I don't to sound like a nag to the younger members of this forum but beware of the Sun.
Today I had a lump on the back of my head checked out by a skin specialist and 40 minutes later I walked out of his surgery with a 3cm cut and 6 stitches.
He basically took one look at it and said "that's coming out" and removed a lump of my skin 3cm long and 1cm wide and probably down to the bone as well.
It didn't hurt at the time but when the local anesthetic wore off boy did I know something had happened to my head.
I also have the double wammy in that I cant take any panadol or aspirin for it because they react and nullify the effects of my diabetes tablets so I have to ride this one out.
The doctor said that the removed section is now tested and if it's benign that all that has to be removed. If it isn't then he will have to remove more to be sure he has it all.
Like I said I don't want to be a nag but wear a hat, long sleeves and sunscreen. I doesn't seem like a big deal now but it will come back to haunt you in the future.
I can understand what you are going thru, i was so ignorant right up till until 3 years ago. I got my first BCC. Then it spiralled from there and now 1 BCC and 3 Melanoma's later I finally realised how careful we need to be. I dont get nowhere near as much sun as most people either.
One of the most irritating is most of my removal have Keloid and bubbling and needed about a years worth of Quarterzone injections.
I do not understand how you are feeling about the pain relief, that would be most annoying.
My optometrist ( michael jackson ) when having a look at a newly noticed growth on my eye stated that he thought that perhaps 60% or more of people don't were sunglasses regularly, I thought straight up thats got to be wrong , but on looking around since , hes pretty much right.
Our eyes have the ability to switch to protecting themselves if there owner won't, I've found this out the hard way
So, being a veteran of numerous unpleasant encounters with Dermatologists over the years, I am left with many questions as to the accuracy and precision standards in diagnostic/treatment process.
Very rarely do I get answers to these questions from busy Dermatologists.
Someday, I may get answers .. in the meanwhile I am resigned to having to live in hope ...
My first question is how accurate is pathology diagnosis? I have had fairly extensive subsequential excision surgery (skin), following a biopsy, only to find out that the original lesion was entirely removed by the original biopsy. I felt like the second stage treatment was entirely unwarranted. Upon going back and reading the original biopsy report myself, I found rather ill-defined terms like "leading towards", which seemed sufficient justification (for the referring Dermatologist) to pass me onto a plastic surgeon for further removal of a sizable chunk of me.
Until this encounter, I was entirely unaware that there is still significant uncertainty following the pathology/biopsy stage.
The second question is about the 'surgical margins' taken during the excision process. It would seem that the size of the chunk removed by these folk is entirely arbitrary, (at the upper end of the scale), and it is this, that can result in the removal of major chunks of body parts … perhaps unnecessarily so (?)
My concern is that frequently, we place our care into the hands of busy professionals who are motivated to make decisions on our behalf, which may involve exceeding the 'minimum' amount needed to remedy the cause of the problem, especially given the uncertainty in the pathology domain.
I am aware of the 'better-to-be-safe-than-sorry' counter to all of this, but following several encounters, I am left with feelings that there are more options, than we are frequently led to believe behind a closed door.
Hi Craig, exactly what my Doctor said, safe than sorry, he initially took out a section, was all clear but decided to be safe took an extra 20-40% afterwards but only after a positive result. I had another mole remove which proved negative and went no further.
Ever been verbally abused behind a closed door by a Dermatologist ?
I have. It seems that questioning one's doctor is verboten !
It seems that its all my fault .. despite the fact that when I was young, I was always the only kid on the beach wearing a full neck and arm covering skivvy, and every other square inch of exposed flesh was smothered in Pink Zinc !
Seems covering up, and 'slip slap slopping', didn't work for me.
'Twas a bit rough when the sand got in the Zinc and inside the skivvy to, I might add.
Mind you, I'm pedantic about my family wearing suncream, hats etc, now. Beaches are to be avoided wherever possible … there's only bad news at beaches.
Ever been verbally abused behind a closed door by a Dermatologist ?
I have. It seems that questioning one's doctor is verboten !
That wouldn't have worked with me....I'd have interrupted his little tirade and said "do you want to keep your job??". I'd have threatened him with being deregistered because I definitely would've reported him to the complaints committee of the AMA. Regardless of what you may have said, he has no right to verbally abuse you or anyone else for that matter.
He's lucky this isn't the US....you could've sued him for a fortune!!!
I think she realised that she'd lost it and ever since, she's bulk-billed Medicare and, despite the occasional 'normal specialist fees', the most she normally charges me is twenty dollars (for the biopsies). These $20 procedures also include local anaesthetics/stitches/cryo, etc and return visits .. so I'm way ahead, financially !!!
Just goes to show how a little moderation (on my part) has probably saved me thousands !
Mind you, it also shows how arbitrary their fees are, too !!
My wife recently had to have a "skin cancer" frozen off the tip of her noze, which totally freaked me out because she is everything to me. My soulmate. So I told her I was marching her back up to the GP to demand he give her a referal to a skin specialist. She is a RN, and agreed without any resistance which i thought was a little strange as she always argues with me on medical stuff. But she had an alterior motive, and that was to get ME checked out as I have worked in the Sun (swimming pool industry) for 18yrs, even installing solar pool heating on roofs for 4yrs. Guess who walked out of his office with a referal ? Back then you didn't seem to hear many warnings (I am 45yo now), and when you did no one took them seriously. I never used sun block and I am fair skinned, as a matter of fact I can remember my boss used to tell us that the girls loved tanned guys because they looked healthy. Seriously they were his exact words. So I'm kind of not really looking forward to that appointment, actually I havn't made it yet for fear of what he is going to tell me. Stupid Stars !!!
Prepare yourself for about 5 - 10 mins of blame laying !!
