New Update

Got a note from Dr K (the ENT):

 I got a message from our interventional radiologist who reviewed your films, and went over them with a neuro specialist, and they feel it is too small and much more likely to be a small amount of fatty tissue to effectively biopsy. They recommended a follow up scan in 6 months as an alternative. Does this seem reasonable to you? Please let me know your thoughts.

Regards SK

Looks like a wait and see approach is happening. Considering how troublesome of a patient I am, this is actually a good idea.

I also got a note from the PCP as well later in the day. Nice to see that my physician doesn't just deal with her emails during business hours (she answered back at around 1am...). Anyhow she's agreeing with the ENT and that maybe the conservative approach to this is the best idea.

Update

On Wednesday, I went and had my MRI done. I managed to handle it well with no medicines to calm me, which is kind of amazing considering that it was one of those closed MRIs and a bit snug for comfort. Kept my eyes closed the entire time and just focused on the clicks/knocks (they were just loud enough to drown out the tinnitus ringing and as such, I almost relaxed enough to fall asleep at one point).

Thursday I got the results. Names removed for privacy. Here is the email I received from the ENT's office:

From:SK MDReceived:5/30/2013  5:49 PM EDTHi I reviewed the MRI report and they are seeing a small nodule that looks like a lymph node and on comparison to an older CT scan (2011), looks about the same size. I think it is reasonable to just observe it; but if you would prefer to get a tissue biopsy to confirm that it is a node and that is bengin, I can arrange for you to have an ultrasound guided biopsy with our interventional radiologists.Please let me know your thoughts when you have a chanceThanksSK

I wrote her back to confirm the year on the CT scan that was used as comparison. I was hoping that year was a typo, because if not...that thing's been in me for at least 2 years now and for sure the antibiotics haven't reduced its size (and I've been on them ALOT this year). It's not gotten any larger but what really concerns me is the fact that no one has noticed it before now. Hubby and I  discussed the next step to take. The ENT doesn't seem too concerned. Well, she's concerned enough to get me an answer right away (she knows I'm a worrywart), but not concerned enough to say it needs to be dealt with right now. Hubby's suggested the biopsy anyway, just for peace of mind. Seems to be the prudent step at this point.

Later in the afternoon, I received this:

RE:imaging results

To:

From:DC RN
Received:5/31/2013 9:59 AM EDT
Dear Ms,
Dr. K is out of the office until Tuesday. The report of the MRI states "CT scan of the sinuses dated 2011 was reviewed and the previously described parotid nodule most likely was present at that time, but imaged only on the periphery of the film suggesting a benign stable etiology."Hopefully the information is helpful. If not, I will be happy to forward your message to Dr. K for a response.Completed by: DC RN, May 31, 2013, 9:59 AM

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

So it looks like it HAS been in there at a minimum of 2 years. My biggest question right now is WHY ... if you see something odd on the periphery of a CT scan's film (it would have been an incidental find there as well) ...you don't say "the sinuses look ok but we saw something a bit odd and would like to send you in so we can get a better look at this" ... just so you can be SURE that it IS benign and stable? Granted, I know that the insurance companies make the doctors jump through all sorts of hoops and stuff. However, it was an incidental find at the Urgent Care too. Why wait 2 years and not say a damned thing? What if it WASN'T benign? So I wrote the ENT office back:

Yes it is, thank you. Really kind of upset at this point that if it was showing (even if it was on a periphery part of the film) that someone didn't say "Hey, we really should get a better look, just in case". Especially since there's cancer on both sides of my family. That said, I think we're going to opt for the biopsy. However, the Dr needs to know that local shots don't numb me as they should and she needs to be reminded that I'm a nervous patient.
Best Regards

Best Regards

I've looked up the type of biopsy they want to do and not liking the procedure at all. Locals don't work on me so I'm looking at pain and terror for the procedure. I'm guessing that even if it's benign, they're going to recommend that it gets removed anyhow. Better safe than sorry.

That's where we stand right now. I still need to drop a note to my PCP and my allergy dr and get them caught up on this. Not really a happy camper right now........

