When my husband’s diagnosis of squamous cell nasal cancer was first given in May, 2001, shock set and a thousand questions entered our minds. Most people think that the word cancer means death. Cancer is not a death sentence. My husband was so devastated by the diagnosis he didn’t speak another word at the doctor’s office that afternoon as our lives changed forever. Trying to keep up a front, I asked lots of questions. Dr. Dinardo explained that he would be operating on Mel’s nose by an opening to the side to remove the cancer and then follow up with radiation therapy. After the radiation therapy he lost all of his top teeth due to infection. Eventually more cancer was found and a Rhinectomy (removal

of the entire nose) was performed April 2, 2003. Now, the hard part of being the caregiver was about to begin. I have kept a journal of my journey as a caregiver, which has been turned into this pamphlet. I hope you find some useful tips, and some comfort, as you travel this same journey as a caregiver of a loved one dealing with this most devastating part of the disease.

Actually, denial became our best friend. Hey, whatever gets you through the day. Why worry about tomorrow, when no one else that is perfectly healthy is promised any extra days? If you worry every day that you are going to die of cancer or lose your spouse to cancer, how are you going to enjoy life? This works for us, while others may choose to actually face the facts right away. Nasal cancer is rare so there is not a lot of statistical data on survival rates. Believe me, I asked and I looked. Counseling is a good idea because this will be an ongoing, stressful time for you and your loved one. We call it the roller coaster ride. Even if you only see a counselor once a month or so, it will do you a world of good to let out your

frustrations on a professional rather than on your friends, who will eventually avoid you like the plague. No one likes to hear bad news. Not that it is bad to share these feelings -- just don’t make it an everyday habit. Everyone has known someone who, when you ask, "how are you," replies with a detailed list of all his aches and pains. Ready to run? Most of us do!

To help Mel keep his weight up (because he had lost his top teeth) I developed a high calorie milkshake that he could take with his lunch that consisted of soft foods such as potted meats, pudding, Jell-O, chicken salad, pasta salad, potato salad.

Recipe:

Place into blender 2 cans of Ensure Plus (Wal-Mart’s brand is Equate and less expensive), 2 bananas (or other fruit), Breyers sugar free ice cream,

chocolate instant breakfast, remove herbs from capsules and put into blender: green tea extract, St. John’s Wort, grape seed extract, flax seed. I read that fresh fruits --berries especially -- are helpful for cancer patients (i.e., strawberries, blueberries, blackberries, raspberries) as are fresh vegetables (i.e., steamed broccoli, brussel sprouts, spinach, etc.).

Mel avoided all mirrors when he returned home from the hospital, after the removal of his nose. In fact, to further protect him, I put newspapers over the mirrors in the house. Mel wore a bandage and a surgical mask to cover the obvious loss of his nose. The nasal cavity area had to be flushed out 2-3 times a day. We decided on twice a day because of our busy working schedules. Clinic, as we began to call it, was at 6 a.m. and again at 7 p.m. Some days were easier than others. Some days the cavity needed extra cleaning and some days we’d be finished in 15 minutes.

I knew the first thing was to get the home care instructions and at least "act like I knew what I was doing." It was important that Mel felt that he was in capable hands at home. It was also important not to push him into anything he was not ready to do, such as look into the mirror. We found a way to flush out the cavity area so he wouldn’t choke on the saline irrigation. I would place the syringe, which looks like an ear syringe, into the nasal cavity opening as Mel leaned over the bathroom sink. I’d say "hold your breath," squeeze out the saline, and then say "breathe," just like they do when you have an x-ray. This way Mel didn’t choke on the irrigation flowing into the open cavity.

I waited about three weeks before leaving Mel alone in the chair with his bandage off. I had forgotten something I needed in the other room. When I returned and got a glimpse of him through the doorway, I backed off. He was looking at himself in the mirror for the very first time. This was the beginning of his acceptance. I then decided that it might be a good idea to do similar things to give him the privacy he must need to look into the mirror and investigate. Around April 15, he asked for the hand-held mirror and he took his first good, long look. It was a shock but he handled it. I had prepared him over the first few weeks by talking a little each day about what it looked like to try to cushion the shock. Once Mel was over the shock, he was the one who took down the newspapers from the mirrors. That was good because he did that on his own time. I hope I didn’t overprotect him, but I knew that when he was ready he would let me know.

