Blog 26 - Phew

Blog 26 – Ultrasound - phew

I only mentioned it to a couple of people: I had an ultrasound scan done on my neck yesterday. I’m more than happy to say there was nothing of consequence to be found. I’d noticed a very small lump under the left side of my chin, no corresponding lump under the right side. I had a vague notion that I’d come across the lump before, but you know I then began to imagine that I was false remembering it so as to make it unimportant. But over the week my hand kept making it’s way to my neck to see how it felt. Some days I could almost feel that it was larger. So on my last checkup on 10^th April, I mentioned it. A finger of shock pinged my heart when the consultant said he wanted a scan done and he wanted to see me again for the results in two weeks time.

The ultrasound department in Lister hospital has moved up from the cellar to the main floor and is now clean and bright and, well, clinical. With a bright orange reception desk. It could be Ryanair. It has six ultrasound rooms. I wondered if there was Jazz in one, Classical in another. Perhaps White Noise in the third (Anyone remember the late 1960’s, cough, experimental band). My dad hated that music. I went into room 4. It was dim, and quiet. The nurse was welcoming. The doctor stood playing the keyboard of his laptop on the work counter. Like Rick Wakeman. But with the sound turned down. Pity. 

You lie on the couch and he squirts lubricant on your neck. Then uses his ultrasound wand to rub over the skin and watches the images on a screen that you can’t see. Every so often he presses a button and a still image is captured. “That’s fine” he says “Nothing to worry about”. But continues to check around the ear, across to the other side of the neck, down to the Adams apple. And back to the lump. “It’s your salivary gland that you can feel”. “Nothing to worry about”.

The question that formed would not come out.

Ah well, I can write it down and take it to the consultant next Thursday.

Do salivary glands change size?

I had another question about ultrasound. But the ultrasound doctor didn't seem particularly engaging. See the end of this tract to see how lucky I was not to ask it.

As you have come to expect, I've done a bit of reading....

Salivary glands (in humans) secrete stuff. Mostly the stuff just lubricates: Without lubricant you can’t swallow. But some stuff (amylase) begins the process of breaking down starch – so you can eat chips! Amylase is also used in home-brewing, converting starch into sugar, which is then converted into alcohol. The third stuff, from the Von Ebner glands on the tongue, dissolves food particles so that you can taste them. There are three pairs of main glands, by the ears, under the tongue and under the chin and up to 1000 further glands in the mouth.

The salivary glands of some species, however, are modified to produce enzymes; salivary amylase is found in many, but by no means all, bird and mammal species (including humans, as noted above). Furthermore, the venom glands of poisonous snakes, Gila monsters, and some shrews, are modified salivary glands. In other organisms such as insects, salivary glands are often used to produce biologically important proteins like silk or glues, and fly salivary glands contain polytene chromosomes that have been useful in genetic research.

Many anti-cancer treatments may impair salivary flow such as chemotherapy and radiation therapy. Radiation therapy may cause permanent hyposalivation due to injury to the oral mucosa containing the salivary glands, resulting in dry mouth or xerostomia, whereas chemotherapy may cause only temporary salivary impairment.

What is ultrasound. I hear you ask. Tee-hee.

Courtesy of Wikipedia.

Ultrasound is an oscillating sound pressure wave with a frequency greater than the upper limit of the human hearing range. Although this limit varies from person to person, it is approximately 20 kilohertz in healthy, young adults. Ultrasound devices operate with frequencies from 20 kHz up to several gigahertz.

Ultrasound is used in many different fields. Ultrasonic devices are used to detect objects and measure distances. Ultrasonic imaging (sonography) is used in both veterinary medicine and human medicine. In the non-destructive testing of products and structures, ultrasound is used to detect invisible flaws. Industrially, ultrasound is used for cleaning and for mixing, and to accelerate chemical processes. Organisms such as bats and porpoises use ultrasound for locating prey and obstacles.

My ultrasound question?

I remember having ultrasound treatment when I was recovering from a dislocated ankle. 6 weeks after my plaster came off. I was fortunate (I thought) to have private health care and so BUPA provided the physiotherapy. They used ultrasound to break down the internal scar tissue that formed when the torn muscles and stretched tendons repaired themselves. So I was going to ask the doctor if ultrasound should be used to break down the scar tissues in my neck that formed when the muscle, lymph nodes, nerve and vein where excised.

I've just been doing some research into ultrasound and physiotherapy. Here are a couple of quotes.

The frequently described biophysical effects of ultrasound either do not occur in vivo under therapeutic conditions or have not been proven to have a clinical effect under these conditions. This review reveals that there is currently insufficient biophysical evidence to provide a scientific foundation for the clinical use of therapeutic ultrasound …

There is nothing a cold slimy prickling ultrasound wand can do that a pair of warm hands can’t do way better.

So a masseuse it is then. You lie on the couch and she squirts lubricant on your neck.