SURGERY UPDATE - 11/1/2021

I spent the night in Palo Alto at a hotel and woke up early for surgery at Stanford. The entire process from anesthesia to recovery was about 5 hours.

The good news: Dr. Whang was able to remove the entire tumor.

More good news: He did not go into my brain space.

Even better news: He did not have to harm any of my olfactory nerves.

Surgery did involve making more space for access to the tumor, so apparently my breathing will improve in the. long run. In the meantime, more healing time and nasal splints have been placed and will be removed in a week or so.

I had a nosebleed for the weekend and my family gave me space/time to heal. It was a great recovery.

WHAT DOES IT LOOK LIKE - 8/1/2021

I’ve had several friends and family members want to know what the new tumor looks like and where it is.

Clinically, it’s greyish pink and looks like a growth/polyp/slug when I see it on the camera that they shoot pictures with up my sinus.

On the radiographs, it looks like a mass. Here is a clip of the MRI. I outlined the tumor in yellow. You can see that I outlined it as it hangs down from the roof of my sinus. If you look at the little yellow arrow, it points to a curvy dark black space that rides alongside the middle of my sinuses. That dark black space is my airway on the right sinus.

My tumor completely fills my left sinus air space, but its not attached to the walls, just the top (dangling like a chandelier).

The plan is to go into general surgery and approach it from my nostril. They may have to open up my sinus space to get a good look at the tumor and to make sure they get complete removal. For those who like to pray, they have two concerns for this surgery:

• They want to get a great removal and clean margins, but they don’t want to go into my brain space. This would mean more complications and a cerebrospinal fluid leak that needs to be patched/grafted with harvested nasal tissue.

• They also don’t want to destroy my olfactory nerves, which would mean that I would lose my sense of smell/taste. As a coffee drinker and a lover of Kendra’s perfumes, this would disappoint me.

Pray accordingly and I’ll report back after surgery.

BACK TO SQUARE ONE - 7/1/2021

We had a good thing going didn’t we? As we all know, COVID-19 disrupted the world in early 2020. Actually, Dr. Whang wrote an initial paper on the ENT surgeon’s approach to treating patients with COVID-19 based on information Stanford was receiving from early reports out of China and Italy. As with most medical specialties (dentistry included), Stanford ENT chose to postpone all voluntary non-invasive procedures. That pushed my follow-up into the Fall of 2020. I chose to wait until the New Year 2021 and then waited a little bit longer until I had both doses of my COVID-19 vaccine.

That put my appointment into the spring/summer of 2021. When I called to schedule, I was informed that Dr. Whang was on a sabbatical and would not return until the Fall semester (teaching hospital), so I went ahead and met with his fellow, Dr. Ash for my follow-up.

As I headed over to Stanford in June for coordinated visits of radiology, bloodwork and clinical visits, I found out my insurance company did not want to work with Stanford radiology/labs, so at the last minute I showed up for ONLY my clinical exam. As the nurse practitioner poked up in my sinus, she noticed what appeared to be some regrowth. Dr. Ash came in and took a few pictures only to confirm that there was regrowth of the tumor. I was disappointed, but at the same time thankful they caught something before I was released.

The MRI and CT scan they orderd only confirmed what Dr. Ash saw in the office. My tumor was back and they needed to be more aggressive this time. Full surgery with general anesthetic was planned for the Fall when Dr. Whang returned to practice.

*** THE GREAT COVID-19 BREAK***

All Clear - 2/12/2018

Great news today. After poking up in my sinuses with the camera and taking a bunch of unflattering pictures, I have the all-clear with Dr. Whang.

Since we have had multiple clear views of my post-op sinus and there is some minor scar tissue, we made a corporate decision to skip 2019 and return in early 2020. That will be the last hurrah! I will go to Stanford for the full day. Take an MRI first thing in the morning, then blood work and then a final view of my sinus. If it’s all clear clinically and radiographically, then I’m released from my “tumor follow-up” schedule and will return as needed.

UPDATE - 12/25/2017

Again: Not meant to be impersonal. This is just an update. I probably won't update again unless things change.

I missed my 6mo checkup, so have an appointment in February 2018 for another nasocamera rescan of my sinus.

UPDATE - 6/17/2016

Again: Not meant to be impersonal. This is just an update. I probably won't update again unless things change.

