Unjustified hand-wringing.

[rivka]

Here's the thing. If you've been paying no attention to a potential health problem for some time, even though you are a health care provider and should know better, you have no justification for complaint if it takes you five weeks to get in to see a specialist. Because you could've gone to the doctor five weeks ago, and then you'd be seeing the specialist now.


By "you," of course, I mean "me."

I am not worried about basal cell carcinoma. Historical evidence documents that I am not: if I were worried about it, I would have gone to the doctor immediately several months ago when I first looked up information about BCC in conjunction with the small, shiny, firm pink bump on the rim of my nose, and found that it seemed to be a pretty good fit. But instead, I came away with the impression that BCC was a more or less benign and slow-moving condition, and put off making an appointment.

If I were worried about it, the couple of times I tried making a call to my doctor and got her answering machine would not have deterred me. I would've left a message and had them call me back for an appointment, instead of putting it off for the next time it crossed my mind, a few weeks later.

I saw my doctor today, mostly for another reason: a hard bump on the skin of my breast, which appeared six weeks ago and hasn't gone away. She said it's a cyst - it might go away on its own, but she gave me a prescription for antibiotics in case it doesn't. I also asked her to look at the bump on my nose. One quick glance and she said, "that's got to be looked at."
"Dermatologist?" I asked.
"Let's send you right to a plastic surgeon," she said, "because that way you won't have to wait if it needs to come off."
I said, "I'm afraid it's a basal cell carcinoma."
"Let's just get it looked at."
"what else could it be?"
"It could also be a cyst. Don't worry about it."

It's not very much like the other thing she said was a cyst. But I'm clearly not worried about BCC, because if I were, I would have aggressively pursued having it diagnosed when it first became clear to me that this thing on my nose was (a) not a pimple, and (b) not a manifestation of my rosacea. Which, I am embarrassed to say, was months and months ago.

There is no reason why I should worry more between now and September 18th than I did last March, or April, or June.

None.

The Merck manual says:

The clinical presentation and biologic behavior of basal cell carcinomas are highly variable. They may appear as small, shiny, firm, almost translucent nodules; ulcerated, crusted lesions; flat, scar-like indurated plaques; or lesions difficult to differentiate from psoriasis or localized dermatitis. Most commonly the carcinoma begins as a small shiny papule, enlarges slowly, and, after a few months, shows a shiny, pearly border with prominent engorged vessels (telangiectases) on the surface, and a central dell or ulcer. Recurrent crusting or bleeding is not unusual, and the lesion continues to enlarge slowly. It is common for basal cell carcinomas to alternately crust and heal, which may decrease the concern of both patient and doctor about the importance of the lesion. Basal cell carcinomas rarely metastasize but may be very destructive by invading normal tissues. Rarely, death may insue because the basal cell carcinoma invades or impinges on underlying vital structures or orifices (eyes, ears, mouth, bone, dura matter). Because of the highly variable appearance of basal cell carcinoma, the differential diagnosis is extensive.

Okay. Because I am not worried, and don't want to become so, I'm not going to read any more about it. Most particularly, I am not going to look at any more pictures. Most of the pictures on medical sites are much scarier-looking than this thing on my nose, and it's pointlessly worrying of me to look at them. Because I'm not worried.

Comments

[rivka.livejournal.com]

what they said. BTDT, got the tshirt last spring. The scar I have from the excision is (IMHO) worse looking than the oddly fungus-y looking lesion which was invisible to anyone else. My internist did the same thing: "we'll have you see a specialist" and then the specialist couldn't see me for 6 weeks, and then I was too sick to keep that appointment and it was 2 more months before it was "seen."

It's very helpful to hear this, especially since it all sounds so non-dramatic. Thanks.

I think Drs. just jump a little faster when it's on the face, since that area has more exposure to the sun (and other elements) than any other area.

That would be consistent with something else she said, yeah.