A few weeks ago I went in for a six month evaluation and pointed out an area in the middle of my chest that at one point was a red blob of something that they burned off. It was nothing major and in fact the one nurse practitioner just left it alone for a year. It drove me crazy, however, whenever I went out in the sun and eventually another practitioner burned the thing off. It has been like a year since it was removed and now another scabby thing had popped up. This practitioner looked at it and declared it looked like a squamous cell. She recommended a biopsy and the nurse numbed the area and scraped off a sample to have taken to the lab.
The call came in a couple of days later. Turns out the area wasn't a squamous cell, but an actinic keratosis, something I have often after being out in the sun all of those years teaching and saving lives. In fact that same appointment the practitioner had frozen off three other keratosis areas on my arms. The lady on the phone told me it was "good news" but that I would need to come in and see the dermatologist so that the rest of the area could be "burned and scraped". I thought it odd that I would actually see the dermatologist since the nurse practitioner has been freezing, burning, and scraping me for years, but thought it a good thing to get established with him seeing as the original dermatologist was most likely not returning.
At my appointment I was taken back to the same room I'm always in by a new girl who took my blood pressure, something that hasn't been done before, but is now required. My pressure was a tad higher than normal and I will admit this had me concerned. She shrugged it off when I mentioned it saying these machines ran higher than a normal listen. Then she asked if I wanted to take my shirt off to "avoid getting tons of blood on it". I must have made a face at that comment because she quickly turned around and checked my chart and then reassured me I was only here to get that thing burned off so leaving my shirt on was fine. She then left the room.
I guess I must have been more anxious now because I couldn't really concentrate on my crossword puzzle as I waited for a doctor I've never seen before who might "get tons of blood" on my shirt while burning and scraping. I was sort of hoping that the nurse practitioner would enter the room to take care of my chest, but the door opened and in came the male dermatologist and nurse #2 whom I've known forever. He shook my hand while introducing himself, sat down on the rolling chair, and rolled quite close to me. He leaned in to me as if getting ready to tell me a secret, patted me on the arm, and said, "So we have a squamous cell that needs to come out so we need to do some minor surgery."
Huh? I corrected him by reminding him that his very own office had called me with the results of my biopsy and it was not a squamous cell. He told me that there was a pyramid and that the keratosis was at the top of the tier and if not treated could become a squamous and most likely would and therefore it was best to cut it out. By this point I was annoyed. I told him that is not what his office told me would happen. He sort of shook his head in disappointment and leaned in to take a look at the thing in question on my chest just below my neck.
Him: "We have two ways of going about this. We can burn it off which will leave a nice white mark in the center of your chest, which I know to you ladies is a very sensitive area."
Me: "Not this lady."
Him: "I know you ladies do not a white dot in the middle of your chest. Such a sensitive and focal area. The second thing is to make a small incision and take out the area in question."
Me: "Well, this lady doesn't care about a white dot on her chest."
Him: "You wear necklaces, right?"
Me: "No. My neck is too thick for me to be comfortable in necklaces. Look, what is it that you are recommending here because I'm confused. I'll do what you think is best, but I was told you were just going to burn and scrape this off."
Him: "Well, I know you ladies are sensitive to that area of your chest. It is up to you what you want done, but a white spot...." He shook his head like he was tsk tsking. "Let's cut it out. You'll come back in two weeks to have the stitches removed. I think you'll be happier."
And that's what he did. His nurse numbed me and they left me alone for several minutes while I fumed about what was suddenly happening here. He returned, reclined me, covered my shirt with a surgical napkin that had a hole for the area he was cutting into, and proceeded to slice me. He worked for some time, stopping once when the first nurse asked him what she was suppose to write down since it was a keratosis. Uh huh. He went over to her and they whispered, not quietly enough because I heard. He said yes it was a keratosis, but post surgical it was squamous. I guessed he was covering for me and himself with the insurance. By this time it was too late to call a halt to everything, and I just wanted him to get back to my open chest so that germs wouldn't invade while he was arguing with his new nurse. He finished the job and let nurse #2 stitch and bandage me up.
Him: "So wash it with soap and water three times a day and keep ointment on it. In two weeks you'll come back to remove the stitches and then in two months you'll come back for laser."
Me: "For what?"
Him: "For some laser work. That's such a sensitive area and it tends to build up some scar tissue so we'll fix that with some laser work because I know how you ladies are about your chest."
Me: "Yes, but if you are a good surgeon who did the job right in the first place then I wouldn't need any laser treatment afterwards now would I?"
I'm afraid by this time I was just plain pissed at everything that had occurred from the phone call, to what was suppose to happen, to what did happen, to now throwing in laser treatments. He didn't appreciate my comment and his face certainly told me so, although the two nurse snickered and then tried to cover it up by coughing at the same time. I patted his arm and told him I was just kidding. I left the room, paid my $40 copay, made my stitches removal appointment, and hightailed it to the car. Once inside there I pulled down the mirror to exam my poor chest. I'm sorry I did not take a picture. The nurse had put a piece of gauze over the wound and then taken, and I kid you not, five band-aids that she put in different directions over the gauze to hold it in place. Band-aids. Now I've been around Connie, wounds, and doctors for some time now and never have band-aids been used to hold on gauze.
Tom: "That has to be the worse rigged bandaged job I've ever seen. Was she blind?"
Later when I removed it all to wash and put on ointment I stared at this in the mirror:
This was better than a white dot?
It was a most unpleasant area to have stitched. When I would sleep on my side at night the skin would all bunch up and hurt so that I would have to roll on to my back. There was quite a bit of swollen irritation and soreness, but I did return in two weeks to have the stitches removed.
The dermatologist couldn't have been kinder. It was like I was seeing a different person. I too was kinder. He sat down and explained why he had done what he did, and I admitted it was an area that was constantly bothering me. He explained about the laser work and I agreed to take advantage of it. He said no matter how great a surgeon is laser is usually used, a little jab and notice to me that he hadn't forgotten my remark, and I gave him props for that. We ended the appointment with some freezing of spots I wanted frozen and then he made several funny jokes, told me I should steer my kids from medicine and to hair dressing as a career as everyone always will have hair, patted me and off I went to return in one month for laser treatments. Joy, oh joy.
funny story. You and your doctors!~
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