**Contains Graphic Post-Surgery Images of Leg**
I don’t know about you all, but I am having a hard time wrapping my head around the fact it is already May. While May is a month full of busyness for my family, it is also an important month for me personally. In the past, May meant finishing up a school year, planning Memorial Day shenanigans and reeving up my tan. Fast forward to now and May means helping my own kids wrap up a school year, try to plan Memorial Day around crazy work schedules and advocating against Melanoma.
I advocate like a person with lung cancer will advocate against smoking, I advocate like a Mother Against Drunk Driving (MADD) will after losing a child caused by a drunk driver. I advocate because Melanoma was, is and will forever be apart of my life. However, the irony of when and why a person starts to take action never ceases to amaze me. Hindsight is 20/20 but when I look back, strangers just like myself were trying to protect me from me. The tanning beds I went to in college had pictures of Melanoma smack dab in the middle of the eyeball. It was gross but of course, “that would never be me”. The tanning beds I used to frequent back home gave detailed warnings about protecting your eyes, wearing your goggles and how it could increase my risk for this or that. Once again, thanks for the warning pal but I was on a mission to achieve the perfect glow and raccoon eyes caused by goggles just couldn’t get in the way so off they went. All these warnings yet I was so caught up in the specials salons threw at me, various new tanning lotions (the hotter the better) and get a load of this one….whitening my teeth!!!! Admittedly, I use to wear the Crest White Strips into the tanning bed and smile at the top of the bed for a solid 15+ minutes (don’t worry, I am laughing just as much as you are right now).
In 2009 I had a strange lump in my groin. I went to two hospitals and my primary doctor to have it checked. Routine blood work suggested I had elevated liver functions and after an ultrasound revealed nothing, my doctor settled on mono. The lump went away and I didn’t think any more of it. Fast forward to 2010, the busiest, proudest, most hectic year of my life thus far. Jason and I had a big wedding planned for October of that year. Everything was just about paid for when I found out in Feburary I was pregnant. It definitely wasn’t the most ideal time as I was finishing up my last semester of college which I proudly graduated with honors, building a home and working a full time job.
Somewhere in between there I noticed a mole on my right thigh that I had knew was ugly but I simply didn’t have any time to have checked out. At one of my routine OB appointments, my doctor took one look at it and suggested I get it looked at immediately. My primary doctor took one look and commented on how it didn’t look bad but because I was there we would take it off more or less for cosmetic reasons. I shutter at the fact that I told him to leave it there if he wanted! The initial pathology report came back that there was pre-cancerous cells. I was then sent to the PA at the dermatologist office. I was assured that whatever I had was caught early but that wider margins were going to be taken as a precautionary measure. Wider margins simply meant more skin around the area would be cut out via a small in office procedure. As I laid in the chair with surgical cloth draping my leg and sharpie x’s in about five different locations, my dermatologist who I was meeting for the first time came in and told me she wouldn’t be able to go through with the procedure. Something was wrong somewhere and she was requesting the pathologist to dig a little deeper. I waited for feeling to come back in my already numb leg and left the office with my mother wondering what had just happened.
Four days later on a Friday morning I got a call that I needed to come to the office within the hour. I should have known that that was code for “something is wrong, real wrong”. I should have demanded my husband who was taking the week off work to drive over with me.I should have asked someone, regardless of who it was to go with me but I didn’t. Instead, I drove myself not knowing what I was about to be told. My doctor explained to me that I was not on the doorstep of melanoma, rather I HAD stage 1 malignant melanoma. While it was caught early, it did start to invade the top layer of the skin. To make matters worse, there was signs of regression which means at some point it was deeper. How much deeper, we will never know. What we did know is the elevated liver functions and the lump in the groin finally made sense over a year later. It was my body’s response to fighting off the beast.
One thing I will never ever forget about that Friday was the nurse hugging me, telling me I would be there for my daughter who was not yet born and me breaking down crying. It was at that point that I knew it was real but I still didn’t think it fully clicked. I took many medical classes in high school, I knew a lot of medical terminology and even started college in a biology pre-med program. I knew OMA meant tumor but tumor, skin, and me all in the same sentence was hard for me to understand. How? Why? Where did it come from? What’s next? These were all questions that played over and over in my mind. Thankfully, I have a fantastic dermatologist who answered my questions thoroughly and with the utmost compassion.
I had my first surgery in the office at about 7 months pregnant. I was wide awake the entire time. She cut down to the muscle where I sat and watched them jump as she cauterized the vessels. It was nasty and a bit nauseating but I survived. three layers worth of stitches and an hour or two later, I was able to go home and returned to work couple days later. I honestly don’t remember it being all that bad but perhaps there is a slight mental block.Below is a picture of my scar about 4 days post surgery and today, almost 4.5 years later.
