On my salivary gland: Vol. 2

August 2, 2012

I have a plugged up salivary gland.  It’s pretty awful.  If you want to hear the tale of my salivary gland up until this point, check it out here.  This is to inform you of what happens when your salivary gland is plugged up for months and multiple doctors don’t know what to do about it.

Spoiler alert: it’s not a lot of fun.

So after months of being bounced between doctors, I finally found one in Meadville, PA who was willing to deal with my mouth.  I arrived at Dr. White’s office ten minutes early and sat in the waiting room, thumbing through my copy of ‘The Sportswriter’ by Richard Ford.  I shifted in my seat uncomfortably.  I always find doctors’ offices a little unsettling.

When they called me to the back room, the doctor poked casually in my mouth with his fingers.  He told me he looked at the CT scan of my mouth and couldn’t see anything and asked if it hurt when he poked my mouth, to which I replied that it did.  He milked my salivary gland, which is a weird experience to say the least, and then told me that he needed to take a biopsy of the swollen tissue.  Reluctantly, I agreed.

This was the first time he jammed a needle in my mouth.  Sadly, it wouldn’t be the last.  After numbing the left side of my face, he cut a small piece of skin from inside my mouth, which would tell him a little about what’s going on with my salivary gland.

Swollen salivary gland

You may notice the little bit of red on my swollen gland. Skin used to be there.

As an aside, I like to imagine my salivary gland as the Martin Riggs of my mouth; completely out of control and doing whatever the hell it wants.  That made my whole experience a little bit easier to get through.

The doctor told me that he was fairly certain that what I am suffering from is a ranula.  A ranula is basically a cyst that fills up with nasty fluid and is typically caused by some kind of trauma.  As I have no salivary gland piercings, I’m at a loss for what kind of trauma occurred in my mouth.  So for a few days I waited for the results of my biopsy.  I don’t know if you’ve ever had to wait for the results from a biopsy, but it’s pretty unnerving.

After a few painstakingly long days, I was scheduled to go back into the doctor’s office.  Thankfully, the biopsy was negative and all it showed was swollen tissue in my mouth.  He said that if he were to cut open my salivary gland, he could use a stitch to hold it open, which could, over the course of a few weeks, reduce swelling as well as help the cyst in my mouth pass.  So the doctor suggested a quick operation.

This of course led to more needles.  Three of them, to be exact.  I’m pretty manly about most things.  I’m of the attitude that if you just suck it up and get it done, things won’t be as bad as you make them out to be.  I will also tell you that if you have had a needle shoved in your mouth once, that’s enough to make you hesitant of having it done again.  Buying into my own shut-up-and-dance bullshit, however, I opened my mouth and lifted up my tongue.

“Go ahead, do your worst,” I told the doctor.  “I’ll see you in hell!”

I didn’t actually say that.  It probably would have made me feel better about getting my mouth stabbed, but I didn’t want to confuse the doctor who was about to cut open my mouth.

There was something about this doctor that I liked.  It wasn’t that he was about to cut open my mouth.  That definitely wasn’t it.  I could tell by the way he nonchalantly stabbed a needle into my mouth the last time we met that he was a no-nonsense kind of guy.  Like I pretend to be sometimes.  He reaffirmed my belief in him by saying, “This is going to hurt a little bit.”  Had I not peed a few moments before going into that room, I probably would have just then.  I appreciated his honesty though.

Feeling a needle pierce the soft underbelly of my tongue three times is a sensation that I am sure will haunt my nightmares for weeks to come.  However, it only took a few moments for the left side of my mouth to go numb.  After that, all I could feel was the pressure of the tools as my glad was sliced, spread wide-open, and stitched to hold as such for the next few weeks.  The end result:

Stitched up salivary gland.

People who voluntarily cut their faces are out of their minds. I’m talking about you, Bruce Jenner.

Now I sit and wait for this ranula to pass through this gaping hole in my salivary gland.  I go back to Dr. White in a few weeks to make sure that everything is on the up and up.  If it’s not, then at that point I have to explore having my salivary gland removed.

I’m hoping that Dr. White is the Roger Murtaugh to my Martin Riggs-of-a-salivary gland.  My gland isn’t too far gone that it can’t be saved; it just needs a partner that understands it and the trauma that it went through.  It was a salivary gland in the Special Forces in ‘Nam and it lost its wife in a car accident a few weeks ago as well.

In all seriousness, if anyone needs a recommendation for a doctor who can repair your salivary gland.  I know the right guy.

Dr. White

Thanks for all your help, Dr. White! I hope I never have to see you again after this month!


On my salivary gland

June 22, 2012

This is a tale of how I ended up on my couch, drinking lemon juice and chomping on Lemonheads.  It’s not a tale for the faint of heart, so proceed with caution.

Towards the end of April, I noticed a change in my mouth.  It was progressive change that I noticed over the course of a week.  It started with what felt like a scratch in my mouth below my tongue.  Uncomfortable, but nothing that was out of the ordinary.  I coach high school baseball.  I was chewing a lot of sunflower seeds.  I figured I scratched the bottom of my mouth and that I’d be in mild discomfort for a couple of days and that would be that.

After a week, that scratch hadn’t gone away.

Finally, on a Sunday afternoon, I looked in the mirror and was shocked at what I found.  I giant lump underneath my tongue.

