To begin at the beginning

I have a tumour in my jaw.

Not cancer, the surgeons assure me.  While they believe it is benign, it is large and aggressive.  Aggressive is their word for destructive, the tumour having already stretched and eaten into the mandible bone in my jaw until paper thin.

It is not the worst news, but it’s not good news either.

It’s going to be a long road though – at least 12 months, leaving aside possible recurrence – and I’m not entirely sure what to expect.

A biopsy is the only way to diagnose for certain, but it’s likely either a keratocystic odontogenic tumour or unicystic ameloblastoma.  If that’s the case, the plan is to “marsupialise” the tumour: it should shrink of its own accord over 8-18 months if exposed to the mouth with the wound packed with an iodine-bismuth pack and held together with a few stitches.  They then plan to surgically remove the tumour and any surrounding “daughter cysts”.

Here’s what has happened so far…

Late March 2011

  • Pain in my tooth, or maybe my jaw.
  • I am due for my six monthly dental appointment.

8 April 2011

  • I tell the dentist that my left back tooth is really sore.  He asks if I am flossing.  Yes, I say, but I think I am missing the back tooth on each side.  I only need to floss the teeth I wish to keep, he jokes.
  • He takes an x-ray of my teeth, the x-ray that was overdue as I was pregnant at the appointment before last. As it turns out, the x-ray is only of the teeth and does not cover the gum or bone area at all.
  • For the next month, I determinedly floss all the way to the back every night.  The pain does not go away, but I figure that it is self-inflicted so I don’t complain, even to my husband.

6 May 2011 (4 weeks later)

  • In the evening, I feel around the sore back left tooth and discover a lump.  I can’t tell if it is on the gum or the cheek but it is definitely a lump.
  • I enlist my poor husband to have a look.  It’s definitely a lump.
  • I’m worried it’s a tumour so he suggests I call Health Direct.  The nurse says it is likely an abcess but I should see my dentist as soon as possible.  It being a Friday, I should see a doctor in the interim.
  • I leave a message on my dentist’s answering machine asking for an appointment on the Monday.

7 May 2011

  • The doctor thinks it is either an abcess or a blocked saliva duct.  He definitely doesn’t think it is a tumour as I fear.  He prescribes antibiotics.

9 May 2011 (initial diagnosis)

  • The dentist squeezes me in at 8.30am and has a good feel around.  He assures me the lump was not there four weeks ago and sends me down the road for a full mouth scan.
  • As I take the scan back to my dentist, I take a peek.  Even I can tell there is a black growth on one side and not on the other.
  • It’s a type of cyst, my dentist tells me.  It’s not good.  He calls around and gets me an appointment with an oral surgeon for the early afternoon.
  • The oral surgeon, Dr S,  confirms it is a type of tumour and runs through the options.  The only way to diagnose for certain is a biospy.  In his best case scenario, the tumour will shrink through marsupialisation over 8-18 months and then be surgically removed.  In his worst case scenario, he will need to remove a large section of the jaw and replace it with a titanium plate, etc.
  • I have a CT scan.
  • We both like this surgeon so decide to go with him, even though he operates out of Westmead Hospital in the west of Sydney and around 40 minutes drive (at best) from where we live in the east.

12 May 2011

  • We see the oral surgeon again.  He shows us the CT scan.
  • We decide on a plan.
  • The biospy is scheduled for 30 May at Westmead Hospital and we need to go out on 24 May for pre-op administration.

24 May

  • We meet with Dr S and a second oral surgeon, Dr D.
  • They now think it may be the worse of the two options because of the nature of the growth but, again, emphasise that it is all speculation until the biopsy results.

30 May 2011 (3 weeks after initial diagnosis)

  • Biospy under general anaesthetic at Westmead Hospital.  Day surgery only.  With Dr S and Dr D.
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