Just finished a tricky procedure.

[Aristus]

Had a patient with a facial skin lesion he wanted excised. It was pretty close to the transverse facial artery, so I didn't want to tempt the beast. OTOH, it was a pretty prominent lesion. I know how badly he wanted it off.

I excised it pretty thoroughly; the pathologist will like what a nice specimen I sent him.

No spurting artery as I had been fearing. But there was some subcutaneous fat that had to be cut away. The more I got rid of, the surer I was that sooner or later, I was going to nick that artery.

Finished up. No problem. But I had been worrying about it all day...

[2naSalit]

1. Kudos.

Not many think about what the doctor goes through outside of the actual interaction. Glad your fears weren't realized.

[CaliforniaPeggy]

2. Worrying means that you're in touch with reality, my dear Aristus!

And the more in touch with reality you are, the better the chance that you won't mess up.

[Aristus]

3. I palpated the left transverse facial artery before the procedure.

The pulsation was very faint, indicating sufficient depth that excising a cutaneous lesion wouldn't cause problems. But it's the complication you didn't plan for that is the one that presents.

All in all, not bad. I predict a biopsy result of benign dermal lesion.

[Ms. Toad]

11. Hope you're right.

The last excision I had done turned out to be a sarcoma. I believed it was cancerous and the resident and the dermatologist believed was benign (specifically, they expected it to be another dermatofibroma - like the 3 prior excisions in that location). They were humoring me by excising it at all.

Oops. That's literally the descriptor give to the accidental excision of a sarcoma before evaluation.

Hope your luck and inutition are better than theirs!

[MOMFUDSKI]

4. Question

My husband had melanoma about 10 years ago on his back. They told him to tell all of his siblings because they had a greater chance of getting it themselves. So now his brother had a thingy removed that they said was PRE-MELANOMA and that PRE comes in 3 stages: low, medium, high and that his was in the high range. So did he have melanoma or not? He is a little doofy to talk to. Thanks

[Aristus]

5. You might get a better-informed answer from a dermatologist.

If a patient comes in with suspected basal or squamous-cell carcinoma, I excise the lesion, biopsy it, then refer to dermatology if appropriate. If a patient comes in with suspected melanoma, I just put in an urgent referral to derm, and call for an immediate appointment.

Staging melanoma is something I have no experience with.

[MOMFUDSKI]

6. Thanks for the answer

What field is it that you work in?

[Aristus]

7. Primary Care with a focus on Healthcare for the Homeless.

n/t

[momta]

8. I would say you're doing "God's work" but...

I'm an atheist. So I'll just say THANK YOU for what you do.

[KPN]

15. I second that! Definitely "God's work". We have so

many genuinely good people in our party. I think it’s part of what keeps us going — our fuel, so to speak.

[MOMFUDSKI]

16. Good for you

on helping the homeless. That is special.

[TygrBright]

9. Good for you, congrats! n/t

[3Hotdogs]

10. My dentist, when something was going wrong,

he would start humming to himself.


At that time, he was about a year out of dental school and a bit unsure of himself. My teeth were in rough shape from years of neglect and there was frequent humming.

[Stuart G]

12. Great Job...Great Post...Thank You for Sharing ...K and R

[Stuart G]

13. Just so you know...My Dentist Saved My Life..Found Cancer on My Tongue...in 2005...

3 mouth surgeries in a year........and..........I am still here...What do you know?...

........Thank You For Your Work...Yes,......... Dentists Save Lives!!!!.


.........................Now everyone knows.....

[Aristus]

14. I'm not a dentist, but okay.

Sounds like you had a good one.

[Stuart G]

17. Sorry, Guess you are an MD.. ...like the guy who saved my life...Thank You...

...not sure... ...Ears, Nose and Throat Doctor...??...Thank You for your work,
and the lives you save....sorry I got that wrong....ain't the first time I got something wrong, & won't be the last..

[Aristus]

19. I'm a Physician Assistant, not an MD.

[TexasBushwhacker]

18. One of the reasons that getting at least an annual check up

and cleaning is important.

[BobTheSubgenius]

20. Congratulations!

I can never find the right words to express the admiration I feel for good, caring doctors. What a vast skillset a physician has to have at their disposal.

[Aristus]

21. Physician Assistant, but thank you.

[BobTheSubgenius]

22. Well, it goes without saying that you are part of the team.

And you obviously have a tremendous skillset of your own. I'll amend my previous answer to read "healer." I've had enough encounters with the medical community over the last 10 years to have a deep appreciation of the entire team's dedication, knowledge and compassion, top to bottom.