Monday, June 1, 2009

Life in Plastic, It's Fantastic - Part II

Met Dr. T. today. He was younger and cuter than his picture suggested. Also friendlier than I expected. He sort of sprawled casually in his rolling chair and smiled occasionally and nodded when I spoke like he was really listening to me.

He looked at my arm and messed with the scar and gave me two options:

A) steroid injection that would help to flatten the raised area of the skin, but would leave everything else (discoloration, that awful texture, and the zig-zag shape) just as it is.

B) surgery that would actually removed the raised, scarred part of my skin and then stitch my arm back together leaving a smaller, neater, and straighter scar.

Or a combo-pack -- start with the injection and then see how it looks and determine whether I want surgery.

A few things to consider:
- option A it could require a series of injections, resulting in visits every couple of months indefinitely
- the injections are extremely painful (needle phobia notwithstanding)
- my insurance should cover 80% of the cost of either option once I meet my deductible ($350)
- option B's surgery would be an out-patient procedure lasting about an hour with the recovery time (and pain) being fairly minimal -- he said I'd be back to my regular routine (not counting exercise) in a few days

I originally planned to have the injection today and then wait and see how it looked before deciding on surgery. But as D and I talked it over, both he and Dr. T. seemed to be leaning toward surgery (he essentially said that was what he would do if it were his arm). I figured that the doctor was a surgeon so of course he wants to do surgery. But D made the point that surgery would be a one time deal and then it would be over and I could forget about it instead of trying to decide whether I wanted to try another injection. Cosmetically speaking, the doctor was certain that surgery would be a far greater improvement in the way my arm looks, and by removing the scar it would also get rid of any annoying little physical symptoms -- itching, tightness, tenderness.

So when Dr. T came back in, ready to give the injection, I was all, "Um, I think I might be reconsidering," and he was like, "Oh, that's ok! You're allowed to do that!"

I'm worried about how much 20% of a plastic surgery might cost but D's response was that we've already spent hundreds of dollars on treatment and doctor visits. We might as well fix it for good.

But surgery freaks me out almost as much as a painful needle (and I don't know what this business about "air" was because the needle the nurse brought into the room was as much a needle as any other I've seen). I don't know if it would be worth having the injection done first or not.

As the doctor said, if I think I want the surgery, having the injection is pointless because the entire scar will be removed. So I asked him if it was so painful that if I think that surgery is a definite possibility, I wouldn't want to go ahead and have the injection just to see what happened. He said "Well, I've never had it myself. But from other patients... and what you've said about how you do with needles..." But really he seemed convinced that the injection wouldn't actually change the appearance of my scar all that significantly -- flatter, yes, but not much prettier.

I didn't know what to do and if D had told me to just get the steroid injection right then, I probably would have done it. Instead I left, feeling like I had chickened out and not knowing what I want to do.

I have time to decide of course. I can schedule the surgery and if I change my mind and want the steroid injection I can do that instead. I just don't know which decision will make me feel better.

Basically, I don't want to regret not having the surgery if the injection doesn't improve the look of my scar. I don't want to go through the pain of the injection and delay the surgery further if the steroid isn't going to improve the look of my scar very much. At the same time, I hate the idea of having unnecessary plastic surgery, although I would like to wear sleeveless shirts and not have strangers ask what happened to my arm. I'm just not sure what the ideal scenario is. (Besides a time-warp in which I go back to November and don't spill freaking hot tea on my arm like a clumsy fool.)

[OK seriously. How bad is it? If it were your arm? Would you want to look at that everyday? To surgically remove or to simply inject with steroids, that is the question.]

So what do I do? I am considering another side-bar survey in which blog readers can vote anonymously. Am not sure that is the best way to make health-care decisions, but please feel free to voice your opinion in the comments.

7 comments:

  1. I would have the surgery. I think you've grown kind of immune to how the scar looks - it looks gruesome to me. I guess another option would be to get a tattoo over it. :)

    ReplyDelete
  2. I would just come up with a better story to tell strangers who ask about it.

    ReplyDelete
  3. The scar kind of looks like a dinosaur. It might even be a Velociraptor. I can see it running around your arm. Haven would be in awe by your tattoo.

    Maybe you should have the surgery.

    ReplyDelete
  4. Surgery. First and strongest instinct...I didn't even consider the injection. But...it's you, not me:) Surgery.

    ReplyDelete
  5. Uncle Dean is right, by the way. It TOTALLY looks like a dino.

    ReplyDelete
  6. Scott says "Eww, that is a nasty scar." And we both say do the surgery.

    Your insurance might have a cap. With my insurance, we pay the deductible, then pay 20% up to $1000, then the insurance covers the rest 100%. (Found all this out at my second prenatal visit). You might ask, it might not be too bad.

    But seriously, that scar is gross. :)

    ReplyDelete
  7. Ultimately you have to live with it, no one else. If you can deal with surgery and want it gone, then go for it.

    ReplyDelete