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radical neck dissection

ricklevans
Posts: 14
Joined: Feb 2009

I may have to have radical neck dissection, can someone tell me what I have to look foward to.

SASH's picture
SASH
Posts: 276
Joined: Apr 2006

If all goes well probably about a week to 10 days in hospital depending on what they need to do. Stitches in neck will probably be the kind that self dissolve. You probably will have tracheotomy to allow you to breath and once they make sure you can breathe without it, they will remove it.

I can only base this information on my radical neck dissection almost 9 years ago. If you have a feeding tube, they might dye the liquid nutrition to make sure it doesn't back up. If they do dye the nutrition, you might have bowel movements with those colors. Don't be shocked if this happens it is normal.

A word of advice if you do have a trach, when they are testing to make sure you can breathe, don't roll your eyes back as a joke. When I did this, my doctor wanted to put me on a 3 day hold in the psych ward.

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hunpot
Posts: 90
Joined: Nov 2008

are they doing anything else then just radical neck dissection. When mom had neck dissection she had partial laryngectomy and had trache in also. She was in ICU for 5 days then regular bed for another 1-2 weeks. I remember being prept and told what to expect but nevr imagined when i walked in after it was pretty scary to see all the tubes and bandages. Mom had oh gosh about 100 staples including dissolvable stitches inside. Had to clean 3-4 times a day and go easey was very sensitive to touch (of course it would be) Not sure if it happens to all but 2 days after surgery she had extensive swelling in facial area cheeks we would call her chipmunk took a week for it to go down. She had gtube which she did excellent on no troubles. Trache tube was in for about 2-3 months got used to it quickly and she was able to speak with it after about 4th week. Go out and by a dry erase board so you can write what you need to say very easy and was the best thing we ever got her. With surgery comes recovery time and all recover differntly so i will pray that yours goes easy and has no troubles. Just thnk of this as possibly and hopefully saving your life or at least extending your time on this earth to share and spend with your loved ones. Mom was so scared to have it but she looked at it as it was her way of hopefully beating the cancer and staying her with us longer. She never wanted to have but was happy that she did and got to be with us for longer period. My mom had stage 4 cancer 3 months after the surgery we were told cancer came back there was nothing more they could do because she had the surgery and scarring she only lived 10 months form that day.

Each person is differnt and you have to go by what the doctors tell you but in my opinion and from what i have saw and been through i would only do surgery as my last option, if you havent done radiation or chemo i suggest doing that first because if you do surgery then you cannot do radiation after surgery because of the scarring and healing that comes with surgery. So make a wise decision and BEST OF LUCK TO YOU. please keep us updated as we will be praying for a good outcome.

dont meant o scare you in anyway just want to share my experience and inform you the most i can so you will not overwhelmed or upset afterwards as you didnt know.

soccerfreaks's picture
soccerfreaks
Posts: 2801
Joined: Sep 2006

I had a radical neck dissection in late 05. It was in conjunction with some other surgery so it lasted a long time, and I can't, therefore, speak to the issue of length of time.

I can advise that you are likely to go into the ICU before your surgery, and that they will draw (with a magic marker or some such) on your neck and elsewhere to show where they are going to cut. If you are awake then, you will not remember it, even so. But those who love you and see it will be in tears. Some of them. (Others might say, "Wow, that is so cool!" THOSE are the ones to disinherit or love forever or both :) ).

You will then wake up and all of your worries will be gone!

You will probably be doing morphine in one form or another, and, if you are getting an IV ativan injection, you may have a psychotic reaction, as I did. (This is not a problem...unlike SASH, I was not indicated for transfer to a psych unit, at least not within earshot:)).

Probably for a 'mere' neck dissection, you won't be in the ICU for too long. They did truss me up like a turkey, around the neck, to keep everything in place, and they did keep me there for four days, but I think the longevity was due to the tongue thing. The trussing up, however, the wire around the neck, I think that was pretty much due to the dissection.

Like SASH, I was provided a trache tube. Expect that. You won't feel a thing. The hardest thing for me re the trache tube was keeping it in, as I considered it part of some plot (IV ativan reaction) and kept trying to remove it, doing so twice in fact, the first time scaring the heck out of my nurses, who put it back in ("Kerplunk") and the second time scaring the entire hospital as they coded me, so that one of my own doctors came to see me, deciding that I didn't need it any more.

Unlike SASH, I did not get dissolvable stitches. I got little staples, and, to be honest, they came out without pain. Bear in mind that I had them even in my lips and chin for other reasons (they got tired of my singing, perhaps :)). I alerted my doctors from the start that I was allergic to pain, and as the resident was removing them, he advised that their job was to remove pain rather than to create it...I hope your doctors are of the same sentiment.

