NOTE: The author was diagnosed with nasal polyps on one side of his nose. The growths had a different look than usual grape-like polyps and surgery and biopsy were ordered by his doctor to rule out malignancy. It turned out the growths were indeed just rotted nasal polyps. This article is about his discovery of his illness, the arduous waiting game for the biopsy results, and his thoughts throughout the entire ordeal. The author apologizes if some sections sound like they make light of cancer and other serious diseases when the intent is the exact opposite. Nothing has made the author empathize more with patients of severe illnesses than what he experienced with the diagnosis and treatment of his nasal polyps. And it his hope that anybody going through the same issues finds some solace and reassurance in this story.
“Your polyp looks different. It’s a different color, black in some areas. It looks like it has veins and solid tissue. We really need to get it biopsied.” Those were the words I heard my ENT doctor say before life left me where I stood… or sat… It’s hard to remember because my mind swiftly drifted out of that room and floated up in the sky.
Mucus That Smelled Like a Stray Dog’s Butt
I’ve always been prone to colds, cough and other respiratory diseases. Sticky, green mucus–the kind that looks like the ooze that made the Teenage Mutant Ninja Turtles who they are, and which healthy people would consider extremely gross–is more like a pet peeve to me. I’ve been living with it my whole life, usually a minor inconvenience but a constant reminder that my immune system unfortunately isn’t as good as others’. But some 5 weeks ago, my normally green mucus turned to brown, or more like the color of rust, obviously due to significant amounts of blood mixed with it.
My girlfriend, Erika, was horrified the first time I showed the specimen to her on a piece of tissue paper (I guess it’s a measure of intimacy when a couple can pull off disgusting stunts like this). She kept yelling at me to go to a hospital and have it checked but I tried to calm her down, saying I probably just had a wound in my sinus because of my sinusitis. No worries–it should go away soon like all other literally sticky situations before it.
A few days passed. One morning, I woke up, blew my nose, and what came out smelled like the maggoty carcass of a dead rat. Or maybe the butt of a stray dog. It had already been smelling off and showing streaks of blood for a few days, but that morning the smell was so revoltingly strong I wanted to burn the shirt I used to wipe my nose.
I finally agreed to go to the hospital.
I entered the ENT’s clinic confident I would leave with a prescription for antibiotics and some advice to exercise (which I would most likely ignore because I’m a stubborn idiot). The ENT was a tall man with a calm voice but who was way less spunky than my pulmonologist (whom I loved because he’s spunky and always brought good news that my lungs are clear every year during the annual physical examination which the company I work for required). After describing my symptoms, telling him my mucus was smelly–although not honest enough to describe it as smelling like the maggoty carcass of a dead rat or a stray dog’s butt–he made me sit in a tall chair so that he could peek into my nose.
He sprayed something in my nostrils before sticking an endoscope down each opening. I told him the brown mucus and foul odor only came from the right side, so he started viewing from there.
“Oh. You’ve got a polyp.”
Immediately, my heart sank. Polyp? Did he say polyp? Where did I hear that before? It was such an unexpected development that he actually found something in my nose that shouldn’t be there in the first place that I found myself already panicking.
He definitely said “polyp” and I didn’t know what the heck a polyp was but even then, all I could hear was the “C” word.
“Uh,” I grunted because the long, thin steel instrument was still up my nose as the doctor watched the live feed on a screen.
“It’s big. We need to remove it by surgery. Don’t worry, everything will be done through your nostril. Nothing would be opened.”
There was a rush of images in my head of me lying on a cold table, wearing a hospital gown, and a group of unaffected medical people silently talking among themselves as they poke my nose with long instruments, longer than the one my doctor had already jammed up inside my nose. This was very bad, I thought. Erika would be worried sick and she’d kill me because my hardheadedness to see a doctor was already proving to be a seriously big mistake.
“Hm. It’s really just on this side. Your left side is clear,” said the ENT as he explored the left side.
“There’s mucus. We need to suck that out.” He told me when he went back to the right side. He proceeded to get another instrument from his drawer and switched it on, letting out a buzzing sound, which I assumed was a motor.
