“The most effective form of birth control I know is spending the day with my kids.”
-Jill Bensley
Cancer of the roof of the mouth rarely occurs in children. Several years ago, I took care of a young teenager whose orthodontist had noticed a slowly growing, painless mass on the hard palate. After determining that everything else was fine, we took her to the operating room and removed the tumor. Once she had healed up, she never had any more problems with her mouth. I saw her regularly for a while and then she stopped returning.
Several years later, her mother brought her back to the office for a check up. The patient sat glumly in the chair occasionally glaring at her mother. As I updated her medical history, she was having some trouble with forming words.
“I feel fine,” she said. “I’m only here ‘cause she made me come.”
“Okay, open up,” I said.
This was no longer the cute little kid I had cared for a few years before. As she leaned forward to let me examine her, I smelled tobacco smoke. When she opened her mouth, she clicked an enormous tongue stud against her teeth.
Her mother rose from her seat. “There! Doctor! Tell her that thing is bad for her!” The girl rolled her eyes.
“When did you start smoking?” I asked. She shrugged and immediately delivered the same withering glance at me that she had just leveled at her mother.
We reviewed what I knew about tongue studs: they are interesting, they don’t help during job interviews, but they are not dangerous.
We also talked about smoking. As a survivor of cancer, she might be at an increased risk of additional malignancies, especially if she engages in high-risk behaviors like smoking. For the first time during the visit, she was engaged and was clearly listening, although she did not give me the satisfaction of saying she wanted help with quitting.
Mother and daughter left the office, both frustrated yet both vindicated, in a way. I'm pretty certain that the battle continued when they got home.
The following is feedback received for this blog:
Thought of you as we recently enjoyed a weekend in SMOKE-FREE CHICAGO. Not only is it safer inside - it's safer outside too. The streets are now monitored by smokers.
C'mon Milwaukee.
- Lucia
I read a cool article in the latest article about a chef in Chicago with tongue cancer..... thought it might be up your alley.
http://www.newyorker.com/reporting/2008/05/12/080512fa_fact_max/?yrail
- buckeye surgeon
www.ohiosurgery.blogspot.com
Great story! My experience with adolescents is that they don't get at all how risky smoking is (or maybe they like it for that), but your young patient at least knows what it is to have to have surgery for a tumor at least. And I bet she was more receptive because you okayed her tongue stud! Nice job!
- Jane Geraci
http://janemariemd.blogspot.com/
