Six Months Later and I’m Right Back Where I Started

Yesterday was my six month appointment with my dermatologist. It was scheduled as a mole check, not necessarily a follow up to my surgery on the malignant melanoma in October. The scar has improved in appearance, but it still has the ability to make my friends pull back in horror and grimace when I show them. The edges are still rather purplish-red prompting the doc to suggest laser work to break down those blood vessels and lighten the scar’s edges if things don’t improve on their own in another three months. Due to lack of insurance – or a job – I’ll be stuck with red, angry margins for a while.

He then did a quick mole-check, literally scanning me from head to toe. He asked if I had any moles that I was concerned about and I showed him three, two of which he agreed should be biopsied, while the third was a wild card and he would biopsy anyway and eliminate it from future worries altogether. A fourth mole, a freckle really, on the top of my foot he marked with his pen to be sliced.

The nurse numbed the four areas quickly and efficiently and then he removed each and dropped them in their respective vials to be sent off to the lab. I should have the results by the end of next week. Then again, maybe not.

I was glad to get rid of the mole on my inner thigh (the one that looks the most suspicious). That fucker was growing a singular hair of bristle brush quality. I remember after my pregnancy with Aitch, once I could finally see that part of me again, the hair had sprouted to mythical proportions. I’m fairly certain a little boy named Jack was eyeballing it as a worthy challenge.

And now I wait again and hope for good news. My doctor was especially pleased when I told him that my swimsuit this year is one that covers me neck to hip and shoulders to forearm. A rashguard designed specifically for women with a built-in shelf-bra. Now I can stop taking those contortionist lessons that I had scheduled to help me apply sunscreen to my back with my feet.

In 24 Hours, I Won’t Even Recognize Myself

It’s been a little over a month since the biopsy of Zee Mole. I have a poor quality pix of it from my cell phone. I wish I had a better one to keep documented. Last week, after showering the scab came off. Aren’t you glad I shared that with you? But it’s still nasty. Here’s how it looks currently.

10.10.2010

 Within 24 hours, it’ll look completely different. If it has taken a month for the initial procedure to look as “good” as the picture above, I am fairly certain the new wound will take most of the winter. Good thing it wasn’t shorts and flip-flop weather, eh? Gotta look on the bright side… 

Here’s the other mole that will be removed and biopsied. This one I will miss, strange as it seems. I’ve had it for a very long time. However, while Dr. Drapenscrape didn’t think we should be concerned, the oncologist doesn’t like the slight feathering of the edges.

10.10.2010

If this one comes back as MM as well AND is deeper than .75 mm, then we will be back to the possibility of a lymph node biopsy. This doesn’t account for every other mole I have that has been scrutinized to the point of being obsessive.

Sidenote: the pre-screening nurse asked if there was any way I was pregnant. Yes, of course I audibly scoffed. She said that the anesthestist may require a pregnancy test anyway. I scoffed again. How do I explain – over the phone and to an utter stranger – that two of the most important elements in getting pregnant: 1) healthy eggs and 2) sex, are nonexistent? I guess I’ll have to spend another $50 for a stupid pee test.

Unrelated sidenote: Thank you…you know for what.

A Little Good. A Little Bad

24 hours is a long time when you spend most of it thinking of one thing, or even if it’s several things in relation to one subject. In the moments I would wake up during the night, my first thought would be, “what if?” and then I would make myself not think it anymore. There were just too many variables out there from the doctor in regards to the melanoma to start thinking of my epitaph. In short, my imagination was being a bit melodramatic.

On my two hour drive to The Metro, I couldn’t help but compare my emotions today to what they were in the years preceding Aitch’s birth when I would drive there to see my RE. I hate that drive as it’s the one I made with the new maternity outfit that I never ended up wearing,  just days before I started spotting with Vivienne. It’s the one I had to make when I was told by my RE that my pregnancy with Wolf was over. It’s the one I made for every CD1…

It gave me time to recall the worst things I had been told in my life:

“I just don’t love you the way I use to.” Thanksgiving weekend, 1995

“I’m sorry, but there is no heartbeat.” November, 2004

“This pregnancy isn’t going to end they way we want it to.” November, 2006

“We are terminating your employment, effective immediately.” January, 2009

“If the melanoma has reached the lymph nodes, survival rates significantly drop.” September, 2010

The clinic is located on the university. My directions to the office itself were poor. I was overwhelmed with what seemed like mundane issues: the parking garage, the elevators, getting registered, and the waiting (and waiting and waiting!).

The oncologist was friendly and optimistic. The depth of the melanoma was what he considered thin even though only .15 mm separated “thin” from “thick”. That’s POINT one-and-a-half millimeters, about the thickness of a piece of ordinary paper.

