Back to the ENT

My appointment was pre-scheduled to meet back with my doctor. It seems I baffled him a bit. He went in to unclog my Parotid duct (technically it has another name but we'll keep it simple) but found it completely blocked. He seemed surprised by this outcome. Apparently no amount of roto rootering would clear the path. Which leads me to tomorrow, the second day of 2019.

The doctor scratched his head about the next step. He had a couple ideas besides the parotidectomy but shot them down as he was discussing them. I could tell by the sound of his voice that the outcome of either was going to be sketchy.

I went in hoping that he would say one way or another that we needed to move forward. I dreaded him saying... Well.... we could wait a bit and see what happens. But luckily he said, We have to do something. That made it easier for me to embrace the surgery and get this thing fixed once and for all.

Health issues can be so confusing. I've been relatively healthy my entire life, so when I do have an issue it always seems to be something they can't fix. And the older we get the more often that happens. I always feel silly mentioning stuff and think that the doctor must think I'm crazy.

Most people have a tumor growth on their Parotid yet I have a cyst. I've been researching lately and have learned that something should be done when the duct is blocked or you have a cyst. That information helped me understand this was the best course of action.

In this practice, after you see the doctor he says you will hear from his scheduler. OK, more waiting. When the call came through, she suggested January 2nd. I guess that date is as good as any. Start the year with a bang. It seemed so far away and now it is tomorrow. In a strange way the waiting was good since I've noticed as each month has passed, the pain becomes more consistent. Also, where I could once flatten out the bump, it is no longer possible. Each thing makes this decision a bit easier.

So... I prepared as good as I can and am now counting down the hours until the surgery. It will be an early morning and a long day. I'm more nervous than before, but that is to be expected. I'm hoping my story will be an easy one from this point forward. Telling the future has never been my strong suit. You can only imagine so much.

Surgery Dry Run

I like to refer to this surgery as textbook, except for the part that it didn't solve the problem. Not quite textbook then? It was a great dry run.

Everything that you would want in a surgery is how it went down. When I arrived I was whisked right in to get all comfy with my gorgeous gown and fetching shower cap. There were a few less pleasant things involving needles of course. That is never fun. A million people came in and asked me the same questions and made hieroglyphs on my neck. They explained everything that would happen and what I could expect. I was strangely calm.

My surgery was scheduled for 8:30 so naturally we had to get up at O-dark thirty. It's no surprise that I didn't sleep well, so I was pretty tired when I arrived. That worked out well since I was able to get a cat nap in while waiting for the doctor to arrive.

My mini-surgery was pretty much a dress rehearsal for what is to come. Had a fun ride down the hall with so many people and equipment. I entered the cold (cold!) operating room and looked up at the clock, it said 8:30. Bingo! The doctor had said it would be an hour procedure. There were so many people around doing things with all parts of my body. Leg pumpy things, arm sticks, more instructions about expectations. It was a total beehive.

The very best part of any medical procedure I've had are the warm blankets! They came and asked if I wanted one... YES! Of course! I must say I was mildly disappointed with the tepid blanket they came out with and laid over my body. Dang, but how could I complain. It's not like I would be conscious much longer. Then some sweet angel (I swear I saw a halo!) hooked up something to the blanket that blew hot air inside the blanket. I kid you not! I need one of those at home. I can see it now... Inflate-a-blanket, as seen on TV. Anyways I got to enjoy that sensation for all of a couple of minutes before the anesthesiologist said he was going to put 'something' in my IV that I would feel very shortly. I'm not sure if I even heard the last syllable, it was show time. I've often wondered if they kept that blanket on or flip the switch as soon as I'm out.

Anesthesia is such an odd sensation. One minute you are awake and aware, and literally the next you are in a totally different location with people hovering over saying your name and asking if you feel ok. Umm... feeling a bit strange at the moment to tell the truth. Next I was told that the surgery didn't work. Well dang! That was a whole lot of nothing for what was a picture perfect surgery.

On a positive note, if you have to have a surgery I'd recommend this one. No scalpels are used. There are no stitches, basically you walk out pretty much as you came in. My neck was a bit sore but I'm sure that was because they had it at a weird angle to do the procedure. I had a bit of a sore throat from the anesthesia tube, but that was it.

