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

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

@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 · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

@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

Repeat CT scan (or MRI) to assess the neoplasm/mass
Do a FNA (fine-needle aspiration) to determine its nature
If benign, then either ignore it, hoping this doesn't happen again.
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.
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 · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

@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 · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

@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...

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

Mik

Glad to hear you found a solution that seems to have worked and can be repeated if necessary. Facial paralysis could make it very hard to drink (cheap) scotch.

Jolly

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

I've never seen a routine path report with references.

That's neat!

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

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

I've never seen a routine path report with references.

As I've said, I've been very happy with the care at the University. As a patient, however, having "connections" to tell you whom to see and whom to avoid is very helpful.

Rather than being referred to "ENT," I emailed a friend and asked him who a good ENT is for this. The guy he recommended did the biopsy and said, "This is not in my wheelhouse, you should see Dr..."

Mik

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

I've never seen a routine path report with references.

That's neat!

I haven't either, and I've converted literally millions of path reports by text parsing. I had to be aware of and program for any situation that might occur.

taiwan_girl

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

Good is nice.

I could live with good...

Agree!! Glad to hear it George

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