July 2006 - finally, a nasal endoscopy

Last July was not a fun month. In the beginning of the month we'd seen many doctors - first for Robin's facial pain, and then for her swollen right cheek. Some clinicians stated diagnoses, others said it was outside the realm of their experience so they could not tell us what was happening.

The second week of July Robin began occasionally blowing debris out her nose that she thought looked like necrotic (dead) tissue. She put some in a sample cup and took it to the office of the Ear, Nose and Throat doctor whom we had been seeing. On that particular Monday the receptionist stated that Robin didn't have an appointment until the next day, so she would have to wait 24 hours to see the doctor. The next day we arrived for the scheduled visit. The doctor didn't see much significance in the sample which Robin supplied. He didn't see a need for anymore testing at the moment and thought we should follow-up with him in a few weeks. That was the last time we saw him, we didn't have time to wait.

The most disconcerting thing abut July was that soon after Robin's left cheek swelled up, puffiness had become apparent around her upper right gums. She and I would spend the rest of the month checking her mouth at least twice a day. She would sit in a chair, I'd examine her upper right gums with a flashlight and then describe what I saw. The area seemed to become more swollen and stretched each day. Throughout this period our dentist would see Robin on a moments notice - giving us some comfort that we had someone in our corner.

The third week of July we had an appointment with an experienced Ear, Nose and Throat surgeon. I'd seen him in the Spring for my sinuses so Robin had met him (she had gone to my appointment) and she liked his practical approach to things and his demeanor.

This new doctor was a big burly fellow who always seemed to be in a good mood. After a brief discussion he was picking up and prepping a nasal endoscope so he could take a look inside Robin's sinuses. He slid the instrument into her nose and had a look around. He picked up a suction tool which he inserted up her nose and I could see him visibly begin to tug. It was apparent by the way Robin's head was being jerked and the tears that were welling up in her eyes that this wasn't fun. The doctor apologized for the discomfort he was causing. He withdrew the tools and stated that there was some foreign debris coming out of the sinus (the maxillary sinus in your cheek drains into your nose) but he couldn't extract a sample - it was solidly in place.

He then studied the CAT scan and MRI images. He took so incredibly long I couldn't understand how there could be so much to look at. I wondered what he could be possibly be thinking about. After a lengthy study he noted one aspect of the image which did not support the idea of a sinus infection. In the blocked right sinus, up near where it drains into the nose the uppermost level of the blockage was crescent shaped. He explained that if it were a sinus infection and fluid, then the uppermost limit of the blockage would typically be a straight line across and not rounded.

We asked if it might be cancer to which he replied that he didn't think so because it was so rare, but we wouldn’t know what it was without surgery. He said he only did procedures on Fridays and wanted her back in ten days (July 28th, 2006). I asked if it couldn't be the upcoming Friday (push, push, push) - nope he was booked solid.

Well, at least we had a new doctor in whom we had confidence, and we had a plan.

During July I had begun to talk to my parents about what was going on. It didn’t seem necessary to start telling everyone about Robin's sinuses. After all, we were not sure what it was - what a commotion we might have caused for no reason at all.