It has been a while since I’ve written anything, partially because summer school is always very time consuming, but mostly because the nose surgery made it at first impossible, and then only difficult to wear my glasses, and none of the work-arounds I came up with, including contact lenses that let me drive, worked really well for the computer. I got the final stage done yesterday, and can wear my glasses again, though at the moment my nose is sore enough that I can’t wear them very long before I have to take them off and resort to the ice pack.
All is going well. To recap, a small malignant melanoma had to be removed from the end of my nose. The location made the removal and reconstruction much more complicated than it would have been had it occurred in any other place, but it was early, removed completely, with clean margins, and there is very little chance of any spread. One of the things that has amused me throughout this process is the number of people who feel they have to reassure me that everything will be alright. I understand relative risks, and of all the things that might kill me, this is actually very low on the list, as long as it is properly taken care of, which I am doing. The other side of that of course, is the number of people I have wound up having to reassure that I really would be alright.
This is my first experience with facial surgery, but not my first surgery. All of the others, except a tonsillectomy when I was 10, have been orthopedic, and have been spread out over better than 30 years, so I have watched attitudes and practices change. My first knee surgey, at age 18, had me admitted to the hospital the night before, kept in bed for 24 hours after surgery, and in the hospital for a few days. That same surgery, if it were done today, would be an outpatient procedure. I have heard some people talk about his as a decline in care, but I see just the opposite. I would rather be home, and I have been impressed in my last 2 surgical experiences, but of which were relatively minor, by the efforts made to accommodate my particular needs and keep me comfortable, rather than carrying on by routine procedure, including making sure they kept a blanket over my arthritic shoulder in the cold OR even though I was going to be asleep. It is not that surgical teams in the past were uncaring, but that they did not really engage with me as an individual, seeming a bit disconcerted when I, having had a spinal instead of a general anesthetic, was awake and talking to them in the recovery room.
It may be a difference in provider, rather than the general attitude in the medical community. All of my recent procedures have been done through Kaiser, and the earlier procedures were private practice doctor and hospitals. If it is a feature of Kaiser’s corporate culture, I have to say it is a positive one, and I have found the integration of care I get at Kaiser to be superior to that I have gotten from stand-alone physicians, no matter how good the individual physician I have had in the past.