Scar

"...destroy all of my beautiful wickedness? I'm gone! I'm gone!"
- The Wicked Witch of the West, The Wizard of Oz, 1939 film

"When I was young  I longed for scars
like my father's   They were the best
scars on the block...
'It's the ones you can't see that kill you'..."
"Scars," Peter Meinke

LBJ taught me the wonder of scars.

I got a few in the 70s, which, following LBJ's lead, I shared in mutual fascination with the fellow scarred, my mother protesting because their location required me to unzip my jeans.  It was the 70s.

Looks like in the 10s I'll be getting a new one for all to see.

I asked Dr. Aaron Prussin, "If it were your wife?"

"It would come out," he answered.

I'll have a parotidectomy on February 15, 2010 for this.  Since the facial nerve runs through the parotid, or salivary gland, in addition to some other possibilities, the major risk of the
two-and-a-half hour surgery is that my face will sag like a Dali clock.

Here's a detailed text description of the surgery and here, on YouTube, is how Dr. Soh does it in Singapore. (Spoiler alert: The needles come out at 4:46 and the knife at 5:18, which is when I stopped watching.)

Feel free not to click on the links here:  I'm going to look like this at first except mine's on the right side.  Hopefully, I'll look as good as Andy does eventually.  You can sit on my left when we're out to dinner if I develop Frey's syndrome.  Apparently, I'll have a nice dent in my neck, too.  A dent in the neck is better than a hole in the head.

The bottom line for this CEO is that I'm probably just not going to be too good lookin'. Ah, well. 

For my cool speaking gig on April 7, I'll bring props.

The procedure will be done out-patient at Montgomery Regional Hospital (which is amazing because they cut OPEN a guy's head in the ghastly video - okay, I looked) and I'll call on Friday, 2/12 to find out when the surgery is scheduled for Monday.  Dr. Prussin suggested I schedule no meetings for a week afterward.  I think that's to protect everyone from the Dali face thing.

He says for sure, long-term, I won't be able to feel my right ear lobe.  Maybe that's the time to finally get my ears pierced.

If you're not into scars like LBJ, or not into the CEO of the company that provides you service or with whom you partner being out of commission for awhile, I can understand that. If you wanted me the way I was, that makes complete sense to me.  For the change to come, small or large, the concern it may cause you, and the time it may take away from you, I am profoundly sorry. 

Dr. Prussin thought I might want to restyle my hair towards my face, rather than away from it, to hide the scar.

It would just get blown back.  I'm face forward, going fast.

Comments

[Anne Giles Clelland]

Thank you for support I’ve received in emails.

Here are questions I’ve received as well, and answers:

How long have you had the growth in your parotid/salivary gland?

I’ve been aware of a sort of “thing” just below my right ear for maybe ten years. I saw Dr. Prussin for it two or three years ago and it was diagnosed as a muscle spasm. When I went to my regular doctor for what felt like my right sinus puncturing on a plane flight on 12/23/09, she added scanning the “thing” in my neck. It’s grown so it’s obvious what it is. So here we are.

How large is it?

7 mm

How dangerous is it?

90% are benign. They’re taken out, benign or not, because they tend to grow and interfere with other things in the neck and face. Cancerous growths are treated the same way. Out they come.

What’s going to happen?

Everything seems to be done by laparoscopy these days so I was thinking, “Couldn’t you just reach up from there and get it that way?” but the cut is made on the side of the face in generous proportions so the surgeon has wide access to the facial nerve. The facial nerve runs right through the parotid gland so it’s just not a great set-up for the surgeon.

What happens to the facial nerve during surgery, from bruising to snipping, determines to what extent facial numbing and facial paralysis occur - from none to full – for some length of time, from never, to a few days, to a few months, to forever. Until the patient regains consciousness - that would be moi - and is asked to smile and raise her eyebrows and perhaps other things that I haven’t read about, there’s no answer to “What’s going to happen?” Which existentially is probably always true, but is not that comfortable to think about.

Sooner better than later works for me, especially when I hear about the growth thing, and Dr. Prussin reminds me of our high school quarterback - an honors student, strong and bold. And Dr. Prussin is a triathlete. So there we go.

Again, thank you for your questions and for caring!

[Anne Giles Clelland]

I have found this site - a chronicle of Andy's parotid surgery which he posted in 2003 - to be of great comfort.

http://www.pokedandparotid.com

On his "Contact Andy" page, he writes:

"If you have questions or want to send email for any reason, you can... Over the years, I have gotten emails from all over the world and try to respond as quickly as possible. Please feel free to write any time."

I did. And he meant it. He replied.

[Anne Giles Clelland]

This link goes straight to a very graphic, well, graphic showing the parotidectomy surgery, so if you're queasy, perhaps avoid it. It includes a mouseover that shows how the facial nerve branches in the side of the face.

It has a straightforward description of the risks of surgery, which I will paste below. "Drooling." Great.

http://www.entusa.com/parotidectomy.htm

Complications of surgery include, facial nerve injury with resultant facial paralysis. If severe, paralysis will cause the face to droop, drooling, and the inability to close the eye. The latter, if untreated, can cause drying of the eye and even blindness.

Patients can also develop a salivary fistula, where saliva drains through the skin incision or a sialocele when a pocket of saliva forms under the skin flap. Both of these complications are treated with the insertion of a drainage catheter and medications to decrease salivary flow.

Many months or years after the operation, the cut nerves to the salivary gland may grow into and innervate the skin's sweat glands. This is called Frey's Syndrome and produces annoying sweating when one eats or salivates.

All patients develop numbness of a part of the outer ear and appear mildly sunken-in where the gland has been removed.

[Anne Giles Clelland]

Quality of Life following Parotidectomy for Malignant and Benign Disease

http://journals.lww.com/plasreconsurg/Abstract/2004/10000/Quality_of_Life_following_Parotidectomy_for.5.aspx

"Nevertheless, overall, parotidectomy does not seem to severely affect quality of life."

[judson maag]

Thanks for sharing your parotidectomy experience. I just 'got mine done' - almost a year to the day after yours - on 02/16/2011. Your descriptions seem to match what I would write if I had a blog. (Un)luckily, because of facial reconstruction surgery 3.5 years ago, I was stocked up on Boost / Ensure.

I hate not being able to move when I sleep. I hate this tube coming out of my neck...

But so far so good. Mine was bigger than expected with the diameter of a 50 cent piece. I am not having much pain, but just enough to 'bug' me. I am draining more today than yesterday and the day before. I think the tube was clogged or something.

I'm surprised I never came across your blog while scouring the net after deciding to have the surgery. All of my friends now know that Lebron James had the same thing done. I have a feeling that this surgery will make me better at basketball and I'll be able to dunk on Lebron in no time.

[Anne Giles Clelland]

Greetings, Judson! Thank you for writing!

This is the post that most people seem to find when they're doing a search so I'll share it here:

http://annegilesclelland.typepad.com/blog/2010/02/parotidectomy-moving-on.html

Wow! Diameter of a 50 cent piece!

I keep trying to remember to take a one-year photo but, truly, it was a huge and dramatic experience that hasn't lingered in my everyday thoughts. The scar is still a little thick and sore, sometimes moreso than others. From my experience, you're going through the hardest part of it now. That you're up and typing is very auspicious!

I have laughed with great amusement and satisfaction to myself several times about you being able to dunk on Lebron in no time. Good courage, very nicely done.

With respect,
Anne