Thursday, October 19, 2017

A Tale of Two MRIs, Part 3: Tell Me How I'm Supposed to Breathe With No Air


In August I found out that the mass in my mouth wasn't what I'd thought. An appointment with my normal dentist led to an oral surgeon, which led to an MRI. Oral surgeon didn't see much, so he sent me to Endodontics (root canal guy). Endodontics found no need for a root canal. Supposed next step was a referral to an Ear, Nose, and Throat specialist.

In addition to the mass in my mouth, the MRI showed two other masses: one on my thyroid and one on/near my clavicle. I would need an ultrasound for the thyroid and an MRI for the clavicle.

Back to the story...

Hubby and I managed to have a really nice weekend away for our anniversary. We stayed at a cute place in Bowler, WI and took a day trip to Green Bay to check out the NEW Zoo and hit up Lambeau Field. We had dinner at a supper club, checked out some geocaches, and spent a lot of time together in the car, which is one of our favorite things to do.

On our anniversary proper (9/18) we went to dinner here in Milwaukee. If you've never been to Lake Park Bistro, I highly suggest it. It may be one of the more expensive meals you'll ever have, but also one of the tastiest. Plus the staff there is wonderful, there's a great view (or so we hear; we've only ever been at night), and the restaurant is beautiful. Oh, and since our anniversary fell on a Monday, the majority of the other patrons were other couples celebrating their anniversaries! :-)

The next morning I went in for my ultrasound. I had an 8 AM appointment, which meant getting there at 7:45. Thankfully this was still done at the same clinic as my primary doctor's office and the MRI, so it was all of a 5 minute drive to get there. I checked in at Radiology, in the basement, and was instructed to take the elevator to the second floor, go down the hall, and enter the last door on the left. So off I went. I walked through the door I had been instructed to seek out, but no one was there. Literally nobody. Reception desk? Empty. Waiting area? Empty. I just kind of stood there for a minute, going over the instructions in my head, wondering where I'd gone wrong. Was it a left turn at Albuquerque? Or a right? Damn you, Bugs Bunny!

I didn't have to wait long. A door across the hall opened and a woman said, "Erika?" I nodded and she beckoned me over. "Thanks for coming early." OK. I didn't have much of a choice, but you're welcome? She led me down the hall and into a small exam room. I took a seat on the table while she readied the ultrasound machine, then she tucked three or four napkins into my shirt collar and asked me to lie back.

This was not my first ultrasound. I've had three others. The first was to check on a lump in my breast (turned out to be nothing). The second was to check for a blood clot in my left leg (nada). The third was to confirm that a lump on my right thigh was a lipoma (yep). So I know the procedure pretty well and I thought I knew what to expect. And I did... mostly.
This guy, amiright?

What I didn't consider was the exact location of one's thyroid. So while I knew that the wand was heading toward my neck, I didn't really anticipate the pressure it would place on my windpipe. You know what's hard to do? Relax (and breathe) when someone is cutting off your oxygen supply. And of course, despite the mass being on the right side of the thyroid, we had to get pictures of the whole damn thing, so when I thought I was done, we were only half done. Yay.

Now, in all fairness, it didn't take very long at all. In fact, I was done with the ultrasound before my appointment time even rolled around. But when you have someone actively obstructing your only source of air, it feels like a lot longer. Also, my throat was super slimy from the jelly afterward. That was pretty gross. But at least it was quick and it was over.

Since I had some blood tests waiting for me, I headed back down to Radiology and signed in to get that out of the way, too. This ended up being an interesting experience for me as well. The nurse asked me some questions and then as she went to look for my veins I told her that she may have to go through my hand.

"Does that happen a lot?"

"Well, I've had two MRIs in the past year and both times they've had to go through my hand for the dye injection. Apparently my veins like to hide or something."

She poked at my left arm for all of 3 seconds before saying, "Really? What's wrong with this one right here?"

I was floored. "Uh, well, that's a good question..."

She got me prepped and said, "Yeah. See, that's the difference between it being their part-time job and it being my full-time job." I watched as she quickly filled two small vials with my blood and then sent me on my way. I've always had mad respect for nurses and I think they deserve far more recognition than they usually get. This woman completely reinforced those beliefs. She was professional, courteous, and good at her job. I can't tell you how much I appreciated a pain-free experience that morning. (It was also nice to confirm that I do actually have veins in my arms as well.)

The results from the ultrasound came in the following day. I have two small nodules on my thyroid. One is a cyst and we don't need to worry about it. The other doesn't appear to be anything concerning, and isn't large enough to warrant a biopsy, so we'll do another ultrasound next year (yay) just to make sure nothing has changed. This was good news, but I still had another MRI to worry about and I was worried my luck was going to run out.