An update and the rest of the story

As most of you know, I've come down sick *AGAIN*. This is about the 4th or 5th time since Thanksgiving and the second since the turn of the year. The last two have gone from bad colds to upper respiratory infections. You may also remember that I went to the dr's on Thursday, given a breathing treatment and prescribed a bunch of meds to help get past this one.

The coughing spasms were horrible. I mean a frightening kind of horrible. Around 4-430pm on Friday, a spasm so bad hit that I blacked out. Not only did I black out, but I fell out of my office chair and face first into the tv cart in the corner of the room. For the smart-asses,  the tv cart and floor survived, but they're demanding hazard pay and the cart needs a good therapist to deal with the weeping and tremors it gets everytime I waddle into the room. Anyhow, I did quite the number on myself and really scared the shit outta hubby (although he's not really admitted it yet). Blood family knows that when I see my own blood, I tend to panic.... which is precisely what I proceeded to do (screaming, crying, hyperventilating , the whole 9 yards). I scuffed my right knee, left shin, back of my left hand (how the hell??), scraped between my eyes as well as under my nose and ended up bruising my forehead, over my right eye and my right jaw. Yeah, when I do something like this... I really do a job and a half on it.

By the time I got cleaned up, hubby had to call the Urgent Care Clinic because it was after hours at the regular clinic. He made an appointment for me there at 7pm. Why they couldn't just send me to the hospital just 5 minutes down the road, I have no friggin clue. Ah naw, send me to the UCC 20 miles away. Idjuts.... but I digress.

The dr that saw me ordered a CT scan, to be certain that there were no fractures or brain bleeds. Thankfully, I'm all clear there. However, they did find something. While reviewing for the cracks and bleeds, they found a lump in my parotid gland (or at least that's what that dr was thinking at the time). Needless to say, I've been worried and scared all weekend because my family... well we don't have a great track record with certain diseases. I'm high-strung and a nervous sort so naturally my brain went to the worst case scenerio (to be expected when a dr pairs "lump" and "biopsy" in the same sentence).  By this morning, I had a raging migraine. Mostly from the stress, but also the sinuses and what the paperwork from Friday calls post concussion syndrome (means that I'm gonna be "off" and have headaches now and again for up to 4 weeks... *ugh*).

The ENT doctor was really nice (she got wind really quick that I'm a very difficult patient).  She told me that the lump was what they call an incidental find. Meaning it's not something they were looking for. Since they weren't looking for this kind of problem and were just checking for cracks, a contrast wasn't used.... so they didn't have alot of detail on it. She did say that it's "only" about 7mm (any lump is too big in my mind, honestly) and she's not really overly worried about it. She had her fingers in my mouth, probing both cheeks as a comparison (and to see if there was anything in the right cheek as well) and couldn't feel the lump at all. She said 90-95% time it's totally nothing. NO biopsy today (which is something I was terrified of having because locals just don't work on me). After a long talk, we're thinking that with my severe allergies and the fact I've been sick so often lately that it might just be some overspill from the infection.  Could be the parotid gland or a lymph node. If it's the lymph, it's usually nothing (but a good idea to check because of cancer in my family, reason why I've been worried). If it's the parotid (it's a salivary gland in the cheek), it's usually nothing either. Normally both are benign ~IF~ they turn out to be tumors. We're hoping a lymph, because it normally means no surgery. If it's the parotid, they may opt to go in anyhow because even a benign tumor still grows a bit and a lump in the parotid can effect (affect?) the surrounding tissue and muscles in the face. I've been instructed to finish up my antibiotic and schedule an MRI in 2-4 weeks after things have settled. Actually, even if I end up with more anti-biotics (which is always a possibility), I'm to go in anyhow. This time they'll be sending some contrast through so they get a better look at it. We're hoping to see some shrinkage from the anti-biotics. If that's the case, they may put me on a month long course to kill it good and proper. Just means no allergy shots for the next month or two (which starts me back near to square one again.. *sigh*).