Jim Kelly's next goal is eating, Rochester surgeon says

Hall of Fame Bills quarterback Jim Kelly is able to breathe through his mouth after surgery to remove an oral cancer and rebuild his jaw.

Kelly's wife, Jill, posted on Instagram Tuesday night that the tracheostomy tube had been taken out of his throat.

"The trach is OUT! Praise the LORD!" she wrote.

The next celebration could come when Kelly is able to eat, according to a head and neck cancer surgeon who is not involved in Kelly's care.

"I suspect he's still receiving at least some of his nutrition through a feeding tube," said Dr. Matthew Miller, an ear, nose and throat surgeon who specializes in head and neck cancers at the Wilmot Cancer Institute at the University of Rochester Medical Center.

"We all have different protocols for when we allow patients to eat by mouth after surgery like this," Miller said. "It has to do with giving the tissue time to heal properly."

He said surgeons have their own protocol for when they allow that to happen.

Kelly underwent a 12-hour surgery on March 28 at Mount Sinai Hospital In New York City.

A tracheostomy is done to allow surgeons a clear path to the mouth and as a precaution in case of swelling after the procedure, Miller said. A hole is made below in the windpipe below the voice box, and a metal or plastic tube is inserted. The tube usually remains in for a week or 10 days after surgery, but it can stay for much longer.

The trach is OUT! Praise the LORD! After taking care of Hunter and now Jim throughout his cancer battle...I have been blessed and changed in multiple ways. I have also experienced and learned more than I could ever have imagined. One thing I know for sure... God is Faithful and Good and Prayer is POWERFUL! Your love and prayers have sustained, encouraged, and helped our family more than you will ever know. THANK YOU SO MUCH! We love and appreciate you!

A post shared by Jill Kelly (@jillmkelly) on Apr 10, 2018 at 8:26pm PDT

Miller said the removal of the tube is consistent with the usual timeline for Kelly's procedure.

"What it tells me that the tracheostomy was removed was that the swelling has gone down enough in the mouth that his physicians are comfortable that he'll be able to breathe comfortably and speak comfortably without needing that kind of bypass valve that the tracheostomy provides.

Miller followed the surgery from afar, partly because of his rooting interest in the Bills —he called himself a lifelong season-ticket holder — and his professional interest in the procedure.

"Anything that raises the profile of head and neck cancers and what our patients experience on a daily basis and what it is we do to try to help our patients is something we view as positive," he said. "Particularly given how up front and how public they've made his entire battle with this disease."

Miller, who has followed Kelly's progress like all his other fans — on social and in traditional media — described what likely took place in Kelly's surgery:

• Part of the upper jaw was removed and lymph nodes were taken out of the neck.
• A section of the fibula, the small bone in the lower leg, was removed, along with blood supply and a portion of skin.
• The leg bone is used to rebuild the jaw.
• The skin is used to rebuild the lining of the mouth.
• Under a microscope, the blood vessels from the leg are sewn to the blood supply in the mouth.

Miller said it essentially is a transplant to one's self. It's the same idea as using belly tissue to rebuild the breast after mastectomy.

This was Kelly's second surgery for oral cancer.

"Obviously this is a setback for him," Miller said. "But putting into context the previous treatment he had, the fact that he does have ... presumably surgically curable disease, at this point is a good sign. Taking a trach tube out is for our patients is always a positive sign. It's another step on the road of recovery, which really will be lifelong for him."