The last time I went to a dermatologist, over 2 years ago, I told her I was concerned about a particular mole on my back because it was itchy, irritated, and scaly, and it would sometimes bleed. The doctor attributed the irritation to my clothing rubbing against it and sent me home with some cortisone.
I have been meaning to go to the dentist, gynecologist, general practitioner, and dermatologist for over a year now and set the goal of seeing all of them before the end of summer. Pregnancy and children seem to make time between doctor’s visits much shorter than they really are.
I finally made it to my dermatologist appointment and she recommended having that same mole that I was concerned about 2 years ago removed. Three weeks ago today I received a call from her nurse. She said that the mole she had biopsied a few days prior had come back abnormal. It was melanoma. Cancer. The nurse had already made an appointment for me to see a surgical oncologist at Ochsner, Dr. Ralph Corsetti, for the following week.
I called my husband and flatly told him what the nurse had said. I told him we could talk more about it when he got home from work. I called my Mom, simply reporting the information to her, unfeeling.
Once I got off the phone, I got on the computer and looked up melanoma with the same ferocity I researched pregnancy symptoms when I found out I was expecting my first. I saw phrases like fastest growing cancer, survival rates, likely to spread to brain and liver. I felt very sober. But I didn’t know any of the information that would give me indicators as to how bad my melanoma was.
The following day, I called the nurse back and asked her for the pathology report. My Mom picked it up for me and dropped it off at my house. It reminded me of getting acceptance/rejection letters from colleges when I was a Senior in high school – the anticipation, excitement, fear. I opened the envelope while sitting next to the computer, ready to research.
I quickly became educated in what phrases like Breslow’s depth, mitotic rate, brisk infiltration, ulceration, and Clark level meant. That evening, my husband and I went through and read each descriptor line by line, looking up what they meant to get a handle on the balance of good news and bad news in the pathology report.
The two pieces of good news were that there were a lot of white blood cells present (meaning my body was attacking the melanoma) and that the mole wasn’t ulcerated. The bad news was that the melanoma was relatively thick, was in an advanced growth stage, and was growing at a pretty nice speed.
When you get a cancer diagnosis, the internet isn’t your friend. You don’t have much information and will get led down black holes of doom and death. The following morning, I called the cancer surgeon and asked if there was any way they could see me sooner. The anxiety was debilitating and I didn’t know how I would make it a week.
They were able to get me in in 48 hours. Thank you, Jesus! My husband and I went to the appointment together, waiting to hear what the surgeon’s take on the pathology report was and what his recommendation was moving forward. He said that based on the information in the pathology report, he estimated that there was about a 10% chance that the cancer had spread. I was so relieved!
The surgeon’s recommendation was to put me under general anesthesia and remove the mole with wide margins as well as the nearest lymph nodes under my arm. The mole would be analyzed to see how deep the melanoma went and the lymph node would be analyzed for the presence of melanoma cells.
If melanoma cells are detected in the lymph node, it means the cancer has spread beyond its original location and has an increased rate of recurrence and a worse 5 and 10 year prognosis. It also necessitates removal of more lymph nodes and possible immunotherapy.
The doctor was able to get me in for surgery the following week on the kids’ last day of school. It’s a chaotic time of year for everyone it seems, but my in-laws were already planning on being in town and my husband was already planning on being off of work. We left the appointment feeling upbeat and hopeful.
It was a long week of waiting, filled with anger, fear, and speculation. Time wasn’t my friend in this regard. The farther we got from my appointment with the surgeon and the closer we got to surgery day, the less upbeat and hopeful I felt. I was angry at people who kept telling me that melanoma was no big deal. It was cancer. I’m 33 and I have cancer. That’s a big deal to me!
Eventually, two days before the surgery, I was overcome with a serenity and peace that can only come from God. I literally felt covered in prayer.
Surgery was 3 days ago and I feel pretty good. I realize I don’t like surgery. That may seem obvious, but I had always been told general anesthesia was similar to the best nap of your life, and this tired Mamma had been looking forward to it! Apparently, general anesthesia makes me feel like crap for several days.
I have a 3 1/2 inch incision on my back where the surgeon removed the mole and a smaller incision under my arm where he removed two lymph nodes.
It can take up to 3 weeks to get the pathology report back which seems inhumane! The days since surgery have felt very long. So, we wait and we pray. We become introspective at times, wondering what the future holds for our family of 6. And I try not to do any research online. It just fuels the fear.
