Was "Cellulitis blows,"now, "Parotid problems"

[jon-nyc]

Ugh. I hope this resolves quickly.

[kluurs]

Crap - sorry to hear this. This is why people don't like to see specialists. They tell you the thing you're worrying you have isn't bad enough. I hope the hydration stuff works. I second the idea of massage .

[Rich]

All pain sucks...but pain that prevents rest sucks X 1000.

Hoping they're able to take care of this asap.

[Jolly]

@Mik said in Was "Cellulitis blows,"now, "Parotid problems":

I'd suggest 5-10 mg oxycodone at bedtime. Less pain = more sleep.

Man's a gas passer, wife is a trained ICU nurse. After she gets the IV line in, the possibilities expand exponentially.

[George K]

I have started IVs at home...

Just sayin'.

[Jolly]

@George-K said in Was "Cellulitis blows,"now, "Parotid problems":

I have started IVs at home...

Just sayin'.

Cats don't count.

[Mik]

Are you kidding? Would you rather start an iv on a human or a cat?

[George K]

@Mik actually, when I euthanized Oscar (our pug) in 1991, I started an IV on him.

[Mik]

Still easier than a cat.

[taiwan_girl]

@George-K :couple_with_heart:

sending positive thoughts to you!!

[brenda]

Oh, George, I am so sorry to hear this. Best wishes for relief and sleep.

[George K]

@taiwan_girl and @brenda thank you!

I'm about 75% better than I was on Sunday. Swelling is remarkably less. It was up to the top of my ear at its worst. Now it's just below the earlobe, and about the size of a thick, thick, half-dollar. If I massage it, I can taste something like pus coming out, so it is certainly draining well.

I still, on occasion, have a generalized feeling of "not well." Like when you get the flu, and you want to cuddle under a blanket.

The most common cause of a blocked salivary duct is a stone - sialolithiasis. However, my CT didn't show a stone. That could be because the stone is radiolucent (doesn't show up on x-ray) or because there's something else obstructing the duct from the outside.

And that's where the word "neoplasm" scares me.

I have an appointment with a head and neck surgeon on the 11th.

Once this all settles down, I imagine the process will be

1. Repeat CT scan (or MRI) to assess the neoplasm/mass
2. Do a FNA (fine-needle aspiration) to determine its nature
3. If benign, then either ignore it, hoping this doesn't happen again.
4. If benign, then do something to prevent it from recurring. Either put a stent in the salivary duct to keep it open, or remove the mass in surgery.
5. If it's not benign, then a parotidectomy is in order. Removal of the entire parotid gland. It's a major procedure which has, as its major risk, damage to the facial nerve which can cause paralysis on that side of the face.

Gonna be an interesting month, to say the least.

Look at this picture, and the parotid gland. Yeah, it was yuge. I couldn't sleep on my right side, and even touching the skin over the gland was painful

[Jolly]

Well, you're getting better and that's good! Now we just need some good healing prayers and thoughts.

[jon-nyc]

@George-K said in Was "Cellulitis blows,"now, "Parotid problems":

I have started IVs at home...

Just sayin'.

Meh. So have I.

I played piano with a seriously large dose (750 mg) of solumedrol dripping into the back of my right hand. As I’m sure you know, when you’re in acute rejection no punches are pulled.

[Jolly]

Don't mess up your drip.

And professionally speaking, don't fuck up my vein!

[George K]

@jon-nyc said in Was "Cellulitis blows,"now, "Parotid problems":

Meh. So have I.

You started the IV, or you had an IV?

[Jolly]

If he started one in his hand, I'm impressed. Median cubital, not so much.

[Mik]

OK, so what's the update? Did it resolve satisfactorily with the anibiotics?

[George K]

@Mik OK - here's the followup.

I had the FNA which showed chronic inflammation and evidence of chronic infection.

I was referred to a doc whose specialty is parotid and salivary gland stuff. She does sialendoscopy - retrieving stones with an endoscope if they're there.

A MRI showed resolution of the infection and she recommended no further antibiotic treatment.

But...

In retrospect, I had been symptomatic for longer than I appreciated. Back in December, I noted a bit of a foul-tasting discharge on the right side of my mouth. I attributed it to dental issues, buy my dental exam in January was fine, so I blew it off.

Then, when this flared in March, it was obvious that the discharge was not dental in origin, but from the salivary gland. In fact, even after I finished the courses of antibiotics, I could "milk" the gland and express some discharge from the parotid duct.

The specialist I saw recommended that we do a "wash-out" of the duct and gland. It's a minor procedure, done in the office. It involves passing a wire into the duct, and over the wire passing a small catheter. A syringe is used to flush out the catheter, hopefully taking any junk. and debris with it. I had it done, and it took about 10 minutes. Very weird feeling - lots of swelling as the duct and gland were distended, and a cold sensation from the irrigation. The gland remained very swollen for about 24 hours, and then settled down to normal size afterward.

For several weeks after the procedure, I could still mild some crap from the gland, but about 4 months ago, I noticed that nothing was coming out, and I haven't had any symptoms since the wash-out. Since there's no tumor, there's not much to do other than be aware of it and, if necessary, repeat the wash-out.

Statistically speaking, had there been a real mass, the odds are that it would be benign - 80% of parotid lesions are benign. However, submandibular and sublingual glands are different, with 80% being malignant. See picture I posted above.

Having your parotid gland removed is a big operation - not traumatic like joint replacements or bowel stuff, but it's very involved, and one has to be careful to not damage the facial nerve which runs through the middle of the gland. Damaging that can cause facial paralysis.

So, all is good.

[Jolly]

Good is nice.

I could live with good...