Wednesday, August 6, 2014

Dermatologist update and my surgical consultations

I received a phone call from my dermatologist in response to the message I sent him after the biopsy was done the other day.  I just wanted an explanation of what happened from his point of view.  He stated that he first removed the mole that was on my foot and put it in the container full of liquid, as is the normal process when biopsies are completed.  Upon visual inspection of that mole, he thought it did not appear as dark as it had before removing it.  He looked back at my foot.  At this point, it was swollen because he had already injected the numbing agent.  He did, however, notice the pigment was a little darker in an adjacent area.  He said the skin tone of a darker person is atypical, but there was a color change so he had to be sure since I have a history of melanoma.  One of the things you look for with skin cancer is a change in the color of the skin.  Without talking to me about it, he decided to take a sample of that second area.  He said he had to cut deeper because there was a little bit of a callous on my toe.  He chose not to tell me before he went in for the second sample because he did not want to alarm me or my friend.  He apologized for how things transpired and for the insufficient bandaging.  He said he had thought about it all night and was very concerned.  He gave me his personal desk number at Kaiser and said to reach out to him directly if I have problems with healing.  I expressed to him my appreciation for his apology but also explained to him that if only he had told me he was going in for the second sample, all of this anger and confusion could have been avoided.  He understood and apologized again.  

Do I believe him?  My gut says yes, but I need to sit with this before I decide if I want to do anything further.  The pain in my foot was pretty bad yesterday but at least I can step down on it today.  I do have a lot of gauze wrapped around it to help cushion the area as much as possible and I'm elevating it quite a bit.  This was not a good experience but at least, for now, it's done.  I should hear back in a few days on the results.

On to better news!  I had all three consultations for my surgery with the psychiatrist, internist and surgeon so I wanted to write about those experiences.  A friend from my pre-op classes offered to take me, which was such an amazing blessing.  Not only did she know exactly where to go, but she dropped me off right in front of the buildings so I wouldn't have to walk too much on my foot.

The first appointment was the psychological evaluation.  This doctor's practice was in a portion of her home.  She was very friendly and that helped me feel at ease.  She wanted to get a feel for my mental state going into surgery, so she asked a series of questions designed to build a report on my present state.  She asked me questions about what it was like for me growing up, what my family dynamic was like then and now, the physical health of my parents, my happiness level and my support system, among other things.  She did have me elaborate quite a bit on some areas, such as being teased in school and how that impacted my self-esteem or some of the details about when I was raped as a teen.  It was a nicely flowing conversation and she said she felt no pause in recommending me to move forward.

We finished early and decided to head over to the second appointment, which was with the internist. That was a good call because he took me in practically right away.  I was weighed and my height was measured before I went back into the examination room.  I had gained weight since the classes ended and I'm working to get it off, but it was disappointing.  However, I had to just say to myself, "Okay, this is where you're at and just move on from here."  It is what it is and everything happens for a reason.  Once in the room, the nurse had me remove my shirt and bra and then put on a hospital gown with the opening in the back.  She then performed an EKG to ensure my heart was healthy for surgery.  The doctor then came in to review those results and went over some of my responses from the questionnaire I completed back in May.  He said my heart looked really good and he has no pause whatsoever to recommend me for surgery.  In fact, he told me that I am the exact person this surgery was designed for.  After surgery, my diabetes will most likely go right into remission and my sleep apnea will be significantly improved if not gone altogether.  Most of the medication I am taking I will no longer need to take and the pain I feel in my body will most likely get significantly better in time.  It was an incredibly positive experience.

The last appointment was with the surgeon I chose in the Pacific Bariatric group to perform my surgery.  All of the surgeons have a great reputation since this facility is a center of excellence, but I have spoken with several people who actually had this particular surgeon and they raved about him.  Beyond that, I felt a connection with him after attending an information session where he spoke.  They weighed me again and measured my height using the Tanita Body Composition Analyzer.  It actually gave me a print-out of my stats.  My BMI is currently 51.3 and my body fat percentage is 52.1.  That was pretty sobering but I also reminded myself that the reason I am here is to do something about it.  I can only imagine how different things are going to look in a year from now.  I was given a CD with a lot of information to read about preparing for the surgery and what things will look like post-op.  The doctor was very kind with me and answered absolutely every question I had.  He also said I was an excellent candidate for this surgery.  He did do a physical exam where he listened to my heart and lungs while also looking at my abdominal region.  He took his finger and showed me on my skin where the five incisions would be since I'll be having my operation done laparoscopically.  In terms of the next step, he talked to me about my vitamin, eating and exercising regimen.  He said the most important thing from now until surgery is that I work on doing things to shrink my liver as much as possible to prevent problems during the surgery.  So he wants to make sure I'm replacing 1 or 2 of my meals with protein shakes and that I stop eating bread, pasta and sweets because the carbs effect the liver.  He did tell me that all three doctors, including himself, would be filing their reports that evening and then I should be receiving a call from their scheduler to pick a surgery date within a few days, but no longer than a week.  A couple of my classmates did not have a positive experience in their consultations with this surgeon yesterday after my appointment, but mine was highly positive and I like him.  I pray the best for them but I feel very comfortable with him and completely satisfied that I chose him as my surgeon.

My friend and I went to lunch after that.  We talked about the fact that this is feeling very real now.  It was one thing to go through the six months of pre-op classes, but being seen by the doctors elevated all of that.  It is very likely that I will be having this surgery before this month ends.  Eeeek!  That is so surreal to me.  I have been working on this since November so it has not been quick at all but I feel I'm as ready as I'll ever be.  So now I wait for that phone call.  Will I be obsessively checking my phone for any missed calls?  Probably.


happyinca said...

Kathy, first I want to say how sorry I am that you had such a horrible, painful experience with the dermatologist. I admire your resolve to confront the doctor in an honest and direct way, and you've inspired me with your actions. I'm personally working on being less passive with medical visits, so your story is really encouraging me to be more assertive. Thank you for sharing it, and I'm also glad that writing it out has been therapeutic for you.

Now for the big yaaaahooooo! about moving forward with the surgery. I'm so excited for you, being at the doorstep of a healthy new beginning. I love your attitude, and I'm going to be sending lots of prayers your way that the excellent surgeon will have an easy and uneventful procedure. Lots and lots of hugs to you my dear!

Kathy said...

Thank you Christy!!! I'm so excited, yet so scared all at the same time. I'm gad I could confront that doctor and own my voice, if that makes sense. It allowed me to be present enough for the next steps in my surgery process. It's major surgery so I have to give it my full attention. Thank you so much for the prayers. I believe in the power of prayer so I will take every single one I can get ;-)

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