When it is all done, I am not sure you will notice much of anything if they do a good job.

You have already had radiation, and that may be the thing that ends up giving you the biggest problems re swallowing. The dissection, as SASH suggests, sounds scarier than it is.

Oh, it is major surgery, don't get me wrong. But, if I remember SASH's post, he is suggesting 7 - 10 days and I would advise that the dissection alone might get you out even earlier, if there are no complications.

Good luck and treat your nurses well :).

Take care,

Joe

ricklevans
Posts: 14
Joined: Feb 2009

I had radiation and chemo. The Lump on my neck went down about the 3rd week in and now I can not find it. The last time the dr felt she said she could still feel a little hardness and I may need neck dissection, but they have never told me what this consists of.

The cancer was on my tonsil and 2 lymph nodes, have you ever heard of the radiation and chemo getting it all and that the hardness may just be scar tissue?

I get my ct scan in two weeks and see the dr on March 4th, I can not sleep at night because I do not want to have this surgery, do you know if there is anything else they can do to get the rest instead of surgery? More chemo maybe?

Is this operation the same for no matter how many Nodes they are taken out? Do they always use a trache tube?

soccerfreaks's picture
soccerfreaks
Posts: 2801
Joined: Sep 2006

Since I had this performed only once, while your doctor has hopefully had quite a bit more experience (and was even awake and alert, we should also hope), your doctor is the best one to ask these questions of.

If you are uncomfortable with your doctor's decision re the dissection, you should seek a second opinion.

My personal take regarding cancer, for what it's worth, is that if there is something in there and it can be removed with a knife, where is that knife and when can we start? Why? Because radation and chemotherapy, while certainly effective and sometimes 100% effective in removing cancer, are not as specific as surgery. But, that is just one man's opinion.

Whichever route you eventually choose, I wish you the best.

Take care,

Joe

victor53's picture
victor53
Posts: 97
Joined: Apr 2008

I did 6 weeks of induction chemo
then 7 weeks of chemo and radiation
then had a radical neck dissection done november last year
it wasnt bad at all
2 days in the hospital they take the drain tubes out and your home
The way they cut it in the crease under your chin you cant really see it.
I have to lift my head up and turn to show someone.
Just get a surgeon who has done a bunch of them i guess is the best advice
I got some turkey neck swelling going on from the remaining lymphnodes developing new routes to drain im told.

ricklevans
Posts: 14
Joined: Feb 2009

after chemo and rad you still needed the neck dissection? How many nodes did they have to remove? When my ENT found the cancer, I asked him if it was curable and how do they cure it. This was in October and he told me they use rad and chemo, even when I went to the cancer center they spoke about possibly taking the tonsil out and doing chemo and rad, they never mentioned a rad neck dissection. My radiation Dr checks me weekly since my treatments were done, my lump is gone and he said it may have a little scar tissue on it, my onc while checking 2 weeks ok mentioned a neck dissection to her fellow and that was the first time I ever heard of it. Last week the fellow examing me and said she can not feel anything where the lump was which I guess is a good sign, the rad dr says he see's nothing on the tonsil when he looks down my throat, I get my ct tomorrow, I'm praying its gone, and have to see the surgeong next tuesday.

Is this what all cancer centers do? Even after seeing the surgeong and he only did a biospy and left the tonsil in, why would I still need to see him again unless they thought something was still there? Is this normal? He did say after he checked my tonsil and took the biopsy that he'll see me in 2 months.

victor53's picture
victor53
Posts: 97
Joined: Apr 2008

i forget how many nodes were removed a whole lot thou. Mine was stage 4 advanced so even before we started we planned the induction chemo then the radiation plus chemo then the operation. I wanted it all the most aggressive they could give. I used to ask them if they could uo the chemo doses because it wasnt that bad and i thought i could handle more but they wouldnt. The nice thing about the neck dissection after i think is that they tested all the materialthey took out and it all came back negitive. The operation plan was this first put me under then biopsy and test the tonsil base of tongue tumor area if that came back negitive
cntinue with the neck dissection and clean out the lymph nodes. If the inside tonsil base of tongue biopsy showed any thing they would stop and plan a bigger operation for a later day.
To tell you the truth i wanted the inside area cut out also. Told them i dont need to talk and i like my feeding tube. But it came back negitive so they went ahead with operation.
3 days in the hospital could have left after 2 but it was a fri sat sun thing doc couldnt come check me till monday. Liquid Roxicet 5/325 {hydro codone pain killer was and is my best friend. After first week of radiation till 6 weeks after treatment ended i was on the hard stuff morphine with the roxicet for break thru pain after operation just the roxicet.
I kept myself comfortably numb thru the whole ordeal.