In spurts that were slightly satisfying, the instrument sucked out the mucus covering that side of my sinus cavity. All these procedures were new to me and I actually marveled at the fact that my nose wasn’t hurting even as the doctor kept poking it with the endoscope. Again, he expressed his alarm at the size of the thing he discovered.
“It’s huge. That’s why your mucus is smelly. It gets stuck in here and rots.”
Ok. That explanation clarified things. In fact, I had already read about that explanation before I went to the doctor because I did some online research about sinus infections to prepare myself for what I was going to find out. Sometimes, when sinus cavities get extremely inflamed, mucus gets stuck there, serving as plentiful grazing grounds for bacteria, resulting in smelly mucus and sometimes foul breath (which scared the hell out of me for obvious reasons).
“It’s really just the right side. We really need to remove it and have a biopsy done.”
My heart further sank into the floor.
Wait–biopsy? It’s THAT bad?
All of this already felt unreal to me. I could sense my brain trying to block the truth of these quick, unforeseen developments because that’s the only way it could protect itself from the deluge of dark thoughts and emotions trying to burst through.
Immediately after he slid the endoscope out my nostril, I asked him whether polyps are dangerous… Of course what I really meant was did it have any connection with the “C” word.
“Not really… usually. But it is abnormal tissue growth, so we need to do a biopsy.”
Right around this time, I realized how the mind tends to focus on certain words and phrases when it tries to cling on to hopes that everything is fine and nothing terrible is happening. The words “abnormal” and “tissue growth” echoed down the chambers of my being moments after the doctor uttered them, so did the words “biopsy,” “huge,” “surgery.”
“You also need to do a CT scan,” he continued.
All the words the ENT were saying were raising alarm bells in my very soul; he never said the “C” word but that was all I could think of. And I couldn’t believe I was thinking it, given that I arrived at the hospital thinking all I was going to get was an advice to exercise.
I had the CT scan done right after I left the ENT’s office. As the platform lifted me up and slowly conveyed me into that dome, I found myself remembering all those movies and shows I watched of people entering this cold, lifeless machine.
The worst thing was knowing none of those movies or shows ended well with regard to those characters. I was so terrified I’m amazed up to now that I didn’t pass out because there were definitely times that I felt myself trying to automatically shut down the swift unacceptable realities happening one after the other by switching off my own consciousness.
The Horrors of Online Research
Obviously, I didn’t wait ’til I got home to Google what polyps were. Searching the terms “polyp” and “nose” returned encouraging results, which nipped my worries for a short while. Multiple websites would tell you that:
“Nasal polyps are common, noncancerous, teardrop-shaped growths that form in the nose or sinuses. They’re usually found around the area where the sinuses open into the nasal cavity. Mature ones look like peeled grapes.”
“Common.” “NON-CANCEROUS.” Good.
That’s from WebMD and many other sites describe nasal polyps almost the exact same way–with that slightly amusing comparison to grapes (it kind of helps calm you down when you imagine these growths look more like fruits than something nefariously uglier).
The WebMD article further explains that:
Often linked to allergies or asthma, they may cause no symptoms, especially if they’re small and don’t need treatment. Larger ones can block normal drainage from the sinuses. When too much mucus builds up in the sinuses, it can become infected.
Unlike polyps that form in the colon or bladder, nasal ones are rarely cancer. Experts think that long-term inflammation causes them or that they run in families. Nasal polyps aren’t painful to the touch. Medications or surgery can treat most. They may come back, though.
“RARELY CANCER” (still good though the word “rarely” was unwelcome). “Aren’t painful to the touch.” Well, that’s exactly like mine. The doctor kept touching it with his instruments and all I felt was a slight tingling sensation. Again–that’s very encouraging that all I had was a simple, non-cancerous, nasal polyp. “They may often come back, though”–not a problem as long as I could get rid of this batch that’s making the air I breathe in and breathe out smell like the worst kind of infection.
I’ve always advised Erika against diagnosing herself using Google whenever she got sick because I’ve had numerous experiences searching mild symptoms and then finding out later that they exactly match a type of cancer or some other frightening disease, but usually cancer. It always happens. But given that nasal polyps were a mystery to me, I gave myself the license to break my own rule and I kept on browsing site after site, looking for more articles that could give me more assurance that I was all right, so I could actually tuck in that night and not have nightmares about chemotherapy, losing my hair, and losing all our money.
