The Ranula Chronicles: The end(?)

Recap: Diagnosis, round 1 local anesthetic surgery, round 2 marsupialization, round 3 surgery with minus one sublingual salivary gland in the past twelve months.

The process of removing the ranula at my left submandibular/neck region had been a lot more involved than I had originally perceived; and, I re-circled to step one 6 months after relinquishing my left sublingual gland, when the swelling returned.

I was admittedly tired. And, a little bit embarrassed to be the person with the ranula that simply would not quit - even after undergoing a pretty significant loss of a body part. This was not the opportune time for my trait of “perseverance” to show up.

So, my surgeon and I got to talking about what options were next. While uncommon, the submandibular gland is also a feeding source of a ranula.

Given the multiple recurrences, my tiredness in readdressing the reality of the recurrence and having to reconfigure my life and schedules around visits and surgeries in the midst of a rigorous dental training, and redoing surgeries in a site that had been manipulated multiple times, the goal was to be as aggressive and thorough as possible to ensure that the ranula would not return.

In addition to my original surgeon, another surgeon was introduced became involved in my case. And another surgery was planned. This time, removing the submandibular gland via dual extra-oral (outside the mouth, through my previous neck incision) and intra-oral (inside the mouth, through my previous floor of the mouth incision) approaches. The goal was to be exploratory, extensive, and make sure no “rock was left unturned”.

Having undergone these procedures separately, the notion of both surgeries being conducted simultaneously was a bit daunting. Double the surgeries double the (un)fun?

Anticipating this to be the case, I was scheduled as an inpatient - meaning that I would be officially hospitalized after the procedures.

So, the day of reckoning came. In spite of the previous experiences, this round brought with it a different sense of nervousness as I realized that if this failed, I was really really out of alternatives.

The result? The left submandibular gland and ranula were removed - good news. Easier-than-thought access to the submandibular gland through the neck incision permitted that the inside of my mouth could be spared from surgery - even better news.

My parents were both present as I went in and came out of the operating room. It was a huge relief to be able to share the load of anxiety, worry, and stress between the three of us. Of course (and thankfully) I had the support of an even bigger network of friends and family who were cheering me on, sending thoughts, prayers, and goodies to help with speedy recovery and lift my spirits.

The support network, as I learned, was so crucial in being able to face the surgical day and its resulting consequences of side effects and symptoms. As I mentioned before, I felt a lot of emotions that ranged from fatigue (mental and physical), worry, and even shame. I felt lonely too because I didn’t know anyone else who went through what I was going through. And, even as I write this up, I feel a bit of guilt for sounding like I’m complaining when clearly, this whole debacle was simply a benign condition.

But in this vulnerable state of feelings, in remembering those individuals who contributed to helping me get through this journey, I feel it is important to honor their support by sharing this to you, the reader, by explaining the process, and the various perspectives and lessons learned as both someone who has trained to be a provider and who has been provided for. Just as my network shared a part of themselves to me, I hope to do the same for others.

I am now seven years out and without major complications. I have partial numbness to the left submandibular region and my right sublingual and submandibular glands have hypertrophied a bit (an oral pathologist explained that they were probably compensating for the loss of their left pair).

The course was long and with this last surgery, I quickly moved on with life and barely thought about the experiences in depth until now. Although I very much have a forward-looking mindset, I’ve appreciated taking this time to be reflective and to truly glean lessons and better understand what I learned in the process. I truthfully do not hope to have to experience (let alone write) a sequel, but I am grateful for everyone involved and who got me through it.

And that includes you - thank you for sharing your time in reading this story of mine. Hope we continue the conversation (in other topics!) :)

This post’s lesson: Hospital socks present an ergonomic and hygienic challenge! A good amount of research has been conducted to understand how to suit up hospitalized patients.