Brett’s Story

Site created on September 16, 2023

It's hard to know where to start - identity? Pathology?  Stories? Hmmmmmm...

Identity is always hard, but since we'll be sharing this with a variety of family and loved ones from many facets of our life and anyone else who finds it interesting, I'll start there.  I'm a husband of Maia, father of Quinn (18) and Wes (15), friend, physician, educator, and proponent of global health and trying to break down inequities in the health of individuals and communities around the world.  In my clinical work at Regions Hospital, I practice inpatient palliative medicine and inpatient general hospital medicine, as well as travel and tropical medicine (trouble committing??). I have been the director of the UMN Global Medicine Program in the Dept of Medicine for the past several years. I teach physical exam approaches with colleagues in the International Organization for Migration, and I also teach communication and medical improv.  

Many will know that I was diagnosed with CLL in 2013, at age 38. In the past, blogging was a way I found helpful to explore and process my own response to how being diagnosed with a chronic blood cancer as a parent of young children and early-career physician. I had appreciated others sharing their stories of dealing with serious diagnoses, so I thought I would add my voice if it's helpful. I don't know what energy and motivation will be like after this surgery, so no promises.  In my work on our palliative care service at Regions, I regularly endeavor to help patients and families walk along their own journeys of serious illness. I would like to think that having my own serious illness with a couple of complications in the past has made me a more empathic physician. And similarly, I do think my work as a physician gives me more insight and experience in navigating the challenges of our complex and fragile health care system. At the same time, doctors and nurses make the worst patients...

In addition to the CLL, I have had a sore on my tongue for about a year. Biopsied twice without evidence of cancer, but biopsied again two weeks ago and found to be squamous cell carcinoma of the tongue. Whether it was missed or the lesion transformed, we won't know. Medicine is imperfect, and things change in our bodies. It doesn't matter.  What I do know is that this Thursday 9/21 I'm scheduled for a "Partial glossectomy and modified radical lymph node dissection." Sounds a bit barbaric.  Next steps from here are a bit uncertain and will depend on Thursday's results. We'll see how it goes. The tentative plan is for me to have an NG feeding tube for about 2 weeks post-op with nothing by mouth during that time. As a lover of food, this could be a bitter pill to (not) swallow.  As a plus, I'll be getting to learn some new things, like what an NG actually feels like. Makes me wonder if I could count hours of surgery and hospitalization as CME (continuing medical education for the uninitiated).

Each of us gets to choose our approach/framework for addressing illness in themselves or others.  I personally don't find the "battle" mentality helpful.  To me it implies that there is a winner and loser - death is at the end of the road for all of us, and it doesn't have to be a loss.  I also have to admit that if I visualize my part in a "fight" I see myself either with my hands up trying to either appease, or curling up in a fetal position on the ground.  I prefer to think of my life and cancers as a journey. There are definitely ups and downs, twists and turns, and easier and harder parts of the journey.  Journeys take strength of will, benefit from companions on the journey,  and can be both joyful and painful. 

So - we're expecting this next part of the journey to be a challenge. This was not on our fall plan, which involved a few trips for both work and vacation, navigating college applications, and adjusting to sophomore year of high school with increased academic demands. But we have taken solace in a few things:



- We are incredibly grateful for our family, friends, and colleagues. Thank you for your love and support
- We have a fun and great family
- We appreciate the support and flexibility of both of our workplaces
- We are grateful for my oncology, ID, and ENT teams as we make a plan. We have faith in the team
- People say funny things coming out of anesthesia - apparently I was super grateful to all the staff, which I can see, but I was also SUPER eager to get home and play Mario Kart - which I very rarely play. I was more worried I was going to open with an inappropriate Dad joke
For me, I'm doing OK. I'm trying to face what's coming with a sense of calm and equanimity. And I think I'm there for more of the time than I'm not. It's also a relief that there's no way that I have to feel.  In these next days, surgery's happening no matter how I feel about it, and the next steps will need to happen regardless of how I feel. But I think I'm ready.  



Newest Update

Journal entry by Brett Hendel-Paterson

I have had a few people ask me if I’m okay, since I haven’ t posted in a while. Rest assured, I’m doing well. In looking back, I guess it HAS been a while. 

 

Over Christmas we had a nice visit to Maia’s parents in Colorado. I spent most of the time resting and continuing to recover. It’s always great to hike through the Garden of the Gods in Colorado Springs, and see the Paterson and Bernthal clan.  I’m happy to report that the pain has improved a lot! I’m off of all of the pain meds now, not even needing Tylenol. After having over a year of pretty constant pain, it’s interesting how quickly I have starting taking “no pain” for granted.

 

I’m definitely still in a recovery phase, trying to take stock of what the effects are.  With the surgery and radiation, the back of my tongue has scarred/stuck to the floor of my mouth on one side (it sounds more dramatic than it is). I’m doing regular speech therapy and swallow exercises to stretch the tissue and strengthen the tongue. I have a series of about 15 exercises that I’m supposed to do 10 times each, and repeat this 3-5 times a day (so 15x10x = 750 exercises a day!). When I last saw my speech therapist I told her I expected the frequency of exercises would decrease soon. She wasn’t impressed. She told me to expect to continue to do them for the next two years. Apparently the scarring post-op and post-radiation takes a long time to fully declare itself. I told her that since I’m a doctor, surely the “usual” approach doesn’t apply to me. Her response was something along the lines of an eye-roll and side-eye at the same time... 

My taste is coming back. As predicted, sweet and salty were the first. Spicy food is out for now, and acidic foods are a challenge. The radiation damaged my salivary glands, so things like chips and crackers take some sipping of a beverage to be able to eat them. I also have to keep my body and neck moving – I seem to get stiff really fast. I know things will continue to evolve over the next year or so, but I’m still improving. I’m noticing that I get tired more easily than I did before, too. I’ll be fine until I’m not, and then Ihave to crash. Over time, I hope that I can predict this better.

I am officially back at work, helping out on pall care for a few shortened days last Thursday and Friday. This ends a four-month hiatus from working as a physician. I’ve never taken so much time away! I wasn’t sure how I’d feel about coming back - it was emotional driving into the Regions parking ramp, and a bit nerve-wracking to be back on the wards. Thankfully I could still find patients, restrooms, etc. I was pretty wiped out after the first day. The 2nd was better. I’m starting back working on palliative care, and I still have a few more weeks before I’ll do a 7-day stretch in the hospital (my usual schedule). One of the biggest challenges is going to be easing in, rather than jumping back in to the same schedule and workload. I am fortunate to have really supportive colleagues – the expectations and pressures are all my own. You would think that I would be better about regulating myself after years of working with CLL. But there are so many interesting things to do, and saying no is hard…

In terms of next steps cancer-wise, the hope is that I am cured. I’ll have a PET scan in March looking for residual cancer. If that’s negative, I’ll be in for regular scans (every 6-12 months) to monitor for any signs of recurrence. In the meantime I will (reluctantly) continue all of my speech and swallow exercises. I will also likely back off quite a bit on how frequently I’m posting to Caring Bridge. So assume that no news is good news!

Thanks to everyone who has been following along and offering words of encouragement. It’s going to take time to understand how all of this has affected me, and my family. But we appreciate the love and support. It has made a difficult time easier on us. 

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