And then somewhere along my fervid online research, I stumbled upon something that stabbed my heart like a cold dagger:
However, there are growths in the sinuses and nose that may look like polyps but can be precancerous or very rarely actually contain cancer. These masses are often on one side of the nasal cavity only, while most true benign nasal polyps are present in both sides. Polyps present in one nasal cavity but not on the other, should be biopsied or removed if they are suspicious.
“Precancerous.” “Often on one side of the nasal cavity only.” “Should be biopsied or removed if they are suspicious.”
Immediately, I remembered with horror how my ENT kept on repeating “Yours is really just on this side.” I thought nothing of it before and actually kind of felt it was a positive thing that my polyp was just on the right side. If both my sinus cavities were blocked, surely that was more serious?
Turns out that was completely wrong when it came to these things.
Digging further, I found more and more articles telling me the same chilling fact: growths on just one side of the nose are unusual and may not actually be polyps (those friendly grape-like things I was just reading about minutes ago), but something else. I realized that’s why my doctor wanted mine to be removed and biopsied–he wasn’t sure he was looking at a benign nasal polyp.
Reading more articles as blood started to drain from my head, I also learned that polyps that bled were even more suspicious. Didn’t my mucus have a ton of blood in it? I was alone in the room because my girlfriend works night shift, but if she were there, I would’ve probably collapsed in her arms as I tried to digest all these dreadful bits of medical knowledge I was discovering.
I probably wouldn’t have slept that night if I didn’t stumble upon an old forum thread where a woman described her own diagnosis of nasal polyp. Hers also appeared on just one side of her nose. Like me, she thought she was totally fine until she checked the Internet and found out “unilateral” growths (appearing just on one side) are unusual and suspicious compared to “ipsilateral” growths (appearing on both sides).
The woman was so wrecked with worry that she maybe had cancer that she was begging for people on that message board for stories where unilateral nasal polyps turned out all right for the patient. And the kind users there did share stories of their friends or loved ones getting diagnosed with unilateral and ipsilateral nasal polyps that were completely benign. Some had theirs removed by surgery, others were able to shrink or cure theirs using nasal sprays, one guy said he was so fed up with his that he blew his nose out so intensely one day that his polyp came out. Gory but it worked (though he responsibly advised against doing it). The woman thanked them all for helping her calm down.
But the stories just weren’t enough. As days went by, the woman described how thoughts of cancer were consuming her day and night, and how she couldn’t wait to get her polyp surgically removed and biopsied. In her last message on the board, she shared the good news that her operation was over and her doctor informed her that her unilateral polyp was benign.
The bad news was she was so overwhelmed by anxiety that she lost her baby. She was pregnant.
It was probably the darkest thread I’ve ever read and I felt so sad for the woman, but perhaps unsurprisingly, her story was the only piece of writing that calmed me down enough to sleep that night.
‘Your Polyp Looks Different’
After a week’s worth of using a corticosteroid spray and tablets, while also taking antibiotics and spraying an additional saline spray into my nose, I went back to the doctor to see whether all those things I did had any positive effect on the growth inside my face.
“It’s still there,” said the doctor, again with the camera in my nose.
“It shrunk a tiny bit but it’s still there.”
I had already talked to my family about the surgery and biopsy in the horizon, while watching my mother’s face sink into worry. I was thinking it might be a while before I needed to do that because all those medicines I was taking could help shrink the polyp–maybe even get rid of it all together because based on what I read, in some cases, corticosteroids handily took care of business.
They didn’t. And the doctor (whom by then was already my least favorite doctor in the world, especially compared to my spunky, bringer-of-good-news pulmonologist) had more bad news to say to me:
“Your polyp looks different. It’s a different color, black in some areas…”
The endoscope kept on poking, turning side to side, looking at various angles.
“It looks like it has veins and solid tissue… We really need to get it biopsied.”
Life left me where I stood… or sat… It’s hard to remember because my mind swiftly drifted out of that room and floated up in the sky.
At that point, it was impossible not to say it out loud in my brain: “cancer.”
We maybe talking about cancer here.
In my nose.
