A Bit Of A Nose Job

Last night (actually it was the early hours of this morning) I was unable to sleep so I was sitting at the computer drafting a post for this blog (I haven't finished it yet, but will probably do so tonight or tomorrow) when I remembered that I needed to make an appointment to see my GP because the results of my ambulatory blood pressure test were in. So I logged into the website to see if there were any appointments available and while I was there I happened to look at the 'Letters' section of my medical records and saw that a fax had been scanned in relating to my referral under the 'two week rule'. Opening this item I was horrified to see that the hospital appointment was this morning and had I not yet received a letter from the hospital informing me of this fact.

So, it was a change of plans for today and a trip to the hospital to see the consultant dermatologist for him to have a look at the area on my nose that has been causing me so much trouble over the last couple of months. I arrived early (I always do, I am a bit of an early freak) and as luck would have it I was taken into the consulting room at least 20 minutes before my appointment time. I sat there for a couple of minutes and then the consultant arrived with his SHO and he took the usual history; illnesses, medication that I am taking, how long had I been troubled by this strange area on my nose. Then it was onto the examination couch for him to have a look at it under magnification and to prod it and stretch it and generally have a good feel at it.

The diagnosis? Probably a basal cell carcinoma. Then he made a small mark on my nose and told the SHO that he wanted a biopsy taken and that I should go back to see him in three weeks. After that I was escorted to the operating theatre and the biopsy was done. There was the usual briefing about what exactly was going to happen, I was made comfortable on the operating couch, and asked to sign the consent form. This was the first problem. I had taken my glasses off and put them in my handbag before getting on to the couch and now I couldn't see where I needed to sign on the form. So the very nice SHO pointed me in the right direction on the form and I scribbled something that experience tells me was probably a pretty good attempt at my signature.

Then I was covered with some towels to ensure that my clothes would not be covered in blood and told that the local anaesthetic was to be administered. The area where the biopsy was to be taken was very near my left eye and it was suggested that because of the bright lights that would be shining on the area I might like to close my eyes. I was going to do exactly that anyway because there was no way that I was going to watch a needle approaching my eye; I'm afraid that I am not very good when it comes to injections of any sort and local anaesthetics in particular. There is no doubt that this injection was the most painful part of the whole procedure, for after a few minutes the area was completely numb and tests to see whether I could feel anything sharp touching the area showed that the anaesthetic had done its job. The biopsy was taken and then it was a case of trying to stop some of the bleeding sufficiently for a stitch to be inserted. I take aspirin every day because I have an unusual form of angina and this means that it can be quite difficult to stop bleeding sometimes, and today was one of those occasions.

Eventually the flow slowed enough for the stitch to be put in place, with some difficulty because of the strange location of the offending area, some antibiotic gel was placed on the wound and I was finished. There was the offer of a plaster to put on the wound but I declined until I tried to put my glasses on and found that even with the effects of the local anaesthetic still present I could feel that this was not going to be easy. So, the decision was made that a plaster would be necessary, but again because of the position of the wound and its proximity to my eye, some surgery would be necessary on the plaster to enable it to cover the wound but at the same time make sure that it did not affect my eye. Then it was off to the reception desk to hand in the paperwork about my follow-up appointment, the letter for which will be sent to me soon (I hope).

It is now some hours since the procedure was carried out and the effects of the anaesthetic have worn off and the wound is now giving me some pain. I've taken paracetamol for the pain, as instructed, I've made an appointment with the practice nurse to have the stitch removed next Thursday, and I am hoping that I can manage to get some sleep tonight to make up for all that I missed last night.

Because I had not received the letter from the hospital telling me about my appointment, in the normal course of events I would have missed it and been marked as a 'did not attend'. The fact that I have online access to my GP medical records meant that I found out about the appointment in time to be able to attend, so the hospital's time was not wasted in me not turning up and becoming an addition to the statistics of 'no shows'. This means that I will have another example of the benefits of online record access when I give my next presentation.

About an hour and a half after I got back home from the hospital the postman delivered a letter. Yes, you've guessed. It was the letter giving me details of my appointment.