on tongues and inspiring better self-care...

[Guest guest]

Hey all,

 

Just wanted to pass along an experience I had with a first-time patient this

week.

 

He's coming for pain relief (arthritis in his thumb due to lifelong overuse

injury).  Even though he's not coming for systemic care, I still checked his

tongue and pulses - as I do with all my patients.  His tongue has an open,

eroded, painful sore on it, about 1/2-inch across.  He also has very obvious,

advanced periodontal disease.  Although he attributes the tongue sore to a bad

tooth adjacent to the sore, I was suspicious about it, so I asked my dentist her

opinion. 

 

She said that the tongue would form a callus-like growth if it was protecting

itself from ongoing abrasion, and that open, eroded lesions like the one I

described, were more typical of tongue cancer, as I suspected.  From reviewing

my patient's health history, I already knew he had several basal cell carcinomas

removed from his face, and a benign tumor removed from his salivary gland.  My

dentist gave me recommendations of 2 oral surgeons for him to consult with. 

Whether or not he will follow up remains to be seen - he did tell me without any

hesitation that he cannot remember the last time he saw a dentist...

 

The reason I am writing this, is because I am grateful for how thoroughly our

schools train us to evaluate our patients.  In this case, it helped me know this

patient " grows things " - cancerous and otherwise.  And I am grateful I looked at

his tongue, even though he was coming for pain in his thumb.  He said that sore

has been there for " a while " , and he never had it looked at.  Goodness, that

made my hair stand on end!

 

By the way, he also has a rather large growth right on the tip of his tongue. 

It's pink, fleshy and round, about 3/8 of an inch across.  He has had this

looked at years ago, and his doctor said it's nothing to worry about, and it has

a specific name that he couldn't remember.  Anyone know anything about these

kinds of growths?

 

Also, anyone have thoughts on how to inspire patients to take better care of

themselves?