And then the World Changed

Speculations on Natural History

And then the World Changed

I haven’t written a post for a long time, though it’s not because nothing has happened. Quite the opposite, as the Buddhists say, “Life is on fire.”

So what has changed for me? The big change is that I had a big surgery, a laryngectomy, about seven weeks ago. A laryngectomy removes the voice box, the larynx, which allows total separation of the two pathways that normally are conjoined in the mouth, food and air. Now my lungs are only connected to a hole, a stoma, in my throat. Nothing that goes in my mouth can get to my trachea or lungs. Similarly, my mouth (and my nose) are only connected to my esophagus and stomach. I am unable to blow my nose because there is no source of air to push. Coughing only concerns my lungs, not my mouth or nose, though old reflexes mean there are still complementary spasms in my throat, but they are “all dressed up with no place to go”. The core reason to do this was to eliminate aspiration, the leakage of material from my mouth and throat into my lungs, which was causing me to have repeated lung infections leading sometimes to pneumonia. As my surgeon told me when suggesting the procedure: “If you think you can continue to regularly get pneumonia and live a long life you are mistaken.”

So this is my love song to my family. I would undergo a difficult surgery (which actually ended up as three surgeries over the course of a week because of difficulties), go through a tough recovery with various complications, and lose my voice; and the trade-off will hopefully be that I will be there for them for a long time. No promises, no surety, nothing that provides a warm blanket of comfort around the process. Simply put, “Do I want to take a shot?” Big risks and big rewards. I decided to roll the dice.

That was seven weeks ago. So how has it gone?

To start with, as I said, my radiation damaged tissues didn’t want to cooperate so, as I said, one surgery turned into three, the last surgery yanking my right pectoral muscle up from my chest to put it around my neck to stabilize and cover the other work. With three surgeries, three areas of skin were borrowed from my legs to put the seal over the top, leaving me with what looks like the worst sunburn you have ever seen. A chunk was taken out of my right arm, borrowed to form a new esophagus to replace my old radiation damaged esophagus that was basically causing all my problems. And now Frankenstein lives.

As difficult as this has been, and I have purposely left out many gory details and anecdotes, I would be remiss not to mention a couple side benefits of the surgery. First, it should allow me to breathe better. This is not yet true, as I work through healing and management of my new paraphenalia. If I can work through a couple issues my breathing should not be as limited as it was through the tiny opening of my trachaeostomy tube. We will see. The second benefit is the ability to eat now that I don’t have to worry about aspirating food into my lungs. The reformed esophagus is significantly wider than my throat used to be and I am getting about half of my calories orally now, learning what foods I can manage and what foods my stomach and gut can manage. It’s not easily predictable, but more of a trial and error process. Two nights ago was an error and I was up most of the night with a protesting digestive system. It is pretty interesting to eat again though. My somewhat phlegmatic personality is overwhelmed by my subconscious saying, “Hell, yes, I’ll have some of that!”

So the winter is for healing and therapy, probably into February. What therapy can accomplish will be interesting. I am late to start therapy, primarily because I have been occupied with some serious challenges to healing. Hopefully I can make some progress this winter and be ready for a fun and productive spring. And if the Covid vaccine truly becomes widely available then an expansive life can begin anew. The world has changed and I need to respond appropriately to learn how to live an abundant life in this new world.

oo

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Semi-retired agronomist going back to my roots by re-establishing prairie on my home farm