Tag Archives: malignant melanoma

Sometimes, Cancer Isn’t Cured with Stitches

Yesterday I found out that a young woman who I was introduced to via social networking shortly after I was diagnosed with Malignant Melanoma had passed away from her cancer. She was only 40 and left behind a husband and two young sons, and her name is Dawn.

While my mole was simply removed with a wide-margin surgery, her treatment was to take out a couple of her lymph nodes in her groin to biopsy them as well along with the mole removal. Dawn’s treatment was considered successful after her second lymph node surgery, CT and PET scans in the winter of 2009, a full year before my diagnosis and treatment. She was instructed to get a mole check every three months; I went in every six.

Last February when she told her doctor she’d been having pain, he proactively ordered a scan even though she’d been given the all clear by her dermatologist. That’s when they discovered her cancer had returned. Then after some chemo treatment, they performed surgery just three weeks ago and basically found the tumors were inoperable. Last week she came home and began “planning visitations and playlists“.

Her story is both frightening similar and altogether different from mine. I don’t compare my situation her hers to bring attention to myself, but as a simple reminder to that I don’t believe that fate has anything to do with how our lives turn out. It’s simply luck, whether good or bad. I didn’t “deserve” getting cancer, and Dawn certainly didn’t “deserve” to die. A roll of dice has left me cancer-free (as far as I know), but her death has shaken me to the quick. In another six months, my diagnosis could be as equally dire. Like her, I look back on past symptoms (the severe breast pain; the bone-melting fatigue) and wonder if the doctors really did weigh in my past diagnosis.

I don’t want to harp on you, my friends, the seriousness and dangers of tanning, whether by bed or sun, but if my story of survival doesn’t convince you that you need to be sun-conscious, I hope that Dawn’s life and her legacy does.

Sing It With Me Now: Sunshiiiine On My Shoooooulders Makes Me Happyyyyyy

In the past week I ran across this article about an elderly gentleman who after nearly three decades of truck-driving, developed an interesting case of what is called unilateral dermatoheliosis (a fancy term for "sun damage"). The left side of his face (hence the "unilateral") is visibly more wrinkled and droopy than the right. The photograph is meant to shock us as to the damage caused by repetitive exposure to the sun and serve as a warning to reduce our risks. Not surprisingly, this has led to the debate as to how evil sunscreen is, chemically altering our bodies and generating third nipples and pus-filled toenails. Have you even met me??

I was diagnosed with malignant melanoma in 2010 and I unashamedly admit to harping on my friends who unwittingly announce, "ohemgee! I got The Worse sunburn this weekend while boating!" Frankly, I don’t find it an amusing anecdote, and I find it similar to my 20-something nieces and nephews regaling of how much they puked in the neighbor’s yard last night after binge-drinking. It’s stupid, self-harming behavior that’s entirely preventable.

It’s been a long time since I have felt so unwavering about a topic. I’m about to get up on my high horse and RIIIIIIDE!!

What really twisted my knickers were the remarks that came up in response to this particular image (which I discovered has been circulating around the ‘web for a couple years now…), specifically how they would rather send their kids outside without sunscreen and expose them to the risks of the sun rather than apply sunscreen because the risks that can be attributed to the chemicals. Then there’s the argument that exposure to the sun is good for us and our children.

…Regretfully, this is true.

My oldest sister was diagnosed with rickets as a little girl. When the disease was described to me, I imagined that she had decided to hole up in the basement and live among the toads and salamanders we shared the dirt walls with, and that she only came up to go to school. It explained so much about my weird sister… Now of course, I was just a child then and have since realized that my sister’s rickets resulted in her refusal to drink or eat dairy of any kind (not an uncommon side-affect of having been raised on a dairy farm. Some day I’ll tell you about chickens. REAL chickens.). My sister did not acquire rickets because she was not outside getting sun, it was her crappy diet.

"Sunlight lets human skin cells convert Vitamin D from an inactive to active state," (Wikipedia) That’s the simplest definition I have found, but what’s difficult to calculate is HOW much sunlight is needed to do this. Surprisingly, it is very little. VERY little: 10 minutes a day for most Caucasians. For me, that’s how long it takes me to walk up our lane to the mailbox and back dressed in shorts and a t-shirt. Plus, our bodies can store Vitamin D, which is how we get by in the winter months, in addition to foods that are supplemented with the vitamin. That means if you are going boating, beaching or biking, you’re going to need to protect yourself from the sun for all but a handful of minutes, which is the amount of time it will take for you to properly apply it. Sunscreens are not your only options here, but let’s talk about it.

