Journal entry by Linda DeLuca

The radiation finally took its toll on Paul's mouth this year. It began about 10 months ago when everything began to accelerate. His teeth were becoming more and more brittle. Pieces would fall out without warning. Our regular dentist would no longer treat him. It was time to have his teeth removed. He was warned that his deteriorating teeth could also cause heart disease if untreated much longer. Our dentist and ENT highly recommended Jaime Brahim, Oral and Maxillofacial Surgeon with the University of Maryland Medical Center in Baltimore City.  On April 18th he had all of his teeth removed in the hospital because of his higher risk of bleeding or other complications caused by the radiation. 

After the surgery we were told that it would not be uncommon for Paul to develop Osteonecrosis of the Jaw.  He was at a higher risk of developing it because leading up to the surgery in April he had dealt with two bouts of infection in his jaw already.  After the surgery the infection quickly came back. They've tried many different combination of antibiotics and antifungal medications.  He experienced severe side effects with every combination.  

Finally after three months of going back and forth, with nothing working, we were scheduled to see Janaki Kuruppu, MD - Infectious Disease.  We will also be seeing a colleague of Dr. Brahim. She is Donita Dyalram, MD - Oral and Maxillofacial Surgeon.  We had appointments with both on July 20th. A biopsy and culture of tissue in the infected area of Paul's jaw was taken during this appointment. We will be seeing Dr. Dyalram this Friday, August 3rd.  The results, we hope will give us an idea of which direction to go in next.  For now, hot compresses, salt rinses and Ibuprofen is all we can do. 

Stay tuned for results of our August 3rd appointment....
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