It’s funny to observe people’s reactions. Some people will walk up to Mel and right out ask him what happened to his face. Others will hold a normal conversation and act like he’s not even wearing a surgical mask. He says that he just tells most people that he had an operation. It’s really up to him as to whether or not he is willing to give up more information and to whom.

For Mel’s vitamins and "other medical supplies," I bought him two cloth-covered boxes. The box in the dining room holds all of his vitamins and prescriptions. The other box is in the bedroom adjacent to the bathroom (clinic) with extra supplies that are not used on a daily basis. This way Mel has his vitamins and he has other supplies, but they are hidden away in pretty boxes. Actually, they are sewing boxes we found that went with the room décor.

Below is a partial listing of supplies we use for his home care. At first we had them scattered all over his sink until we found an over-door-caddy with six shelves for supplies. This gave Mel his sink back and therefore, some control in his life. He seemed very pleased to have his sink back. It’s important to give a cancer patient as much control over his or her life as possible and to make life as normal as you can for him.

• Over-door-caddy – 6 shelves (found at Wal-Mart)

• Bag holder for plastic bags for medical waste use

• Paper towels

• Plastic bags for medical waste (we use plastic grocery bags)

• Breathable non-stick bandages by Johnson & Johnson

• Paper tape (3M also makes a skin colored tape)

• Saline irrigation for flushing cavity (available at VCUHS & Westbury Pharmacy)

• Flush throw away plastic Solo drink cups

• Solo bath throw away plastic cups

• Q-Tips – soft

• Surgical gloves (in addition to frequent hand washing)

• Scissors

• Alcohol for disinfecting

• Tissues – soft with lotion

• Pure vitamin E oil for dry skin around the nasal cavity

• Anti-bacterial soap

• Salt to rinse mouth (due to mouth surgery – peroxide dissolves stitches)

• Biotene mouthwash (no alcohol)

• Biotene toothpaste

• Fluoride toothpaste by prescription for the remaining bottom teeth

• Johnson & Johnson floss sticks

• Chair for "clinic" – we use an outdoor folding chair

• Surgical masks

• Lab jacket (to keep work clothes clean)

Depending upon your situation, you may add or delete some of the ideas. As I said before, the over-the-door caddy was far the best idea because it gave Mel his sink back and therefore gave him some power over something in his life. It also helped to keep an eye on the inventory to see what we were low on. Keep a pad and pen handy to make a list of what you will need to pick up next time you’re out and about. We found most of our supplies at Wal-Mart, which has been most accommodating to Mel’s needs.

Don’t do what I did as a caregiver. I gave until I hit rock bottom and became sick myself. Wearing too many hats can only end in disaster, as it did when I suddenly lost my friend, Joyce, to cancer. My immune system kicked in just when I thought all was fine. I am a chronic pain patient already, so more stress added fuel to the . re. Developing shingles on my right toe on a Friday spread up my right leg by early the next morning. Shingles, as many of you know, is caused by extreme stress. Somehow I was pulled out of my denial box that was warm and fuzzy, and had to face the reality of the unexpected cancer death of my friend. I did not have time to mourn my friend Joyce’s death because my schedule would not allow. I am now seeking pastoral care counseling to help me deal with the loss of my friend and to learn how to receive as well as give. Take my word for it, get  help early on before you become sick and are unable to be a good caregiver. Even the folks in pastoral care say they have to take a break from giving to receive. I understand that now and have done the things that have been suggested to me. Finding a private place for lunch Mel needed to find a private and safe place to eat his lunch while working. I mean a place safe from prying eyes. He had been eating lunch in front of an old building that was being torn down. He would climb the steps up to a column where he could eat in privacy. This area became a safety concern because dust particles could be in and around the construction area. Mel has a bandage on underneath his surgical mask, but you can still see the open cavity area from the side when he removes it to eat. This is a very sensitive issue for us. He finally decided to go over to the capital grounds to eat. He said he enjoyed the outdoors. I was glad he decided to go somewhere else, as this was a big step for him to eat in a semi-public place. Once Mel understood the safety issue, he was willing to deal with the problem at hand.

