Mole removed (mostly) and 3rd class

Discussion in 'Medical Topics' started by Mole, Mar 1, 2019.

  1. Mole

    Mole Guest

    I recently went for an annual physical (not for the FAA) to a doc who is not my AME. He decided he'd like to remove a mole from my back, but said it did not look like melanoma. So a couple weeks later I went back for the removal/biopsy and he removed it using a punch tool.

    The lab report came back as:

    Final Diagnosis: "Junctional melanocytic nevus with architectual disorder and mild cytologic atypia of melanocytes, transacted peripherally"

    Microscopic: "Sections revel a proliferation of mildly atypical melanocytes arranged predominantly in nests at the lentiginous and focally bridging dermal-epidermal junction. Pagetoid spread is not seen. The papillary dermis is fibrotic. There is a superficial perivascular infiltrate of lymphocytes and melanophages. The lesion extends to the peripheral specimen margin. Clinical follow-up is suggested."

    This is way too much medical lingo for me to understand. My doc said that it is not cancerous, but that he didn't quite get it all out as a tiny hairline was missed... thus the suggestion to follow up. He said he could remove the rest (at a future appointment) or just forget about it as he didn't see a problem. My insurance changed a few days later and I can no longer see this doc.

    How will this affect my next 3rd class medical? Do I need to go to my new doc and have the tiny sliver removed and re-biopsied ($1,000)?

    I guess I am a bit concerned about the "Clinical follow-up is suggested" even though my original doc didn't seem concerned.

    Thoughts?
     
  2. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    The original "I don't know it all" of aviation.
    Sure you can... it's called "customer pays". Talk to the doc, explain you are here for the follow up as he suggested, and negotiate for preferred pricing for him, the pathologist, lab fees, etc.
     
  3. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    yup, get it totally removed. You will be able to fly!
     
  4. Kenny Phillips

    Kenny Phillips Pattern Altitude

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    Yeah, for most of us, it doesn't matter if you have a large deductible. My one-mile-away hospital is covered under my insurance, but not my personal doctor. They give me good rates on stuff, however. Remember, you can keep your doctor! [at your own expense]
     
  5. Mole

    Mole Guest

    That's great if your doctor will take self-pay patients. Not all do.

    I'm just wondering if I need to go have the last sliver of this mole removed and re-sent to a lab given what my former doctor and the lab said previously. They seem to contradict each other, but my former doctor will not write any sort of letter and has only given me the lab report.

    I think since he can't/won't see me again he doesn't want to be bothered with writing a letter.

    I'm hoping Dr. Bruce will see this thread.
     
  6. bbchien

    bbchien Touchdown! Greaser!

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    Why would you ever want to let that thing (edges) persist? It's as close to cancer as pre-cancer gets and it only goes on ONE direction which isn't good. Being cheap (yes I said that) on your primary healthcare is not economical in the end.

    And as he didn't get the whole thing you don't know that what's left isn't a melanoma....sigh.
    Pilots are cheap, cheap, cheap....

    I just got something whacked off my scalp which turned out to be a nothing. Didn't even bother with the punch biopsy. No matter what it was to turn out to be (a keratosis) I wanted it gone. And it actually was a better deal to go directly to full thickness surgicenter removal!.

    "don't be doing that!"
     
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  7. Mole

    Mole Guest

    Ok.

    I can get an appointment with my new doc in May... that's a long way out!

    I'll try to beg my old doc to do a cash deal but they seem to only take insurance patients. Otherwise a random urgent care should be able to do it I suppose.

    Thanks.
     
  8. benyflyguy

    benyflyguy Pattern Altitude

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    Have him refer you to a gen surgeon to do a wider proper excision and get it over with. Done in office.
     
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  9. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    The original "I don't know it all" of aviation.
    two things came to mind as I read this.... (read the following while simulating me poking you in ribs)

    1) out of all the pilots in the land, you are likely the only one that already knew the correct answer as to how to report this activity to AMCD before you scheduled the procedure.

    2) Does this mean that one of our favorite aero docs now has a hole in his head?
     
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  10. EdFred

    EdFred Touchdown! Greaser! PoA Supporter

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    Dry ice is cheap. Done a number of self removals that way. Takes a few cycles, hurts a little. But, nothing to report on the medical since nothing is in the system.
     
  11. bbchien

    bbchien Touchdown! Greaser!

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    See what I said?
     
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  12. EdFred

    EdFred Touchdown! Greaser! PoA Supporter

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    And this was BEFORE I started flying. :eek:
     
  13. Half Fast

    Half Fast En-Route

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    https://www.chemtronics.com/freeze-spray
     
  14. EdFred

    EdFred Touchdown! Greaser! PoA Supporter

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  15. Mole

    Mole Guest

    Well, the doc won’t see me as they are under contract to not take cash patients. Our medical system is terrible.
     
  16. bbchien

    bbchien Touchdown! Greaser!

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    Find a way. Get 'er done.
     
  17. 3393RP

    3393RP Pattern Altitude

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    It wasn't always that way.
     
  18. Mole

    Mole Guest

    Indeed. I can either wait a month or so for my appointment with my insurance-approved doc, who may have to refer me to someone else (that's how the system works), try with the county health department, or do it in Mexico. :) I'm told it is not something that urgent care will do and my FAA doc doesn't do that sort of thing either. In any case I have an appointment with my insurance-approved doc next month to deal with it.

    It seems to be more and more common. We don't have many choices for health insurance here and they seem to have all the docs under contract to only see patients with specific insurance and to not accept any cash payers. I got a phone call 24 hours before my appointment with my original doc and was told they have to cancel as seeing me would violate the contract with their insurance partner.

    Many moons ago, I had a doctor who would make house calls. :(