To be continued...

Friday, October 6, 2017

A Tale of Two MRIs, Part 2: When It Rains...


In early August, I found out that what I thought was a perfectly normal mandibular torus was NOT a mandibular torus at all. What is it? We don't know!

A dentist appointment led to an oral surgeon. The oral surgeon led to an MRI. Back to oral surgeon, who didn't see much of anything in the MRI. Oral surgeon referred me to Endodontics. 

Based on other findings in the MRI (another mass), my doctor was checking with Radiology to see if I could have an ultrasound in place of a second MRI.

Back to the story...

When I left off, I had just been told I was being referred to Endodontics, which turned out to be located upstairs from the oral surgeon. The assistant I'd been working with, Chuck, was nice enough to walk me upstairs so I could get started on paperwork. At this point it was around 10 AM.

I handed in my paperwork to the receptionist. She told me that they had me scheduled for 12:30, but said that if I stuck around for a few minutes she would check to see if the doctor could see me earlier. I waited. About 10 minutes later I was told I would have to come back at 12:30. So I drove home (about 15 minutes) and worked from about 10:30 until noon. Then I headed right back to the very same building where I'd sat just hours before and sat some more.

I got called back pretty quickly and got a few more x-rays (this would be the third set of x-rays, for those keeping score). Then the specialist came in and talked to me.

"I hear you've been in and out of appointments and machines." Yep. Sure have.

"Is there a plan for what happens next?" I told him about the oral surgeon's suggestion of a referral to ENT if this didn't yield any results. He seemed to accept that and got to business poking around my mouth. Then he explained what was coming next: the root canal test.

Allow me to explain this quickly for the uninformed. Basically, they make the end of a long Q-tip extremely cold (like, liquid nitrogen style) and then touch it to a tooth. If you feel something - anything - you raise your hand. Once the feeling goes away, you lower your hand. Repeat on the surrounding teeth.

I got worried when I didn't feel anything on the first tooth, but I definitely felt it with the rest of the teeth. (It didn't hurt, thankfully, but it's not a particularly pleasant sensation either. Not so much an "Ouch!" as a "The f*ck is that? That's weird. I don't like it.") Apparently that was all it took. The specialist said I didn't need a root canal. I had all the right reactions, my bone and root structure look strong and healthy... No problem from an Endodontic perspective.

While most people are probably relieved to hear they don't need a root canal (and trust me, part of me definitely was), this was just another appointment, another test, another set of results that showed nothing. For everything I'd been through, there were still no answers for me. I started to tear up and said, "On to ENT then!" I took a breath and calmed myself down so I could get going.

Just before I got out of the chair, this doctor (who is clearly doing well for himself; the Endodontics office is REALLY nice - fireplace in the waiting room, sculptures and art everywhere - and the beautiful Corvette in the parking lot may very well have been his as well) looked at me and said, "Since you're not having any work done, I'm just going to comp this appointment."

What? As in, you aren't going to charge me? Well that did it. Tears welled up anew. I was floored by his kindness, and so (SO) grateful. One less charge to worry about? You better believe I'll take that. I thanked him again and again before finally heading out. So I left feeling a little upset that this appointment hadn't given me any answers, but the greater feelings I had were gratitude and relief.

On my way home I was almost in an accident (a guy turned out in front of me and I had to lock up my breaks to keep from hitting him). Then a few blocks later I witnessed an accident (a head-on where one of the vehicles spun into a building) and got to call 911 for the second time this year (and in my life). Aside from the asshole behind me who was honking and gesturing for me to move (despite the fact that there was an accident right in front of me, I had my blinkers on, and I was on the phone... with 911), I made it through the experience pretty well (which is saying something for me!).

When I got home, I was taking things out of my purse when I saw the copy of my MRI results. What the hey, I'll take a look at it, review it on my own. I was reading through it, trying to remember what my doctor had told me the week before... And that's when I figured out that I had misunderstood my doctor. Badly.

After my appointment with her, I had come away thinking that they had found an additional mass during the MRI. But there were three separate things noted on the report. The first, of course, was the original bump. The second was a mass on my thyroid, for which I was referred an ultrasound. The third was a mass near my clavicle, for which I was referred another MRI. So it wasn't a matter of having the ultrasound instead of the MRI; it was whether I'd have to do both the ultrasound AND another MRI.

