*heads up — there are before, during, and after photos below

It seems I have a thing for patterns. June last year, less than two weeks from vacation, I went to my dermatologist to have a small (like three cooked quinoa) lump removed from between my skin and skull. It had been there a while, maybe a month or maybe a year, but had started to grow and I didn’t want it to protrude from my hair and cause a larger removal issue later. It took a few minutes and less stitches and I was back to work the next day. I later got my stitches removed and was clear to dive as our flight left that evening.

With this knowledge, I went to my new primary care manager aka doctor on March 31, and told him it would be a simple snip under the skin as last time, but he reminded me that my hand has way more going on — nerves, tendons, muscles, and little bones — and that I would need a hand specialist to address the issue. My first referral was to an orthopedic surgeon that only works on pregnant women. I had a hard time telling the corpsman aka nurse that I refused to bring a child into this world just to get my hand looked at and that’s why I needed a new referral; and that I wasn’t coming back in for more x-rays as I was sure my hand hadn’t changed in a week.

I get my new referral April 7 and am scheduled to see a new surgeon, who is only available on Wednesdays, so I’ll have to wait until May 10. It takes me longer to fill out more paperwork than it does for the two of us to agree to surgery because whatever is on the palm side of my knuckle gets pressed into the joint when I grab things and I don’t want it growing into my hand and becoming harder to remove in the future. I have to wait for my insurance to approve the process, which takes another week.

On top of this, my dentist and periodontist have agreed that it’s best that I get my teeth cleaned every four months, of which I pay for every other visit. I was ok with this as was Gentle Dental and Regents Dental who I visit for their more affordable services, but having moved I had switched to another Gentle Dental and they’ve started taking patients’ blood pressures (because they’re able to raise mine each time). I was supposed to have a cleaning on May 15, but they canceled an hour before because they wanted to do an exam as well.

They schedule my exam for Thursday and my cleaning for May 30, which just happens to be the same day as my surgery, but the timing should work. They call me back the next day to cancel my exam because I had one in February and my insurance only pays for one a year. So you can imagine my surprise and verbal upset at being subjected to a fucking exam 15 minutes late and then them wanting to schedule me for future visits, unbeknownst to them that this would be my last time in this office.

I walk into my surgeon’s office that’s 25 minutes from his other location. I check-in at 11am, fill out paperwork, and am brought back to change into a plastic bag aka medical gown with a hole for a hose attachment where more heat can be added to your personal sauna bed service. At least on the low heat setting it provides some air movement. I’ll fiddle with the ties on my gown for half an hour before I speak up and chat with the nurse to keep me company until the doctor arrives.

swelling above the line, initials approve the site, dots are where the cut will be made

He has brought in a tray and very sneakily, under the gloves, in it a three inch needle of the smallest gauge to ever pierce my skin, a 25G. He injects just below my initials and begins to fill my hand with numbing solution, to the point where my skin swells to accommodate all the cc’s. I’ve already asked if I can watch the procedure as I sit there and start to feel weird about the chickpea-size lump that has been turned into a tiny jell-o mold taking up a quarter of my palm. At this point, I realize my blood pressure is lower going into surgery than it was at the dentist’s office.

I’m wheeled into the operating room, with the machine that goes ping! (for people under anesthesia), and asked to sit up so a board can be put behind me. My first thought is that it will make it easier to watch, but then I remember the doctor wouldn’t ask me to hold my hand in the air while he cuts into it; I say as much out loud. Joining me in the room is the nurse in charge of vitals and covering me with a blanket again (I wiggle out from under it), the kind doctor willing to let me see and allow a second nurse to take pictures, and the third nurse who will help hold my hand open.

I wish they’d have let me take the pictures

Prior to the incision, my middle finger and half of the fingers on either side were numb. A tourniquet was applied to my forearm with medical-grade pressure — just enough to reduce the blood on scene and to put my arm to sleep after ten minutes. I was scheduled to have the room for 30 minutes but it only took 12 for the doctor to slice my skin, and pull it back like I do to get at mango flesh, hook out my tendon and relieve it of its passenger, before sewing me up with extra stitches to ensure I move my fingers and don’t let them get stiff.

I’m asked to give a thumbs up, with my palm out I go up and not out, for a laugh, so that my hand can be wrapped in gauze, cotton, and ace bandage. I’m wheeled out, get changed, and as I ask what to do with the bloody gauze that I held throughout the surgery from the prick of the numbing needle, the doctor asks if I know when I can go home. Funny enough, my answer was, “as soon as I pee.” It wasn’t medically necessary but I wasn’t going to make the 30 minutes drive home at 1pm without doing so.

Day 3, bloody gauze in the background

I asked if my hand was wrapped too tight, but the doctor is able to spread my fingers out so I’ll go home and sit with my hot and swollen fingers for hours while Caleb and I do crosswords together. I take some expired codeine before bed, but I’m always hesitant of taking too much so my hand will wake me at 2am and again with a spasm at sunrise. Caleb has waited to leave for work to make sure I survived the night as we didn’t sleep well.

I have fun over the next two days at work telling customers it was a different incident that caused my “broken wing” as one man called it. A co-worker asked if it was a shark bite (since I like to dive) and though there are species small enough to cause such minor damage they live too far below the surface for me to encounter them while still breathing. Bear was met with disbelief; one guy didn’t know what an ocelot was; badger and fence were met with silence. Another asked if I owned many snakes as he used to work in a pet shop.

Day 6, bruised palm with iodine evidence near fingers

I can change my bandage on day three and wash the dried blood from amongst the eight knots resting in a tiny sea of bruising. I’ll wrap it again for another three days and then let it air out at home for two nights before my follow-up appointment, which just so happens to be on the same day as another dentist appointment, but an actual cleaning that’s on time. I work for two hours and clock out. I’m expecting a short visit, but the doctor has patients in rooms (that I didn’t see go in there), and it’s his birthday, so on my way out, his wife and mom are showing up with treats.

The doctor unwrapped my hand, pushed my fingers straight, asked me to make a fist, and then rewrapped my hand that I would loosen when I returned to work an hour after leaving. I was scheduled to have the stitches removed, two horizontal mattress and six simple interrupted, a week later, but I called to cancel the appointment, figuring it was something Caleb and I could handle. Ah, were we in for a surprise? I had done my research, and we weren’t going to boil the tweezers for twenty minutes, but the internet said I could remove the mattress stitches first (to me, meaning a day early).

Day 14, all the stitches out

I got home after work on the 12th, no dinner yet, and we got the mattress stitch closest to my finger removed, but it required some digging to get into the cavern the doctor had made, so I got to cutting other stitches to release the skin that he had doubled up against the wound and released dried blood. We agreed it’s not the best stitch job we’ve seen and I’m glad this doctor wasn’t the guy putting my face back together, but once my hand was partially open I was done and we were both stressed out. I had removed five stitches and then put on a butterfly stitch, after tearing one to bits, to hold my palm together so it could relax and heal from the nylon trauma.

The next morning, I removed another stitch before work and the last two when I got home. The second mattress stitch had to be pulled all the way through because it was buried in my skin, and I luckily was able to snip under the knot, which left a dent. I have calluses from the stitches, but I also don’t have any hand-modeling plans for the future. I’m just looking forward to my hand being watertight in 48 hours, though I will still wear a waterproof bandage while diving, and regaining full use of my hand.

UPDATE:

Here is my hand, over 16 months after being cut into. Those are the tendons popping in my palm, which is perhaps a side effect of my excitement in getting to watch the procedure, making the doctor more zealous than he might have been with me asleep. But as with most things, I’ll take function over form.