Journal entry by Linda DeLuca

We had our appointment on Friday, August 3rd with Dr. Dyalram. It was decided that surgery is Paul's only option for the possibility of relief from the infection and pain he is experiencing.  The surgery is scheduled for October 2nd and will be performed at the University of Maryland Medical Center on Greene St. in Baltimore City.  For now he needs to be there at 6:00 a.m. but they will be contacting us the day before after 1:00 p.m. to change and or confirm his arrival. It will be an 8 hour surgery and he will be in the hospital for 5-7 days.  They will have to perform a tracheostomy during the surgery and it will stay in during his stay but is assured it will be removed 24 hours prior to being released. 

The surgery will consist of cutting out all of the dead bone of his jaw until they reach strong live bone. The CTA scans revealed a minimum of about 3-4 inches of jaw bone on the right side of his face will need to be removed.  He does have some Osteonecrosis on the left side but they will not make that call until they are in surgery.  They will be harvesting bone from his right lower leg along with flesh and blood vessels.  The bone will be shaped and inserted, using a plate and titanium screws to attach it to the live bone.  Since he has no blood supply to the dead area of his jaw, the blood vessels and flesh will need to be connected to good vessels in his neck area. 

He is anxious to have this done.  The infection in his jaw is constant as well as painful. He looks like a chipmunk who has a baseball in his cheek :-(  Since he has had so many bad reactions to pain medications we have been limited to what he can take. Vicodin is one of the few he can tolerate for everyday pain. It doesn't make the pain go away but it does dull it a bit.  He is constantly exhausted (with or without the pain meds). Any activity during the day requires naps. Then at night it becomes difficult to sleep through the night. It's such a vicious cycle.  

For me, it's giving me a chance to get caught up on my own doctor appointments.  As well as getting the house in order. For now, we're taking it one day at a time.  He continues to see his Oncologist and ENT doctors every 6 months. Those appointments will be taken care of before the surgery; that will be such a relief.  

Lastly, I want to thank everyone who is still with us on Caringbridge, keeping up with the Journey. We thank each and every one of you for your prayers, thoughts and well wishes. The encouragements help him get through the day at times.  We're staying strong and god willing, we will persevere!

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