5 Stitches

Over 2 years since my pulmonary embolism and without a hitch. Today I had my first unrelated medical procedure. I chose, at my own will, to have a benign mole removed from my back. I was born with the mole and have carried it with me for almost 28 years now.

The mole had always been a source of anxiety, mostly image related anxiety but also the fear of the unknown in skin cancerland. Last summer alone I had three people address their concerns over the spot and how I should get it taken care of. That was the first time anyone had said anything to me since I was in high school when my childhood doctor would address it every year. I figured it was time to get going on removing it.

Coumadin doesn't exactly make any kind of a procedure an easy task. You can't just make an appointment and show up to get things done. There is a long, at times tedious, process involved to get various different doctors talking about INR level requirements and when to stop/restart Coumadin.

At any rate, I figured this was a good opportunity for me to learn about the various hoops of doctors, blood thinners and medical procedures all in one shot. My best advice is to make sure you get concrete answers from the doctors and get the planning done well in advance. I almost cut myself too short between my last INR Nurse Clinic visit and the date of the procedure. I had already talked to the dermatologist and asked him where my INR should be. His response of "low" was not good enough for the INR Nurses or my Internal Medicine Dr. to be able to gauge what my INR level should be at. I had to orchestrate talks between my nurses, regular doctor and the dermatologist and then talk with my doctor's nurse to get the final plans. A little too much effort if you ask me.

Thankfully, I was allowed to go off the Coumadin completely and not have to supplement with lower dose blood thinners like Heparin. As essential as Heparin is for me to live, I am just not up to the injections and bruising that comes with it. As strange as it may sound, I have been feeling pretty happy the past few days not having the ball and chain of Coumadin wrapped around my ankle.

The procedure went well and was relatively fast. I was extremely nervous and cried the whole time. It wasn't painful physically, just painful to let go of a part of me. I ended up with 5 stitches and a giant bandage. The dermatologist said that the scar will be approximately 1.5 inches long. He had to make a football shape cut to get all of the area that the mole covered. He let me see the incision area before he cut into me and gave me a second chance to back out. It was very tempting to say "nevermind, maybe next time" but I let my logical mind win over that debate. I do hope that the scar will be more attractive looking than the mole! Not that scars are sexy, but at least I won't bet the "eww" reaction from people, again I hope!

I will restart my Coumadin tonight and get my INR checked in a week. I am pretty content with the way things worked out, albeit there was a good amount of stress and anxiety going into this. I made it a point to get up and walk around every hour for fear of another clot. I am grateful that my regular intake of Coumadin erases all of those clotting fears.

Today, my INR was 1.2. Back to the blood thinners!