the (future) evil resident

featuring tips and tricks for the medical student doing clinical rotations
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So I went to see the ENT today because I've been having this chronic irritation on the left side of the floor of my mouth, and also occasional sharp pains in my cheek, as well as this constant feeling that the left side of my entire face is swollen, even though it doesn't look that way grossly.

Apparently my Warthin's duct is completely inflamed, probably due to an obstruction, likely due to stones, although it might be a stenosis, or, of course both. The etiology is a little mysterious. The ENT recommended that once the inflammation went down after at least a month's course of antibiotics, that I should get a sialogram (where they take a blunt needle, stick it in the duct, and inject dye, then take X-rays) He didn't do a culture because there's no pus being expressed. Then of course, he might eventually have to do an excision if it turns out to be a ranula (a walled off collection of mucus.) And if just doesn't get any better, he mentioned the possibility of just cutting out the salivary gland and/or ducts.

But, yeah, so I'm on amoxicillin for 30 days (the infectious disease guys are gonna love me), and if that doesn't work, we'll go with a 2nd generation cephalosporin, or maybe a fluoroquinolone. Assuming I don't get septic, the ENT figures we don't have to hurry. Tylenol or ibuprofen prn of course, for fever and/or pain.

We'll see how good my compliance will be, since it was prescribed for every eight hours.

But the point I wanted to make is the amount of relief I feel now that there's a diagnosis, or at least a differential. I am not crazy, I'm not being a hypochondriac. There is really something wrong with me. It feels great. Hehe.

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DISCLAIMER: This site is a parody in the spirit of The House of God by Samuel Shem and the TV show "Scrubs." If you take anything I say seriously, well, you probably have some problems you might want to see a psychiatrist for.