Caroline has a lump on her arm about halfway between her elbow and her shoulder. I couldn't tell you - as I couldn't tell her pediatrician - exactly how long it has been there. At least a year. Maybe two? Possibly from birth - there was so much going on with them in the beginning and she was so very small that I might have easily missed the odd bump or two.
But I know I have been aware of it for a while and I know I pointed it out to her doctor in the past because I remember him prodding it and saying that it was some kind of cyst; we can keep an eye on it but should leave it alone if it wasn't bothering her. So we did, except for every now and then when it would catch my eye and I'd say, "Caroline hold still. Let me look at your arm in the light." And then I would press around the area with my finger and say hmmmmm until she snapped, "Leave it alone or take me to a real doctor!"
Which, you know, fair enough.
Lately, like in the past month or so, I noticed that the area has started to look faintly bruised. Nothing major, just a little reddish-blue discoloration under the skin. I called my mother who said, "Good heavens what's wrong with you, take her to the doctor." I consulted Steve who agreed that whatever it is; it seems to be growing and concurred with my assessment that it feels more hard than squishy.
And if you are asking yourself at this point why I hadn't taken her back to the doctor weeks ago - I don't know. In retrospect it is obviously what I should have done but change is gradual and I felt like I had already asked the pediatrician and he had already answered: it's fine.
Anyway, I took her in yesterday with the firm conviction that It Must Go and asked Steve coach me on the appropriate way to respond if her doctor was inclined to wait.
Steve looked at me incredulously.
"She has a... thing that is growing under her skin. Of course it has to be removed."
"And if he says it is a harmless cyst and we should leave it alone?"
"Say that we would be more comfortable having it removed."
"OK," I said.
And that is pretty much how it played out. Caroline showed her arm. He said it was in all likelihood a dermoid cyst. I said but do you see how it looks like it is bruising under there? He said hmmmmmm. Then we blinked at each other until he asked Caroline if it hurts at all.
"No," she said.
He asked me if I felt like we were seeing extremely fast growth.
"Yes," I said firmly.
Finally he said ok, I'll send you to Dr. Specialist.
I said, "Oh you don't... " and looked around the exam room because honestly I was expecting him to get a little numbing gel and some gauze and... you know.
He said, "No, we send these to the pediatric surgeon so they heal nicely. But we have a guy who comes to our clinic a couple times a month; I'll give you the number for his scheduler."
I came home. Called the scheduler. He had an opening today at 11:30 and I took it.
When the surgeon walked in
[I have tremendous respect for everyone in the medical profession and I know that we all need vacations but it was all I could do not to ask, acidly, if he had enjoyed his recent trip to the Caribbean. He was tanned to such a lustrous shade of mahogany that he looked like a billboard for Hawaiian Tropic. An early one from back in the 80s when people still thought baby oil was a good idea. Not that I am envious it is just that there is a reason why the Pillsbury Doughboy was created in Minnesota - by February we all look exactly like him.
Maybe a little envious.]
When Dr. George Hamilton walked in he shook hands with Caroline and looked at her arm for a millisecond before announcing, "Oh yes I know exactly what that is. I knew from the description you gave on the intake sheet."
Apparently the hardness, the growth rate and the blueish tinge are hallmarks of something called pilomatrixoma aka calcifying epithelioma of Malherbe which is a rare, benign tumor.
"Absolutely nothing to be worried about."
"Oh good," I started to rise.
"But we do have to remove it. They can cause complications since they don't stop growing."
"Oh," I started to lower and again - AGAIN - I looked around the exam room for... rubbing alcohol? One of those little scalpel kits we used in ninth grade biology?
I feel dumb admitting this but I honestly thought we were going to see him today and he was going to go ahead lance or excise or whatever and Caroline would come home to a DVD with a stitch and bandaid. If I had really thought about it I would have realized how absurd this was. Caroline has a 20mm mass deeply embedded in her arm - did I honestly believe he was going to pop it out on the same paper draped table where they do strep cultures?
Yes. Yes I did.
Instead she has to go back for a pre-op exam on Wednesday and then over to the children's hospital for an anesthetized surgical procedure next Friday.
Five minutes after he entered the room - he was actually very kind and made sure he answered any questions I had (the only one I had I was too embarrassed to ask: you mean you aren't going to just take care of it right now?) and that Caroline understood what was going on and that it wasn't a big deal - he was gone.
Caroline looked at me. I looked at her. I looked at my watch. She said, "You said I wasn't going back to school! You said I was done for the day!"
And I thought, well, yeah, that's because I thought you were going to be in pain but I decided against it.
I took her to the library instead and since it was just the two of us and we had hours before we had to be anywhere I sat down on the floor with a book I grabbed off the end cap (The Great Typo Hunt - meh) and let her browse nonfiction to her heart's repletion*.
*Do you want to know how many books we brought home on Greek mythology? All of them. Which reminds me. The twins are in a mythology phase right now and during the course of some incomprehensible imaginary game that they were conducting all over the house Caroline went all Mrs Siddons and intoned, "I am the goddess of romance... and TORNADOOOOOOES!"
From the other room Patrick said, "Romance and tornadoes? You mean, marriage?"
Ba. Da. Boom.