Wednesday, September 10, 2008

The Final Checkup

I had a lump in my right arm for about 2 years.  It had progressively gotten bigger, darker and uglier as time passed.  It was quite sore, but I got used to it being there.  Over those 2 years, friends, family and even the occasional acquaintance would see the lump, profess how disgusting it was and insist that I get it checked.

About 2 months ago, I decided to have it looked at.  After calling 4 (yes 4) dermatologists, all of whom "Are not seeing new patients", including my former dermatologist (it was so long since my last visit, I would now be considered a new patient), a friend of mine recommended a general surgeon that she had seen and really liked.

Off I went to see my new doctor.  After a few Ahha's and Uhmhmm's, he told me that he thought it was either an ingrown hair or oil gland that had not only an infection, but a secondary infection as well.  No Big Deal.  We'll just take it out.  

My first clue that this might not be the surgeon for me was that he asked me how long it took me to get to his office.  After I told him about 10 minutes, he decided that when he had some "spare" time, he would have his office call me and I could pop in to have it removed.  "Oh, OK" was my response. . .  and off I went.  A little later, it dawned on me that this might just possibly be the strangest scheduling of a surgery that has ever happened.  The next day, I called and discussed this with the office.  We then set an ACTUAL date and time for the removal of the lump.  

Clue #2 that this might not be the surgeon for me - yes, there are more - I am pretty thick-headed and clueless on occasion.  After checking in and getting settled, with dear hubby by my side (I am a big baby and always need moral support if any kind of pain is involved in a procedure), the surgeon enters the room with his trusted nurse.  

After a brief "Hello", the fight ensues.  Nurse hands Surgeon his gloves.  Surgeon sniffs - yes, sniffs - the gloves and says, "These better not be the gloves that smell like fish."  I am thinking, Did I hear him correctly?  So I say, "Fish?"    "Yes, fish, they bought gloves that smell like fish, I don't like them, I like the minty fresh gloves."    At this point, dear hubby and I are looking at each other dumbfounded while Surgeon and Nurse have a 10 minute argument about the fish vs. minty fresh gloves.  I wonder at this point if I should run for the door, or at least ask to see his credentials.  But, no, I continue to lay prone on the little table and wait for Surgeon to use his minty fresh smelling hands to cut me open.  

Clue #3 - After a very painful bout of numerous pokes with a very large needle to numb the area, I swear to you he numbed from shoulder to elbow, Surgeon proceeds to cut around the offending area.  "Oh, hmmm, I don't know what this is?  I've never seen something like this."

WHAT??!!  You've got to be kidding me, he did NOT just say that!  "What?" I ask.   "Oh, it's not what I thought it was, actually, I don't know what it is, but the good news is, if it were something bad, I would probably know what it was."    OH MY GOD!  OH MY GOD!  OH MY GOD!  Get me out of this nightmare.   "That's OK, we'll just pop it down to the lab for the biopsy and call you with the results."   

This is just grand!  Please, just sew me back up and let me get out of here.  

A gazillion minutes and 20 stitches later, I am running for the door, wishing I had just pressed on and looked for an actual, legitimate dermatologist.  But, at least it's over, I'm done and I only have to come back in 3 weeks for my follow-up and never see this man again. 

2 weeks go by.  I don't hear from Surgeon's office.  I assume everything is fine and the biopsy is fine and I happily go on with my life.  WRONG!  

Clue #4  - Phone rings, it's some moronic woman from surgeon's office.  Remember, 2 WEEKS LATER! 

 "Hi, I'm calling to let you know that we need to change your follow-up visit to a re-incision." 
 "Oh, I guess there was a problem with the margins of the first one."  
"Problems?  If there are problems with margins, doesn't that mean that it is possibly something bad?  What did the biopsy say, was the lump malignant?"  
"Hold on . . . Weeelllll, the report doesn't say malignant, so I would ASSUME that it isn't.  I wouldn't worry, we just need to schedule a new surgery."
"I would really like to talk to Surgeon, please."
"He's on vacation for the next 2 weeks, but I can have Partner Surgeon call you tomorrow."
"No, I would like Partner Surgeon to call me TODAY."
"Oh no, he can't possibly do that."
"Just have him call me please."

So, Partner Surgeon calls me later that afternoon.  
"What exactly did my biopsy say?" I ask.
"Oh, not to worry, it was a benign tumor, they just want to make sure we got it all.  The margin issue is microscopic so it isn't a big deal.  Just keep your follow-up and Surgeon can re-incise then."
"Oh, OK.  Thanks."  VERY confused, I hang up the phone and wonder what is going on.  Still a little misguided and clueless, I don't think to really question all of this.  

