squeegee
I’m pleased you posted. I was thinking about you on saturday.
Best of luck with the surgery.
Ikes!!
{{{{Squeegee}}}}
I must say, I am grateful on your befalf that you stuck to your guns on Doc #1’s overall attitude. It is easy to write off such arrogance in a number of ways which trivialize it, and subsequently trivialize you. Good on you!
Prayers comin’ at ya!
Thanks to all for the thoughts and best wishes!
I should add that I got a really good feeling about ENT#2 – she seemed as responsive and informative as ENT#1 was not. And she gave very good answers about her surgical experience with these types of cases (‘hundreds’ of operations of this sort; currently doing about one a month but used to do 4-5/mo before private practice; no recurrances that she was aware of; no facial paralysis in any of her cases. Pretty impressive – nerve damage can be a common occurance in this sort of operation (as ** CRorex** mentions), and recurrance is not unheard of either).
One more complexity that’s killing me: ENT#2 is outside my health network, so I need to pay 30% of the costs if I use her. I understand that this type of operation can cost $20,000 or more. My max out-of-pocket is $5500, so I’ll probably hit that or close. Ouch.
OTOH, I called around my health network and nobody could see me for 6-8 weeks, or worse, just for an initial consultation, and then I’d expect a further delay before surgery. Meanwhile this tumor is sitting there, possibly malignant, probably growing (ENT#2 expressed the opinion that it had grown since the MRI 2 weeks ago, but admitted it was difficult to be sure).
Hmmm, a $5500 ENT in the hand vs another in the bush. Decisions, decisions.
ENT#2’s office is supposed to contact me tomorrow to schedule surgery and we’ll talk $$$ and I’ll find out how bad this will hurt the pocketbook. Maybe its not as bad as I think. And it is only money (but then why do I have health insurance, dammit?).
Thanks again to all for the best wishes and thanks very much for listening.
Good luck, squeegee, and good on ye for doing the research to get a better idea of what you’re looking at.
What choosy beggar said, twice!
I won’t pretend to be as informed as him/her but, in your position, based on the limited reading that I have done, I would want to ask about the merits of less radical surgeries, (superficial parotidectomy, or especially extra-capsular dissection.)
(I should stress that I have no medical expertise, I’m just one of those folks that likes to keep a copy of the Merck medical manual handy.)
Best wishes, & keep us up to date.
Um, can anyone please elaborate on these issues? My impression has been that:
a) whatever the sampling from the parotid tumor, malignancy cannot be ruled out without removing all of the questionable tissue and having it examined by a pathologist. On that basis, I don’t see how an incisicional biopsy would give any comfort. Why not just remove it straight away?
b) What I will be scheduled to do is a partial parotidectomy, where one parotid lobe (of 2) where the tumor lives is mostly or completely removed. I’ve read up quite a lot in a very short time on parotid tumors and parotidectomies, but hadn’t heard of these other options (yeah, like i’m a doctor or something). How are these procedures different?
Thanks much to choosy beggar, Larry Mudd, CRorex for all the proferred medical jargon, and to everyone for the support.
FYI, I’ve just found this forum which is devoted to parotid tumors. I’m still rooting through the posts, but there seems to be good information there.
>Doink!< Ow.
Thanks. 
Here is a website with concise descriptions of some of the surgical options for salivary gland tumours. Note that the more conservative surgeries are only options for benign tumours.
As I read it, a partial parotidectomy is already a more precise variety of a “superficial parotidectomy.” If the entire parotid gland were removed, a degree of facial paralysis would be guaranteed, so all that is removed is the part (or a portion thereof) that is above the facial nerve. And extracapsular parotidectomy goes a step further and leaves the gland intact.
In my humble (and I stress, barely educated,) opinion, as surgical techniques become more advanced, they become more targeted. Of course you can’t rule out malignancy in any tissue until you’ve got it on a slide under a microscope, so the tendency is to sacrifice the surrounding tissue “just to be on the safe side.” Not so long ago, amputations were much more common, until surgeons gained enough practical experience to learn more targeted techniques.
Of course, depending on what options are available to you in your region, it may be better to go with a partial parotidectomy from a surgeon who has done the technique many times, than an extracapsular parotidectomy from someone who is “trying something new.”
The forum you linked to looks like a fantastic resource for experiences and opinions from people who’ve actually been there. I love the internet.
Larry Mudd: thanks for the clarification on procedures.
I’ve been scheduled for surgery on 8/21/2002, a superficial parotidectomy. I’m going to talk again to the surgeon next week and ask her about partial and extracapsular options and if that’s a reasonable course and if not, why not. It does seem like less ay be better, to a point.
Thanks again to all for the encouraging words and advice.