Collecting Comorbidities: The Case of the Blocked Salivary Gland

Traveling along this seemingly endless road of aging with MS, I’ve had new and weird ailments pop up here and there like those cheeky vermin in a really, really long game of Whack-a-Mole. Ailments I had never heard of before. Ailments I could completely do without, if given a choice.

If you’re old enough to have gotten Mumps at age 8 or 9 like I did, then you remember your cheeks swelling up and people asking if you’re storing nuts in them for the winter. Those sub-maxillary glands just under your jaw growing big as golf balls, too, and they hurt like the dickens whenever you tried to open your mouth to eat or talk. Fun stuff. Mumps is a viral infection of the salivary glands that children are vaccinated for in infancy nowadays, sparing most of them the discomfort and aggravation. Little do we know, however, that an adult version awaits us down the road.

I tried to ignore it

A week before my brother was due to move into the apartment next to me, my right gland swelled up and that side of my jaw hurt every time I ate. I wondered if it was an infected tooth, but experience told me it could just as well be a sinus infection so I did nothing. Just like every other jaded/procrastinating/seasoned MS patient, I tried to ignore it. As most of you know, that’s usually a dumb idea. One morning I woke in pure agony. Not only did it not go away, it got worse. I had to decline my brother’s invitation to dinner in his new apartment, the pain was so bad.

Blocked salivary gland

I couldn’t get in to see my primary doc soon enough so I high-tailed it to the walk-in clinic and sat for a surprisingly quick interval of only 90 minutes. “It’s a blocked salivary gland,” the PA announced, pressing on the right sub-maxillary gland and making me wince from the pain. Blocked salivary gland? What the @^*%?

“There’s either a stone blocking the saliva or a mucus plug. Whenever you eat, saliva tries to drain into the mouth but it can’t get past the blockage, so it goes back into the gland. That’s what makes it hurt so much.” This definitely hurt more than my memory of Mumps.

Like a kidney or gall stone

I did some research on what constitutes a salivary gland stone and yes, it’s just like a kidney or gall stone, a calcified lump that makes the most stoic macho man cry like a baby. My dad had a kidney stone in his 50s. We were in the car waiting for mom to drive him to the hospital. I was in the back seat with he directly in front of me, wailing like a wounded animal, and between screams, he would ask me to join him in a song. When I was a kid we used to sing in the car as a family years ago, during Sunday jaunts that would end at an ice cream parlor. The Trapp Family singers without the braids and lederhosen. The family that sings together stays together. Except my parents divorced eventually.

But at that moment I couldn’t make a sound, paralyzed with fear while my father screamed in pain. At the ER, a generous dose of morphine finally quieted him. He looked blissful in his stupor. Not unlike the peaceful slackness of his countenance when he lapsed into his final coma 30 years later.

It eventually cleared itself

The PA prescribed a ten-day course of Augmentin and referred me to an Ear, Nose and Throat specialist. I was instructed to massage the gland and suck on lemon drops to promote salivation. The duct would eventually clear itself, and it did. The specialist told me that if this condition recurs, removal of the gland is the course she would recommend. That’s nipping it in the bud, I thought. If thine gland offends thee, pluck it out.

Practical, if somewhat Oedipal.

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