Sunscreens can be filled with lots of nasty chemicals. The kind of stuff you don’t want on your skin when you go out in the sun, much less every day and certainly not every day on your kid’s skin. I found this wonderful website that can help you immensely wade through the goop of sunscreens, whether you just need a lip balm or something mineral-free for your family. It’s Environmental Working Group (ewg.org) and this database on their site lets you look up the sunscreen you are using; research the ones that your friends have "recommended"; or to research what ones are the best to go out and get. I wish I had known of this website before our Disney trip as it includes make-up and moisturizers as well.

From this website, a bullet-point review of sunscreen (emphasis is mine):

  • Use a sunscreen with a minimum of SPF 15 and a maximum of SPF 50;
  • Make sure labels list UVA and UVB (or broad spectrum protection);
  • Avoid products containing oxybenzone and retinyl palminate if you’re concerned about potentially toxic chemicals;
  • Choose lotions versus spray sunscreens for a more evenly distributed protection.
  • Remember to apply at least 2 ounces of lotion (about a shot glass full) and reapply often. The sun breaks down the ingredients in sunscreen that protect your skin. Experts recommend reapplying every two hours, or after swimming or heavy sweating.

Not only is anything over SPF 30 a waste of money, it can actually contain more harmful ingredients. With the new labeling requirements, it’s easy to spot the ones that say "broad spectrum". I do like the convenience of the spray, but only because I use to not like having the lotion on my hands and nowhere convenient to wipe them. Now that I can use every drop of coverage possible, excess just gets wiped off on my arms and legs. You all should know what a shot glass looks like. Imagine it full of your fave booze. That’s how much an adult needs to use with EACH application.

OK. You don’t like sunscreen. Fine, I get that it smells, is sticky, can make the kid’s eyes burn out of their heads, attracts dust, is full of poisonous shit. Well, whatever. No one ever said "sun protection" comes in applicable sunscreens only. Here’s your chance to show off your Scarlett O’Hara straw hat or to take a stroll with a parasol or wear a flowy beach cover-up. I have versions of all of those and I can’t tell you how freeing it actually is to 1) not have to do my hair just to go to the pool or beach; 2) get to use the silk parasol my husband had personalized with my name from Disney (and receive compliments everywhere I go with it) and the luxury of shade when there is none to be found (soccer field! track field! local car show! parade!); and 3) keep my fat ass under wraps.

I am definitely in the minority here in Hickville, USA. I guess I would have to call myself progressive when I’m surrounded by a sea of farmer’s tans, exposed bra straps and tank tops. I had to make this lifestyle work for me. I’m aging and my children are so young. I want to see my daughter get old enough she can sign my living will and put me away in a nursing home. I don’t want her to get married and have "In memory of my late Mother" typed in hindsight on the wedding program.

I honestly didn’t mean for this to be so long and I admit that about three-quarters of the way through, my bitch-and-complain sail lost wind, which explains why I started off so ranty and then petered out. To end this diatribe, I’ll share a quick exchange between my husband and myself from this weekend when we went to the local lakeside beach. Setting the scene: Me, sitting under our enormous sport-brella. Sparring Partner, sitting just outside of the shaded area next to me where I notice his back is getting a bit red in spite of getting an application of sunscreen.

"Hey, why don’t you scoot back a bit so you’re in the shade?"

"I’m fine. It’s not affecting you."

"If I had had lung cancer, and I knew you were smoking cigarettes when you weren’t around me, would you still say ‘It’s not affecting you,’ as an excuse to smoke?"

He moved to sit in the shade with me.

Your choice to not protect yourself may not directly AFFECT me, but it does have an effect on me. I care.

Looking Good

Aside from whining about not being able to enjoy the summer and sun as much as I use to, I actually am being proactive and getting out with the kids when I can. I happen to have this week off from work which coincided with summer actually making an appearance (heat index today of 105-110 F). That means trips to the local city pool or even hitting the road for an hour’s drive to a water park.