If the accident hadn't erased my good mood, this certainly had. Hubby and I were just about to go on a weekend away for our 7th anniversary, and here I was staring down one or two more tests for two more unknown masses. If the ultrasound would suffice for both, though, that would really help. I kept a good thought.

Friday, on our way out of town, my doctor called: the ultrasound and MRI were both going to be needed. Yay.

To be continued... 

Wednesday, October 4, 2017

A Tale of Two MRIs, Part 1: The Fascinoma

When is a trip to the dentist more than just a trip to the dentist? When you're me, apparently.


I went something like seven years without going to the dentist in my 20s. It wasn't some kind of protest, nor did I have a bad experience, I simply didn't go. Mostly because I had moved from my hometown and didn't know how to seek out a dentist of my own in a new area. Adulting is hard.

About 6 or 7 years ago I was finally worried enough to look into things. Sort of. I had these bumps in my mouth and I knew my husband was going to the dentist soon, so I told him to ask them if that's a normal thing. When he came home from his appointment, he told me that I now had an appointment of my very own. Yay.

At that appointment, I was told about mandibular tori. Basically, they're extra bone growths that are perfectly normal. Sweet! I assumed that accounted for both the bumps I was worried about, so I stopped worrying about things. For awhile.

Current Day 

This August I went to what should have been a normal dental exam. When asked if anything was bothering me, I said no, but that I was curious if there was anything I could do for jaw clenching. See, I carry my stress in my upper back, neck, and jaw. Always have, probably always will. This results in frequent clenching of my jaw, even when I don't realize I'm doing it. Also, I have no idea how to actually relax my jaw. (If you've ever been in choir or anything similar, you might remember being asked to relax your jaw and then move it back and forth with your hands. I had to fake it. I literally do not understand how to make my jaw relax like that.)

My hygienist asked if there was a reason I was asking, and I told her that I thought my bump might have grown in size. I had read online that this was a possibility with bruxism (teeth grinding and/or jaw clenching), which she confirmed. She decided to take a look so we could discuss getting a custom mouth guard.

While poking around she seemed to be a bit perplexed. She did a few extra x-rays and called the dentist (who we call Doc) in. The bump didn't show up in the x-rays like a normal torus (singular of tori) would. Actually, it didn't really show up in the x-rays much at all. To make sure everything was OK, I was referred to an oral surgeon.

Fast forward to the oral surgeon's office a week or so later. The assistant there asked me some questions, took a look, and started talking about tori. Another set of x-rays led to a quick CT scan. The CT scan led to a referral for an MRI. See, tori, as I've explained, are growths of bone. A CT scan would pick up a bone growth pretty easily, but my scan showed nothing in that area. The oral surgeon took to referring to it as a "fascinoma" - it's fascinating, but no idea what it is. He sent the referral to my doctor, who set me up with an MRI in early September.

As I've already talked about MRIs and the super amount of fun that they are, I won't go into that this time. Here are the highlights of the experience:

  • I went all on my own. Thankfully, it was in the same building as my primary doctor, so I was familiar with the place.
  • They had to administer the dye through the back of my hand again. Bastards.
  • This MRI was MUCH shorter than last year's (which is likely because last year's was 2 MRIs rolled into one). 
It just so happened that I had my annual check-up with my doctor the next day, so when I got to that appointment, she already had my results. She told me that nothing looked bad or suspicious about the "fascinoma" and that generally if it were a problem (we avoided the C word, but it was implied) then the area around it would show warning signs, but everything looked good. Then she went on to mention that there was another spot they found during the MRI. Wait, what? No, I was just here for this one, thanks. Please no. :-( She told me they recommended another MRI, but that she would talk to Radiology and see if an ultrasound would suffice (since they're MUCH cheaper and faster). She said she'd get back to me when she had an answer.

In the meantime, I went back to the oral surgeon about a week later. He looked at my MRI. He looked in my mouth. He showed me the MRI and gave me a copy of the results. And he said the same thing as before: still fascinating, but still no idea what it was. He came up with the following plan. First, a referral to Endodontics (root canal guy) in case it's a dying/infected root. If that's not it, then a referral to an Ear, Nose, and Throat specialist. If there's still nothing at that point, then he would say as long as it's not causing issues, leave it alone. He mentioned that if I wasn't placated by that and wanted to get it biopsied, he'd be happy to go in and get some of it for me (no thanks), but if all these specialists looked at it and saw nothing, then it really probably wasn't anything to be concerned with. Since that more or less echoed my doctor's thoughts, I was fine with that, and off to Endodontics (which was just upstairs from the oral surgeon) I went.

To be continued...