Medical musings

If not for the priceless blog fodder, I’d be pretty steamed after my visit to my dermatologist yesterday. I’m ever so grateful for my sense of humor, especially after last week’s doctor’s appointment on a day that went from bad to worse to are you freakin’ kidding me??

My dermatologist is lucky I have this little blog as my outlet for all the things I’m compelled to rant about, to rail against, to bitch & moan about in general.

A little background: she’s a fantastic doctor. She embodies many of the traits I’ve come to appreciate and insist upon while spending time in an exam room. She’s punctual, no-nonsense, very thorough, and more than ready with the prescription pad. Her office is staffed by all women, with nary a male doc in sight, which thrills me to my feminist bones.

She is, however, not going to win a prize for compassionate bedside manner. She is not the most compassionate doctor I’ve ever met, and this was on full display yesterday.

Perhaps it’s my bad for scheduling a first-thing-Monday-morning appointment. Maybe she had not had her RDA of caffeine. It’s possible that her personality pills had yet to kick in at that early hour. Whatever the reason, she didn’t waste any time with pleasantries. I’m cool with that, and as much as I enjoy having a comfy relationship with my health-care practitioners (especially those who see me naked), I’m good with the all-business appointment that gets me out of there and on with my life.

I sat on the paper-covered exam table in my thin paper gown precariously close to shivering — yes, people, a temperature of 52 degrees in South Texas does count as c-o-l-d, and I’m aware of the fact that 52 degrees could be considered a heat wave in some parts of the country at this time of year. I was awaiting my doctor to come in and do my annual mole check. Because I had melanoma several years ago, I take my mole checks very seriously, and as much as I hate stripping down to have every inch of my flesh examined, it’s a necessary evil and one I never skip out on.

My melanoma showed up on the inside of my right foot, on perhaps the one and only body part without any excess flesh. A number of specialists were consulted on how best to excise the infested tissue in such a delicate area. Opening the area and excising the melanoma weren’t the problem, but closing the incision was. Little did I know that that experience would be the first of many “think of the most complicated scenario” scenarios in which I would find myself. Post-mastectomy mycobacterium, anyone? In case you’re wondering, the solution to the flesh-less foot melanoma was Mohs surgery in which the surgeon used a zig-zag shaped incision to allow him to close that incision with limited flesh upon which to draw together. I have a now-faded zig-zag scar that predates Harry Potter’s lightning bolt on his forehead. I had a lightning bolt scar before lightning bolt scars were cool.

Anyhoo, back to my terse and not-so-warm-and-fuzzy dermatologist. The first thing she said when she walked into the exam room was, “What are you doing about your rosacea?”

Um, I didn’t know I had rosacea. My face gets red when I exercise and when it’s cold outside — and again, 52 degrees does count as cold — but I certainly have never had the bright red spots that I associate with rosacea. Great, now I’m feeling self-conscious.

I asked her what she thinks I should do about my rosacea (and I want extra credit for not asking it in a smart-assy way; I mean, she is the doctor, after all). She shrugged and said there aren’t any creams on the market that really help, although there are a couple in FDA testing that should be available in a few years. Meanwhile, she thinks I should go for several laser treatments, which start at $600. Out of pocket, I’m sure. She suggested that I figure out what my triggers are and avoid them. Since she didn’t go into any detail on the common triggers, I looked them up myself and found that they include stress (not gonna get away from that one anytime soon), spicy food (I do like my jalapenos and Frank’s Hot Sauce; I put that beep on everything!), hot beverages (I’m a two-cup-a-day coffee girl), sun exposure (did I mention I live in South Texas?), exertion in hot weather (again, South Texas), oral antibiotics (so I’m guessing that 267 days of two different oral abx would factor in here), and drumroll please…the last trigger for rosacea is…alcoholic beverages.

Ok, I’m out. I’ll just have to figure out a way to live with my extra-rosy cheeks because every item on the list is a factor, but the last one is a deal-breaker.

Moving along, she examined me and made notes of the normal-looking moles scattered here & there on my body. Because of being inducted into the pink ribbon club, I’ve spent plenty of time mostly naked in doctors’ offices. I’ve had my flesh poked & prodded and examined quite intently enough times that I don’t even think twice about it; in fact, I got so used to the weekly follow-up exams after the mastectomy, the multiple surgeries to rid my chest wall of the mycobacterium, and then the Big Dig reconstruction that it seemed weird to not take off my clothes at the doctor’s office.

However, none of my previous time spent in my birthday suit with a doctor prepared me for her question: Why did you have a mastectomy?

Ummmmm, because I had breast cancer?

Why else do women undergo such a physically and emotionally taxing surgery? What kind of question is that???

