A Life Lesson Learned….

Hi ..

Years ago when I was training in periodontics I had a friend who was an accomplished oral surgeon .. frankly- he was way above my pay grade but for whatever reason he took a shining to me. After following him to the O.R. to watch  a radical neck dissection I thought to myself ( apparently out loud ) that this guy was REALLY making a difference…  He heard me and in front of everyone admonished me by telling me that “no.. we all make a difference.. perhaps some more subtly than others.. and that I should remember that you don’t have to do life altering procedures to alter someone’s life.”   Point taken.

Two weeks ago I met an 80 year old woman- still practicing law- as of now for a homeless advocacy group,-but previously a judge… who presented with a large hemangioma on the right commissure. It has been there ” for too many years and I hate it.. I can’t wear lipstick and it’s just horrible.”  Unfortunately- the cure for this problem.. to this patient was worse than the disease.. She would have to undergo a procedure which would require removal by scalpel and numerous sutures to close the wound. And, most likely, a follow up procedure to correct the appearance depending on the healing.

Just to round it out.. she was  taking anticoagulant medication, which always complicates things.

I saw her for the procedure- utilizing the Periolase– ND: YAG and with local anesthetic ( which many do without.. but she was “feeling the heat” ) the procedure was quick and she reported no discomfort whatsoever..Unlike with a scalpel.. utilization of the laser requires only non -contact  i.e. placing the fiber close to but not actually touching the lesion itself for it to affect the hemangioma.  Post-ops were unremarkable and today at 12 days she was completely healed. By our standards… not nearly as complex as a full mouth reconstruction- not by a mile. But what struck me was when she left today.. she told me that she felt young again and that I had no idea ” How i just changed her life..”  Hat Tip to Dr. Wilk for teaching me that lesson so many years ago.

This is a simple procedure that any with a nd:yag and some other wavelengths can routinely incorporate into your practice. Too many people are walking around with lesions like these that for one reason or another do not get treated .. Now – we have the ability to do so with ease in way that is easy for both clinician and patient. What a way to alter someone’s life….

Happy Holidays…

Explanations are under the photos….

Before LANAP by NYC Periodontist Dr. Lehrman

pre-op…hemangioma situated at commissure

 

Before LANAP by NYC Periodontist Dr. Neal Lehrman

ibid.. at rest

 

LANAP Post-op by NYC Periodontist Dr. Lehrman

immediate post-op.. Lip looks swollen due to infiltration.. It is possible to do this with topical.. but my choice is to use a small amount of lido @ epi. Perhaps half a carpule.

 

4 Days Post LANAP by NYC Periodontist Dr. Lehrman

4 days out. No pain reported.. no restrictions and patient reported she went right back to work after procedure.

 

8 days out… fibrinous area resolving…commissure filling in.

8 days out… fibrinous area resolving…commissure filling in.

 

12 Days After LANAP by NYC Periodontist Dr. Lehrman

12 days out. Healed and pt very pleased.

 

After LANAP by NYC Periodontist Dr. Lehrman

why we do what we do…..