Thursday, August 18, 2016

Top Chef, the Endonasal Edition

[This post may ruin your appetite.]

The surgery was unexpectedly easy. Although my nostrils are normal to even small, once you stick the endoscope in there, it's bigger on the inside*--like walking into a cathedral, relatively speaking, except with mucus. My previous surgeries obliterated my sinuses, etc., so, on the right side, there's nothing but air between my cheek and the outside of my cranium. For an endoscopic surgeon, it's like cheating. So the operation was over, lickety-split.

When I woke up, after the initial fogginess, I felt great. I had no pain. I was hungry, and I had energy. That's when I Facebooked that picture with me and the clock showing how good I felt so soon after the surgery.

That was a bit premature. Shortly afterwards, the fentanyl wore off. They had to put my head in a special position for quite a while to do that surgery, so my head and neck feel beat up, and my throat is a little sore.

Then, the propofol kicked back in. Roughly speaking, there are two basic types of medicines--water soluble, and lipid soluble, like balsamic vinegar and olive oil. In general, the water-soluble meds mostly stay in your blood, and when they stop pumping them in, your kidneys or liver get rid of them, and they are gone. The lipid soluble ones get absorbed into your fat, so once they stop pumping them in, they may wear off temporarily, but then they leak back in from the fat. So, after I sent that picture, the propofol kicked back in like a hangover, and all I could do was sleep for a while.

Still, not a bad deal for a surgery. Just one step up from a vanilla colonoscopy.

Now for what they found in the Cathedral of St. Snot. There is scary news and reassuring news, and it's all about food. The scary news is that there was something in there that looked like a cauliflower. The cauliflower is a vegetable that frightens doctors in the same way the apple is our fruity nemesis. Cancers can look like cauliflower.

However, the reassuring news is that beyond the cauliflower was cheese (or, as we doctors call it, caseous material, from the Latin for cheese). Cheese smells strongly of infection, and, in this case, there is nothing I want more than an infection. That, generally, can be cured. Probably, the cheese is a more important than the cauliflower, which is exactly what you tell your kid when you serve it to them.

The dish was examined more closely. The surgeons took a couple of bites and sent them to be frozen, sliced, and examined. They did not find any malignant-appearing cells in the cauliflower. The cheese looks like an infection, or, maybe, smoked gouda. However, I am not yet breaking out the champagne.  As grandmother used to say, "it's not over until the pathologist sings."** The pathologists will soak my cheese and cauliflower in their special blend of herbs and spices for the next week or so. Only then, will it be (mostly) safe to come to a firm diagnosis.

Of course, this will only be the aperitif for what will be a longer meal of either antibiotics or cancer treatment. We'll have to wait for what the chefs have coming.

Be well,

Tom


*Acccording to The Doctor.

**She didn't really say that, as far as I know, but she was a doctor and had a good sense of humor.

And for a nice recipe for cauliflower and cheese, click here: https://www.reference.com/food/easy-recipe-cauliflower-cheese-31cf2f7dbb153c36?qo=cdpArticles

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