A few days later, the phone rings.
"Hi, we need to schedule your re-incision."  It is moronic office lady.
"Partner Surgeon said that I could have it done at my follow-up with Surgeon."
"Oh no, he won't have enough time.  You need to come in on the 15th."
"I can't come on the 15th, I am working."
"You have to, it's the only date we have."
"I can't, you don't have anything after that?"
"I'll have to call you back."  Please note, not said very nicely.

A week later, I get a message on my cell phone.
"Hi, you are scheduled for the 18th."
I call back and confirm.  On the 18th, off I go, sans Mr. P this time, he has to work.  

Before the surgery begins, I ask what exactly is going on?  What exactly is the report.  "Didn't my office call you?"  Surgeon asks.  After telling him my saga, he says, "Apparently you were misinformed."   WHAT?!

Clue #5
Surgeon tells me that the biopsy went to 2 labs.  The first lab could only confirm that there wer 'Spindle Cells' present, but could not diagnose any further than that, so they sent it off to lab #2.  Lab 2 determined that it was one of three things.   2 of which are malignant and not a good thing and the third being a benign tumor.  They were favoring the benign tumor, but wanted another biopsy to make sure.  Apparently, as the story goes, Partner Surgeon only read the last page of the report.  The first two diagnoses were on the previous pages.  YOU HAVE  GOT TO BE KIDDING ME!  Does this office communicate AT ALL?!  Now, in a panic, I ask Surgeon what happens now and he says that we are doing more removing and sending it to the Mayo Clinic this time.  Great.  He tells me we will go from there.

Again, the numbing process seems to last forever and Surgeon begins his digging. After quite a while, he says "Oh!"  Oh no, not again!  I am beginning to wonder if I am actually in some foreign country, in an illegal doctor's office that sells chicken heads in the front room and performs the surgeries in the back.  "What?" I ask, although I am not sure I really want to know.  "Well, your body seems to have rejected the sutures from the last incision."  "Rejected?" "Yes", he further explains that in basic simple terms, that although my skin closed up, I had a large gaping hole just under the surface of the incision.  My body apparently did not like the material of the sutures and decided to get rid of them altogether.  Any longer, and I could have had a nasty infection.  "You are going to use different sutures this time?"  You never know with this guy.  "Of course, I'm going to use silk."  Silk is good.  My body shouldn't reject silk.  We like silk.  

So after more digging, . . . I thought the margins were very small. . . Why is he digging so much? 60 stitches and an "I'll call you" later, I go off yet again, upset, confused and terrified.  Is it malignant?  Does this guy even know what he is doing?  How did I end up here?

To make a long story a little less long, today was my follow-up.  According to Surgeon, everything is gone, my body accepted the sutures and the incision is healing nicely.  It is quite large, but healing nicely.  The bad news is, they never did find out EXACTLY what it was.  The new sample was full of clean cells, old sutures and a little scarring, but nothing else.  Great, second time around was just for kicks, I guess.  They are "favoring" a benign tumor, whatever that means.  The good news is that whatever it was is now officially gone.  In a lot of after- thought, I requested copies of everything and also copies to be sent to my physician.  

Needless to say, the top of my TO DO LIST says, call physician, make appointment, discuss Surgeon and have her get me in to see a Dermatologist.  Hopefully, if I can make the commitment to a Dermatologist, I won't be so quick to put things off and end up with a doctor that I am now not so sure really has a license.  



Thinkinfyou said...

That is a really scary story, that unfortunately probably happens all the time. I hate health care as a whole.

I'm glad everything is fine now.

Preppy Pink Crocodile said...

Sixty stitches? OMG how big was this thing? I am so sorry you had to go through all of that!! I find this to be more and more common. A few years ago I felt a lump and pain in my breast so I went to my dr. He was so annoyed that I MADE him feel me to check. He said he didn't think it was anything to worry about. Um, let's see here....I feel this and you feel this but you would like me to just go about my life not thinking about it? He begrudgingly referred me further and I found out it really was nothing to worry about. I stopped drinking (for the most part) caffeine and I've been much better. But still....his two second feel me up was hardly the same as an x-ray.

Gifting Gumshoe said...

Wow-what a horrible ordeal! I'm glad that it's over for you, and everything is okay.

DMLD said...

Thanks so much for your comments and concern. Ironically enough, the lump really wasn't originally that big. The scar I have know, however, is.

Fortunately for me, everything is fine and whatever it was is completely gone, but it makes me shudder to think that they still aren't definite about what exactly it was.

I can say this, in the future, I will be more apt to do a little research on the docs I choose and what they are going to do to me.