Do not go gentle

I’m 75 today. I was born in Whakatane in 1946 and I’ve outlived my poor mother who died at 69. I feel pretty well in my body and brain apart from my head and neck cancer affected mouth. I wouldn’t know I was 75 from how I feel but I’ve got the birth certificate to prove it.

I’m at Greenlane Clinical Centre waiting for an appointment with a maxillofacial surgeon and prosthodontist. It used to be called Oral Health but now it’s called Hospital and Specialist Dentistry, Oral and Maxillofacial Surgery. Sometimes explaining is losing! It’s still the same shabby-clinical place I’ve been coming to for six years with its playground fenced off with a picket fence of coloured toothbrushes.

My son is with me. He’s working on his phone. We wait an hour or so and I am very nervous with a “pit” in the bottom of my stomach. This appointment will determine whether I have an op to remove my bottom teeth, insert some implants and therefore provide me with support for my paralysed left lower lip. It’s risky though and I had a bad report from my Cone Beam scan. Yes the mandible was okay but the maxilla showed signs of osteoradionecrosis already.

Finally we go into the clinic room and see both men who virtually plan the surgery in front of us: which teeth to take out, where to put implants. The maxillofacial surgeon tells me that the signs of ORN shown in the cone beam scan are not of great concern. Lots of examining and discussion. Is my trismus a problem? Should I continue to stretch. Maxillofacial surgeon said the scarring in my jaw would be set by now and I could only have improved it in the time after the flap surgery. It’s been 6 years after all.

There’s a pleasing decision to be made but before that a typical cancer rollercoaster plunge. The prosthodontist asks the maxillofacial surgeon to look at a patch of buccal mucosa near my back bottom teeth. There’s muttering.

The decision is to remove the bad top teeth which won’t affect my plate and the bottom teeth apart from one at the back which is sort of embedded in the gum. They’ll give me up to four implants and “bury” them and then open them up after six months for a week or two before placing something on them to attach a bottom denture. This is exciting but before he goes, the prosthodontist asks the surgeon casually if he wants to look at the right buccal mucosa first. Surgeon says no, we’ll do it at the same time, explaining to me later that it’s unlikely to be cancer and he wouldn’t have noticed it himself but it needs biopsying and he’ll hurry the surgery forward a bit.

These guys are great to me and my son is such a support but for a cancer patient the word “biopsy” has tons of negative connotations. I sign the form but not until I have forced the surgeon to admit the buccal mucosa biopsy, which they weren’t going to mention, is for possible cancer.

Time for me to apply my long held skills dealing with uncertainty. I know I can handle the very small odds of cancer. Still a shadow though.

It’s an honour and a privilege to reach 75 with three lovely sons and two superb grandchildren. I appreciate being treated in such a friendly way by the clinicians. I am so glad they are doing this surgery which has great promise for me (at my age!).

In spite of the buccal thing, you couldn’t really get a better birthday present than some expensive implants for free!