victor53's picture
victor53
Posts: 97
Joined: Apr 2008

i forget how many nodes were removed a whole lot thou. Mine was stage 4 advanced so even before we started we planned the induction chemo then the radiation plus chemo then the operation. I wanted it all the most aggressive they could give. I used to ask them if they could uo the chemo doses because it wasnt that bad and i thought i could handle more but they wouldnt. The nice thing about the neck dissection after i think is that they tested all the materialthey took out and it all came back negitive. The operation plan was this first put me under then biopsy and test the tonsil base of tongue tumor area if that came back negitive
cntinue with the neck dissection and clean out the lymph nodes. If the inside tonsil base of tongue biopsy showed any thing they would stop and plan a bigger operation for a later day.
To tell you the truth i wanted the inside area cut out also. Told them i dont need to talk and i like my feeding tube. But it came back negitive so they went ahead with operation.
3 days in the hospital could have left after 2 but it was a fri sat sun thing doc couldnt come check me till monday. Liquid Roxicet 5/325 {hydro codone pain killer was and is my best friend. After first week of radiation till 6 weeks after treatment ended i was on the hard stuff morphine with the roxicet for break thru pain after operation just the roxicet.
I kept myself comfortably numb thru the whole ordeal.

victor53's picture
victor53
Posts: 97
Joined: Apr 2008

i forget how many nodes were removed a whole lot thou. Mine was stage 4 advanced so even before we started we planned the induction chemo then the radiation plus chemo then the operation. I wanted it all the most aggressive they could give. I used to ask them if they could uo the chemo doses because it wasnt that bad and i thought i could handle more but they wouldnt. The nice thing about the neck dissection after i think is that they tested all the materialthey took out and it all came back negitive. The operation plan was this first put me under then biopsy and test the tonsil base of tongue tumor area if that came back negitive
cntinue with the neck dissection and clean out the lymph nodes. If the inside tonsil base of tongue biopsy showed any thing they would stop and plan a bigger operation for a later day.
To tell you the truth i wanted the inside area cut out also. Told them i dont need to talk and i like my feeding tube. But it came back negitive so they went ahead with operation.
3 days in the hospital could have left after 2 but it was a fri sat sun thing doc couldnt come check me till monday. Liquid Roxicet 5/325 {hydro codone pain killer was and is my best friend. After first week of radiation till 6 weeks after treatment ended i was on the hard stuff morphine with the roxicet for break thru pain after operation just the roxicet.
I kept myself comfortably numb thru the whole ordeal.

clu65
Posts: 1
Joined: Feb 2009

My husband had radical neck dissection, just last week. Yesterday his face began swelling, above the staples. Today he'll check with the doc about it, but it appears it will go down in a week or so, that without those particular lymph nodes, it will take time for the body to figure out what to do...He was in the hospital barely 3 days. Yes, you will get a shunt & a drain, an IV, and maybe a catheter. But after that anesthesia, you need them all, because you can't do anything. Staples will come out in 10 days. There are many variables--what else is removed in the neck, so everyone's experience is different. If anyone knows about the swelling, please advise. This is new for us, too!

soccerfreaks's picture
soccerfreaks
Posts: 2801
Joined: Sep 2006

clu:

I was in the hospital still as halloween approached, and my doctors or nurses or both conspired to fill some of their famous latex gloves with water and freeze them. The purpose was to lay them around my swollen neck so as to appear as if I were being strangled by bodiless white hands (in accordance with the fesitivities).

I got a big kick out of it, but the point is that they used ice during my last days inside to try to reduce the swelling.

You are, of course, wise to ask your doctor's opinion :)

Good luck and best wishes to you and hub.

Take care,

Joe

ricklevans
Posts: 14
Joined: Feb 2009

I was told today there is still a lump in my neck and they want to cut it out. Dr told me that while in there he'll also remove lymph nodes. Some of the side effects he said i'll have are a numb neck for the rest of my life and I won't be able to lift my right arm past my shouder without thearpy. Has anyone had these side effects from this operation?

victor53's picture
victor53
Posts: 97
Joined: Apr 2008

i got some numbness on neck an jaw line everything else is fine

ricklevans
Posts: 14
Joined: Feb 2009

you had no problem with your shoulder at all?

victor53's picture
victor53
Posts: 97
Joined: Apr 2008

no problems and i got fileted real good

ricklevans
Posts: 14
Joined: Feb 2009

how long before you were able to get out of the house? Were you stuck in the house long?

victor53's picture
victor53
Posts: 97
Joined: Apr 2008

got operated on a friday tubes were out sunday and i could have went home then but doctor had to sign me out on monday. I was out with a bandage on a day later. I handle pain meds well roxicet in my peg tube and i was refinishing the basement (for an hour or 2)

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