I’ve developed a formula to facilitate running after having surgery on my tongue: two-thirds medicinal, one-third mechanical. First, fifteen minutes prior to any run, take 3 tsp. of hydrocodone (definitely key to taking the edge off). Second, apply a generous amount of topical 20% benzocaine all over affected areas (ie sutures, ulcers etc). I find a blend of both liquid and gel formulations to be helpful, particularly for those hard to reach places.
Mechanically, there are two options; anchoring your tongue to either the floor or the roof of one’s mouth. For me, the tip of my tongue to the top of my mouth was a no-brainer. However, the downstream effect makes it impossible to mouth-breath and thus nasally dependent for air. My tiny nostrils and huge nose add to my work of breathing; a small trade off to escape the constricting walls of my house
My choice to run is tolerated, if not somewhat frowned upon, by the majority of my family. I am still recovering from my surgery and struggling at times to talk and eat, so I get why, on face value, my preoccupation with putting in some miles is perplexing at best.
My psyche has been more damaged than my body since my recent diagnosis. I have a second opinion and a review of pathology still out there in the near future, but there are now more knowns than unknowns, and most of this is good. The range of potentially bad news is smaller and less likely than the more probable and much broader potentially positive information. I am acutely aware that many people dealing with uncertainty are not in that position.
Sure, I am a doctor and not used to being on the “other side” of a physician-patient relationship. But I’d probably struggle just as much if I was not an MD. My guess is that most people do not view themselves as “unwell”. I am no exception. Call it vanity, pride, or a mid-life crisis, I have come to rely on my daily tests of physical conditioning in the pool, on the bike or running on the side of the road. I challenge my body to accommodate and adapt to whatever I throw at it. I control the degree of stress and strain. I decide when it has been too much. The damage and pain are of my own making. The blisters on my toes, the ache in my piriformis, the strain on my lower back.
We live in a physical world, where typically, I feel in control. I choose my actions and choices and live with the benefits or consequences. Hammering up a hill on the bike for two hours or continuing to run through miles 11 and 12 in 90-degree heat and 100% humidity are powerful conscious decisions. I am now forced to accept that I am powerless at the cellular level. I hold no sway over my body’s DNA repair mechanisms or cells that have gone rogue. For the last 72 hours I have been reminded of nothing else, because of the constant pain in my mouth.
Sick versus non-sick. Patient versus person. I know these binary descriptions are not accurate. We all live on a continuum of health and these adjectives are not exclusionary of each other. But for the last three days I felt sick. I felt like a patient. So I need to prove otherwise to myself. I need to be on the other side of the walls and windows of my house.
Running shoes as opposed to the bicycle is an easy choice. Hydrocodone and my new tri-bike do not pair well. And I know that gravel under my shoes usually quiets the negative voices inside my head.
The sun is out. The air is warm. I start my run and adjust to my new forced nasal breathing. After a mile “test run”, I decide I need more than the 20-30 minutes I had planned. I head to a park a few more miles away and just run. Not particularly fast but not really slow.
I smell fresh cut grass mingled with exhaust belched from a noisy aging car. Running through the park, birds in formation circle high above. On the ground, rabbits dart for cover bounding through the prairie grass. I feel the burn of a blister forming on my toe and the sting of sweat working its way into my eyes. Both are a welcome change from the tears of fear that I have shed in recent days.
For the moment, my tongue doesn’t hurt me, inside or out.
Thanks Jeremy, for sharing your journey and writing. Wishing you peace and meaning in all of it. Write on, my friend.
Thanks for sharing your story. Glad all is heading in a positive direction. I am all for blisters from n your feet if your mind is free.
Hi Dr. Topin, your story has been inspiring. I am a 31 year old resident physician and I too was found to have leukoplakia on my tongue during the pandemic. I was hoping to connect and talk to you to share your experience as I am coping with the anxiety of having this lesion.
I’m sorry to hear that you are going through this. (I found your blog after calling your office.) I hope you are doing well and that the road continues give you some comfort.