We had to find things to do to . ll in gaps of time as Mel began to heal from his surgery. Weekends were particularly hard for Mel. He didn’t want to go out into public eye, and that meant no eating out, no going to the movies, no doing anything outside the house. He loves Cracker Barrell, so I called and asked if they handle take out. They did, so one Friday I asked him if he’d like to have some dinner from there and he just looked at me funny. "Just trust me," I said. "You stay in the car and I will bring the menu out to you and we’ll get carry out." "They do that?" he asked. Then I explained that I had called in advance. He finally gave in and it was a hit. He enjoyed the restaurant without prying eyes. Another time we went to the video store. He actually surprised me and went in with me and loaded up on the videos for the weekend. Eventually, he went to Wal-Mart with me and began to get over being afraid of people looking at him. Actually, it wasn’t as bad as he imagined it would be. After that, he began to come out of his shell and go about normal business. He still won’t go out to eat, but when he does, this pamphlet will be done. Mel says he wants lobster when we do go out to eat, so lobster it shall be!

Two months after surgery, in late May, Mel is taking more of a role in his home care. I have to say I am so proud of him. He took off the bandage and there was a lot of white drainage, which is normal. Barbara, his nurse, told me that if it was green, brown or had an odor, then we may need to take a look at it for possible infection. Some days there is none and some days, well, let’s just say clinic is extended from 15 to 30 minutes. I told him that I would hold the flashlight and let him get the drainage out with the Q-tips. "Who me?" he said. "Sure, you can probably get it better than me," I replied. He looked into the mirror and instead of being fearful, it became a challenge to him. It’s important not to use a dry Q-tip, so dip it in saline irrigation first. Sometimes you need two to use like a soft pair of tweezers to pull the drainage out. Once that is done, the regular flushing of the cavity can be done. Mel was on his own as I stood back. I was so proud of him. He did the hardest part of the home care. Mel said, "No one can know what if feels like having someone sticking foreign objects in your open nasal cavity but the one having it done."

Mel and I are now able to kid around during our clinic. I asked him if that was his tongue I was seeing through the fistula (hole). He laughed and said yeah, and stuck his tongue through the fistula. I told him we should put him in the world book of records for any human who could stick out his tongue from two locations! This tells me that Mel has completed his acceptance stage of what has happened to him. He laughed and said something I couldn’t understand. It’s very hard to understand him without his upper plate to close off the fistula. On another occasion a little boy at Rite Aid asked his mom, "Why is that man wearing a mask?" She turned and looked at Mel. By the look on her face, she knew she had to think of something quick. She told the young boy (about 5 or 6 years old) that Mel was the Lone Ranger. That seemed to satisfy him and he went on to something else. It didn’t seem to bother Mel. He winked at the boy and that was that.

Mel developed what are called nasal polyps inside the nasal cavity. They look like little balloons as they begin to puff up. Dr. Dinardo had been popping them and then we would see a lot of drainage. We also had a question about an area on the nasal floor that looked different. It will be important to point out these things to Dr. Dinardo. It’s a good idea to write down questions for the doctor before your appointments. Since Mel and I look in the nasal cavity twice a day, we notice things that look different and can ask questions when needed. Dr. Dinardo explained that the nasal polyps were nothing to worry about and he popped them gently. Lately, Mel has only one small polyp, which the doctor just left alone. Maybe they go down in numbers after a while, at least that is what seems to have happened. Dr. Dinardo said that the differences in the nasal floor area we noticed were changed caused by radiation damage. He said it was good to have that extra pair of eyes to keep an eye on things. Dr. Dinardo checks Mel’s lymph nodes each visit.

