Tattoos and New Years Resolutions

Good news and bad news.

This statement is both.

TATTOOS HURT!!!!

I just had to say that.
One would think the fact that if I close my eyes I can't tell if someone is touching my chest, I wouldn't have PAIN! Of course, if you remember my story of having nipple reconstruction done without sedation or general anesthesia, you know that this is something we already discovered. Still, it came as a surprise to me just how very much I could feel. Not pleasant at all.

I did opt for local anesthesia and I am so glad I did. It STILL hurt in certain areas and it certainly did sting as the local was being infiltrated. What amazed me was that it not only hurt while the tattoos were being done, my pseudo-breasts hurt afterwards. I was sore for the remainder of the day and into the night. I suppose I could have taken a Tylenol or something stronger, but it was nothing compared to the post-op pain I've had with other procedures. Plus there was something odd and bizarre about the fact that I was experiencing discomfort in an area where I allegedly don't have feeling.

Now, more good news.

I cannot even begin to explain how real these things look. If you are a breast reconstruction patient and haven't had this done yet or have been putting it off, it is SO worth having done. Even if you don't have nipples. It's been a day and I can already say that those huge long mastectomy scars that run across each "foob" and into my side on each side are much less noticable. The eye just doesn't go there. It's amazing. I realize the color will fade, but even the color they are now is OK. They used a base coat of one color (flesh 4, I believe) and then added several other colors to make them look natural (I know brick red, chocolate brown and some kind of pink were used). Simply amazing. It's that something out of nothing bit again. Amazing.

I'm really hoping this takes. There's a small percentage of people who end up with the color rapidly fading due to mast cell activity. Knowing that I do tend to be an allergic type person, I'm hoping I'm not in that percentage. I don't want to do this again. Don't want to even need a touch up. I am so very much done with procedures and surgery. My number one personal New Year's resolution is "SURGERY FREE IN 2008!" I will gladly perform any and all surgeries on other people. I am just not planning on having anything done in 2008... and maybe even never again. Never is a very long time though. I'll take it in smaller steps. I know I made need some revisions and certainly, the implants may very well need replacing someday. In the meantime, I just want to finish healing both these tattoos and my blasted toe.

Surgery free. I like the sound of that.

Another Day, Another Doctor

I think I much prefer having my appointments more spread out than this.

Yesterday's issues have been resolved. My normal podiatrist called me back, told me he would address the issue and told me there would be no charge for the visit. I have an appointment to see him after the new year.

Today is something different though.

Today is TATTOO day!!

I never in my wildest dreams imagined I'd have tattoos. Granted there is nothing exotic or creative about these tattoos. That's really just fine. I've known for a very long time that anything I'd choose to put on my body would be something that I would hate eventually. I change my mind and my tastes far too much!

It's kind of funny. I've had the reconstructed nipples now for 5 months. I've gotten used to them. Now, with the tattoos, I'll be getting areolas and color. So bizarre when you think about it. Just like when the nipples where made back in July.

I admit I'm a tiny bit nervous about the whole thing. Not too nervous though because, unlike your regular tattoo parlor and even unlike the other breast reconstruction plastic surgeon in the office, my doc uses a local anesthetic! I know, I know.. I allegedly have no feeling. But that's not the reality. We learned when I had the nipple reconstruction that I actually DO have feeling, especially on the right side. Ouch! I felt the needle for the local go in on both sides, it only hurt on the one side... and that was 5 months ago. I didn't get to watch that procedure though. I was draped and prepped in the usual sterile fashion (that's a dictation phrase every surgeon and many medical transcriptionists will recognize LOL). I wonder if I'll get to watch this. Rachel is accompanying me and is hoping that at least she will get to watch!

