Thursday, February 19, 2009

The results are in...

Katie's biopsy results came in last week. Over the phone the nurse told us that the results showed a benign growth, but that an appointment with our doctor would be needed for further discussion. So I pretty much knew what was coming when we got to the ENT's office this afternoon.

I guess I haven't previously posted what's going on with her. She had a red bump appear on the side of her face in early November... her pediatrician noticed it and asked about it. I had seen it too, and assumed it was a pimple or bug bite. Then I noticed a small black "spot" in the center of it - barely a speck. December was a whirlwind, but I noted that the bump began to change, turning purplish-red. The pediatrician put her on antibiotics to get rid of whatever the culprit was (and at the same time kill the strep she was in that month for). Late December came and the bump was more pronounced and the pediatricians referred us to an ENT. The ENT took one look and sent us for a biopsy - he said he frankly had no idea what it was.

The good news is that the infected-looking nodule on the side of Katie's face is not malignant, however it is a tumor. They suspect it's a case of pilomatrixoma, a tumor "composed of cells resembling those of the hair matrix, which undergo 'mummification' and may calcify." It doesn't look quite like what our doctor has seen and it's developed rather quickly, but he's young, so I take that with a grain of salt. I'm beginning to get used to being the screwballs with the "rare" presenting case.

Dr. Sally was wonderful in talking to us at a level that was over her head when needed, but at her level for what she needed to know. He made one fatal error though - he said "operation" instead of "excision" at one point in the conversation. Katie was a ball of nerves from that point on, breaking down into tears the moment he left the room.

I don't think any kids are thrilled about the prospect of an operation, even a "minor" one such as this. Katie, however, is terrified of them. One has to remember her short little life's experiences with operations and the scars they left, the stress on the person and those around them, etc.

As a parent one never knows the right way to comfort kids. In this case, I just let go and let her get it out. We've been talking about it all night. Really, it's not a major surgery - it's minor in the grand scheme of all thing surgical. In fact, I'm thinking it might be outpatient, but I'm unsure as it does require full anesthesia. But for Katie it's scary as hell, so I'm working on validating her feelings but at the same time educating her on what, exactly, will happen and how very different it is from her frames of reference. I'm sure to screw her up somehow, but I hope it's not on this one.

I think I need to sell our story. Our freaky health cases are at least good enough for an episode or two (or three) of House.

OK my medical-world friends, I have a quest for you. I asked the doc where the best place to go for her surgery was, and he said it didn't matter, anyone could do this - scarring would occur no matter who does it, but it will be a small one (1 inch or so I think). Still, I've learned not to trust doctors on their referrals or lack thereof. I trust my friends who've been through these things much more. Suggestions? Anywhere/one I should avoid?


  1. Kristin2:11 PM

    Dessert at Cracker Barrel? That baby needs to gain weight ;) Call me.

  2. Hey Kim

    Wow lady, nothing crazy passes you by huh? I read your post to Michael and he had some suggestions - namely, to go to a pediatric dermatologist at a children's hospital (of course we love DC children's, but know there are others ... he's interrupting to me that he doesn't recommend Kings' Daughters for derm issues). He thinks you should take the slides from the biopsy with you where ever you go. And e thinks the answer you were given, that anyone can "cut" on a child's face is (I'm searching for a nice word here to insert in place of his) ridiculous. While it probably will scar, there are people who are trained to minimize that. The dermatologist will be able to recommend a good plastic surgeon to close the incision (excision). Michael thinks that the skill of the surgeon actually does matter in this case. We do have the name of the dermatologist at DC if you want it. I know this is only one opinion, but apparently he feels very strongly about this! {I was just the stenographer for that paragraph, sorry!}

    From a mom's perspective, I'm just sending you big hugs. I'm sure this is amazing difficult for Katie, but also for you. Nothing like reliving and revisiting old scars. I have confidence that you will get her through this with flying colors.

    Lots of love,

  3. Anonymous12:06 PM

    My goodness - you guys are really being bombarded. I hope everything goes well - and pray for a respite from all the health challenges for you :-D

  4. I agree with Josie (and Michael) on this one. I will say that a plastic surgeon at DC Children's (one I didn't particularly like and I'll tell you who in person) removed Harlie's skin tags on both sides of her face when she was just one month old. She has some scarring on both sides and some "puckering" from the skin being pulled together - I'm assuming too tight??? Anyway, I think it most certainly matters who does the "operation" as well. And I plan on asking her plastic surgeon at King's Daughters to see if he can fix the scarring on her face later. So, I second Josie - talk to a dermatologist and look around to find a surgeon that you feel comfortable with. We can talk more later and I can give you some names... Hang in there!