Biopsy Report & Long Range Plans

Yesterday, Tuesday, 23 March, was my big meeting with Dr. Hernández, post-surgery (though I had one earlier visit to remove the drainage tube). Here’s what we did and discussed for over an hour. And by the way, all the doctors here take as much time as needed and never rush you, yet they are very punctual with appointments, meaning that most allow an hour or more per patient for consultations. Compared to the states, better service for a fraction of the cost.

Removed the Bandages

Though we actually talked first, this was one of the reasons for this post-op visit included in the price of the surgery.

He is a young surgeon proud of his ability to provide “scarless” facial surgery by closing up the incision with “internal stitches” that I don’t understand, but there were no stitches for him to remove, just the bandages over the line that still shows right now, but will not later as it heals.

Sorry that my “selfie” doesn’t show it better, but he cut me from in front of and above my ear all the way down my neck to nearly the chin, all on the left side.

Then if it doesn’t gross you out, he peeled back the left cheek skin and cleared out all the tumor he could find, including the whole salivary gland and a part of my facial nerve, then put my face back together again. He said that when the swelling goes down, I will look younger on the left side because he stretched the skin tighter or smoother. 🙂 Like an 80 year man cares! 🙂

The Biopsy Report

He shows or explains everything to me on his large-screen computer monitor including photos of the actual tumor whole and when sliced to show what was inside. Then I receive a 3-page printed version of the biopsy including photos (only 1st page at right) but this version is en español which I roughly understand but he promised to send me an English version soon. Expats are more trouble as patients! 🙂

As expected all along but confirmed by this biopsy, it is cancer – invasive epidermoid carcinoma (translation of Spanish “carcinoma epidermoide invasor”). This is the same diagnosis as the skin cancer removed from my left cheek in 2019 by MOHS surgery which is supposed to assure one that all the cancer is removed. So much for MOHS! 🙂 Dr. Hernández said it is possible that a “root” or even a tiny piece of the original carcinoma on the surface was left in the cheek and it grows fast or matastisizes into the tumor that was not found earlier because of staying home for the coronavirus It was a large tumor, 4.5 X 3 cm.

Radiotherapy Follow Up

For the second time, a surgeon believes he “got it all” but that can never be guaranteed and the closest to a sure way is to follow up with radiotherapy. Thus I already have an appointment this Friday with “the best radiation therapist for head and neck” in Costa Rica, another female doctor who is “the best.” She works for 21st Century Radiotherapy, the only private company doing radiation. (None of the private hospitals do. They send patients to this company.) The only other radiation treatment available in Costa Rica is with the Social Security or Public Health at Hospital Mexico, where I had my angiogram. It would be “free” with my national health plan but Dr. Hernaández says they are too slow and could take months or a year to work me in while this private company can get started within a month or6 weeks which he says is essential for a spreading cancer. And of course that is a private doctor speaking. 🙂

But he also said that Dra. Bonilla would know if public health could get to me soon enough and she might be able to work that out, otherwise I will use my “MediSmart” medical discount card for up to 50% off the regular charge at 21st Century. But we are still talking thousands of dollars and me with no insurance. So Friday will be the next big decision time on this latest adventure.

I fully expect to deplete my saving a bunch more (Getting low already!) and have the radiation done with the private company, but will explore every reasonable option with the public health radiation. So another report Saturday on that! 🙂

And About the Eye and the Mouth

I have an appointment with the Ophathamologist in two weeks to discuss a surgical procedure she has done before that partially closes the eye lid and may allow me to have more use of my eye , where now I just keep it covered all the time. It will not bring the blinking back but possibly more use of the left eye.

The mouth will improve somewhat in time – months – but never back to totally normal. I might regain some muscle use on the left side to help with eating and maybe a less exaggerated lopsided smile. We will see! 🙂

And another little amusing side effect, I just learn that when I wrinkle my brow, it wrinkles only on the right side! 🙂

As Doris Day sang when I was a kid . . .

Que sera, sera

Whatever will be, will be

The future’s not ours to see

Que sera, sera

What will be, will be

And the feature image is another shot of my favorite Triquitraque Flowers still blooming! 🙂

¡Pura Vida!

15 Replies to “Biopsy Report & Long Range Plans”

  1. Charlie, you continue to amaze with your attitude of positivity and humor always abounding. My thoughts are with you as you navigate all these different issues and I have no doubt that in a few months, you will once again be as active as you have been. Best wishes. Love the triquitraque, it’s one of my favorites too.

  2. ¡Muchas gracias Marietta! Your kind words encourage me and yes, I plan to stay as active as I physically (and financially) can! 🙂

    Pasa un buen día.

  3. You look great. It is amazing that they are able to do such an involved surgery and the incision marks are so invisible already. I hope you are feeling well and thank you for sharing the details. It helps other people to not be so afraid of medical procedures.

  4. Thank you for sharing. Yes that incision looks so smooth already. Great job by your surgeon.

    You have a great attitude and spirit. That goes a long way in this battle. Continuing to pray for the best for you on this journey.

    Thanks for continuing to share your wonderful gift of photography! The Beauty of nature and your surroundings can be a real comfort in any time of stress.

    Pura Vida!

  5. Charlie, Glad to read that you are not letting this get you down. You are a fighter and are doing what you need to do for your health. Praying for comfort and courage going forward. Thank you for the update.
    Kathy

  6. Your Dr. Hernandez did a great job…big difference from your last selfie! Your next pic reminds me of a pirate with your eye covered…Aarg!

  7. Charlie, you are strength and courage and bravery in one beautiful soul. I am sending
    Big hugs and prayers for healing.Much love, Millie

  8. Dearest Charlie, I am seldom on the computer so I just learned of your latest problem. I am so, so sorry. Your attitude is great and I fully believe you are in good hands from your description. Please know my thoughts and prayers are and will be with you. I wish I could give you a big hug. Having fought cancer, I know you can win and in your case I am sure you can too. My heart is with you and do keep the updates coming. You are loved by so many people including me. I am so grateful for our friendship. Take care. Love, Nancy (Mangano)

  9. Nancy, I am very grateful for our friendship and the memories that I have of time with you and Joe. And thank you so much for your encouraging words! It is good to know someone else who has defeated cancer and I de believe that a positive spirit will help. The most specific prayer is that it doesn’t spread through that facial nerve to my brain. God bless you Nancy!

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