A piece of bone that was left on the right side of Mel’s nasal cavity has been very hard to keep clean. It seems everything wants to stick to it. Using Q-tips has not been enough to keep it clean. Dr. Wornom, with Richmond Plastic Surgeons, will be removing this unhealthy bone area and covering it with skin. We feel this will help greatly in the cleaning of the nasal cavity. We have spent more time trying to clean the bone then the rest of the nasal cavity. Mel was put back on antibiotics to keep infection down around the bone. In trying to keep it clean with the Q-tips, a small tear in the skin formed and it became almost unbearable to clean. Once Dr. Wornom removes the bone he also will shave down the scar tissue at the upper gum area to prepare Mel for his upper plate with teeth. Mel will be ready for his prosthetic nose once he has healed from this surgery. Dr. Wornom’s office will be setting up the outpatient surgery to remove the bone from the side of the nasal cavity and wrap skin around the area making it easier to keep clean. He said he would also . x the small cleft-lip area on Mel’s upper lip. Then lastly, he will remove some scar tissue right under the upper lip area preparing him for the upper plate and prosthetic nose. The fistula cannot be closed because there is just too much radiation damage and not enough skin to pull it closed.  Dr. Wornom is hoping that Dr. Kazanoglu, associate professor, Prosthodontics at VCU’s Dental Faculty Center, will be able to close the fistula with the upper plate and then make Mel’s prosthetic nose. Dr. Kazanoglu makes prosthetic noses, ears, dif. cult plates with teeth and much more. This is such a friendly doctor;  he even takes your personal phone calls. Dr. Wornom said to give them a day or two to call our insurance company to set up the surgery, which looks like it may be in a few weeks – four months after the surgery. This should give Mel enough time to heal so that he will be able to enjoy his vacation the last week of August. Dr. Wornoms’ office called on Mel’s birthday, July 21, and we have a go for the surgery on August 4, 2003. This is outpatient surgery, so Mel will be able to come home the same day. The office will mail pre-op instructions to him. He will need to go for pre-op testing on July 28, 2003. You can tell Mel is getting excited as he grows closer to getting his prosthetic  nose. He says the combination of the bandage and the surgical mask is hot in the summer heat. Mel should heal up nicely and should be ready to be fit for his prosthetic soon after, as well as his upper plate with teeth. Mel's two brothers and sister are planning to drive Mel to the hospital for his surgery. This is their baby brother and they love him so much. A week doesn't go by without a phone call from one of the three of them. I love the closeness of their family.

Mel’s older brother picked us up at 5 a.m. and took us to the hospital where Dr. Wornom did his magic when he removed the dead bone in the nasal cavity, removed scar tissue from inside the upper lip and closed a small cleft lip remaining from the first surgery. Dr. Wornom gave Mel the personal touch, which meant a lot to us. We were given a pager and the family was told we would be paged to check in at the surgical waiting area desk to talk with the doctor. Well, I looked up at around 9:30 a.m. and here comes Dr. Wornom walking toward us. My mind froze as I realized that’s Mel’s doctor! He shook my hand and told us that everything went well and that Mel would be ready to go home soon. Dr. Wornom explained what he had done in surgery and then let us know that the dressing could be changed the next day. I decided then that I needed to stay home to help with that. After surgery, home care is very delicate for the first week or two. Once again Mel’s family rallied behind their baby brother. This is a new beginning for Mel as he anticipates the healing process and what is to come to put his life back together again. I contacted Massey Cancer Center’s Wig Salon and got the name of a company here in Richmond where we can get an artificial mustache for Mel. It’s called Premier Costume, located at 3339 Cary Street. It is open Monday through Saturday from 10 a.m. to 5:30 p.m. and their phone number is 355- 3887. Once Mel has gotten his prosthetic nose, we will see if we can go visit the shop. Some cancer had invaded his upper lip area and had to be taken out. The lip was cut, the cancer removed and then the lip was pulled back together. It looks good, but if Mel wants to finish off the look with an artificial mustache, at least we have that option. I want him to feel as comfortable with his new look as much as possible. With an artificial mustache, he could grow a beard on his chin to give it a finished look. It will be up to Mel and to Dr. Kazanoglu as to whether or not he could even wear one without damaging the prosthetic nose.

