Thrush Sighted in Baltimore

It was very comforting to be back in the care of our wonderful doctors.

Ernie started the day with a swallowing study. Unfortunately the study showed he is still at risk for aspiration. This means at least two more weeks of sleeping sitting up.

Next up was the Radiation Oncologist whose job it is to evaluate the effect of radiation on the throat and mouth. He invited the Medical Oncologist to the appointment too so she could view the Endoscopy and do a joint consoltation. Unlike the Winston-Salem doctors who "couldn't be sure" if Ernie had oral thrush or not, these doctors agreed that he had thrush and a rather severe case at that. They feel that the thrush is largely responsible for the swelling and the pain. On a 5 point scale where 5 is the worst case of thrush, they rated him a 4.

The docs in Winston-Salem had started Ernie on a mild thrush drug but it was obviously not effective. So, tonight we start on the strongest thrush drug. Ernie was on this drug last time he had thrush and did fine. This time, however, he is on some narcotics that can cause some scary interactions (ie-you can stop breathing). To reduce this risk, we will cut back on the narcotics. Everyone agrees that more pain is the preferable option.

We were coming back to Baltimore on January 3 for an MRI to check for cancer cells. Now we will also use that visit to reevaluate the state of healing in the throat. Best case is that eliminating the thrush eliminates all problems. Another possible outcome is that there are complications with his throat and voice box that will need to be addressed. The Radiation Oncologist said Ernie's throat had the appearance of someone that had the full 7 weeks of radiation, which could cause the complications.  We are trying to focus on the upside.