中It was a Saturday, also Lunar New Year’s Day. Festivities without spending my annual leave allowance, nice. Just before bed, it was time to floss and brush my teeth. That evening, I opened my mouth super wide for an extra check on my four wisdom teeth, to validate whether my simplified dental care regime was adequate when earlier that month I travelled light for a holiday, without bringing the electric toothbrush.
“Ah ——”
The wisdom teeth were all fine, my dentist would be pleased.
But hold on! The back of my throat was asymmetrical, how come!? The dangling “bell”* should be at the centre but it shifted to the right! Oh, there was a big swelling protruding from the roof of my mouth (the soft palate), and it seemed to be pushing the “bell” off position.
My first reaction was to give the lump a little prod. It’s firm, with not much give, but there’s no pain whatsoever. Well, if it’s painful, at least I could have blamed it on some sort of gum infection related to the wisdom tooth. But then if it’s really inflammation, the pain would have made my life pretty miserable and I couldn’t have been oblivious to its presence through the holiday and festive feasting.
So, what could it be? Everyone started guessing. An unusual dental condition? A fluid-filled cyst?
Nobody dared mentioning the tabooed “C” word though.
Guesses wouldn’t get me anywhere, so I promptly sought medical help. My trusted traditional Chinese medicine (TCM) doctor (who also trained in western medicine) said he didn’t have a clue what the swelling could be and TCM can’t help, so urged me to see my general practitioner (GP), who equally had no clue. The GP made an emergency referral at the Ear, Nose and Throat (ENT) department of our local hospital.
This was my first experience as an outpatient and not as a visitor. The ENT surgeon must have asked patients this set of questions many times before:
Surgeon: “How long have you had this lump for?”
I: “No idea...... I only inadvertently discovered it last week......”
“Any pain in the neck, throat, or headache?”
“No, no pain at all.”
“How about swallowing, appetite and your weight? Any changes?”
“Swallowing felt normal. Appetite is good, and my weight is stable.”
“I need to have a closer look at your throat. Have you had an endoscopy before?”
“No, but there’s always the first time, right?”
The endoscopy only took a few minutes. Without having any scans, the surgeon gave a preliminary diagnosis of a rare tumour in the “parapharyngeal space”, and that the commonest treatment option is surgery. The immediate next step was to have an MRI scan to precisely locate the tumour, measure its size and have an idea of tumour type or the originating tissue.
Sorry, what “space” did you just say? I didn’t quite catch it.
The surgeon calmly repeated the anatomical term. I jotted it down for my homework that evening.
A cavity next to the pharynx? I’m a biologist but I’ve never heard of it!
Well, this is just the beginning of the many “unheard-of's”. A lot more unknowns, uncertainties, unexpected experiences await!
*the uvula