I walked back out into the living room and asked my girlfriend to look in my mouth.  It was a weird request, but she obliged.  After peeking inside, she immediately suggested going to an Urgent Care down the street.

When you find a lump on your body that you know doesn’t belong there, it’s incredibly disconcerting.  The fact that someone who had looked at that lump was concerned was even more troublesome to me.

Clint Eastwood The Good, The Bad, and The Ugly

“I do whatever the hell I want in my office.” – Dr. Eastwood

After filling out the paperwork, I was promptly ushered into the doctor’s office.  He strolled in with a shoot-from-the-hip look on his face.  He was reckless.  The villagers said he was dangerous.  But some called him the best around.

I made up all of that narrative.  I didn’t know the doctor.  But it helped to calm me down to imagine my doctor like that, so Dr. Eastwood he was.

“Let’s see what’s going on with your mouth,” he said, as he looked over my paperwork.

I told him about my swollen mouth.  He told me to open up.  He looked around for a moment, felt around for a second or two, then told me to sit tight.

Sitting anywhere when you’re waiting for someone to tell you what’s wrong with your body is not a fun feeling.  I’m a neurotic guy to begin with, so things like this tend to make me automatically think of the worst-case scenario: this lump in my mouth is going to kill me somehow.

Once the doctor returned, he said that he could lance the thing in my mouth, which he referred to as a cyst, but he wasn’t really comfortable doing that.  So he recommended I go see Dr. Simmons, someone he assured me was much more qualified to do such a thing since he was an oral surgeon.

I agreed that if he were to cut my face, he should feel comfortable doing so, so I wished the doctor good day and set up an appointment with someone I hoped was knowledgeable enough to slice out that thing in my mouth.

At Dr. Simmons’s office, I was greeted by a medical assistant who was a graduate of the same high school I attended.  That was neat.  Overall my experience at this doctor’s office was enjoyable; until she looked in my mouth, took some pictures, and then said, ‘Oh.’

Now there’s a couple different connotations associated with the word ‘oh’.  You can say ‘oh’ with a nonchalant, almost cavalier tone.

“Did you know I have seven cats and I’ve named them after all my favorite characters in Leonardo DiCaprio movies?”

“Oh.”

You can say ‘oh’ with an inquisitive tone.

“Did you know that my brother used to play for the Boston Red Sox?”

“Oh?”

This ‘oh’ was more of a surprised tone.  Like you hop in your car, turn the key, and nothing happens.

Clearly this lady was not familiar with my neuroses.

Clogged salivary gland

This is what a plugged up salivary gland looks like in a mouth full of spectacular teeth.

After a few moments, the doctor came in and looked at the pictures on the computer.  He was a gentlemen; he got to know me before he shoved his fingers in my mouth.  Then he laid it out for me.

“You have a blocked salivary gland.”

That didn’t sound so bad.

“I’ve only ever dealt with this twice.  So we’re going to have to send you to Pittsburgh.”

That didn’t sound so bad.

“There’s risk of infection, so they’re probably going to cut underneath your chin.  Once they do that, they’ll be able to remove your salivary gland.”

Typical guy.  Always moving way too fast.

I took a personal day, got a CT Scan of my mouth and sent the results to Dr. Bernard J. Costello.  I then took another sick day and traveled to Pittsburgh to meet with Dr. Costello, who told me that I have the equivalent of a kidney stone in my salivary gland.  You see, your saliva is full of dissolved minerals.  Apparently these minerals collected in my gland and formed a stone that is preventing my saliva from passing completely through my gland.

I was then presented with two clear options.

1. I can wait and hope that if I salivate enough, the stone will break apart and pass.

2. I can have my salivary gland removed.

Call me crazy, but I opted for choice number one.

In all seriousness, after dealing with three different doctors, two of which were oral surgeons, I felt like I had no better option than to continue to live in discomfort and hope the problem cleared itself up on its own.  I didn’t feel like sacrificing a healthy gland seemed like a great idea, especially given the unconcerned attitude of all the doctors involved.

I’ve been dealing with a sore mouth for over two months now.  It’s completely changed my personality.  I’m much more irritable because the pain is chronic.  It’s not overwhelming, but it’s constant.  Imagine a fresh papercut.  Now imagine that cut in your mouth.

It’s also caused weird salivating habits.  My salivary glands that aren’t blocked are producing excess saliva to compensate for my gland that isn’t working properly.  If I’m not paying attention, I’ll end up with a mouth full of saliva and drool on myself (which has happened twice).  My salivary glands will also squirt at random, and often at inconvenient times, like when I’m in the middle of a conversation with someone.  Every so often my gland fills up with blood, puss, and saliva and a little bubble bursts, filling my mouth with a delicious cocktail of nastiness.  Occasionally, the few people who were privy to this will ask how my mouth is feeling.  Most of the time I just shrug and say fine.  I’m tired of talking about it.

So after all this, you can probably imagine my relief when, at my dentist appointment this week, my dentist recommended me to a friend of his who is an oral surgeon that deals specifically with people’s salivary glands.

My appointment with my fourth doctor is now scheduled, and while July 12th won’t get here soon enough, at least I know that there is some relief; a light at the end of the tunnel.  Until then, here I sit with a bottle of lemon juice and some lemon candies, trying to salivate enough to alleviate the stone that has been the bane of my existence for the last few months.