Based on that alone, he doesn’t feel the sentinel lymph node biopsy is called for. The chances of anything being found in the node is less than 1%, he says. However, he would still like to go back after the tissue surrounding the mole creating 1cm margins and this will be biopsied as well. While this sounds fairly simple, I will actually be under general anesthesia as where the mole is located creates a complication in how to close it. There’s no way to just stitch it closed. There’s not enough excess skin on the back of my lower leg so a plastic surgeon will also assist to creatively close it.

My leg modeling days are over.

Just as we were finishing up, he decided to check out the other moles I have on my feet and did a double take on one. It’s in the arch of the opposite foot. While Dr. Drapenscrape looked at it as well, he let it go. But the oncologist noticed that it has uneven coloring, hard to spot in the thin, wrinkling skin of an arch without close examination. That mole will be removed during my surgery as well and sent off to pathology.

No more tanning for sport he said. No tanning beds. Sunscreen with SPF30 or higher on ALL exposed skin. My day wasn’t as bad as I had feared, but I know this new journey is just beginning. Surgery is on the 12th.

I’m Learning Too Late That Baby Oil Does Not Have An SPF

Dr. Drapenscrape didn’t keep me waiting long in the exam room. I was sitting on a chair and he pulled the other up next to mine and sat down, my medical file in his hand. I knew going into this appointment that the mole hadn’t been benign, but to see it on the pathology report’s Final Diagnosis…well, I don’t know how to describe what I felt.

Malignant Melanoma

Zee Mole has now got himself a fancy new name and a lot more respect.

Dr. Drapenscrape went over the findings in detail, including the following important points about Zee Mole, which will now be “MM” for brevity’s sake:

1. It has a depth of .6mm. My doctor’s policy has been anything with a depth of .75mm or greater is a ticket for an automatic CT and PET (Positron Emission Tomography) scans. Mine, at .6 is right at the point Dr. Drapenscrape’s orders the scans if he’s feeling a bit of hypochondria. His words. This measurement is the Breslow Measurement.
2. It is at Clark’s Level IV on a scale of 1 to 5. Not to be confused with the stages of cancer, this just tells how deep into the dermis the MM goes. Clark’s is not used as often as it had in the past, and according to Dr. Drapenscrape, it will become obsolete by 2012.
3. Add in the Mitotic Index. That’s the growth of the MM cells. It also has a scale: 0 – 3. The path report indicates mine is at a 1. So there’s growth, but slow, however…there’s growth.

Take these three facts, all gray and borderline, and add them to my age (which I am considered “young” – Finally!), and we have a situation that would lead my doc to err on the side of caution. Why wait 10 years to find out that things are way more serious?

Tomorrow I meet with an oncologist in The Metro for a consult. We will then schedule a Sentinel Lymph Node biopsy that will be more definitive as far as stages, if there’s even one I’m at. He may decide that I should go ahead and have the CT and PET scans prior to the results, or we may hold off.

The words “survival rates” came up and I felt the first real moments of panic settle in my chest. Googling what I have so far has added to that fear: “most serious form of skin cancer” and “deadliest form of skin cancer”. Fuck you, Google.

It’s not just skin cancer, kids, it’s cancer. And I have it.

Things Just Got Interesting

Last night I looked over my calendar and was happy to see that over two weeks had passed since my appointment when the doc biopsied a mole on the back of my leg. Happy because I was told that if something showed up, they would call me within two weeks. If all was clear, they would send me a letter but that probably wouldn’t get to me for almost three weeks.

In fact, I was going to post on facebook that the doc had created a divot in my leg for nothing. I should add to that by explaining that while I thought they had just scraped off a bit of the mole, I discovered after it finally started to heal up that they carved that fucker like a jack-o-latern. Yes, there is a divot in my leg. One could place a golf ball on the back of my ankle and tee off without a problem.

As you’ve probably already figured by now, the letter that should say the scribed tissue was normal will not come. Instead I got a phone call just this morning that went like this:

*annoying cell phone ring because there isn’t a normal one on my phone*

“This is Yo-yo Mama.” I answer this way in case it’s my future employer. Normally I would answer, “Whaddup, Bitch?”

“Yo-yo, this is Nurse Stoic at Dermatology’s clinic. Dr. Drapenscrape would like to see you to discuss the results of your biopsy.”

“So. I take it, it’s not good news.”

“Dr. Drapenscrape will go over the details with you. Will Thursday morning work for you?”

A decade of employment with the healthcare system combined with four years of negative beta calls from an RE clinic is enough experience to know that when a nurse calls to ask you to come in to speak to a doctor, that the news is not good. So as far as how bad things are? Well, I’ll know more Thursday.

The mole itself appears to be out, but has very small margins. Commonly, more cutting will be necessary. I might even get myself some KY jelly that’s been nuked by Chernobyl to smear on my divot. Maybe I can act really pathetic and get a script for medicinal merijewanna?

I’m sure that everything will be fine. No one ever dies of skin cancer, right?*

*The first person who tells me otherwise will be haunted by my divoted leg that is also spouting some very unsexy stubble as it’s pretty difficult to shave one side of a leg divot’s scab without running the razor into the other side.