As the bone and tissue that were cut from from his first surgery began to settle, Mel experienced sharp pains when he yawned or opened his mouth  too wide. I suddenly remembered this as it began to happen to him once again. I now recall that it happened right after the removal of his nose, but settled down within  a few weeks and all was forgotten. Mel now cried out in pain in his sleep. That was my eye-opening reminder that this had happened before. It has been almost one week and the swelling around Mel’s right eye has gone down and he seems to be healing nicely. At Mel’s follow-up appointment, Dr. Wornom took the stitches out of his lip and asked that Dr. Dinardo take out the stitches from his nasal cavity over the bone later. He wanted those stitches to stay in a little longer. Dr. Wormon said he would really like to see the finished product once Mel gets his prosthetic nose and upper plate with teeth.

We are planning a late August vacation camping near the water. We both love the water and we plan on staying the entire week. We will need to take home care with us, but that’s ok. Mel will still be able to enjoy time near the water where we both feel at peace. Our camper trailer is not big, but it’s just the two of us and that’s all we need. We should be able to take what we need to make sure Mel is comfortable. We are back from vacation and oh my what a difference a week can make with no responsibilities. The weather was perfect. Home care was different. The bathroom in our camper is about three by four feet. Mel had to do most of the home care himself, then I would step in and take a look and clean up any areas with the Q-tips that he could not see. Mel would then put on his bandage and we would resume our vacation. When we went down to the water, we practically had the beach to ourselves. The water was like bathwater, so warm yet refreshing. Mel took a chair umbrella to keep out of the sun. He did get some sun on his arms and as they began to get a bit red I suggested we go back to the camper for lunch. He said, "Is my nose peeling yet from the sun?" then laughed. Mel hasn’t lost his sense of humor. Most people we ran into didn’t even ask about the mask and talked to us about their vacation, camper or dog they had with them. It seemed to make Mel feel he was fitting right in. We did have to re-arrange how home care was to be set up in the camper. We packed everything for home care in an under-the-bed box and slid it under the camper bed. We used zip lock bags to keep his nasal cavity syringe clean once it was disinfected with alcohol and rinsed with distilled water. Barbara Jenkins, Dr. Dinardo’s nurse, said that the use of distilled water would be safer than using the water at the campsite for rinsing. We agreed, and took several bottles with us. We were used to using the distilled water for cooking anyway, so a few more bottles didn’t make that much difference.

Dr. Kazanoglu wanted Mel to get his bottom teeth cleaned before he came back for his September 22, 2003 visit. We made Mel an appointment with our family dentist, Dr. Tony Agapis, to check Mel over and have his teeth cleaned by the dental hygienist. Mel went in mid-September and had his bottom teeth cleaned. Dr. Agapis and his staff have treated us like family for years.

Hurricane Isabel hit our area September 18, 2003. We lost power at 11:30 a.m. Thursday, way before the brunt of the storm hit that evening. We were without power only until late Saturday night, but Mel’s home care was first and foremost on my mind. It still had to be done. Mel and I were one of those who had prepared for a bad storm, having gone a week without power during the 1998 ice storm. We said we would never go through that again. We had plenty of batteries, flashlights, bottled water, lanterns, lamp oil, a propane camp stove for cooking, a full tank of gas and two bags of ice. The preparedness paid off for us. Even when they said we no longer had to boil the water, to me it still had a strange smell to it, so we used distilled water for cleaning Mel’s nasal syringe instead of the tap water, just to err the side of caution. We had two downed trees in our back yard and Mel had a good friend come over to help him cut them up and pick up debris. Mel is his own man and of course had the chainsaw in his hand cutting away. I had to pull him aside and tell him to give the saw to his friend because he could not chance any sawdust from the chainsaw getting in behind his bandage or mask. He was under the impression the mask would keep it all out. After a brief discussion it was understood and the chainsaw was given to his friend. Mel picked up the wood and debris using a mask and safety glasses. The safety glasses were hard to keep on because he still has no prosthetic nose.

I spoke with Janet Lavetta in Wal-Mart’s Vision Center concerning the fitting of glasses for Mel once he receives his prosthetic nose. It was suggested that Mel get his eyes re-checked after having two surgeries before putting money into a new pair of glasses. Janet said, "Oh yes, we have seen you and Mr. Jordan in Wal-Mart and sort of figured it was cancer. We’d be more than happy to help fit Mr. Jordan with a pair of glasses to fit over his prosthetic." Mel felt comfortable about working with someone we’d worked with several times before on his glasses. It was also important that they know the circumstances and be able to accommodate the situation. Janet said no problem, just let her know and she would be ready for him. This will not happen probably until September, but we are at least ready for the process. We understand that glasses will help to hold the prosthetic in place. In addition, if need be, we can buy a band that goes around the head to hold the glasses, the kind that people use in sports.

