a cancer but the biopsy was inconclusive and that they would try to get me into the Multi Disciplinary Meeting next Friday 16 April.
That was the hardest day ever. In the MDM you get to meet everyone who will be involved in your treatment and recovery, you sit in a consulting room for hours and one by one everyone comes to visit and give you the worst case options.
Another biopsy this time a FNA, fine needle aspiration, that was the most painful experience of the whole process so far.
Now it was the 3rd of May and I checked into Ward 74 at Auckland Hospital for my pre-op blood test and final checks. My surgery was early on the 4th so I didn’t sleep much the night before. The nurse came to wake me about 5am, one last shower and wash my hair ( don’t shave as they don’t want any damage to the skin ).
Pre-op was a bit like a dream – lots of people around me some talking to me, most talking to each other The only things I remember were the ENT doctor stopping by to tell me she would be involved in the surgery and a surgeon with the name Robbie on his cap.
Rolled into the Operating Room, oxygen mask on, said, “it smells funny” and then I was gone.
I was woken by the ICU nurse asking if I knew what day it was. I said Thursday. She smiled and said it was Wednesday morning, I had been in surgery for 12 hours and slept for the next 8 hours before they woke me – somehow I totally lost Tuesday. They asked me if I could stand to get off the surgical bed and onto a ward bed. I remember saying, ” I’ve got no legs.” They were just numb and useless.
Two nurses helped me prop myself up using my arms and one said, ” How tall are you?”
I answered, ” 6 ft 3 “.
She laughed and said, “NO you’re 5 ft 3 like me.”
That was my motivation to pull myself up.
“Oh there’s the 6 foot tall,” she said as they quickly replaced the bed from behind me and lowered me onto a nice clean ward bed for my ride back to ward 74 to start the recovery process.
My wife, workmate, his wife and 1 year old daughter came to see me on the first night in the ward. I must have looked terrible. They had removed the squamous cell carcinoma from my left cheek but also located an adenocarcinoma in my saliva gland so that had to go too. My left ear drum and canal were also removed. Then just for good margins they also removed part of my jaw bone, a number of lymph nodes from my neck and 2 wisdom teeth, more on them later.
The thigh flap in place
To repair the big hole in my face they took a chunk of my right thigh including the quad muscle and 2 blood vessels to be attached onto the blood supply in my neck. This left me with a scar from the top of my leg down to the knee with a piece of meat the size of my hand missing, replaced with stitches and staples.
The lateral thigh flap wound
The next few days are a blur, visits every hour or 2 to check my blood pressure and also listen to the blood flow through the free flap grafted onto the side of my face. I remember not even being able to eat, just living on Fortisip meal replacement chocolate milkshakes. I also remember the surgeon Robbie. Whenever a group of people came in to visit, he was always there with his name on his cap.
At this stage I had 3 vacuum bottles hanging out of me, 2 on my neck and one on my leg, oh and a morphine pain pump. My only clear memory of this time is not being able to sleep one night and pressing the morphine button just to see if it would help. It did but before I went to sleep I had the most interesting experience. I felt like the bed was quicksand and I was sinking into it. I remember feeling that I was drowning and my feet were up in the air and my head was under the water. It was so warm and inviting I didn’t care, I just watched the water close over my body as I sank into the bed and fell asleep.
They took my morphine pump away the next day as I had only pressed it twice so I obviously didn’t need it. Over the next few days I became more mobile and could walk with a crutch to carry my 3 bottles. I was starting to eat again but struggling as my mouth still didn’t want to work properly.
Taking myself for a shower was a great milestone for me. I’m thankful for the nurse who helped me take my first shower & clean all the mess out of my hair.