My appointment is at 11 am today. I totally forgot to ask how long it should take. I'm thinking we'll have to go out to lunch afterwards. :) What a long way we have come, my little girl and I. It really wasn't all that long ago, spring 2006, when we went out for lunch after that drastic hair cutting session. I remember asking her about a million times if the wig was still on straight. I was so self conscious that first outting. I was so self conscious everytime I wore it those first few weeks. Funny how things change, because at the end, I was self conscious when I DIDN'T wear it! LOL! I also remember the tears. I really held myself together and didn't cry when my hair was cut down to nothing. We were actually laughing and having fun. The tears came later. No tears today! They actually came yesterday. I'm tired of dealing with the aftermath of cancer, but glad I am around to do so.

Please and Thank you or IT'S IN THE CHART!

In the last year and a half, I've spent far more time than I ever envisioned I would on the other side of the proverbial (or not so proverbial) exam table.



There are some (and these people annoy me endlessly) who say I'm going to be a better physician as a result from what I've learned by being a cancer patient. Hate to disappoint those folks (NOT) but what did or did not make me a good physician has not changed. And, saying something like that implies you know something about the type of care I provided in the past. I've not ever heard someone who actually knows that first or even third hand say something like that. I think what might have changed is my level of tolerance. I have absolutely no tolerance for substandard medical care of any sort.



Can you tell I had a medical appointment today? LOL



Today's appointment is reminiscent of when one of the ob/gyn residents made rounds on me when I was in the hospital last fall after my marathon surgery (a little review for those that might not know or remember... I had a bilateral mastectomy, tissue expander placement, port removal, and bilateral salpingo-oophorectomy... and a few other smaller procedures). It was so obvious that this resident did not bother reading my chart before he walked into the room. He clearly had NO idea what specific surgeries I had and by what approach. This was the very next morning after the surgery. Not a time when I was up for teaching, but I moved into that mode very quickly.



This may come as a shock to some, but there is actually a reason, aside from insurance requirements and possible lawsuits, why we keep medical charts in the first place. {warning: I'm feeling the sarcasm come on}. Did you know that physicians actually kept records BEFORE there ever were insurance companies in the first place? :P This is so very basic, but the first thing you do, before you even enter the room, is you read the chart. It's like a good book. There's so much information and background in there. It's why we, as patients, fill out all those forms. As a physician, I respect the time someone spends filling them out. I still ask the questions though because I often get more tidbits of relevant info. When I am a patient, I expect the same courtesy. Not only is there important information in there that the patient has written, but you can {more sarcasm} actually find out what the previous physicians have found/prescribed/thought/planned, etc. If, perchance, one does not look at the chart before entering the room, one looks at it after introducing oneself to the patient. It's like saying please and thank you. It's basic, basic, basic.



So, that's what happened again today. When it happened with that resident, he obviously reported it to his superiors (I would not let him take off a dressing because I DIDN'T HAVE ONE TO TAKE OFF!!!! LOL). He must have been a good guy because he let them know that I was not pleased and why. I first explained that he needed to read ANY chart before he walked into a room, no matter what his superiors told him to do. I also explained that I understood the pressure to get everything done as I had been an ob/gyn resident at the same hospital, but that not looking at the chart is inexcusable and something someone should have told him long before. I rarely ever pull the doctor card, but when I am complaining about medical care I think it shows where I am coming from. I used to be involved in teaching students and residents, but I am not now. Honestly, I think this is the sort of thing, like please and thank you, that should not have to be taught at this level.



Today, however, I was not seeing a resident. I went to see a podiatrist, someone who has been out of training at least as long as I have. I did not see the podiatrist I normally see. Instead, I saw his partner. When I am seeing a practicing medical provider of any sort, I have basic expectations. If it is the first time I am seeing you, I expect you to introduce yourself and I expect you to read my chart. "Have I seen you before?" is not usually a question for the patient, but if it is, and the answer ends up being "no," that's your cue to LOOK AT THE CHART. Sadly, I am no longer an uncomplicated early 40-something with a single straight forward problem. I have a nice little problem list. You should be aware of that when you speak to me about my medical issue, ideally before you even enter the room. I do not expect to have to give you a full detailed history in the middle of the appointment or even at the end of the appointment because a) IT'S IN THE CHART and b) IT'S IN THE CHART. Your opinion becomes worthless if you don't know my medical history and current medical problems. You just wasted my time and my money. Maybe. I've already complained to the office about this and do not plan to pay for an appointment where not only was nothing done, but the advice given did not apply to situation.

