Are You Giving Yourself the Best?

Today I had my 3 month skin check with my dermatologist.  Actually, it was my 2 month, 2 week checkup, since I moved up a little early due to the lovely new beauty mark over my lip.

 So, since it was skin check day, I did what my fellow warrior suggested at Respect the Rays. I circled all the marks I was most concerned about. I always leave the doctors’ offices forgetting to ask questions. ALWAYS. So this way, at least if I forget, the circles will draw her attention to them. 

I asked Mr. LSM to help with some of the circling, and he got a little carried away.  I, too, almost got carried away. I was recently asking my 3 year old what it was she enjoys SO much about writing on herself. Well, today I got a little reminder of the power you hold with your pen in hand and your skin as an empty canvas. I won’t question her again.

I've been visiting my current dermatologist office and seeing the Physician’s Assistant since my surgery to remove my melanoma in July.  I left my former dermatologist’s office, the office where I got my diagnosis. For the entire 10+ years that I went to that office, I only saw the actual doctor once. It was for an appointment about my hair loss.  He was never EVER available for any of my other appointments for skin examinations, nor did I ever even see him in the office. I always saw his PA. I am extremely grateful for her finding my melanoma (after I went in and told her to remove the mole on my neck), but I felt that this was just not the place for me if i want to stay ahead in my war on melanoma. 

Much like parents who make sure their child has  the latest Xbox, but could care less about whether their child can SPELL Xbox...
Or the Real Housewife who gets a non-surgical, fat-reducing machine brought into her home and eats a slice of pizza while sitting under it...
Or the mom who makes sure to stop off at Starbucks on her way home from the dermatologist’s office, but doesn’t bother to stop off at the store to buy toilet paper her home, which currently has none...  I absolutely know NO one like this btw.

These people aren’t necessarily BAD people, but I am quite certain their priorities are in order.  

My former derm’s office focused on beauty, Botox, and hair implants. 

 If you want to look like a Joan Rivers, they can help.

If you want to live as long as her, probably not.

Here’s what I think are signs of a great dermatologist’s office (and what I happen to love about my new one):

Click to purchase

Reading Material:

How can you not totally ADORE this book all about the spots on your skin??? I think everyone (elementary age and up) should either own this or at least read it over a few times. I am thinking every one of my kids’ classrooms will have one donated by me all through their elementary school years.

A Space Heater:

Ok, so this isn’t the end –all, be-all of determinging whether you have a good derm, but I mean come on, who doesn’t get a tad bit chilly when sliding down into your unmentionables? Those paper gowns aren’t thick at all.

Posters on the Wall:

Notice the view from the patient’s chair.

  

I am a reader, and I will read the back of a shampoo bottle to occupy  my time if it’s all I have available (This usually when I am taking my 5 minute bathroom escape every evening. The only place and time I can sort of get a few moments peace.)  So had these posters been up in the office of my previous dermatologist, well, maybe I would have known about the E in the ABC’s of skin cancer and gotten my butt in there a lot sooner-like a year sooner- to have my “suspicious” mole removed. This would have drastically decreased the chances of my melanoma getting into my lymph nodes or blood stream.

Priority on the Patient:

My PA takes time to listen to me. She is not at all annoyed if I come in with 100 circles on my body. She knows what I have been through and she will "humor" me, even if I do sometimes appear totally nuts. 

She asks about different marks, “How long have you had this?” She checks under my unmentionables. She checks my scalp. She looks between my toes and my fingers.  She examines me ALMOST as good as I would examine myself. Also, when I go in with a concern, like the mark on my lip, she takes it serious. 

Importance of the Patient:

As I mentioned earlier, in my new dermatologist office, the doctor has always been there when I have visited. Twice now, he has come in to help my PA with a concern she had about a mark on my body. Today it was my lip. She noticed the mark had gotten darker. She thought removing it was a good idea when I asked, but she was also concerned about where the mark was located and how I will look after. She asked the doctor to come in. They could have just said, "Screw it. You need it cut, and it's a yucky place to cut. So deal." But together they determined the best way to remove it  in order to leave me still looking like a decent human being ( and somewhat of a pretty mama).

