Random stuff I can think of no coherent way to piece together.

New domain. Namecheap, my registrar of choice, recently won Lifehacker’s “Best Registrar” poll, and as a thank-you, had a one-day, one-per, limit-of-10,000-uses $0.99 domain sale. I still had some credit left from their last winter/Yule/Xmas Twitter trivia contest, so I couldn’t pass that up, could I? (Answer: no, no I could not.) Besides, I’d been wanting to replace Winterish.net as my domain collective for a while. So, I snagged Colourise.net. What it is now is what it shall remain: a one-page “Hi, I’m Shannon, I do this stuff” page… thing.

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Had a post-surgery follow-up today. I expected debridement and a general recap of how the surgery went.

The debridement went as it always does. One “chunk” of crusting was too big to remove, so he tried to break it up, which hurt like a motherfucker. He finally pushed it down/back, so I’ll either cough it up (and doesn’t that sound fun) or the daily irrigation will soften/break it up. Definitely hoping for the latter.

What I didn’t expect was to be told George had returned. Yep, the more insidious of thw two, good old inverted papilloma, had returned. It had been lurking behind and under Bjorn — the everted/exophytic papilloma — so it went undetected until the routine post-surgery biopsy was done. Most of what had grown out from the septum was actually inverted, which is highly unusual: exophytic is the one that usually grows outward from the sinus; inverted generally arises from the later wall of a sinus. George apparently decided to change thing up.

Neither I nor Dr F had expected this. When he’d seen the exophytic growth — which had been biopsied and confirmed as exo, not inv — he’d not been in a huge hurry to remove it because it doesn’t become malignant as inverted does — but now, as he says, “if I see it, I’m going to take it.”

This also means the “Whoo, inverted free for a full year!” thing is gone. There’s no way to tell when it came back, but it was definitely before the surgery (obviously). We’ve known about the exophytic growth since February 2011, so, who knows — it could have been there as far back as that.

So now my 50/50 is more like 70/30. It’s going to come back. It’s just a waiting game.

Everted I didn’t fear: it’s benign, grows outward, no malignant transformation. But inverted… inverted scares me. And now it looks like I’ll never be free of it.

I know many other people have it far, far worse than I do, but still, fuck this.

Me and my fucking tumours.

No sooner do I get over this Shoulder Thing (never mentioned it here, but suffice to say, my shoulder hates me) than I get confirmation from my ENT doc that yes indeed, I will be needing surgery again, for the new tumour (which I have named Bjorn). First the requisite pre-surgery CT scan and MRI, of course, to give said doc a better idea of exactly where Bjorn has set up house, and then surgery. Woo. I knew it was coming, both because he told me it’d likely be necessary and because, once again, it’s getting difficult to sleep on my left side (where both tumours reside(d)) without losing the ability to breathe through my nose in that nostril. I’m also getting more migraine headaches and sneezing more often.

Best part? Like the inverted papilloma (George), this exophytic papilloma (Bjorn) dwells in the soft tissue of my left maxillary sinus. Since this is the fourth surgery, there’s not a whole hell of a lot of soft tissue left there (Dr F had to remove nearly all of the soft tissue on the floor of the sinus; there’s little more than naked bone there now); he told me he’ll have to “figure out how to remove it all without taking too much of the underlying tissue. I want to get good margins to prevent it from coming back, but I have to be careful because if too much is removed it’ll start to affect the shape of your nose and lead to unnecessary scarring…” That… well, there’s no way to spin that so that it’s not unnerving.

On the bright side, Bjorn is much smaller than George, and less insidious: whereas there’s a 10-15% chance of maligancy (cancer) whenever George is around, Bjorn by nature doesn’t generally become cancerous, and usually doesn’t recur the way George does. It’s not lost on me that the tumour that does usually come back again and again so far hasn’t after a full year (a great sign, so I’m told; if it were going to come back, it probably would have by now), while the one that usually doesn’t recur might not be totally removable right now: if Dr F can’t fully excise it without deformation, he might have to get what he can and… maintain it as necessary.

If that last bit sounds familiar, there’s a reason: that’s exactly what Dr W, my last ENT doc, told me about George: not possible to remove in total, must do partial resection every few years. slkdlskjdlksjdlkj. Obviously, I’m hoping it can get it all.

