One Year, Eleven Months Post-Treatment Follow-up Appointments, October 29, 2013

My follow-up visits with my treatment team physicians went well on October 29.  My chemical oncologist, Dr. Shanti Marur, had informed me in April that she would be moving to a different hospital and that a new medical oncologist would join my treatment team.  That turned out to be Dr. Hyunsoek Kang, who had reviewed my case history and examined me.  He found my recovery to be going well and reviewed my blood tests results from this visit.  He recommended that I return to Hopkins for my next follow-up in six months and that the return interval would become yearly in the fourth and fifth years following treatment.  He went on to say that if no sign of recurrence occurred after five years that I would considered cured.  Next, my radiological oncologist, Dr. Harry Quon, examined me, including with his endoscope, finding tissue healing to have progressed well.  He viewed my re-grown beard with his endoscope, recording the image to document how his precise targeting and execution of my radiation treatment avoided my lower jaw.  That was important for minimizing impact to salivary glands with the benefit of re-growth of my beard to neatly follow my jaw line.  Dr. Christine Gourin, the head and neck surgeon on my treatment team who was the first physician whom I saw at Johns Hopkins following my initial biopsy in Costa Rica and who diagnosed my cancer, also scoped me and found my tissues to be recovering well.  I mentioned to her that I had experienced some occasional instances of aspiration of liquids and food, and she asked if I was seeing my treatment team speech/swallowing therapist on this visit.  I wasn't, and I commented that I had never had a swallowing test when I had seen her on previous visits.  Dr. Gourin made an entry in my chart that my next visit in six months should include a swallowing test.  She asked me if I had been regularly doing the swallowing exercises that my treatment team speech/swallowing therapist had provided, and I said, "Not very regularly."  She stated that patients who had undergone concurrent chemo-radiation treatment and had daily performed the swallowing exercises during and after treatment had been found less likely to experience swallowing difficulties years after treatment, whereas patients who neglected to do the exercises often developed swallowing difficulty.  So I need to get on the ball and resume daily exercises to strengthen my swallowing muscles.

I had made an outpatient appointment for the Johns Hopkins Dermatology Department prior to my travel to Baltimore in order for a skin exam.  Both my father's and mother's sides of my family have some history of skin sensitivity to the sun.  At my appointment, the same day as my appointments with my cancer treatment team, a lesion on the right side of my face that I had been concerned about was biopsied.  Last Friday I received a call from a nurse in the Dermatology Department to inform me that the biopsy was positive for basal cell carcinoma.  Because I'm flying to Chicago tomorrow, November 4, I can't have the lesion removed at Hopkins and will try to get that done at a facility in Chicago before returning to Costa Rica on November 11.

Once again, the best part of my visit so far to the States was seeing and spending time with our daughter Raquel.  I'm very grateful for the hospitality of my friends Mark and Bella Smith in Vienna VA and of my friends Tony and Cheri Catanese in Harpers Ferry WV.  This week will bring the joy of visiting our son Tim, daughter-in-law Bret, and first grandson, Ollie, in Chicago.

One Year, Four Month Post-Treatment Follow-up Appointments, April 16, 2013

I returned to Johns Hopkins Hospital's Sidney Kimmel Comprehensive Cancer Center's Head and Neck Cancer Center for follow-up appointments on April 16, 2013, one year and four months post-treatment.  My doctors had not indicated a PET or CT scan for this visit, apparently an indication of their determination that I was recovering well from treatment and that the four post-treatment PET scans would have shown any tendency toward re-initiation of tumor growth.  Doctors Marur, Gouin, and Quon all examined me this visit, Dr. Gourin with an endoscope.  Dr. Quon examined my tonsillar area and larynx visually and tactilely.  They all commented that my tissues had healed so well that it wasn't apparent that I had undergone radiation treatment.  Dr. Quon commented, I sensed with a bit of pride over the skill of his programming of my radiation field exposure, on the re-growth of the hair of my beard along my jaw and the substantial saliva on his examination glove when he removed his fingers from my gullet.

My doctors recommended that I return for my next visit in six months.  Since they'll probably want a two-year post-treatment PET scan, I'll need to clarify whether I return in October, which would be six months from this visit, or in early December, which would be two years following the end of my treatment.

As always, I've enjoyed seeing and spending time with Raquel, who once again drove me to my Baltimore for my appointments, and also visiting my friends Mark and Bella Smith.  Mark and I played 18 holes of golf (with a cart) on the Lakes Course at Twin Lakes Golf Course in Centreville VA.  I also went into Washington DC one day and visited the Sackler Gallery of the Smithsonian Institution to see the Cyrus Cylinder, with its cruciform account of King Cyrus II of Persia's liberation of the Jews and other peoples from slavery upon his conquest of Babylon around 530 BC.  The sun-baked clay cylinder, discovered by a British archaeologist in 1879 while excavating Babylon, resides permanently in the British Museum, and was loaned to the Iranians in 1971 when Shah Pahlavi celebrated the 2,500 anniversary of the Persian empire of Cyrus the Great.  A replica of the cylinder was presented by Pahlavi to the United Nations, which considers Cyrus's declaration engraved on the cylinder that the peoples of his kingdom were free to practice their religions and customs and have their religious objects returned to be the "Original Declaration of Human Rights."  I was fortunate that my follow-up medical visit allowed me the opportunity to see the Cyrus Cylinder in person.

I fly tomorrow to Chicago to visit Tim and Bret and meet my grandson Oliver Stephen Ford.  I'm excited about holding and getting to know our first grandchild.  Damaris flew there the day before I flew to DC, and has no doubt already spoiled Ollie.