Tuesday, August 5, 2014

Two for the price of one

I had a biopsy done today and to say it was a negative experience would be an understatement.  I'm going to try to go into as many details as possible so that I can not only share with you what happened but so that I can document what happened.  I don't want to eat over this, hence this is why I'm posting all of this here.

In a previous medical appointment, my primary care physician was doing a foot exam with me and noted that there was a mole near the tip of the big toe on my left foot.  She advised that I follow up with my dermatologist since I have a history of melanoma.  

A friend offered to come with me to the dermatology appointment for moral support.  I thought that would be great since I was feeling a little nervous about this one.  Mind you, I've had quite a few biopsies before from this same doctor.  They are not pleasant, but I knew exactly what to expect.  The doctor would examine the suspicious area and then determine if a biopsy would be advised.  If so, he would call a nurse into the room to assist him.  We asked the doctor if my friend could stay and he stated that he normally had family and friends wait outside the room unless I would like her to stay.  I did tell him that I would prefer she stay, which he seemed to accept.

He had me laying on the table on my right side so that my feet were toward him.  It was incredibly awkward because my head was pointing down into a part of the bed that was lower than the rest.  I took a pillow and folded it in half to give me a little better leverage.  My friend sat on the edge of the bed close to me so that we could chat while the doctor was injecting the Lidocaine and performing the biopsy.  The doctor had plenty of room on his end to perform the proper procedures without any restrictions.  As he injected the numbing agent, I felt pain.  After a little bit, I felt an incredibly extreme amount of pain on my foot as he was cutting into my foot and removing skin.  I mean, it was pain that was beyond what I would have expected.  I anticipated a little pain because the mole was little, but nothing like that.  As my friend was trying to distract me from the pain, I had to stop talking and I inhaled deeply to fight through the discomfort.  She reminded me to breathe because I was trying to keep it all in to avoid feeling the pain.  Then I felt another pain.  It felt like he was digging deeply into me.

The doctor pronounced that he was done and that I handled it well.  They were going to put on a simple band-aid and that's when my friend really chimed in.  From her vantage point, she could see more than I could.  She asked if that one little bandage that was put on would be sufficient.  We were assured it would be.  We were given extra bandages to change the dressing at home and then informed that the visit had ended.  I requested the doctor call me with the results instead of sending them to me through the mail since I have an appointment tomorrow with the surgeon.  He left the room.  I put my flip flop back on, careful to avoid my big toe and then stepped down onto the shoe.  The next thing we knew, there was blood all over it.  I took it off and rinsed it in the sink while my friend went and got  help.  The nurse looked at my foot and there was blood all over my big toe, almost gushing.  She ran to get the doctor to show him what was going on.  

My friend was able to see that the doctor had, in fact, done two incision.  I did make the comment that I had cut the bottom of that toe the other day, but it's clear that he had definitely cut off skin in two separate areas.  The nurse was trying to stop the bleeding and, meanwhile, I didn't know quite what was going on because I couldn't see the bottom of my foot.  My friend took a picture and this is what I finally got to see.

At this stage, the nurse had cleaned up all the blood and we were waiting for more dressing to be put on it.  As you can see from the top of the toe, there is a little skin shaved off where the mole was removed (I'll call that area Section A).  But if you look in more detail at the center of my toe, the doctor had removed a crater of skin and went pretty deeply (I'll call that area Section B).  What my friend and I think happened was that the doctor had started cutting into the skin in Section B and likely realized he was cutting into the wrong area.  Then, we theorize, he went to Section A and performed the biopsy.  My friend even saw him with scissors in his hand at one point, which I don't recall he has ever done before.  We started asking him questions and he basically went into an explanation that sometimes the skin is "nicked" during procedures.  I'm sorry, that's no nick!  He did apologize, but he didn't specify for what.  He also said he was able to get a "broad" sample for further investigation.  I was eventually handed a hand-held mirror so that I could see the bottom of my foot and was utterly shocked at what I saw.  The doctor went into further explanation, utilizing some medical jargon, and then eventually left the room, apologizing as he did so.