All of these things make a huge difference when it comes to my health, to my life. So it is important that i make sure I treat myself to the best. We all deserve that. 

Final notes: 

1.  In case you ever wonder, getting a needle stuck in the top of your lip hurts like a MOFO!!! I can take a lot. I've had needles in my eye lid, needles in my neck, needles in my back, and I took this one like a BOSS- make no mistake of that- but I can't lie, it stung inside my heart a little. 

2.  The dermatologist said by looking at the mark, he was pretty sure-99%- it is benign, but given my history, why ask me to wait and watch. Why stress me out when I do need to? Removing it was the right thing to do and me wanting it removed was the right way to think, regardless of the location.  It feels good to have doctors on your side.  I should get the results in about a week.

Thank you for reading. Until next time, practice safe sun...and give yourself the BEST of everything!

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.

http://www.melanoma.com/sln_biopsy.html

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. 

  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.

And Then There Was Melanoma, Part 2

The first five minutes of my ride home from the dermatologist’s office on June 15, 2012, I rode in silence.  Then I called my husband.

Me: It’s melanoma. 

Husband: What’s that? 

Me: Skin cancer. The worst kind.

We sat in silence for a few seconds.  Then I told him we would talk more about it when I got home.  Next, I called my web searching sister and told her.   Mrs. “Internet MD” was shocked at the diagnosis, and before we hung up, she was in tears.  It was during that moment I decided I would NOT go home and search the web for information about melanoma. I would wait until I saw the doctors.  The last call I made from the car was to my youngest sister, the one who was out by the pool. I wasn’t calling my mom until I knew she was home from work.

At home there wasn’t a lot to be said. I told my husband what the next steps were, handed him the pamphlet, and went back to my office to make some calls.  My refusal to research melanoma lasted about five minutes once I sat at my desk. After all, I work from the computer all day long, and I’m a total Google fanatic.  So, against my instincts, I searched for ‘melanoma on the neck’.  Go ahead. You do a search for it now. What’s the FIRST thing that pops up?

If you didn’t look, this is what I saw.

I clicked on the link and began to read.  To say my heart dropped is an understatement.

It felt like every one of my bodily organs was at the bottom of my torso. My body was being smothered from the warm feeling of dread rushing from the back of my neck through my arms and legs all the way to the tips of my fingers and toes. I couldn’t breathe.  I looked over and saw the time. My mom was home from work. I pulled myself together to call her.  I told her about everything that happened that day.  Then I said, “Mama, I want to be as positive and optimistic about this as possible, so I am asking that everyone do the same for me.”  That wasn’t an easy thing to ask, considering I am probably the most optimistic person in my family (and that isn’t saying much), but she did it.  She stuck with me, as I totally expected her to, but she never cried or expressed any doubts- at least not in front of me.  By the end of that phone call, I had utilized every bit of strength I had. I closed my laptop, went into my living room, sat with my kids and watched cartoons.

I watched as much television as possible for the next two weeks.  It was the only thing that was able to take my mind off of cancer. And dying.

It was VERY difficult for me to talk about it. I told my closest friends via Facebook. Then I sent a message to a large group of my actual friends that I speak to often.  I asked them for their prayers and positive thoughts. I kept them posted with my treatment that way as well.  I barely called my sisters or my mom, because I just couldn’t keep my mind off of it, and I didn’t want to talk about it.

It wasn’t until recently that I could even write- I had cancer- much less say it aloud. I always said, “I had a mole removed, and they found melanoma.” My mole had melanoma. Not me. I refused to own it. I couldn’t own it, because my plan was for it not to become a part of me. I wasn’t claiming ownership to anything I damn well planned to get rid of as soon as I could.

The next day, on a Saturday night, I received a call from the MD Anderson clinic. I was so grateful I didn’t have to wait until Monday. They said they would be in touch with an appointment (the call was to basically ensure that I was insured.) I received an email 3 days later. I had an appointment a week later at the MD Anderson Center…in Houston, Texas, Orlando, Fl.  My dermatologist’s office had accidentally sent my info to the one in Texas. Half a week had passed and we were at square one all over again.