6.04.2012

Under the Knife

At around 8:15 this morning, I was laying back in a dentist's chair having a needle inserted into the underside of my tongue. Once the anesthetic rendered everything of consequence perfectly numb, the surgeon picked up his scalpel and, much in the manner of tracing an outline on paper with a pencil, incised and removed a small, flat oblong piece of my tongue measuring about 8mm in diameter. In expert fashion, he sutured in the wound, winding the thread around the curved needle with a well-practiced speed and precision. In less than five minutes, it was done. If only the excruciating pain of the aftermath was so short-lived. 

I knew exactly what to expect, having had this procedure done twice in the past, albeit not quite as extensively. Perhaps I could blame it on several years spent smoking cigarettes in my youth, but for whatever reason for the past ten or more years I've had small, abnormal patches of tissue on the side of my tongue. Albeit painless, these types of things are always worrisome because occasionally they turn into oral cancer, which is certainly not painless and often involves much more cutting than the simple biopsy I had today. Fibrosis, epithelial hyperplasia, dysplasia; only histology will evince an exact answer, but right now the largest of my areas of mystery tissue is on the way to the lab.

This is probably a good thing but would be much more easily celebrated if it wasn't so mind-bendingly painful after the anesthetic has worn off. I can say for certain that Tylenol/Hydrocodone combo pills do little to placate the agony save offering an hour of mild euphoria (and that's probably not the Tylenol silently destroying my liver). Though hungry, the logistics of eating are slightly more than I care to unravel today. Swallowing water is a feat not to be taken lightly, especially since with each gulp the accompanying ripple of muscle activation through the tongue sends a bolt of lightning through my embattled nerve endings. The pain is, in fact, what prompted me to write a few words. It is a meditative sort of pain, unyielding and fierce. In these cases I always find myself delving into the sensation with fascination, trying to uncover the secrets to why it feels so unequivocally horrendous. The brain is in command of this interpretation, of course, and with good reason: the pain is there to warn me that there are six stitches in the side of my tongue and a sizable chunk of skin missing. With painkillers there are the effects of both direct analgesia and, with opioids, distraction. Neither really tackles severe pain completely, it seems, so for these (thankfully rare) moments (days, in this case) of intractable pain there really isn't any other method of management other than with the mind. Maybe by focusing brainpower one way or another it's possible to understand the pain as a mere ephemeral sensation and simply see through it. By another name, perhaps, this would be meditation. As pain management is a multi-billion dollar industry fraught with addiction and greed on the part of drug manufacturers, I wonder whether these of non-pharmacological techniques are considered at all? It seems that with so much treatment failure (with drugs, at least) there have to be better elements to explore that involve more personal responsibility and introspection. Who knows? I'm gonna keep popping my pills, of course, but it seems like I'll have to use a little brainpower in preference to just drinking milkshakes and suffering, although those are certainly on the menu for this week.

So don't smoke cigarettes unless you want to regularly have someone cut pieces from your tongue and sew it back together like a sweatshop garment.

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