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

[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...

[George K]

[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]

@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