Health Fitness

All I want for Christmas is to eat solid food: A throat cancer patient’s wish

This First Person column is written by Glenn Deir, a retired journalist who lives in St. John’s. For more information about CBC’s First Person stories, please see the FAQ.

I was a six-pack-a-day man for five months.

Not beer — god no. I haven’t touched alcohol of any kind since early summer.

My six-pack was Boost, the meal replacement drink. It promised the nutrition I needed to get more out of life.

My goal was much loftier — life itself.

I had my last normal meal — tenderloin steak — the night before my throat surgery on July 13. The right tonsil, a piece of the back of my tongue and the tissue in between had to come out because they were jam-packed with cancer.

Afterwards, the surgeon declared my throat to be “normalish.” Unfortunately, not normalish enough for solid food.

Boost (the vanilla or strawberry flavours) and puréed food kept me alive. There’s nothing more unappetizing-looking than a slurry of meat and vegetables. A pasty spoonful of lamb chops and green beans doesn’t taste much like either.

No wonder I lost 15 pounds.

My diet couldn’t change because I kept “failing” swallow tests. The test in August had me sitting next to a camera shooting X-ray video of me downing teaspoons of liquid and food laced with barium. Christina and Kerri, who are speech language pathologists, anxiously watched a monitor as my throat muscles struggled to safely squeeze nourishment towards my stomach instead of my lungs.

Water got into my airway, touching my vocal cords. It should have triggered a cough except it didn’t. But it was the dense pudding I was served that kiboshed the rest of the test. It got hung up at the base of my tongue and not even multiple swallows could entirely clear the blob.

My tongue wouldn’t curl like it once did, the flap which keeps food out of the windpipe didn’t always flop over properly, and my throat-clearing reflexes were rusty. I was deemed not ready for solid food.

Still, my health-care team at St. Clare’s Hospital in St. John’s didn’t give up on me. They would try again, but first I had to get through radiation treatment and chemotherapy, plus cancel a moose hunting trip. I wasn’t healthy enough.

As part of his treatment, Deir received targeted radiation to his throat. The machine is designed to deliver precise radiation to tissue, while he was pegged to the table by an immobilization mask to ensure he could not move. (Submitted by Glenn Deir )

Returning my licence and tags, and being eligible for the draw again next year, required a sympathy-inducing letter to the provincial wildlife department. My radiation oncologist, Dr. Brent Tompkins, wrote I was quite unwell, would require months of convalescence and needed the daily support of my wife. He drafted the letter without a moment’s hesitation or murmur of complaint

The Good Glenn was grateful. The Evil Glenn daydreamed. I imagined Dr. Tompkins railing to the other doctors at the cancer clinic about wasting his time. “I’m trying to save lives here and the only life this guy is concerned about belongs to a moose.” His stethoscope-wearing audience shake their heads in disgust.

Blasted by radiation

Such dark fantasies kept me amused while being blasted by radiation twice a day. Should the Good Glenn ultimately bag an animal, some moose could go from my freezer to the good doctor’s.

I was reminded during treatment that even liquids have risks. While hooked up for chemo, I swallowed water the wrong way, which prompted a coughing fit.

A nurse rushed to my side.

“Are you all right?”

“Don’t worry,” I said, after catching my breath, “I won’t die on your watch.”

An X-ray of a skull, with a finger pointing to a computer screen.
Deir points to a frame of X-ray video, that shows unswallowed pudding. It had become caught in a pocket at the base of his tongue. (Submitted by Glenn Deir)

“That’s good. There’s a lot of paperwork.” We shared a laugh.

No matter how tired I was, I always found the energy to do my tongue, jaw and swallow exercises, often while gazing through the bedroom window. I can only hope I didn’t stick my tongue out at any of the neighbours.

By late November, the cancer treatment was in the rearview mirror and I was ready for another swallow test. My exercises paid an unexpected bonus.

WATCH | For some cancer patients, Daffodil Place in St. John’s will be their home this Christmas

Cancer treatments during Christmas: How Daffodil Place tries to ease minds and lift spirits

For some people undergoing cancer treatments, the Daffodil Place Lodge in St. John’s is a far cry from the sterile environment of a hospital. It provides three meals a day, transportation to and from appointments, long-distance calling and at a cheaper rate than a hotel. Manager Carl Smith tells CBC’s Heather Gillis this holiday season, 27 people will make it their home for the holidays.

“You sound like Sean Connery,” said Christina, the speech language pathologist.

When you sound like the Scottish actor who played James Bond, it’s going to be a good day. And indeed, it was. My swallowing had improved enough to qualify me for intensive swallow therapy. One hour a day, five days a week, for at least three weeks.

My culinary world opens up

My instructions were simple: put my tongue to the roof of my mouth, swallow fast, swallow hard. Keep swallowing until the food is gone.

First up, a pudding cup. I wasn’t self-conscious about eating until I had a speech language pathologist — sometimes two — intently watching my throat and counting every swallow. It took 110 swallows to get that first pudding cup down.

Week two was my breakout week. I ate solid food for the first time in five months. That honour fell to a humble banana, cut like coins. They found the right path down. My culinary world opened up — mac and cheese, chicken pasta, apple pie — anything soft. Steak has to wait.

Swallowing my food requires considerable encouragement. Radiation has permanently reduced my saliva to a trickle. I’m allowed an apple sauce chaser and water. If water were beer, I’d never be sober.

I still cough sometimes but I haven’t aspirated yet. These are meals of small bites, countless chews and enough swallows to try the patience of even the most dedicated speech language pathologist.

I once was so slow that my wife brought her knitting to the table.

I might be the last one to finish my Christmas Day dinner, but I’m pretty sure I won’t be eating gruel.

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