Mel’s check-up appointment on October 3 with Dr. Dinardo went really well. Dr. Dinardo said that the polyps were down in size and numbers so he didn’t even pop the existing ones. I believe he only had two small ones this time. Mel has all but taken over his home care. He retires in one week and says he hopes this will take some stress off of me. He will do the morning and evening clinic and I will check behind him in the evenings. I sent a few questions with Mel to Dr. Dinardo. Mostly we wanted to know if he could use a clear welders mask along with a surgical mask to finish cutting up some trees from hurricane Isabel. Dr. Dinardo said yes, but to be very careful to keep the area free from dust and wood particles. Can’t take the man out of the man! On the day that Mel was diagnosed, Dr. Dinardo told Mel that they were going to be good friends for years to come. In other words, he is going to look out for Mel’s well being. We believe in Dr. Dinardo’s sincerity with all of our hearts. Dr. Dinardo seems very pleased that Mel is doing so well and taking such an active part in his home care. "It’s looking clean, keep it up," Dr. Dinardo says! Dr. Dinardo will see Mel every 6 to 8 weeks for now, and then if all goes well, the time between visits will continue to lengthen.

Mel will be retiring from his job October 10, 2003. At first he said it just hasn’t sunk in yet. As the time grows closer, he is now counting the days. There’s much to do around the house, he says, "Besides, I know I’ll be given a honey-do list." Mel may be able to do some things with an industrial mask to protect his nasal cavity. I would feel much better if he checks with Dr. Dinardo before any major projects. Mel wants to work on our camper, which we bought at a good price, but which needs some fine-tuning. I think Mel would enjoy that; I’m just a bit overprotective when it comes to what kind of work he wants to do on it. We don’t want him around any airborn dust particles. Mel wants to fix some of the flooring

and that worries me, so I suggested that he check with either Dr. Dinardo or his nurse, Barbara Jenkins, before beginning a major project like that. Mel’s retirement seems to agree with him. He has been quite busy the first few weeks of retirement. We bought another vehicle so that he won’t have to get up early to take me into work. He has plans to take our dog to the boat landing and relax this week.

Once Mel gets the prosthetic nose, it will help his self esteem. We will need to get his eyes re-checked. Dr. Kazanoglu, associate professor, Prosthodontics at VCU’s Dental Faculty Center has been very good to Mel and I think Mel has a lot of confidence in what Dr. Kazanoglu will be able to do for him. Dr. Kazanoglu made Mel a plate early on to close the fistula so that he could eat and drink without choking. With a fistula (hole between the nasal cavity and the mouth) that large, it was hard not to choke on food and drink. It also was very difficult for anyone to understand what Mel was trying to say as he would try and speak without the plate. This next upper plate to be made will have artificial teeth attached, as Mel begins to reach the end of the journey to put him back together. Mel says, "It’s like putting Humpty Dumpty back together again." The upper plate will do two things. First, it will cover the fistula keeping food out of the nasal cavity and second, the artificial teeth will enable Mel to eat normal foods again. We were told to make an appointment with Dr. Kazanoglu for the prosthetics around the second week of September. I called and got Mel an appointment September 9, 2003. Dr. Kazanoglu made impressions for Mel’s upper plate and told him in the meantime to have his lower teeth cleaned. Mel had his appointment with Dr. Kazanoglu and has to go back next week for adjustments. No prosthetics yet, but I think Dr.Kazanoglu wants to do the best job he can for Mel, so he has an appointment to come back October 20. After Dr. Kazanoglu finishes up the upper plate with teeth, he will begin working on Mel’s prosthetic nose. Mel seems ok with the progress. I am guessing he will be done by December or January 2004.