This spring I bought a new swimsuit. I’ve worn it now a couple of times to the pool and to say I feel conspicuous is an understatement. The other day I sat at the edge of the baby pool while Aitch played and another mom sat down not far from me. She had on a cute bikini and I thought how lucky she was to not only have a svelte post-baby body but to let the sun’s rays soak into her skin for that healthy looking tan. Then there I was with my swim skirt, rash guard top and large-brimmed hat. I wondered briefly if I could pull off the celebrity-in-disguise bit, but realized pretty quickly no celebrity would be at the delapidated city pool.

Yesterday I took the kids to the water park. Aitch wanted to wear her “princess” swimsuit, a Target purchase quickly made so she’d have something to wear for swimming lessons at the Y a couple months ago. I hate it because Ariel is emblazoned on the front, but it was cheap, she liked it and it would never see the light of day. I had already ordered a swimsuit to wear outside, which she did at the water park. I told her that I had already packed her swimsuit and we couldn’t wear “Mermaid” anymore (time to hide that sucker!).

I’m glad she’s too little to have noticed all the little girls (and babies!) dressed in tiny little swimsuits. Even bikinis on the infants! Really?? Here she was in a long-sleeved rash guard and the only girl wearing one. My son has a rash guard as well, but it’s not unusual to see boys wearing them. I had one parent ask me where I found the girl’s rashguard as she had a niece who easily burned and I gladly shared that I had ordered it from Land’s End.

When we got home after spending a few hours at the park and took our baths/showers, I was actually happy to see that neither child showed signs of having been in the sun and water for the afternoon. While I do miss getting a tan, even I was just as pale as I was when we left the house…except for one area: my upper chest. My swimsuit covers me to my neck and I had a hat on, but the shallow scoop-neck left uncovered an area that I never thought to add sunscreen to. It’s not burnt, but there’s color. And that color is a reminder that I wasn’t as deligent as I should have been, but now I will know for next time.

I ordered my swim top from Girls4Sport (G4S). While they have swim tops that are traditional in coverage, they also carry short-, three-quarter and long-sleeves. I bought the three-quarter ringer style and am very happy with how it looks and performs. It took an extensive search to find rash guards that weren’t plain looking AND that had a built in shelf bra. How awesome are these UPF50 fabrics?!

(This is the style I got)

 

(This was my 2nd choice)

Here’s how my kids looked at the water park:

As I mentioned, I bought Aitch’s suit from Land’s End. Of course, they are marked way down now, but this is her top in green batik. Her skirt in tide green, while the pattern was not marketed as “coordinating”, I purchased because the colors were similar and I liked more of a quirky look.

The swim trunks on Doodicus were from Target. I think the rash guard was from Old Navy. I got these last year before I understood the importance of the UPF so I have no idea if his shirt is rated. I will be ordering him something I know has proper protection for next year.

Survivor

It was just a couple of months ago that I was diagnosed with malignant melanoma. It seems odd to even say or think the word cancer since in my case the diagnosis and the removal of it occurred within days of each other. In other words, could I really be a cancer survivor when I really don’t feel as if I ever had cancer?

Very shortly after I lost my job at the hospital two years ago, I found out one of my friends still working there was diagnosed with Stage IV breast cancer. They gave her six months to live. As of last week, she is still alive but in so much pain that she refuses to see anyone. The only treatment available to her at this point makes her violently ill and unable to function physically or mentally. Her family doesn’t know if she’ll make it through the holidays.

Last week we received word that Sparring Partner’s CousinP from Boston, the one who graciously gave up his free time to me while I was visiting there, was diagnosed with testicular cancer. We don’t know any more than that right now except that he has taken the news very, very hard.

S.P. told me I should give him a call and talk to him “about what we had in common.” Obviously, I understand where he was coming from but the suggestion was ludicrous because I just don’t feel as if I do have anything in common with him, just as I don’t know how to talk to my friend who is quite likely on her deathbed with cancer.

I had a cancerous growth. I had it removed. I don’t see myself as a cancer survivor and quite frankly, I’m sure many feel the same way towards those with this particular type of cancer…some might even say it’s a pseudo cancer.

I rarely think of it, except when I accidentally hit my leg against something or when Aitch demands to see my “big owie” (to which she always exclaims “Oooh! That’s a big owie!” and then kisses it to “make it better”). Sometimes I examine it while getting dressed. I stopped commenting out loud about how ugly the remaining scar is as S.P. would remind me, almost reprovingly, “The cancer was ugly. This (he would look pointedly at the hole in my leg) is not ugly.”

