Steps Toward Treatment - Week of August 7

On the afternoon of Friday, August 5, after returning with Damaris from my appointment with Dr. Gourin in which she diagnosed with tonsil cancer, I received an email from Amy Brady, the coordinator of the Head and Neck Cancer Multidisciplinary Clinic, with attachments including a draft letter for dental clearance.  I wasn't surprised that dental clearance was requested, since when my aortic valve was replaced with a bioprosthetic at Johns Hopkins in October 2005, dental clearance was required, for which I had to have a root canal and crown mounted on a lower molar.  The need for dental clearance prior to my cancer treatment caused some concern, because a month and a half ago I broke a tooth in Costa Rica, which was repaired with a temporary crown that I hadn't yet had replaced with a permanent one.  Today I saw a dentist at the dental clinic in Prince Frederick MD used by my hosts here, the Snyders.  Prior to my appointment I called the number for the dentist identified as part of the Multidisciplinary Clinic Team to ask whether a temporary crown would have to be replaced with a permanent one.  He returned my call as I was brushing my teeth in the lavatory of the dental clinic office, and said that the principal concern is that radiation treatment lowers the supply of blood to the jaw, making any tooth extraction or restoration much more complicated, at least during a recovery period after treatment.  The dentist at my visit today provided a letter stating his opinion that my dental health met the criteria established in the dental clearance guidance provided by the Multidisciplinary Clinic.  However, he recommended that I be evaluated by a periodontist prior to my cancer treatment, and an appointment with a local periodontist is scheduled for Thursday.

I was informed this morning by Dr. Gourin's assistant that I'm scheduled for an MRI of my neck area tomorrow afternoon in the Radiology Department of Johns Hopkins Hospital, Aug. 9, and for my PET scan on Thursday afternoon, Aug. 11.

The attachments from Amy Brady included the Guest Acceptance Policy for Hope Lodge, where we hope to obtain lodging during my treatment in the cancer treatment patient lodging funded by the American Cancer Society.