Of course, me. Nobody else was in that room after all, sitting in that chair, with a camera up his sinus.
Using the term “C word” in my head was already ridiculous even though that’s what I called it the week before as I tried to push that possibility out of my mind. After the doctor said those words, I could only call it by its proper name, like a devil finally breaking you down so that you can yell out his monstrous name: “cancer.”
Everything turned grey. The ENT’s office with all the books and instruments melted into a haze and nothing was real anymore aside from that dreaded word and the reality it defined.
“Doc,” I asked him after he sucked the mucus out again. “Is this dangerous?”
For about two seconds, his face clearly worked up the best expression to tell me the facts without causing me to have a panic attack. He then said in his calm, almost vacant voice: “Well, we’ll have it biopsied. That could take 3 to 4 business days. Then we’ll know if it’s benign… or malignant.”
That last word squeezed the remaining life out of me.
Nothing Matters–Not Even Game of Thrones
Every single day leading up to the biopsy–not the operation, the biopsy–was torture of an inhumane kind. I still went about my day-to-day tasks, including working my day job, but I couldn’t muster any smile that was genuine. I held everything back from my friends because the thought of dragging them down into the depths of my worries with me was intolerable. My only source of comfort was Erika and my family who showered me with the best food when I came home. But even that food I could barely taste because the prospect of cancer only made you think of cancer. Nothing else.
Not even Game of Thrones.
This might seem like an insignificant detail but I’m a huge Game of Thrones fan and the fact that its most epic episodes were not having any positive effect on my mood was a great indication of just how deep depression and anxiety had sunk in. While waiting for my turn to do some tests for the surgery clearance, I remember watching the episode where Daenerys rode her dragon for the first time to burn a massive opposing army, but none of the epicness rubbed in. On the contrary, I found myself wincing inside as I watched fictional characters getting burned alive.
That’s when I realized that any thought of death bothered me, made-up and real. I just wasn’t comfortable thinking about death and I certainly didn’t enjoy seeing it onscreen.
Which wasn’t the case when I was healthy… or part of the fully living crowd. It was then I understood that fully living meant having the freedom to laugh at death while it played its themes safely away, usually behind a screen. Watching death on TV or in the cinema thrilled me, whether it’s characters whose lives are in danger or characters who were actually dying–sometimes the more horrible the method, the better.
All of that stopped the moment it was me whose very life was in peril.
There was a strange, eerie transition from being the audience to the object, feeling like your life–your tragedy–is playing out onscreen for someone to marvel at or cry over. And the worst thing was you couldn’t get out of the situation, like you’re trapped in your own story.
The title of the story would either be “Nasal Polyps” or “Sinus Cancer” but you just didn’t know because you’re inside that story and you couldn’t see the script or the credits.
I had read somewhere that sinus cancers were very rare, and many patients actually had real reason to develop them, such as mining workers whose sinuses were exposed to various harmful elements like nickel. I’ve also been inhaling pollution in the streets my whole life as I travelled to and from school and then later, to and from work; and since two years ago, living in condos had exposed me to more dust, triggering a seasonal allergic rhinitis, which prevents me from breathing normally for months. Living in a third world country was bad–but I was damn sure I wasn’t inhaling anything like nickel.
Despite that, death by sinus cancer still felt like a genuine possibility to me. One horrifying article actually described that your eyes could pop out when sinus cancer spreads, and I kept remembering this documentary I watched in my youth featuring a man whose face was operated on because doctors discovered he had a rare sickness that manifested itself through recurring colds.
Half of that man’s face was removed and replaced with a horrendous prosthetic.
I couldn’t imagine having to go through anything like that.
I couldn’t imagine death or the process by which one gets there.
The Longest Month of My Life
From the moment I heard a biopsy was needed to determine whether my growth was benign or malignant, the results were all I could look forward to. I marked the date on my calendar. I repeated it in my head like a mantra. Thursday, Thursday, Thursday. Then it changed. Friday, Friday, Friday. My life revolved around it, and there was nothing beyond it–no plans, no future, no nothing. It’s like a curtain of static has been pulled over my life and I couldn’t see beyond that day regardless how much Erika told me that it’s going to be all right and that we should plan a trip for our anniversary. I imagined myself reaching a fork in the road and one led to long suffering for me, my family, and friends, while the other led back to life where I left myself waiting a long, long time ago.
