Thursday, October 25, 2012

Surgeons, Appointments, and Scans- Oh My!

When my dermatologist sent my information to the MD Anderson Center, they used Google to find the number. They sent my information to the first number that popped up. Unfortunately, that was the one in Texas, not in Florida. At the time, I was all prepared to go to Texas if needed, but I knew that there would be some time and multiple appointments involved in this process, I had no idea HOW much time, so it would be best if I went local, since we had one 20 minutes from my house.  The people at my derm’s office were apologetic and when the PA learned of the mistake, they set up an appointment for a general surgeon.

I was diagnosed on Friday, June 15 and saw a general surgeon on Thursday, June 21. My husband, Mr. LSM,  went to the appointment with me.  The doctor introduced himself and asked what I knew about melanoma.  Mr. LSM and I looked at each other, then him, and said, "Not much."
He said to us, “Melanoma is not a good cancer to have.”  That comment stuck with me. I mean, I never thought ANY cancer was good to have, so if this is the cancer you don’t want to have, what in the world was going to happen to me?

He explained that my melanoma was found 2mm into my skin. This meant that there was a 10% chance it spread to the lymph nodes. That is the SUPER scary part about melanoma- the spreading.   Ten percent wasn’t too shabby, right? I mean, like my good friend said, if you had those odds on the lottery , you’d play wouldn’t you?  But still, any chance scared me. 

He explained that he would have to do a lymph node biopsy the day of the surgery.  He drew on my neck to show me where he would cut and then sent us on our way to await to hear when the surgery was scheduled. The time spent in his office was pretty short.  I left  feeling a bit uneasy. I mean, how does he know HOW much to cut? Will he take any sort of tests to find out? It didn’t sit right with me, but  I wanted it done ASAP.  I begged for that Friday or Monday, but that was entirely too soon to book an OR.  They would call me and let me know.

 A week went by. During that time, I made at least 3 calls wanting to know if the surgery was scheduled. I finally I got a date- July 9.  I asked if it was bad for me to wait so long and the nurse told me she had patients with pancreatic cancer waiting that long. I didn’t understand what her comment meant, until I found out that pancreatic cancer is one of the deadliest.

The Orlando MD Anderson Clinic called me a few days later. I had an appointment for  June 26 with another doctor.  Again, Mr. LSM and I went to the appointment, not knowing what to expect. A few minutes after meeting with the doctor we realized I was meeting with another surgeon. This one did a LOT of explaining. It was kind of like taking a math class with a professor who was WAY over your head. I sat and listened. Every few minutes I would realize that I had been holding my breath and let out a large exhale. He would stop and ask me if I was OK. I just kept nodding my head, yes.  He explained to me that he was a head and neck surgeon.  That was all he worked on.  He also let me know that he dealt with melanoma cases about once a week.  He said he would send me for a PET/CT scan prior to scheduling the surgery. I liked that. He was going to check some things out before going in and cutting all willy nilly.  I asked how long it would take to schedule surgery once the tests were taken and he told me no more than a week. That meant I would still be having surgery in the same week the first one was already planned.   

Where I would be spending a lot of time

When we left, Mr. LSM was frustrated. He didn’t understand why they sent us to another surgeon. We already had one. And he wasn’t crazy about this one. He “talked too much.”  Everything inside of me was telling me to go with this one.  I spoke with my mom, my friends- one who is a highly trained nurse, and they all felt better about the second surgeon. Then I realized that going with the new surgeon, meant waiting longer, and my husband wanted it out - possibly even more than I did.   Still though, he supported me when I decided to go with the head and neck surgeon. I am SO grateful I did.

Over the next few visits he began showing more of a bed side manner he didn’t in the first appointment. He even gave me his personal cell for questions.  My only complaint is that he didn’t have the best way of delivering news. At the appointment following my scans, he came in and said, “We went over your scans at our convention last night.” I still sat in my seat, exhaling every few minutes, while I listened to him talk about things that should be lighting up and things that shouldn’t be lighting up.  Then he looked at me and said, we did not find anything lit up in you.  That is good.  I looked at my sister and then back at him and he said, “maybe I should have started off with that.”

Ya think so, doc?

My sister, who was sitting in the chair next to me, later told me she was certain he was giving me horrible news. She flashed back to her experience with the last eight seasons of Grey’s Anatomy, and said, “You only go over the worst cases in front of a room full of doctors.”  We then joked about how my breasts looked uneven in the scans that were shown to all the doctors. I was grateful for our sick ability to always find humor in tough times. 

He sent me to more scans that day (since I made the mistake of telling him I hadn’t eaten yet).  One of the scans involved getting shots injected all around the site on my neck and then watching it with a machine to show wear the injections would drain. That would determine the sentinel lymph node. I had to have that done twice.  that day and a (since I hadn’t eaten anything yet) and then again the morning of my surgery. This would determine the nearest lymph node, the one to biopsy during the surgery. I had that done twice before the surgery.  For a much more detailed explanation, check out this article. It truly is an amazing thing.

So, the plan was to cut more skin around the site where the mole was and do the lymph node biopsy.  He would lightly stitch me up and send me home over the weekend to wait for the pathology reports.  (He assured me he would cover up the incision well, so my little ones wouldn’t go trying to poke their fingers in it.) Then I would return on Monday. Depending on the pathology results, I would either have my wide excision closed up or he would have to do entire neck dissection, cutting far more than just the area around my mole site and removing all my lymph nodes. 

 The oval to the right is where he would make the first cut. If I needed the neck dissection, he would have to cut along ALL of the purple lines. 

The final step before surgery was to meet with my oncologist, who was kind, friendly and very familiar with melanoma.  He assured me that I was going with a great surgeon. I waited on meeting with the radiation oncologist until after the surgery.  I felt satisfied in the people who I would be in charge of my treatment.   All that was left to do was pray and wait.  

                                 One last look at my neck before surgery. Notice the big sun hat.

I went in on Friday, July 13 (fortunately I am NOT a superstitious person and 13 has always been a good number for me).  The wide excision was done. I was stuffed and basted to keep things together while I went home.

 Hours after the first surgery

On Sunday, I called my surgeon because my sister noticed my face was a bit swollen. He returned my call shortly after, telling me that was to be expected. He then shared that the pathology reports came back early. The margins and the lymph node biopsied were negative for melanoma. 


I would go in the next day for surgery to be sewn back together.   No more cutting

Just before that surgery, the doc came to see me and give me the pathology reports again. He held my hand and told me congratulations.  I have never been more grateful in my life. I truly felt God had put me in the right hands.

I had about a week of recovery. I was mostly tired with pain in my neck. The following Friday, I took a good look at my neck for the first time. 

 Four days after the closure

I showed Mr. LSM.   He looked at it as if it were nothing more than a pimple. I was so grateful for that look, but I didn’t feel that way. It looked like I had a rod in my neck. I was afraid I would walk around looking like Frankenstein forever.  I began to cry, and he reminded me that I was crying over something that was just superficial. That was the first and last time I cried about this scar.

 Three months after surgery

Prior to my surgery, I thought I would be utilizing all the scarves I’ve been buying over the years, hoping to have a reason to wear them in Florida.  Instead, this scar has become my badge of honor. It is my mark proving to me that God really does love me, and that He wants me to do so much more with this life.  Three months later, I can honestly say I wear it proudly.   Most days don’t even think about it.

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