Sentinel node biopsies are not typical for stage 1 patients. However, because of the regression and prior node swelling, my dermatologist demanded I get them tested. I waited until Caroline was 7 weeks old to have this done. The process was pretty involved. The first day I spent a couple hours getting dye injected into my leg and put in and out of a machine resembling that of an MRI machine. The surgery was the very next day where thankfully only one lymph node was removed because only one lit up. This lymph node tested negative for cancer cells which was a blessing. The struggle was not being able to nurse Caroline for a full 48 hours. It was pure hell on all of us. After the lymph node removal I had a pocket of fluid that would have to be aspirated three times. The aspirations didn’t work for more than a day or two which landed me another surgery to put a drain in place. It was a total pain in the rear (or leg in my case). I literally had to wrap it up and tape it to my leg with the bulb hanging out the top of my pants. The bulb would fill with fluid and I would have to measure, dump and record. That process lasted all of about a week when I got a major infection around the site. Celluitius is not a force to be reckoned with. II wish it on nobody. I have a high pain tolerance and it was enough to put me in tears begging for pain killers. Since that day forward I get a bout of celluitius with every single biopsy I have to have. I have even been known to get celluitis from a mosquito bite. My skin is no longer what it used to be before melanoma.
A few months after my stage 1 diagnosis, I was faced with yet another Melanoma in my groin. The same groin that had the lymph node swelling and removal. About a year later I had a mole removed behind my right knee that had pre-cancerous cells. Once you have Melanoma it is standard procedure that anything that comes back atypical automatically comes attached with another surgery to get clear margins. My doctor has assured me that although all three incidences have been on my right leg, it was just a coincidence. Unfortunately, what she also told me is once you have one you are at an increased risk for two and so on and so forth. They say that the first five years following a stage 1 is the most critical because it will most likely come back within that time frame. However, I disagree. After being apart of several melanoma groups and reading articles over and over, the grim truth is that it can come back at anytime. It can come back on the skin or it can rear its ugly head in any other part of the body. Therefore, melanoma patients are never considered free of the disease but rather NED (no evidence of disease).
After my first diagnosis, I began seeing my dermatologist for full skin checks every three months. I am now on an every six month plan and probably will remain on it forever. Twice a year makes me feel safe and therefore it works for me. Full skin checks are very invasive. All modesty goes out the window as I lay on a small exam chair with one of those hideous, bare all gowns. No bra, no panties, nothing as every single nook and cranny is checked. If there is anything of question she will look closer with her dermascope as she did during my last exam right in the crack of my backside! We also have an awesome understanding that if there is something that looks suspicious to her it is removed, if there is something I am not comfortable with it is removed. We work together, I ask questions and together we determine what is best for me. If I had to guesstimate, I would say I have had approximately 12-13 biopsies in addition to the three that were bad. Thankfully, all the others have come out negative but the large keloids that each one leaves behind serves as a definite reminder. For those that are not familiar with keloids, they are raised lumps of fibrous scar tissue caused by excessive tissue repair. They are not fun or attractive by any means.
For those of you who have read to this point, thank you. I know it is very lengthy and a bit egocentric. However, I feel that when anyone is sharing a story or a piece of information important to them they should not leave too much out. Especially if it can potentially help others. I try not to get too gruesome but at the same time I try to be real. For example, nobody really needs to know that a dermascope was used to look at a mole in my rear but to some it may be eye opening. Melanoma is an ugly, ugly beast and will certainly inconvenience you when you least expect it. It can position itself anywhere, in the strangest of places and possibly the most painful. I have had a biopsy done on the bottom of a toe (ouch!), I cringe at the fact that one could come off my rear but my biggest fear above all is Ocular Melanoma. For those that don’t know, it is melanoma of the eye and yes, fake eyes are a real thing.
So what do I do to prevent future melanomas? I have formed a wonderful relationship with my dermatologist. A person who I though only saw patients with bad acne is now my go-to for questions, wisdom and knowledge where the skin is concerned. I wear sunscreen when I am out in the sun. I get naked and evaluate my skin daily. I do not obsess but I do stay vigilant. I try to live a healthy lifestyle by exercising regularly and trying to stay aware of what I put into my body. I enjoy life and try to keep stress to a minimum. You too can stay safe by avoiding any and all tanning beds like the plague as there is no such thing as a safe or healthy tan, limit exposure from the actual sun, wear sunscreen and check your skin regularly for any new or changing spots. Melanoma is the deadliest form of skin cancer but let us not forget about the other types of skin cancers such as basal cell carcinoma, squamous cell carcinoma and kaposi’s sarcoma . Let us also not forget about other side effects such as premature aging, altering the effectiveness of birth control, sensitivity to sunlight and rough, uneven skin to name just a few.
If you or anyone you know are currently using a tanning bed or striving to get that beautiful glow, I urge you to please stop immediately. I know that may be easier said than done as tanning has be proven to be very addictive. However, the side effects and damage start the very first time you step foot into one. Melanoma is not an old persons disease like I once thought it may have been. I was diagnosed at 22, I have a friend who was just diagnoised at 26 and another friend who’s 4 year old had pre-melanoma cells in a spot he had removed at only 3 years old. It is real. It has no remorse, respect or concept of age and it can kill!