Oh, what a couple of years this has been for Mel! On Monday, October 20, 2003, Mel came home with a new upper plate with teeth. He may have to use some adhesive to help hold the plate in place. He said he could feel it slipping some. Dr. Kazanoglu wants to see Mel in one week to make any adjustments. When asked how long it will take to get his prosthetic nose, he was told two to three months. Dr. Kazanoglu wants to get it right. He did say he was not sure about getting an artificial mustache. Of course we don’t want to mess up his prosthetic, so we will cross that bridge when we get to it. For now, he will get his upper plate adjusted and then Dr. Kazanoglu will begin the daunting task of building Mel a prosthetic nose. Mel is still getting used to his upper plate with teeth. It’s made with an extra space to cover the fistula between his mouth and nose that occurred because of so much radiation damage. Dr. Kazanoglu did a great job. The teeth look so natural and we are very impressed. Dr. Kazanoglu is now working on the task of making Mel’s prosthetic (October through December, 2003). He will notify Mel when

prosthetic nose is ready. We will go in together as this will be another big step for Mel. We were hoping that he would have it done by the holidays, but that doesn’t seem to be the case. The actual making of the prosthetic will take longer than we had anticipated, but we know that with Dr. Kazanoglu’s expertise it will be worth the wait.

We often wondered what would happen if Mel caught a cold since he doesn’t have a nose any more. Well, the flu season began early and even though Mel got the flu shot back in October, he fell hard and quickly to the flu. His cough was scary enough that even our pet cat, Jessie, jumped. I have to tell you the cleaning of his nasal cavity has been a nightmare. Once the color of the mucus changed from white to brown, I immediately called Barbara Jenkins. She checked with Dr. Dinardo and agreed he needed an antibiotic. When we got home last night, Mel fell to the sofa with his coat still on and threw a blanket over himself. Gee, I thought he must have really been feeling badly. His temperature was 103! I felt so bad going to work today and leaving him at home so sick. Thank goodness it’s Friday. We discussed his home care. There is so much mucus that Mel may need to clean up three times a day. Even as sick as he feels, it must be done. Since he has no nose from which to blow out the mucus, it just remains in his nasal cavity and it is very hard to get it completely clean. I guess now we know what happens when Mel gets the flu or cold. I’m just so sorry it is so close to the holidays and that he will miss one of the family’s get-togethers.

Mel goes in for his check up with Dr. Dinardo on January 13, 2004. Dr. Dinardo is very thorough and checks Mel as though he was family. Mel has an ulcer inside the nasal cavity that needs to be looked at. I will go with Mel on this visit because we will also be meeting another couple who has gone through a very similar situation and the husband already has his prosthetic nose. Our favorite nurse has set aside some time for the other patient and his wife to meet Mel and me. It should be good for Mel to meet this carefree man who has been though a similar situation. He will tell us how to put on the prosthetic nose and how to remove it. I understand these folks have it down to a science. We are looking forward to meeting them and have many questions.

Mel had an appointment with Dr. Kazanoglu yesterday, February 10. Dr. Kazanoglu made a facemask of Mel’s face from which to build the prosthetic nose. It should take four to six weeks for it to be ready. I will go with him to see the fitting. Dr. Kazanoglu says he’s more than happy to work with someone to get Mel an artificial mustache. We will then go to the store and get some liquid foundation and some make-up sponges. This will be used to blend in the areas around the prosthetic to make the color look natural. The next step will be for Mel to return to the eye doctor with his prosthetic nose to have his eyes re-examined. Remember, he had problems getting his eyes checked with the bandage over his nasal cavity because the lenses kept fogging up. The glasses will help keep the prosthetic in place along with some special glue that we will order from a specialty company. Dr. Kazanoglu will instruct Mel on the care of his prosthetic -- cleaning, gluing, keeping the skin from drying out and helping him get the right artificial mustache. Mel has progressed so much in the past year. He can now make jokes like, "I can’t be nosy anymore." Then he laughs. This has been a great motivator for my sister who has now been diagnosed with breast cancer. She sees and feels his strength and is ready to fight her battle. Once all of this is done, Mel will be ready for his big night out to dinner like we promised, a Lobster Dinner!

Mel with their "baby" Jenny Christmas 2005.                                                           PJ and Jenny. Both dressed in their Christmas best!