Totally ruined my day.

And, it reminded me why I stick to physicians who come recommended by other healthcare professionals. This is not the first time I've seen a partner who was not up to snuff. It shouldn't have to be this way. As I mentioned before, when I am in the patient role, I don't bring up the doctor card. I expect the same care as anyone else. Days like this make me wonder though. This office clearly does not realize I'm a physician (even though IT'S IN THE CHART, lol) but maybe they should. Maybe I need to give my name as Dr. Ackerman and sign in that way. It should not have to be that way... and it won't be. I will not see this podiatrist again. I'll stick to the one that actually looks at the chart.

Am I too picky? Are my standards too high? I don't think so.

The drama of December

Wow. Blog much? I guess I don't! LOL.

So much going on. Lots of running around. All things that were definitely more difficult for me at this time last year, even though I didn't want to admit that at the time. I much prefer being further away from treatment (shh... yes, I am still being treated but taking a pill everyday has become routine).

I never shared the results of haircut number two. I think I can safely say that the chemocurl is gone now. I still have curlier hair, it's just not those tight curls I had before. I think I was always fighting my curls in the world before chemo. I definitely had wavy hair, but I was always trying to get it to be somewhat straight. Now, I treat it like curly hair, I don't brush it and I use those shampoos and products for curly hair. Who knew? LOL.

And since a post like this deserves a photo

This was taken at the end of November, just after haircut number 2. This is my friend Nancy, one of my college roomies. She and her girls came up for the Princeton-RPI hockey game. We went to RPI, who happened to win the game. :) I am extremely proud of Nancy, who looks lost in that sweatshirt... something that fit her a year or so ago. She will be featured in the March issue of the magazine put out by Curves for it's members. Over the course of about 2 years, she has lost 200 lbs through diet and exercise alone. That's right, diet and exercise alone! And a good measure of persistence. I've known her for over half my life and never would have recognized her without her kids. She sounds the same and her eyes are the same, but that's about it. The last time we saw each other was just shortly before my diagnosis and when she was at about the halfway point, so we were both new women in one way or another. I'm also going to point out that I actually fit into my old band shirt from college. :P

And because our girls always reunite as if they had just seen each other the day before instead of a year or two before, here's a photo of the whole gang minus dh, who took the photo. That's 11 yo Nikki, not yet 11 yo Rachel (she has another 3 months to go), and 13 yo Emily. While they were visiting, we went through some old scrapbooks, going all the way back to March 1 1997, when Rachel was still in utero (for 5 more days).

I did title this the drama of December. There has been a lot of drama lately. Fortunately, it's all just life with a tween. In the last week, we've had 5 performances and countless rehearsals of the Nutcracker (almost, still 2 school performances to go today), There was a band concert on her only night off from dance where Rachel forgot her flute (don't even go there... it was the first event that Howie could attend in sometime and he rushed the 45 minutes to home to get her flute, but arrived moments too late). Some little dramas at school, mostly involving hating gym. Nothing too huge. Just enough to make me excited for winter break!

My own little drama is going quite smoothly at the moment. I am getting my tattoos, the last stage in my breast reconstruction, on Dec 20. Picking the color was rather anticlimatic. I am so very pale, that there were really only two possible choices of colors. The surgeon had a card with areaola colors grouped by skin color. He held the card up and the choice was obvious. Of course, reconstruction is not a static event. There may be revisions and I may need the actual implants replaced someday. The tattoos may also need some touching up in the future. But for now, this is it for me. I've had enough.