Had my tooth pulled by the oral surgeon today.  It was pretty quick and I was home within an hour of my leaving home.  My favorite part was a comment made by the oral surgeon while trying to extract the tooth.  He said, "Wow!  You really know how to grow roots!"  Apparently my roots were pretty long and hard to extract.  Now on to the healing part...

I went in today for a consultation with the oral surgeon on having my tooth pulled and an implant put in.  It was a really weird visit because somehow he was under the impression that we were going to pull the tooth today.  He came back to talk to me for a minute and then said something like, "Okay, let's go back and get you numbed up."  I stopped him and asked what he was talking about and he said, "Isn't that what you are here for."  I said that I thought I was coming in just for a consultation because I have had some recent health problems that may affect my treatment.  So I told him about the cancer and the Avastin that I have been on and he did express some concern with the Avastin but said that the only thing they can do is to keep an eye on the jaw and treat any infections that come with antibiotics and oral rinses.  He also feels that it would be good to pull the tooth first and give the jaw a chance to heal and then if that heals well we can look into putting in an implant at a later date.  The tooth is far enough back in my mouth that I don't think anyone will even notice unless I show it to them.

I still want to wait a few more weeks if I can before I have the tooth pulled so I went ahead and scheduled an appointment for March 11.  DH isn't too crazy about just having the tooth pulled but at this point I think it is the best option for me and I think that if I can get it done in between any kind of cancer treatments then it is probably the best time frame for me as well.

I called the dentist's office today to ask if I could get a prescription for an antibiotic.  They called one in to the pharmacy today and I picked it up and started taking it.  Hopefully it will clear up the infection quickly.  I also called the oral surgeon's office and set up a consultation for an extraction and implant.  And of course the way that the specialists work is that the earliest they can get me in is February 27 - which will be at about my 3 week mark from my last infusion.  And they won't even do anything most likely for another couple of weeks after that.

One of the nurses from Huntsman called me today to talk some more about the Avastin with my dental work.  She said that she had talked with my doctor and since the Avastin has a pretty long half-life, she recommends that I try and put off any major dental work for 3-4 weeks if I can since I just had an infusion on Wednesday.  I will be taken off of the study and will keep my CT scan and lab work appointment in six weeks as well as meeting with the doctor.  We will discuss then what our next step will be once we have results from the scan and labs.

I asked about getting my port flushed if I am not keeping my infusion appointment in 3 weeks.  It is a good idea to have it flushed at least every 4-5 weeks and I will not be going back in now for another 6 weeks.  We decided to set an appointment for the clinic near me for 3 weeks from now just to have it flushed.  That should be a nice, quick visit.

Some not so great news today.  I had a dentist appointment this morning just for a rountine cleaning and mentioned that I had been having some tooth/jaw pain off and on in the right lower side of my mouth.  This is the same section of my mouth that I have an implant already and then a year after the implant had to have an apicoectomy/root canal procedure on the tooth right behind the implant.  After the hygienist did the cleaning, they took another x-ray of my lower right jaw and the dentist came in and looked at the x-rays and apparently I have some tooth decay on that tooth once again.  The dentist drew me some pictures of what is going on with the tooth and told me what my possible options would be.  My concern with hearing all of these options is that the Avastin that I am on has some warnings with it if there has to be any major dental work done.  The Avastin interferes with the blood stream and clotting and healing.  I expressed some concern to my dentist and he told me which of the 3 options would be the least invasive.  I don't think that that options is the one that I would prefer to do though.

Then later on in the day I talked with the study coordinator at Huntsman and she said that my CA-125 number has now jumped up to 70.  That is the upper limit for the study so she said that I can stay on the study through my next infusion in 3 weeks but once they get results from my next lab work in 6 weeks, I will probably have to be pulled from the study - assuming that my number stays the same or continues to go up.  She said that the decision was up to me if I want to stay with the study through the next treatment or not.  I then told the coordinator about my dentist appointment this morning and she said that she would look into the specific requirements and recommendations regarding dental work while on the Avastin.  She said that she would discuss it with my doctor and let me know, but at this point I will most likely be pulling myself from the study to get this dental work done.

Well, yesterday I had a dentist appointment and things are not looking good with my mouth...  I have been very good about brushing and flossing since a few years ago when I had to have some extensive dental work done and I have been going to the dentist regularly - at least twice a year.  Well, yesterday the dentist found 5 cavities on my teeth and he said that I had more plaque build-up than he has ever seen on my teeth...  He kept making comments on how damaging to the mouth a lot of these cancer drugs are.  This is making me question even more if I want to stay on the Avastin or not...  I have to go back in to get the cavities drilled out and filled and the dentist is putting me on a prescription fluoride toothpaste.  He said that if that doesn't work at keeping the cavities at bay then we may have to switch to me sleeping with fluoride trays on my teeth at night.  He said that he has several other patients who have had dental problems while undergoing cancer treatments and a couple of them he has had to switch to the fluoride trays.  Definitely more to think about now...

Last Thursday I went to the dentist for the first time since my diagnosis of cancer. They advise you to avoid the dentist if possible during chemo treatments because of the added risk of infection with any dental work. This was just a routine cleaning, but my Huntsman doctor also wanted the dentist to be aware of the Avastin treatment that I am on and the increased risk of osteoneucrosis of the jaw. He made sure that they took x-rays so that he could look at the bone but he didn't seem too concerned with me developing the problem. He said that it is a problem that usually doesn't show itself unless some kind of dental surgery or tooth extraction has taken place and then for some reason the bone just doesn't heal. He said that I just need to be extra careful of my teeth and gums and make sure that I continue to brush and floss regularly so that we don't have to worry about any type of dental work in the near future. He said that if I do need any kind of work done, such as an extraction, that he would send me to a dental surgeon to make sure that I get the best, specialized care possible.

I wore my new wig to church on Sunday. This was the first time that I have worn the shorter wig to something where a lot of people that know me would see me. I got a lot of compliments on it and I think it will make the transition to my real hair a little easier and less drastic of a change. There was even someone who asked if I had gotten my hair cut and colored! I wasn't quite sure how to respond to that so I just said that I got a new hairdo... I also had a couple of people who said that at first they thought that I had just cut and restyled my original wig.

Today I put my shorter wig on to go somewhere and Kay told me that she wanted me to wear the other one because the hair was longer and prettier! I'm not sure how to respond to that! Some girls interpret longer hair as prettier hair, so maybe she is just expressing that feeling. I think I will stick with the shorter wig because it is a little cooler to wear since it is shorter and I don't want to be changing my hairstyle every couple of days. I am a little more nervous wearing it though because it is shorter and I need to pay special attention to making sure it is on correctly and that the hair is laying flaton my head. It also doesn't have ear tags that pull down in front of my ears so it is harder to tell if it is on straight.

And can I just say that it is hard putting sunglasses on when you are wearing a wig!! I have to use two hands to make sure that I get the sides on top of the wig, over my ears and that I pull some of the wig hair down over the sunglasses frame.


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