And I've found that a vigorous defensive response also comes into consideration in the 'surgical margins' decision (ie: how much to chop). Once when I defended my life's history, I was confronted with being told that they'd have to take a strip 1 inch by 2 inches and I'd need a skin graft as well.
.. That one eventually got talked down to cryo (freezing) treatment and left no visible scarring !
G'Day Craig;
Prepare yourself for about 5 - 10 mins of blame laying !!
Not going to happen my friend, I eat doctors for breakfast. If you knew me you would understand. It may have something to do with how they like to treat my wife like crap from time to time being a nurse. I once stripped a doctor down in front of 3 nurses who had been taking his arrogant crap all day when I was in hospital a few years ago. You wouldn't believe how he spoke/treated them in front of myself and the 2 other patients on the ward. They looked after me real nice after that, I got whatever I wanted including beer with my dinner after that. It's not what I was looking, for or why I did it, I just can't stand men standing over women in any way, shape or form. It's gutless and tweeks a nerve in me. I am the patient/customer and things will proceed only if I agree with them. Sorry for the rant, and thanks for the good luck. I feel I may need it.
I prefer politcically incorrect doctors, we rely on them to cure us and provide advise and we sue them if they fail. I bet you if the doctor was correct and didn't become more forceful in the advice then we would sue them for not telling us correctly. Not only do they help cure they are also teachers and I alway find one that is not wimpy. If i can't take the heat then I should dig my own grave now.
I find it interesting that you all seem to have to argue with your doctors etc to get answers. I've been lucky enough not to have had too many encounters with them but when I have had it has always been on a very consultative approach. Ask the right questions, get the best known answers and agree on treatment and feedback. And I have had a number of doctors over my nearly 62 years so not an isolated instance.
We currently are managing my sinuses and tinnitus, both ongoing issues without much hope for real relief and he is active in finding things that may help releive it. When I got made redundant we had quite a long chat about stress and choices with regard to my health.
He is part of a medical group of about 4 or 5 and I have seen most of them when my particular Doc is not available and never had issues with any of them.
Don’t get me wrong there are a lot of good doctors out there, I have 2 that I use. One is a moron, but is directly across the road from where I work, he bulk bills and you don't need to make an appointment. I use him for scripts only. The other I go to when I have any sort of major issue, he is the one who gave me the referral, etc. He is awesome and understands me. It's just that some of the doctors out there seem to have a "God" complex and treat people as though they were inferior and beneath them. I hate people like this and will always knock them down a peg or four if they try that crap on with me, or my family. I can't be the only one that has experienced this, or seen it for what it is. The way some of them treat nurses is appalling, which I have seen first hand and of course have been told the stories from my wife. That being said they are not all bad, I have met a lot of very nice, genuinely caring and dedicated doctors which is what a doctor is supposed to be. I have no doubt the many years of dealing with the a$$hole Public(seems especially in Sydney, all of you that have travelled around OZ a bit will understand this comment) has taken it's toll and left their mark on some of them, anyone who works with the Public knows what I am talking about.
Anyway back on topic I would rather they take a little more of me than not enough as the ramifications of not is that it spreads through the lymph nodes and then you either end up with years of suffering chemo and radiation therapy or you die a horrible death you wouldn’t wish on your enemies. Just my 50 cents worth.
Upon having a deeper think about all this, the personality issues/attitudes and bedside manner issues are really 'in the noise' as far as I'm concerned. Admittedly, several rather unusual incidences have happened to me over the years but honestly, I acknowledge that in instances where I have been allowed to review the pathology report, I would not have requested a change to the treatment.
This would not necessarily be the outcome however, if a functioning bodily part was about to be seriously impaired with little/no evidence of adequate review of all the variables involved in coming to a decision.
Very frequently, (on other medical issues), I find community based statistics being raised in conversations, and subsequently I find myself being categorised, (seemingly), entirely on a statistical basis.
Surely a diagnosis and/or treatment should be primarily based on the evidence specific to my own test results/clinical history .. not solely on an interpretation of which category of a parent population I fit into.
In my experience, I have frequently found that humans (doctors included), have difficulty in keeping all risk factors present in mind, prior to making decisions. When it matters, I will actively seek out a doctor who has strengths in this aspect, rather than being concerned about their personalities.
Ric: Apologies if I've altered your intent for this thread. As I said earlier .. I am extremely cautious about covering up, whilst outside. Removal of that variable makes it simpler for everyone involved in the process.
(Its a lot like smoking, in that respect).
.....I find myself being categorised, (seemingly), entirely on a statistical basis.
Surely a diagnosis and/or treatment should be primarily based on the evidence specific to my own test results/clinical history .. not solely on an interpretation of which category of a parent population I fit into.
In my experience, I have frequently found that humans (doctors included), have difficulty in keeping all risk factors present in mind, prior to making decisions. When it matters, I will actively seek out a doctor who has strengths in this aspect, rather than being concerned about their personalities.
Funny you should say that. For 2yrs I was unable to get off the lounge, it was thought to be laziness, depression or chronic fatigue syndrome. I was treated with a whole swath of anti-depressants(and like I was a bum), etc, but in fact I was about to have a major heart attack which came within a hair of killing me. All of the medical staff who came to see me said I should not have survived. The reason it wasn’t diagnosed is, I believe, for two reasons, 1.) I was only 33yo and 2.) I was not experiencing any chest pain, just felt nauseous whenever I did anything physical. 2 weeks after a blood test which showed my cholesterol at 8.9 I chucked a hearty. So I hear you on the “being categorised” bit as it nearly cost me my life.
But all you young'ens, don't worry about how the opposite sex is going to see you just because you are nicely tanned. It won't be worth it.
sorry to hear that Ric 