I’m not a religious man but it was God whom I talked to throughout this period. I implored him to spare my life and others in the same boat as I was (I kept remembering the woman who lost her baby in the forum thread I read), to give me the strength to face people every day even while I was on the verge of buckling underneath the pressure of it all. Pretending to live was mighty difficult when there was a real chance I already had one foot inside my grave, and I just didn’t know it.
There were times I actually wanted to drop everything all together. What if I just stopped all these checkups and tests? What if I just cancelled the scheduled operation? I mean–I could just live my life not knowing whether I had cancer or not. After all, the smell in my nose had been gradually subsiding since using the saline and corticosteroid sprays.
Perhaps I could just give up and continue my life?
Isn’t this like Schrödinger’s cat–I’m both alive and dead until I actually read the results?
Both alive and dead kind of sounded better than definitely dead.
These were the thoughts that occupied my mind throughout my waking moments but a lot of them were fantasies and an excuse to pass the time.
The day of the surgery (which is by the way called FESS for Functional Endoscopic Sinus Surgery), I almost didn’t even care what was going to happen, which was probably irresponsible of me. I didn’t think there could be any complications or that I could bleed severely or that I might feel excruciating pain. Somehow, I just knew that my ENT was going to pull it off without a hitch. I kept wishing I could jump forward in time to when I’m already reading my biopsy results–learning about my ultimate fate.
The operation took around 4 hours–or at least that’s the span of time from when my mind totally shut down because of the general anaesthetic to the time I opened my eyes in the recovery room of the hospital’s surgery suite. There wasn’t any pain at all although I was extremely thirsty when I regained consciousness. My doctor repeatedly warned me beforehand that I wouldn’t be able to breathe through my right nostril after the surgery because of the packing inside, but I could breathe in and out just fine when I woke up. There was some relief–but not because the operation was over, but because I knew I was one step closer to Friday.
I plodded through seven more days before I was finally in that room I imagined millions of times in my head, waiting for a hospital clerk to hand me the documents that would reveal my destiny. I was with Erika whom I missed terribly even though I was with her every day. Minutes from now, I knew I was either going to collapse crying or scream with joy… or maybe I would still collapse crying regardless of the results. Looking around the medical records office, it was haunting knowing that countless people have retrieved their results from that small room, many of them probably breaking down in the arms of their loved ones when they saw their future at last.
I was still putting my signature on some acknowledgement forms when the clerk handed Erika the test results. I didn’t ask her right away but I was watching her in the corner of my eyes, looking for any sign that spelled my doom. For a couple of seconds, I was almost sure that my nightmares had come true because she was reading the papers so silently–no smile or any sign that there was good news at all.
“What does it say?” I finally asked her, my voice cracking, as I took the documents from her hand.
I immediately scanned for familiar words. No mention of “cancer” nor “tumor.” Nothing said “malignant” or “pre-malignant” or “pre-cancerous.” Nothing.
To my surprise, I didn’t fall down bawling nor jumped with joy. Perhaps it was just my severe exhaustion after reaching the end of this long treacherous journey, but I simply smiled, embraced Erika, and said “It looks like I’m ok.”
We immediately went up to my ENT’s office and showed him the results. He confirmed the good news–the great news–that my growths (because there were two of them that were removed) were indeed just nasal polyps. My doctor had shown me pictures of them after my operation and they looked nothing like grapes. They were unevenly shaped shiny masses colored brown and red with some parts yellow. According to my doctor, the reason for that was because the polyps themselves had rotted (not only my mucus) because of the legions of bacteria that had thrived there.
The packing in my nose was removed by my doctor after another week. Once the ordeal was over, I saw my ENT in a different light–somebody who had saved my life by taking away the main culprit for my recurring infections, which I thought could’ve developed into something more serious had no action been taken to correct the situation. Needless to say, I was thankful to him, and to Erika, to my family, and to all my friends who supported me and expressed their concern for me throughout that dark period.
The truth is I was grateful for everyone and everything. Even people who never knew I was sick. People who never knew who I was. People in the streets. Stray dogs and cats. To God.
I was–I am thankful for life.