They offered me something to eat and drink and shuffled me and my bed off to a side room to rest a bit before getting dressed and heading home. So... that was it. In and out, but that same as I was before. More waiting.

ENT Part 2

Time is passing. I was mistakably scheduled with a doctor that could not take my insurance. I saw a PA instead. She was lovely but couldn't really do anything as far as surgery went. It was the first time I asked about surgery. She told me about a parotidectomy, more on that later.  It was also the first time that this seemed a bit more complicated than I thought.

More time passes. Finally at the end of August I get to see the new ENT. He agrees that he should try the procedure to open up the duct. I guess I was surprised at this point since the PA had suggested something different. I figured it was an office procedure, but soon learned that it was outpatient from a local hospital. Since I had asked the PA questions about the other surgery I didn't think to ask too much about this surgery. All the doctor said was that I might have a wire hanging out of my mouth. Um... ok... what?? I searched the Internet to find out information about what was about to happen and pretty much came up empty. I knew I had to just trust the doctor. If it worked, it would be a lot less invasive and I'd have a working gland again.

By now my little bump isn't a whole lot bigger, but it hurts. Not terrible pain, just constant ache in different parts of my face and ear. The tricky part of this whole Parotid thing is that your facial nerves pass through the middle of the gland. I'm guessing that is why the pain feels different from time to time.

I had no idea that it takes so long for surgery to happen. On the good side, that means it isn't critical.. the bad side is that you have much more time to worry. Health care drives us, not the other way around. Now it would be mid October when my surgery was scheduled. Ok, only 6 more weeks... not so bad. And yet, this is late December, right? I'm not to the bottom of the hill yet.

ENT Land

Phew! Referral process went smoothly, if slowly. I can't decide if it is better to look up a doctor or not. This time I did. He looked decent and he was located in my favorite medical center, so win-win. I guess it is late June by now.

The doctor was very professional, however he spent most of the time complaining that he could not see what the radiologist saw. He kept zooming in and out and muttering. I didn't quite know what to say. He decided to do a needle biopsy, but felt confident it was a cyst. Hmmm. Something I didn't consider before. The biopsy wasn't too painful and for the first time in 5 months there was no bump.

At this point he said he felt like the fluid would collect again, but there wasn't anything unusual looking in the syringe. Mostly clear liquid. Strangely, after the needle biopsy the lump stayed flat for 48 hours. But, alas... it came back and was pretty much the same as before.

I returned to the doctor for a follow up a week later. He told me that the report came back clear (not a surprise) and basically there wasn't much he could do for me. He suggested a few things like the compression bandage you wear after a face lift, but then almost immediately said... but I doubt that would work. A lot of head scratching went on, then he finally suggested I see another ENT doctor who does a fairly new procedure that uses a tiny wire to go in via the mouth to try to stretch the duct tube open. If that doesn't work, he said... you can come back here and I can do a facelift like surgery where I pull a muscle over the gland to basically keep it flat. Yikes! I think I'll take my chances with the next ENT. This doctor didn't seem very jazzed to find a solution. And the beat goes on....

DMZ of the Human Body

Have you ever had a jaw problem? My daughter suffered from a locked jaw issue when she was younger. That was when I learned that the jaw is more like the strip of land between two opposing entities, a health DMZ. We have dental insurance and medical insurance, but it seems like the jaw is a bit of both. I understand that teeth are dental, but why does the jaw get mixed up in that? Perhaps in this case it worked to my advantage since I didn't need my primary care to go to either. This has always bugged me.

Anyways... back to my trip. I made an appointment with my dentist. At least this was quick and easy. An x-ray revealed nothing unusual in my dental structures. After a bunch of head scratching the dentist referred me to an oral surgeon. I love my dentist and the doctor he recommended was one of the best I've encountered.

Just a week later I sat in the oral surgeon's office. I must admit at this point I'm feeling somewhat silly about all of this. Honestly in May I wasn't feeling any pain, just the lump. My neck felt a bit tight, but that was all. I told the doctor how embarrassing it felt to have this smallish bump checked out but he assured me that it is better to catch something when it is easier to resolve.