I appreciate his sentiment, but I guess I’m vain. The large scar seems to be the “pay off” for what seems to be a curable (for the time being) cancer; simply cut it out much like a rotten spot from an apple.

My friend with terminal cancer is a survivor, regardless of what comes in the next few weeks. My husband’s cousin will be a survivor because of the uncertainty he will face. If I am lucky (very, very lucky) my cancer will not return and I will never have to perceive myself as a survivor.

Earning a Medical Degree One Illness at a Time

You know, as soon as this whole business with my melanoma has blown over, I can’t help but wonder what other crap bit of luck is going to drop in my lap. Maybe I shouldn’t wonder too hard, hmmm? Especially since Sparring Partner’s dad has been feeling under the weather; or since my dad is recovering from a crushed vertebra; or since two year olds are prone to all kinds of accidents…

My second follow up with the plastic surgeon was a couple of days ago. I was looking forward to this one because it meant getting the stitches out of my foot. I had no idea that the stitches were causing me so much discomfort until they came out. My foot had healed up so well that they were ripping my skin back up again with every step. In fact I think they were in too long since the resident had to open a third set of pick-ups when the first two he tried were too dull to remove a piece of blue nylon that had become embedded under the skin.

Oh, you’re shuddering at the thought?? Trust me, I had a death grip on the exam table, nails dug in deep, and my head averted to keep myself from kicking him in the face as part of an automatic reflex to watching some one picking at the sole of my foot with a foot long pair of sharp tweezers.

The tagaderm (a transparent film dressing) is still in place over the donor site. I was told that eventually it’ll come off on its own and the site will still be red and raw. Funny isn’t it, how long it’ll end up taking to heal, huh? Another fact I wasn’t made aware of by the oncologist or surgeon. These were the EASY wounds.

As for the MM site? It’s still ugly, but getting better. It’s sore, especially in the morning, but at least the swelling in my ankle goes down by then. Oh, I didn’t mention that earlier, did I? Yes, my right ankle swells and gets painful by the end of the day. Apparently there was significant damage to the vessels and my lymphatic system needs to figure out a new way to move fluid around the site.

As for the good news, at least 80% of the graft took. I didn’t ask what will happen with the area that didn’t. I’d ask in two weeks when they asked I return, but I didn’t schedule that appointment. I walked past the desk without a second look. Sparring Partner suggested I go back in a month instead.

You’ll have to check out my “Cost of Healthcare” page. I’ll have that updated soon. Here I was just thinking a month ago that overall, our out-of-pocket expenses were way less than an annual insurance premium plus copays and deductibles. Alas…the kids didn’t need to go to college anyway. Look where it got me.

I Did Not Escape So Easily

My follow-up appointment to my surgery was yesterday. I was SO excited about it because it meant finally getting the plaster splint removed, letting the surgical site heal, and just moving on. Bye-bye, Cancer! Pfffft!!

I was excited about finally getting to take a shower. Shaving my legs that were resembling a tarantula’s. Washing away the week of bed-ridden stink. Wearing shoes; REAL shoes, not Crocs (actually just Croc, since I could only wear one shoe). Returning the walker and the crutches.

What did I say earlier? Bye-bye, Cancer? Pffffft?

I wasn’t prepared – at all – for my appointment yesterday, which was a follow-up with the plastic surgeon. I guess what I saw on the bottom of my other foot was what I thought I would see on my leg. I was thrilled when the nurse started removing the splint without the doctor even there. She unwrapped the compression bandages and then carefully cut away the padding from my shin and eased the plaster cast from the back of my leg, pausing briefly when the gauze seemed to have stuck to the site.

She picked it away from what was holding the gauze: a staple. A staple that was connecting my skin to a sponge. There was a sponge stapled to the back of my leg. A round sponge. The staples pulled on my skin to create unnatural and gruesome wrinkles. I was shocked but fascinated. I took a picture and sent it quickly to Sparring Partner who was in the lobby with the kids.

The surgeon came in shortly and picked up the staple-removing pliers and lifted my foot to his lap. I awkwardly turned my leg so he could reach first one side and then the other, plucking at the staples as I bit my lip in pain. One of the staples was stubborn, he picked at it and I yelled OUCH! and quickly apologized as he halted the torture briefly to almost glare at me.

Finally the staples were out and I fanned my face with my hand. He asked if I was going to faint. I said no, that I had just gotten really hot. I wish I had fainted. The pinching of the pliers and the quiet “click” against the staples was sickening. He pulled the sponge away and a wadded mess of bloody gauze lay underneath. I turned my head away as he removed it. I’ve never shied away from gore, but this was too much.

