My ENT finally called today, still having NOT talked to general surgeon. He is leaning now towards letting general surgeon remove thyroid and then ENT removing submandibular gland through neck, and lymph node too if frozen section is positive. This could all be done in one surgery. (General surgeon is insisting on two separate surgeries if ENT goes through the mouth, which is why ENT is leaning towards going through the neck). Problem is, CT scan can not say whether mouth lesion is part of submandibular gland or not.

As much as I want this over with, I am wondering if it is worth sacrificing my submandibular gland if it turns out that is not necessary. I am seeing PCP tomorrow and am going to ask for referral to Shands MD for 2nd opinion. There are two MDs on my insurance-- Dr. Nelson Goldman (listed as otolaryngology with clinical interest in head and neck surg.) The other is Dr. Rui Fernandes (oral and maxillofacial surgery, head and neck microvascular surg., head and neck surgical oncology). Just from the credentials, Fernandes sounds a little better, although I know I have read good things about Goldman on this forum. Anyone have any input on Fernandes?

As I've said before, 2nd opinions = prudence. Prudence = sound judgement in practical affairs...which I understand is a stretch in the medical field! HA! Sorry, I'm having fun at your expense but it's just my sense of humor.

Don't you just wish it were as easy as just looking at their credentials? It would be like making that decision based off of their name and ethnic backgrounds...Goldman sounds Jewish, so you'd expect, smart, well educated and good with accounting and probably more expensive. On the other hand Fernandes sounds hispanic so if you're looking for a quick and dirty job at a good price then he would be the option! It sounds racist (which is why it's funny...) but there's some subtle sense in there somewhere.

Look them up(research them), meet with them and then go with the one that makes the most sense to you...

As for those that would call me racist...my wife is an odd mix between Mexican and Jewish (maiden name Rosenbaum) so I'll let her read this and decide if I deserve to be beaten like a White Supremist at a cultural rally.

As I am sure I am speaking for everyone who has been a OC patient, you don't want ANY unnecessary procedures done to your oral cavity! Believe me they do enough damage with the ones that ARE necessary!

I can't remember where I read it, but from what I understood removing the submandibular gland was basically removing the second step of metastasis in Anterior 2/3's of the tongue cancers. Like I said, I can't remember where I read that or if that's total bullshit. LOL It might have been a standard of care sort of thing.

I do know that mine was removed and I haven't had any problems with it gone. The only time I have a problem with it gone, is if I snore with my mouth open. My mouth gets much drier than it used to. It takes a minute to get my mouth moist again.

Can you call the hospital and ask to speak with some of Fernandes' patients? Dunno if they'll give you names but it's worth a shot. Since you already know about Goldman you could either skip that with him or try contacting one or two of his as well. I agree that you don't want anything unnecessary. Plus you only get one shot at this so make it one you feel comfortable about. Keep us posted.

another david

There are federal laws that prevent them from giving out patients names, contact info, or any treatment related information.

You guys are all a great sounding board, and I really appreciate everyone's input and patience with all of my questions! I have had another curve ball thrown my way in that I had an abn. EKG at the primary care MDs office yesterday, so now have to see a cardiologist for a stress test before any surgery will be scheduled! I have an appt. with cardio for July 1 although a connection at the hospital is working on getting that moved up for me. In the meantime, without going into too much detail it has become abundantly clear that God does not intend for me to go through surgery with the current ENT. I have the stat referral into Shands, but I have no idea how long that will take to go through and have not been too encouraged in my phone conversations with them. However, several medical professionals I work with at Baptist have HIGHLY recommended another ENT who works at Baptist downtown (Baptist is made up of five hospitals and I work at the biggest whcih is the downtown affiliate). I got a referral for him this morning and have an appt. to see him Monday. He does do thyroidectomies. I have a great sense of peace about this situation now, which I did not have until today! I will keep you posted on what I find out Monday!

Thanks again!

Dr. Goldman is a no nonsense ENT. Knows everything OC. He has knowledgeable staff, performs biopsies right on the spot if needed, has an audiologist, etc. on board. Another words, he doesn't do anything unnecessarily. He also is head of the Combined Tumor Board. Gets everything rolling.... His word carries a lot of weight there at Shands. A few nurses and office people wondered how Carol was able to get in to see him on short notice.

Dr. Fernandez we aren't familiar with. Carol was to see him to get her teeth removed prior to chemo-radiation therapy but another Dr., Dr Share performed that surgery. It was amazing what he did considering Carol had trismus bad, could barely open her mouth. Hopefully Carol won't have to have surgery to remove her lymph nodes..CT Scan in late July or August.

Good luck with your appointment on Monday.

Linda

Finally making some progress! I got my cardiology appt. moved to this past Friday and had a "stress echo" which was entirely normal. Today I saw the ENT at Baptist downtown. I liked him very much. He went over the CT images with me and said the only involvement the mouth lesion might have with the submandibular gland is that it may be near the opening of the duct-- even I could see on the CT scan that it looked like it was pretty far away from the submandibular gland!! (Thank God I didn't agree to let the other guy remove it!) This ENT is not at all concerned about the lymph node. His plan is to go through my mouth and do an excisional biopsy of the mouth lesion and then remove the thyroid all in one surgery. Unfortunately, he will be out of town next week and so is not doing any surgeries this week (since he would not be able to follow up on them). The week after next my family has a biannual family reunion in W. VA. He says it is fine to wait and do the surgery the week after that, so we are looking at the week of 7/19.

This ENT did say he could do a FNA of the mouth lesion in his office today, but since he wouldn't be able to do anything about it even if it were positive, and after all the pain I had with the radiologist's attempts, I opted to just wait for the surgery.

By the way, Shands did call and give me an appt. for July 30! I am just going to keep that appt. in case the biopsy is positive-- then I can go see what they would recommend!

I'll keep you posted on the date when I know more!

Susan