I wondered for a sec if I’d heard her right, then answered “Ummmmm, because I had breast cancer.”

She then wanted to know why I had a bilateral mastectomy; was the cancer in both breasts? I replied no, at least not that was detected by the multiple mammograms, bone scan, or PET scan, but that was the right decision for me. Once I heard I had breast cancer, I took a slash-and-burn approach. Good thing, too, because my post-mastectomy pathology showed a large and scary smattering of micro-mets that were likely just waiting to organize into a full-blown tumor, with a bonus of Paget Disease to boot.

She complimented my reconstruction and said it looks good, that they see a lot of it, and mine is better than most. I replied that I was very fortunate to have such skilled surgeons, yadda yadda. It never seems like the right time to mention that while my surgeons did an incredible job with my reconstruction (especially considering how wrecked my right chest wall was after the infection), it’s still reconstruction, and I was perfectly happy with my breast before I had to have them chopped off and rebuilt using another body part. It never seems appropriate to talk about how the reconstruction restored some mass to my previously scooped-out chest, but it’s not the same and will never be the same as it was before. I never feel as if the conversation will meander toward the topic of how no matter how skillful the reconstruction, there’s no way to escape the constant and visual reminder that I had cancer. I’ve yet to find a way to say that the myth of getting new boobs after breast cancer is just that, a myth. Yes, they’re new, but they’re not really boobs. I can’t ever figure out how to say that while I’m very grateful to have had access to the best docs in one of the best medical facilities in the world, and yet my reconstruction still leaves me feeling less viable. It’s certainly not considered polite chit-chat to recount how grueling the DIEP surgery is, how precarious the transplanted blood vessels are, how unbearably uncomfortable it was to be in the ICU with heaters blowing to warm those blood vessels, or how the stress of flap-failure can bring on some serious PTSD.

All that from a sincere compliment about my reconstruction. Sheesh, what a head case I’ve become.

Just as I was talking myself down from the myriad ledges my brain landed on and working hard to get back to the present moment, which was a simple mole check, my dermatologist asked another question: Where did they get the flap from for my DIEP? From my belly, I replied, and braced myself for the inevitable comment about how nice it must be to get a “free” tummy tuck. Before she could utter that platitude, I launched into a distrationary tale about how I had to gain weight to create enough belly fat to make a good flap; ha ha ha, I said, it was so funny that I had plenty of fat in my hips & thighs but not in my belly. As I lay on my belly and she examined my back, she asked why they didn’t take it from my back (because apparently there was plenty available, and she was staring right at it). Well, because I didn’t want to lose my tennis serve, I said, resisting the urge to ask for a mirror so I could see just how fat my back is.

The coup de grace, though, came when she said how lots of people probably envied me having to gain weight for the surgery, and then delivered the final crushing blow to my already-battered ego by saying, I guess you’re still working on losing that weight, huh?

Yep. Still working on it.

And I’ll keep working on it. Right after I find a new dermatologist.

I wonder if this guy is still in practice.


Fiat fever!

I’m very fortunate to have a good and generous friend in the car business. Thanks to the Rajah, I have been tooling around town this week in the hottest car to hit the streets in a long time — the Fiat 500C. It’s even better than the <a title="I Fiat 500 I drove a while back.

I am in love. The industry’s talking heads have lots of good things to say about this car, namely that “the cutest car just got cuter” with the addition of the fully-automatic canvas soft top. The 500C is super cute, super fun and super chic. I love every single thing about it, which came as a bit of a surprise for this card-carrying member of the “bigger is better” SUV club. Downsizing from a Tahoe loaded with more features that I even know how to use to a Fiat that could practically fit inside the bed of a pickup truck is extreme. And fantastic. And liberating. Oh so very liberating. 

I’ve had so much fun driving this zippy car. I’ll admit, I just wanted to drive it but wasn’t even considering buying it. My Tahoe is cool and comfy and big enough for a family to live in, but after driving the Fiat I realized the Tahoe is not fun. Or zippy. Or chic. It’s nice looking, luxurious, and functional, but not fun. And don’t we all need more fun in our lives?

I’m not a die-hard convertible lover. Trevor has had several convertibles over the last 15 years, and I have to say I’ve never loved any of them. Every once in a while, on a beautiful day, it’s fun to take his car, but I never wanted a convertible.

Until now.

