Friday, September 30, 2022

New Cancer Fear: Curse of the Inconclusive Ultrasound


This won't be the best piece of writing I've done, but forgive me: I had a rough day today. Missed the full day of VIFFing because I went back to the ER with a mysterious lump in my throat, in proximity to one of the locations of my December surgeries (which included a neck dissection and the harvesting of lymph nodes and salivary glands for biopsy; no cancer was detected at that time, or in the biopsy of the parts of my tongue that were removed, but there was definitely some scar tissue and weirdness left in the operation's wake, including an ear-to-Adam's apple surgical scar that is gonna make a fun conversation piece someday, maybe.)  

Luckily, with a little help from Erika, I arrived at the hospital early and was triaged relatively high up there, so that within a jaw-droppingly brief six and a half hours, I managed to see a doctor, get an ultrasound done, and have it discussed with me by a doctor who explained that the results were inconclusive. There was a 2cm something-or-other that he thought did not look like a swollen salivary gland, unless my architecture was significantly altered due to surgery, which it may be. It was still a long day, and way faster than I expected, as I went home unseen after longer waits twice when I was in a panic during my surgery recovery, and Erika was just in there just waiting to be seen for over nine hours the other week, just to get seen, after she coughed up a little blood during her encounter with Mr. COVID (811 nurses really gotta start factoring wait times in when they send people to the hospital - it was nine+ hours to be told it was nothing, which was exactly what the triage nurses probably thought, too. I guess Erika was glad she went, but if it had been me... well, I wouldn't have gone at all: "So I coughed up a little blood, what the fuck!"). 

All the same, 6 and a half hours is a fair chunk of change ot spend on inconclusive results.

Anyhow, a swollen salivary gland was kind of the best-case scenario, what we were hoping it was; in fact, the idea came as a relief, back when I was terrified Thursday, contemplating a return to the surgical ward and how it didn't seem very appealing, when Erika remembered a past swollen gland of mine. Looking at the lump in the mirror, that old lump, several months ago, was just on the tip of my mind, but not quite within reach ("I seem to recall having had something like this before, but... when? What was it?" I was prettily heavily medicated back then!)... I do recall it clearly, now that she twigged the memory, and it was similar to this, but it behaved a bit differently, I think, too - I was distinctly aware of being able to close my mouth and suck the saliva out from it, but the present lump doesn't seem to respond well to that. It does seem soothed by a hot compress, but that could mean more than one thing, as that treatment is recommended for both swollen lymph glands and swollen salivary glands.

Short version, the doctor may be right - it might not be salivary in nature at all. 

Unfotunately, the report he shared with me just before I got sent home included speculations about "neoplastic etiology," which sounds like a phrase you'd hear in a Cronenberg movie. Institute of Neoplastics, say, or maybe neoplastic surgeons, who sew tumours into you? Because decoded, in this context, "neoplastics" means cancer. So that was taken off the plate at the start of the day ("it's moving too fast") and back on the plate at the end of the day, with the reassurance that it could just be a swollen lymph node, perhaps related to a localized infection (they've given me antibiotics to see if they help, but could find no overall trace of infection in my bloodwork; but if the lump goes down, if it responds to them, it's a good sign). 

Then again, lymph nodes can swell in response to cancer too. But what tumours grow this quickly? My surgeon, the one who did the operation on me last September, just over a year ago, and also the first of the two operations I received in mid-December, examined me just last Saturday for the yearly annivesary, more or less, massaging under my jaw in just this area. There were no lumps. I even called to report today's trip and confirm that he had felt no lumps ("he would have mentioned them if there were," I was told, tho' I dunno, he was rushing and I had other questions and he DID schedule a PET scan, without saying whether it was routine. Maybe he felt something but wasn't sure? There must be some category of "it's probably nothing" stuff for him as much as anyone, some threshold beyond with, especially with "sensitive" patients, he does not disclose everything he thinks). 

But I mean, I certainly didn't feel lumps there either until about four days ago (Tuesday, maybe?). So from Tuesday to Friday, it went from a small thing I wasn't even sure was there to something that feels the size of an egg, even if it's only 2cm across on the ultrasound. It's visible to the eye if the lighting and angle are right, and it has made the skin around it all tight, while making it sometimes a bit painful to swallow. It's like a hard knot in there, on the left side of my throat, where there are still a fair number of nerves.

I mean, fuck, maybe it IS an infection. Maybe some poorly-swallowed or half-swallowed jagged edge of potato chip that I choked on and/or coughed up cut me and caused damage and that damage got infected? I do have chewing and swallowing errors, with my tongue like this. I mean, it could be that, it's wholly reasonable. It feels a little less swollen now that I've had two antibiotics (though I've been told that it takes a few days for them to work). Maybe that's all it is? A swollen lymph node responding to a localized infection...? 

...Or maybe it IS a blocked salivary gland, even if they didn't think so from the inconclusive ultrasound. I'm still doing the hot compress, having lemon in my tea and sucking extra-strength Cepacol and taking my antibiotics (last one was maybe half an hour ahead of schedule, to be honest, but I may be impatient for them to work...). Maybe it will be gone by Monday? Then we'll know if it was an infection or not, I guess. They have scheduled a CT scan which they say will take place in a few days. They'll call me. 

I actually believe they will. Meantime, I'm watching the new Cronenberg movie, which I'm enjoying more the second time through, but holy hell is it weird. Quite funny, quite awkward. Erika, with my blessing, is off to the island for a previously planned visit with a friend, so I can dip into Cronenberg, who has definitely been helpful through all this. Might watch The Creature Walks Among Us, next. Horror as coping mechanism, seems like it might fit the bill. Or I could always do The Island of Dr. Moreau again. Certainly De Humani Corporis Fabrica will fit the bill well when it screens...

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