At any rate, this surgery’s less of an ordeal — no removal of bone this time — so I should be able to go home “that night.” That he said “that night” irks me, because if I have to sit in the damn post-op room for hours and hours again I am going to be pissed. If I have to sit around, I’d rather do it in a private (or even semi-private) room or go the hell home. With Dr W, I was in and out in four hours. After my first surgery with Dr F, I’d bled so much (mostly due to the removal of that inferior turbinate/concha) he kept me overnight. That combined with “go home that night,” when the surgery’s scheduled for 7:30am…

I’m going with the assumption I’ll have to stay overnight. If I don’t, well, better to have and not need than need and not have, right? Because I didn’t know I’d be staying overnight last time, I had to have my mother go feed the cats and grab the essentials: hairbrush, laptop, phone charger, something to read, etc. This time I’m bringing all that with me and leaving it in the trunk of the car; if I stay overnight, mom can run out and bring it in for me. I’m also bringing a box of some kind of single-serve juices; last time I had to keep waking up my mom to go get me juice to salve the horrendous sore throat I always get after surgery (thanks to the way my intubation tubes rub against the back of my throat). That and popsicles. Lots and lots of popsicles. And Frostys from the Wendy’s downstairs, of course.¹ I’ll probably bring along one of my external hard-drives, the one I store movies and TV episodes on. Hopefully all this preparation will turn out to have been useless, but again, better to be prepared than not.

The thing I’m dreading most of all about this is how I have to cover my nose (usually with a scarf) whenever I leave the house, because cold air in ravaged, healing sinuses (it’s not feasible to dress or cover the wounds [to get decent margins he has to remove some healthy tissue. Imagine having the first 1-2 layers of skin from a patch of your arm removed] so it’s basically an open wound) is very, very painful. I swore after the last round I’d never have surgery in winter again, but Bjorn clearly disagreed.

I hate my goddamned sinuses.

1. Bless, you, Harper/Karmanos, for having chosen Wendy’s and not some other fast-food restaurant; Frostys are the best things evar for my post-op sore throat. [↩]

About two weeks ago, I went in for another ENT follow up. My surgery to remove George, my sinonasal tumour, was just over a year ago, but I’m still not fully healed: there’s still some inflammation — for some reason, it’s not going down, and I’m just not healing normally. During the routine exam, which involved some numbing spray and an endoscope jammed up my left nostril, my ENT doc, Dr F, noticed something “suspicious” growing along my septum. He’d already discovered a bit of something in February, but it wasn’t anything to worry about — everted, not much more than a wart. This time, the thing he saw was a little larger, and a little deeper. He took a sample and told me to come back in two weeks for the result.

Today, I went to get the results. As is normal, before I saw Dr F, one of the residents he works with (he’s an assistant professor at a local University as well) came in to administer the hideous spray, ask the typical “no swelling, blockage, loss of smell, etc” questions. I mentioned that I was there for biopsy results, and this resident proceeds to say “Oh, that, yeah. The results came back as Schneiderian papilloma, so he’ll have to talk to you about scheduling a surgery date.” Then he walked out, and I wanted to slam my head against the wall. There are three types of Schneiderian papillomas, and one of them is — wait for it — inverted papilloma, aka George. The thing I’d had removed. So, he’d just told me it was back. Again. FUCK.

And then Dr F comes in. I tell him what the resident said and he shakes his head and laughs. The resident had been right and he’d been wrong: yes, the biopsy had come back as Schneiderian, but this new tumour was an exophytic papilloma (also called fungiform and/or everted papilloma), not inverted. I had managed to get another type of Schneiderian, but the inverted (George) had not returned.

No George. Yay! But new tumour. Boo. And another boo: this new cluster of glorified wart was in a bad spot, and it was growing. It wasn’t growing inward, as does inverted papilloma, but it is growing outward, in a way where it can block the choanae, which is more or less what George did. Dr F said it was up to me: I could either choose to have surgery soon-ish, or wait until it actually started to block that choana. I’d rather not deal with that kind of blockage again, so I opted for door number one. He agreed it was the better of two evils and said he’d want to see me again in January, to confirm that it is still growing (if it hasn’t grown, it could wait, but he’s already seen growth since last month, so it’s unlikely to stop now…), at which point we’ll schedule CT and MRI scans and then a surgery date — likely in early February.

So… not at all what I was expecting. I’ve always known I’d need surgery again — there’s still a good change George will come around again — but I had no idea it would be for anything other than the inverted papilloma. Surgery to remove another type of papilloma — another tumour?¹ That I did not foresee. Thankfully, this is an everted papilloma (which is unlikely to recurr and does not become malignant), little more than a wart and only needing surgical excision because it’s decided to set up shop in a bad spot, but still. Another tumour, another surgery. I’ll almost certainly not need to stay overnight again, but it’s another dose of general anesthetic — which is unnerving and strange every bloody time — and another few weeks of healing. I haven’t even finished healing from the last surgery!

But, at least it’s not George… yet. At least it’s not George.

1. Because yes, a papilloma is a tumour. [↩]

Someone on Twitter made the mistake of asking what one of my “nose scabs” looks like. Neither Flickr nor any Twitter-centric photo sites allow for “click to see more” disclaimer-type things, so I put it here for anyone so morbidly curious.

Don’t say I didn’t warn you, eh?

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