Apparently I’m allergic to the pain meds they gave me and my incision is infected. Other than that, I’m doing great! :)
5/31/13, Pathology Report
Dr. Corsetti just called. The lymph nodes were clear!!!!!!! No medical therapy needed!! He did say that there was residual melanoma on the surface that was closer to the margin that he had hoped, so I will need one more surgery to get wider margins. One more surgery. That’s it. Not horrible, mean medicines that take you to death’s door then turn you away. I am so very relieved. And so very thankful for all of the prayers.
The point of this is to remind you all to stay out of the sun and to get your skin checked annually by a dermatologist. He or she should look between your toes, on your scalp, and between your cheeks (yes, those cheeks). The survival rates for melanoma are outstanding when caught early and removed surgically. Once it has spread, though, the picture becomes much more complicated.
Thanks for all the prayers and well wishes over the past month.
6/15/13, Second Surgery
Yesterday I had my second surgery to remove the potential residual melanoma on my back. The doctor went a centimeter above and a centimeter below my current incision.
I had a preoperative appointment with Dr. Corsetti three days before surgery and he said it looked like the infection was gone. He said he didn’t need to put me under general anesthesia this time because he wasn’t removing the lymph nodes. The thought of local anesthesia for the removal of 4 in x 2 cm of my back made me visibly uneasy. Dr. Corsetti could see this and said he could do it under general – I felt very relieved.
I arrived at the hospital at 7:30AM and was prepped for the procedure by some really lovely nurses. Anesthesia came in and said that they were doing local anesthesia, not general. Eek! Okay, I squeaked, sucking back the tears. The anesthesiologist reassured me that local is much safer than general and that I would just feel a bee sting when the numbed my back.
I also told him that the 2 sedatives I had gotten in previous surgeries made me feel horrible. One made me really out of it for about 2 weeks. The other made me feel like I was sinking and spinning into a black tomb. It was terrifying! We agreed that neither of those were okay, so we went with Option C, a slower-acting sedative that was just as effective of making me a little loopy during the surgery.
I was wheeled into the OR, completely awake, talking to the nurse anesthetist. She kept asking if I was feeling any effects from the sedative yet, but I wasn’t. They started cleaning my back, draping me, putting an oxygen mask on my face, waiting for the drug to kick in. Eventually, I felt a little sleepy and told her so.
That was the green light for the surgeon, and I felt the bee sting. Ouch! And another. And another. And another. And another. That really hurts, I said. The doc calmly asked the anesthetist to turn up the Versed, the drug I had politely declined. I’m sure she cranked up what they were using, but with a 10 minute delay, it didn’t have much of an effect before the surgery was already over.
That was when I felt the scalpel cut my back. I shouted. He asked for more of the shots – one, two, three of them. Please turn up the Versed, he requested. She didn’t want Versed. She has a reaction to it, the anesthetist repeated.
I felt him cut me again. This is what torture feels like, I thought. Just sitting here, unable to fight, submitting to pain. Is this was the scourging was like for Jesus? Dear Lord, get me through this! I prayed.
He began cutting again and this time I didn’t feel anything. Then he used the cautery to stop the bleeding and I felt it. I felt him burning my back! I can feel that, too, I screamed. Another shot, 2, 3, 4. Then came the stitches. Hail Mary, full of grace… I felt like he was taking a tube and shoving it in the incision. I can still feel it, I cried.
By that point, about 10 minutes had passed and I fell asleep, tears rolling down my cheeks, Hail Marys falling off of my lips. This surgery was right up there with my delivery of Ben when the epidural didn’t work properly. This surgery seemed inhumane. It makes me cry to think about it.
Did you know that women need more anesthesia than men, and that redheads need 20% more anesthesia than blondes and brunettes? Apparently, redheads are less likely to go to the dentist compared to the rest of the population. Wonder why? Because we can feel it! I tell everyone I come in contact with who is responsible for numbing me that redheads need more painkiller than they think! It’s science! Unfortunately, I didn’t tell the anesthetist yesterday because I was of the mindset that I was going to be under general. Here’s the study out of NIH and here’s an article written in laymen’s terms.
The only upside to all of this is that I feel great now. Not having general anesthesia makes me mentally clearer right away. That being said, I would gladly trade mental clarity for never having to endure that kind of pain again. If we do this again, and we may, I will demand general anesthesia. I don’t care that I can’t formulate a complete thought for several days following. Would you?
You know what I have to show for all that sunbathing that left me with a gaw-jiss summer glow? This.
6/27/13, Cancer free!
I got my stitches out today, and my oncologist said my margins from surgery were clear! He said there were lots of abnormal cells in the tissue, but it wasn’t melanoma. I’ll take it! This girl is done!