When I looked again, he was examining his work and I gasped and said, “That looks terrible! ….no offense…” He ignored me and picked up a tiny pair of scissors and snipped an overhang of graft skin. I felt nothing. I said it looks like a shark bite. He replied he’s seen one and yes, the site does look like a shark bite; a very small one, he amended. Small. The size of my palm. I took another picture with my phone. And then I said, “So. This is what malignant melanoma can do…” He nodded sagely.

He cleaned the wound, added some ointment, which because of the depth of the wound, most nerves were gone and I never even felt, covered it with a pad, packed it again with gauze and wrapped it all back up again in a compression bandage. He told me I could shower. I asked what’s the best way to cover it during the shower. Oh, no, he said, you will change this every day and can leave it uncovered for your shower (!!!!). I’ll see you in another week, he said, and walked out.

I have pictures, but quite frankly, they are awful. I will post them, but not today. I am still trying to wrap my head around everything. I wasn’t prepared for being incapacitated for a week. But mostly, I wasn’t prepared to see what I have seen. I guess that’s what I get for thinking this whole MM went too smoothly for me: diagnosed and removed with negative secondary biopsy results. Smooth sailing…I knew I would have a scar. I expected something similar to what was on my foot. A vertical line or something less invasive. But to see that hole in my leg. Well, it upsets me even now to think about it so that’s why I’ll wait to show you another time.

Pain, Pain, Go Away. And so on and so forth.

The night before my surgery I woke up pissed. I was thinking about that stupid pregnancy test and it just made me angry. If my word that I definitely am not pregnant wasn’t good enough, then why do they bother asking?? I thought of all the snippy responses I could make including, “If my test came back positive then I wouldn’t need the surgery, I could heal myself and everyone in the general vicinity.”

The surgery itself went well I guess. It took about an hour and a half. I was a bit shocked to see my right foot bandaged from toe to knee, wrapped in an ace bandage and fortified with a hard splint. Not sure why they didn’t just boot me. While the option of a skin graft was there, it wasn’t until I moved on the gurney that I realized that’s exactly what had happened. The graft site was on the back of my thigh, just under my buttocks. I realized painfully, that the site is exactly where a toilet seat hits when I sit down to pee.

My left foot looks fairly normal with a wadded hunk of gauze taped to the arch. It also hurts like a mo-fo.

Everything hurts.

The dozen steps I had to take between the gurney and the bathroom in post-op made me realize that not even my c-section surgeries hurt this much. On the two-hour drive home from the Metro, we had stopped at a gas station to get something to drink. I think the combination of morphine, percocets and vehicle movement were too much and I nearly threw up in the back seat of the van. The wave of nausea passed but I just felt like crap.

Once we made it back into town, I started dreading the walk that was necessary to get me from the van to the bedroom. There’s no way Sparring Partner could carry me, with his back in poor shape. So we stopped at the in-laws and borrowed an extra walker.

Yes, you read that correctly. A walker. It has been a godsend. Now originally, the oncologist thought that this surgery wouldnt hamper my ability to go to work the day after. I’ve quickly realized that I won’t be going back to work (it’s another temp position) until Monday. The doctor’s instructions are laughable: “toe touch weight bearing”. Not sure how one walks with just toe touch on both feet. I would need a pair of fucking wings for that. Going from the garage to the bedroom was excruciating: I was crying half-way there, which is at the kitchen table where Doodicus was sitting with his homework. I saw from the corner of my eyes (full of vision blurring tears) that he was staring at me, afraid to say anything. I’m not sure he’s ever seen me cry in pain.

I’m throwing back percocets as soon as the four hours pass to counter that pain. I am taking something to help the nausea pass. I am taking something so everything I eat while on pain meds will pass. On top of those three things, I am also on an antibiotic.

I return to the Metro on the 20th to have the splint removed. By then the path report should be back on the second mole. By then, I should only be limping. By then I will be dying for a bath or a shower as I’m not allowed either since there’s no way for me to keep one entire leg dry. It’s whore baths for the next week. You better count your lucky stars that you are where you are and I’m where I am. Not that I’ll get too stinky, but because my mood is most foul. Until I have my perc and then I’m a happy camper. A sleepy, nauseous and wounded camper.