I headed over to Stanford again today. This was a follow-up from surgery and from the biopsy that I mentioned below.

I'm quite familiar with the ENT routine. Three puffs of gross anesthetic/decongestant up the nose holes followed by a few Werther's Originals to kill the flavor. I had a quick photo session with the endoscope and we looked at my upper sinuses and the base of my brain. The tumor is still there, but it is behaving. The pictures look the same as they did after the first surgery.

The collective decision was to wait on further surgery at this time. So, like I said before, we will monitor the tumor every three months for changes. If it starts growing or expanding, I'll get new CT/MRI scans and we will plan at that time whether or not we go to the OR for a full removal or just another simple removal in the office again. The best part is I get a day trip to Stanford 4x/year.

Answered Prayer:
- It didn't grow and so far it's not aggressive.
- The surgery was successful and everything looks good.
- No more surgery right now. No downtime. 
- This is one LESS thing to deal with right now. 

For those that love details, Check out this webpage This gives a good overview with great You Tube videos. This page talks about tumors. Even though mine is benign, this page details how the location makes removal tricky.

- Fletch

UNEXPECTED NEWS - 5/15/2016

Disclaimer: This isn't meant to be impersonal. I just don't have everyone's email or phone numbers, so creating a page/link was the easiest way to share all of this information at once. 

Hey gang! I haven't been really good at giving out information, so this will get everyone in the loop at once.

My specialist at Stanford just contacted me (Sunday night - seriously, this is the best care I’ve ever received). He had some unexpected news from the surgical procedure and biopsy I had done last week in his office. Not horrible, just unexpected.

As you may or may not know, I had a large tissue growth removed from my left sinus last week. Dr. Whang (for any of you that read things phonetically, it's pronounced Wong...that should take care of my friends that like to be silly like me) removed the majority of that growth last Friday(5/6/16). See the scan on the left.

The surgery was super easy. I stayed awake and because it had been diagnosed previously by biopsy as a benign non-tumor, we chose to leave a small percent of the growth behind. If you look on the scan, you will see this growth starts very high in my nasal cavity and attaches to the bone at the base of my brain. By not removing all of the growth, the surgery was less traumatic and not as risky because the bone between my sinus and brain is very thin. I was totally cool with that decision! 

It was pretty gnarly as I watched Dr. Whang pull this large mass out of my nostril. Because of it's size and appearance, the doctor chose to do one more biopsy on this giant mass just to confirm the results from the previous biopsy. We thought we were just going through the motions.

Today’s results were UNEXPECTED.

As it turns out, I have a very rare nasal sinus tumor (I'll spare you the medical name). The good news is that it is still benign, but these tumors can act very aggressively. They can become cancerous/malignant (invade other tissues adjacent) if they are left untreated or portions of them are allowed to remain. Essentially, the cells in my nasal/sinus lining are fired up and want to grow every direction at once. At this point and prior to the initial surgery, we were happy this tumor grew down my sinonasal cavity and not up into my brain! 

What does this mean? Because we left part of it behind, I will eventually have to go into the OR for a complete removal of the entire growth/tumor remaining. This is the aggressive surgery I was trying to avoid the first time around. It will involve "getting good margins" around the tumor. This means bone removal between my brain/sinus (grafting/patching) and portions of the olfactory nerve bed alongside the walls of my nasal/sinus cavity (no smell). Thankfully, this does not require that I undergo radiation/chemotherapy, which would be required with a malignant tumor.

The plan is for me to go back to Stanford next month and take pictures and compare them to the surgical photos from last week. Then we will track the remaining tumor every three months until it starts to grow again or looks aggressive. When that happens I will have a new round of CT scans/MRIs and then schedule surgery at Stanford to remove the remaining tumor, bone and inside wall of my sinus. We watch and wait.

If you are inclined to pray:

• Praising God this is not cancer.

• Pray that my tumor is the non-aggresive type.

• I’m not fearful, just bummed to have surgery/down-time.

• It’s weird to have something growing in your skull that you can’t control. Pray for my humility, patience and peace as I go through scopes, scans and surgery all over again.

• It's just one more thing. Kendra and I are really sick of the "one more thing" because there seems to be a lot of "one more things" in our life lately.

Thanks, Fletch