The Fiat’s 3-way power retractable roof changed my opinion about convertibles.

fiatusa.com

The 2-layer canvas roof is awesome. With the push of a button, you have 3 options for topless excitement: sunroof, in which the top slides back from the windshield; panoramic, in which the top slides back further to open up the roof over the back seat; and the full monty, in which the entire roof folds itself accordian-style into a neat stack above the trunk. This effortless motion is quiet, smooth, and fast. And the best part: you can operate the roof while driving up to 50 mph. If raindrops start falling on your head, no need to pull over to put the top up, just push the button as you keep on truckin’. Multitasking at its finest. The rear window is glass, and it covertly slides out of sight when the roof opens. Another super smart feature is that when the roof is open and you need to access the trunk, the car automatically moves the neatly-folded pile up a bit and out of the way, allowing full access to the trunk. If only everything in life worked that smoothly.

caranddriver.com

Perhaps the best part of the 500C is that when the top is open, the roof rails stay in place. It’s quiet and you’re less exposed to road noise, allowing for normal conversation and stereo volume with much less wind. It’s having your cake and eating it, too: you still get the convertible experience without the wind-blown hair. 

The divided side-view mirror on the driver’s side is nice too. The smaller pane of glass shows a more remote view of the traffic behind, so changing lanes is safer. The specs are in line with what you’d expect from a small, sporty car. The engine is a 4 cylinder, 84 cubic inches (whatever that means). The 16 valve engine has 101 hp. The 6-speed automatic that I’m driving is plenty zippy in the 40 to 50 mph range, which is the majority of my driving. On the highway, you’re not going to win a drag race with a bigger car with a more muscley engine, but you shouldn’t be drag racing on the highway anyway. The top speed is 110 mph, which is plenty fast even on Houston freeways. This little beauty weighs somewhere around 2,550 pounds and I’m no car expert but am guessing its lithe frame accounts for its zippiness. (I think I just made that word up but am granting Fiat full permission to use it in promotional materials.)

It may be small, but it’s safe. With 7 airbags, I feel very secure, and I like that the 500C earned Best in Class for rear seat leg and shoulder room, as well as Best in Class for interior sound quality. Another safety feature is the Blue&Me, Fiat’s collaboration with Microsoft that provides hands-free mobile access in the car. As long as your phone is in the car, whether on the dashboard or in your purse, you can make and receive calls using the in-vehicle, voice-activated Blue&Me system.

The gas mileage makes me want to dance, then drive around all day. It sips instead of guzzling (hear that, you greedy Tahoe?). The standard transmission gets slightly better gas mileage than the automatic, at 30 mpg city/38 highway, but the automatic is no slouch at 27 mpg city/36 highway. Even with my limited radius of driving, i.e., noncommuter driving, I was filling up my SUV to the tune of $80 to $90 every week or 10 days. The Fiat can go, go, go on its petite 10-gallon tank. I always dreaded filling up my SUV, not only because of the cost but also because it took forever to quench that beast’s thirst. The Fiat fill-ups are quick & easy, just the way I like it. 

I haven’t attempted this pose, because I don’t actually own the car yet, but this chick at the 500C launch party in England makes it look tempting.

Supermodel Elle Macpherson has the exact car I’m driving, except her steering wheel is on the other side. She’s a loyal Fiat owner who’s been quite outspoken in her love for these cars.  “I love the Fiat 500C, it has that sexy, cool, Italian thing going on!” 

With all the color combinations and the retro styling in the interior, it’s as much a fashion accessory as a car. Here’s the inside of Elle’s 500C, which looks just like mine except for the stickshift and the steering wheel on the right sideHere’s mine.The bone-colored leather steering wheel is so fine, and the shiny red accents across the dash are the most stylish thing in the car world. 

George Clooney is a Fiat fan, too. Check this out.

In one article I read about the Fiat 500C, the proclamation was made that “If you like being the center of attention, never has the price of admission been this low.” This car most definitely gets people’s attention. I’ve seen drivers craning their necks to get a better look as we drive; several times I’ve come out of the store to find someone taking a picture of the Fiat in the parking lot. I’ve answered lots of questions (how does it drive? what’s the gas mileage? how much do they cost? what colors are available?) and happily introduced the curious people in my neck of the woods to this cute little car. 

At the New York Auto Show, the 500C was called “relentlessly adorable” and it was said that its “oddball modernism still astonishes.” It’s “super-chic, super-stylish, and effectively retro.” Nice. 

I read another review that had this to say about this little Fiat: “The new 500 is remarkably similar to its predecessor with a flowing and harmonic design which softly mutters – rather than screams – retro. In flowing Italian. The end result of Fiat’s effort is a car that people smile at – on the streets, in parking lots and in traffic jams. Not many cars can be called ‘sweet’, but the Fiat 500 can definitely satisfy any automotive sweet tooth.”

If you need a sweet little Fiat, get with the good people at Fiat of Clear Lake. Tell Joey and Donald that you need a dose of Fiat fun. Ciao!