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...

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