We were then left with the nurse who explained to me that she had never worked with this doctor before and was just as upset with what happened as my friend was.  Was I upset?  Frankly, I was a little stunned and wanted to just leave.  The nurse bandaged me up with something stronger and tighter around my toe.  Before ending our time together, she reprinted my visit summary sheet and included information for me to escalate this to the next step if I so choose.  She was incredibly professional.  She was just as dumbfounded as we were as to what the doctor had just done.

As we attempted to leave, the bandage fell off after I walked a few feet.  So we went back to the exam room and a second nurse decided on a different bandaging system.  After three attempts, that one worked the best.  The doctor popped his head in the door and asked if everything was alright for probably the 10th time.  He even had the audacity to attempt to fist-bump me and my friend on one of his visits back in the room.  He probably shook my hand 4 or 5 times and even called me after I got home to see how I was doing and to see if I had any questions.

At that point, not everything had completely registered in my mind.  I had a houseful of guests with my classmates from the pre-op program visiting for a get-together.  They were all so supportive as I recounted my tale, with the help of the friend who sat by my side today.  The biggest concern with this, aside from the fact that he ripped deep skin out of my toe when he shouldn't have, is that I am a diabetic.  One of the things they teach us as diabetics is that the last thing you want is a cut on your foot because some diabetics have a hard time healing.  The lack of ability to heal, provided you are so afflicted, can possibly lead to foot amputation.  Obviously I am concerned because I am an insulin-dependent diabetic.  I don't take cuts on my foot lightly.  And I really don't take cuts on my foot that were done in error lightly at all.  

After all my guests left for the evening and I was attempting to walk on my foot without hobbling, I was met with excruciating pain and the anger finally hit me.  This doctor, whom has performed numerous other biopsies on me before, really fucked up.  I mean, he really, really fucked up.  Excuse my language, but I really can't sugar-coat this.  He made a huge mistake.  An "I'm sorry" is not good enough.  I sat down and wrote him an online message through Kaiser's system, requesting an explanation of why he did what he did.  Regardless of what he says to me, I will be escalating this and filing a formal complaint.  I don't have anything against this doctor, but what he did was absolutely wrong.  I hope everything will be okay in my situation, but what if it is not for the next person that needs a biopsy done from this doctor?  

The good news is that I'm not eating over this.  I'm choosing to take care of myself.  I have consultations with the psychiatrist, internist and surgeon tomorrow.  One of my friends has offered to take me and I graciously accepted her offer.  It will help me with not having to walk as far on my bad foot and, really, the moral support is just what I need.  Ugh, what a freaking day!


Anonymous said...

Ugh, what a day. So sorry you went through all of that! Sounds like someone messed up and was trying to cover his tracks. I had a mole biopsy that needed to be done on one of my fingers and my dermatologist sent me to a plastic surgeon to do it. I thought maybe they'd do the same thing on a toe. Instead of leaving a big divot in my finger, the plastic surgeon put several stitches in to close it up. He also mentioned that having that type of work done on the fingers was extremely painful - again, I can imagine on the toes was equally as bad. Anyway, I'm surprised they didn't plan on stitching it up a bit if they could - to perhaps speed the healing process. It also seems like they would take extra precautions with you to make sure it is bandaged correctly and protected against infection, etc. Anyway, I hope the results are clear and that *both* of your spots heal quickly. I was going to mention that, from what I learned back in my melanoma research days, melanomas found on your trunk or close to lymph nodes (like yours and mine were) are riskier than ones out on the extremities. Hopefully this is the end of it but if you do need to pursue further treatment, I would maybe inquire about a plastic surgeon doing the work.

Kathy said...

Thank you Martha. I did post an update on my most recent blog entry. I'm not sure if my insurance company doesn't allow plastic surgeons to do the biopsies, but at least it's done now and hopefully I'll receive positive results.

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