After more poking and prodding and a more thorough x-ray he recommended that I get a CAT scan. He was so helpful lining it all up with my medical insurance. When the results came back he called me personally to report the findings. I was impressed.

The good news was there was no tumor! The bad news is that didn't really help to figure out the actual problem. The radiologist noted that there was quite a bit of narrowing of the duct and would need to be looked at more closely. Oh dear! This is like a progressive dinner. Next stop... ENT (Ear, Nose, Throat) doctor. It also meant that my primary had to get involved again, sigh. I'm hoping this part goes smoothly.

That's funny... I feel a lump!

In our busy lives, time seems to meld together. You can't always remember the fine details. I'd guess is was sometime in mid February 2018 when I noticed the lump. It didn't hurt, it was just there. I won't reiterate what I thought in my previous post. Let's just say I found the lump disturbing after I caught my breath.

I had an appointment already scheduled with my primary care doctor, however it was several weeks away. So... I naturally went to Plan B. I asked my son-in-law (a Physician's Assistant) what he thought. He touched, poked and prodded and told me it was a swollen Parotid gland. A what? It's an understatement to say I'm not all that familiar with human anatomy.

It's not a big deal, he said. I mostly wanted to know if I should move up my appointment, so this made me feel a lot better. The lump was soft and with gentle pressure would reduce in size. Often the duct gets clogged, he said. He told me to eat sour things, like citrus fruits or candy and gargle salt water. That generally flushed out issues like mine. Great! It turns out I'm not going to die after all.

A few weeks and multiple bags of sour candies later (the only fun part of this story) the bump had not changed. It was still soft and when massaged seemed to drain and flatten. It was almost flat when I woke up and gradually grew as the day progressed. I just needed more time, I thought.


I pointed out the lump to my doctor at my next visit. Hmmm... says he. Oh, it's nothing, just a lymph node. There is nothing to worry about. Say what? I'm not about to argue that my son-in-law told me something entirely different. Way to get on the bad patient list. I ask a few more questions but soon realize the subject is dead. OK, I think... guess it will eventually leave the same way it came. Besides, that meant I could treat myself with more sour candy, right?

Fast forward 2 months and I'm still eating candy. This can't be good. What can I do when my doctor doesn't think I have a problem? It's the modern curse of HMO insurance. I thought back and remembered I once had an abscess on my jaw. That was another long story that I won't bore you with, but the upshot was that by the time I had seen the 7th dentist a chunk of my jaw had disintegrated from the infection. So, perhaps a dentist is the way to go? What if my jaw is slowing dissolving? Bugger! I hate health issues.

Parotid Gland 101

What did we do before information was so easily available on the Internet? It can be overwhelming, but also a blessing. It has only been in the last few days that I wanted to learn more about what is about to happen and also the about the recovery process.

Searching for pictures can be a bit daunting. You will see things you hope to never see again. You will wonder how a growth could become so giant before something is done. You start to think that this itty bitty bump on your neck is hardly worth the effort. But, in the end, my research helped me understand that I'm on the right path to restoring my health.

In case you don't want to look on your own, I found a not entirely gross picture to illustrate the location of the Parotid Gland. There are actually a pair of glands located in front of and below each ear. Each gland has a long thin duct that runs into your mouth. There are also a couple of other salivary glands located below your tongue. That would be another blog. 

Basically, the job of the Parotid (rhymes with Carotid) is to make saliva to help with chewing and swallowing.  It is also the gland most associated with the chipmunk cheeks of Mumps. 

There are various things that can go wrong with the gland. Naturally, the first time you notice a lump your brain goes full speed to... OMG! I have a tumor I'm gong to die. Your brain doesn't? Hmmm. Ok... moving on. 

While tumors are often the lump you feel, luckily cancerous tumors in this region are rare. There are various types of tumors or other growths possible. Additionally, you might experience issues with the Parotid duct. Infection can cause the duct to narrow, or you may develop a stone in or near the duct preventing the flow of saliva. Sometimes the treatment is quite simple and then there is Lombard Street. Welcome to my trip.