I was taken down to have a dental X-Ray to check on my broken wisdom tooth. I remember riding down on my ward bed and being left in the corridor because they were so busy that the waiting room was full. It wasn’t that the Radiology was busy but they just couldn’t get enough runners to take people back to their wards, I was in the red lane ( cancer treatment so I went to the front of the queue ). I felt sorry for those people waiting & for the overworked orderlies trying to clear the backlog. I was taken back to ward 74 by someone from the emergency department. He told me it was COVID protocols that had slowed down patient transfers as you had to have a complete change of PPE if you entered or left the emergency rooms.
About a week after surgery I was taken to the dentist as they had removed my wisdom teeth on the left side to make way for the radiation treatment but one of the teeth had broken & left the root in my jaw. This was the most painful experience of my life. The Novocaine didn’t work for me. I was given 3 shots then they just went ahead & pulled the root out. The dentist was amazing, talking to me & keeping me calm through the procedure. I could barely open my mouth enough to get a finger between my front teeth. By the time she had finished I had sweated my shape into the chair.
Day by day my mobility improved, one by one my bottles were removed, then it was a big surprise that on the 11th of May they said I could go home if I could walk up & down the stairs – they didn’t have to tell me twice. I’m out of here!
I went back to work a couple of weeks later. Life was almost back to a normal routine except for the twice weekly dressing changes at Greenlane Hospital.
Early June I went in to see the Radiation Oncologist, had a mask made & had a CT scan to plan my Radiation Treatment. The next stage was radiation therapy starting early July & finishing on the 13th of August, 5 days a week. I learned a lot about the machines & the technology.
The worst thing about radiotherapy is being bolted down
During this treatment it was like I had the worst sunburn of my life just down my left side. It looked so funny as I was told not to shave as it could damage the skin & cause an infection. After about 3 weeks all the hair fell out on the left side so I was half werewolf & half tomato.
Radiation was surprisingly easy and uneventful. Go to work in the morning, off to the hospital for treatment in the afternoon then home for dinner 5 days a week. The worst part was losing my taste & everything tasting like I had a mouth full of garlic salt, not a bad taste but it didn’t go well with chocolate and a persistent sore throat that just wouldn’t go away. I think I lived on pasta with sauce for about 2 months. I was so pleased that my taste returned a couple of weeks after the treatment finished & eating returned to my new normal.
Half werewolf, half tomato
January 2022 I had a small surgery under local anaesthetic to remove another SCC from under my left eye. It was a quick in & out visit with a few hours in the transition lounge before & after the surgery then I was home for dinner.
July 6th was the day of my latest surgery, a 90 minute procedure to realign my left ear. This was a straight forward operation. I arrived in the transition lounge to have a Covid RAT test, all clear as expected but it’s a great way to protect everyone else in the hospital. A quick questionnaire about my medical status & consents were signed. Walking down to the pre-op room to change into my surgical gown & a last minute chat with the surgeon about what we are trying to achieve today then a final consent with my anaesthetist.
Walk into the operating room only to be asked to take off the blue wrap-around gown followed by a quick laugh as someone said it’s not blue it’s purple. I said you’re all wrong its RAF Azure Blue as used on the underside of a Spitfire Aircraft. Lie back on the table as a line is put into my left arm & a mask goes on my face. She says you may feel a little drunk. I say “the worlds gone blurry” & the lights go out. Wake up about 3 hours later in PACU (post anaesthesia care unit) to hear the nurse call my wife & let her know I’m awake. A quick ride up to Ward 74 in time for dinner. I don’t sleep well in hospital. After a day doing nothing it’s hard to sleep, a shot of IV antibiotics and a blood pressure check before breakfast.
A smiling hello from my friend Joyce as she will be my nurse for the day then just a couple of hours later I’m handed my discharge papers a prescription & told I can go home now. A quick consult with Joyce about what I need to do for the next few days & I’m on my way back home.
The dressings came off 2 days post op with only a little cleaning required and a light application of Epicyn ointment to keep the suture line soft & clean. I’ve been so lucky with very little pain throughout the entire process.
Maybe nurse Jackie in the transition lounge is right, ” No Brain No Pain ” I’ll happily accept the no pain bit.
