Graphic Photo Alert: Please note, further down in this post are two semi-graphic photos of an open, but healing, wound.
Moles. No, not the ones that dig holes in your yard. The ones that are on your skin. Those brown spots that look like overgrown freckles, that add character to your physical appearance. You can't feel them, they are only a discolored portion of skin, right? Maybe.
I have a few moles. Some raised, some not. No big deal. One of them in particular was on the 'larger' size. It was on the back of my left leg, about 2 inches above my ankle. It was an oval shape and darker than most spots on my body. I don't remember always having it, but then again, it's not like it was exactly in the best spot for daily habitual viewing.
Back in July, when I sat Indian-style on the bed one night, flipping through a magazine, I happened to look down at it. It had changed from an oval, to what seemed like a slightly faded, figure-8 shape. The oddest part was that the top portion looked almost black. At first I thought maybe I had banged it on something, like a smashed fingernail that turns black due to bleeding under the skin.
I tried pressing on it. I figured that if I had banged it, pressure on that spot would help me remember what happened. Nothing. It didn't feel any different than the rest of my leg. There was no 'hard spot' under the skin. Other than the color, nothing else had changed. I pointed it out to my husband, and decided to wait a few days and keep an eye on it.
After about a week or so, the black spot remained, still the faded figure-8 shape, no tenderness, no hardness, nothing. So, I decided to make an appointment with my dermatologist to have it 'checked out'. About two weeks passed, between the day I made the appointment and the day I was to see the doctor. The figure-8 changed again during that time, slightly though enough that I noticed. Still, thinking nothing amiss, I took our 4-year-old with me to the appointment. I figured he would look at it, tell me it was fine, and send me on my way. Instead he told me he "wasn't impressed with (my) story", and he "wasn't impressed with the appearance of it".
He suggested that I have it removed for further analysis. It was in a "bad spot" he said, and it "wouldn't scar nicely". Surprised, I signed the agreement for the procedure and found myself laying on my belly on the exam table. Thank goodness for the Leap Pad and good local anesthesia! If I had yelped or winced at all in pain, I'm pretty sure my little guy would have freaked out! Luckily, I was able to chat with him about his game, and never felt the Dr. remove the spot from my leg. When he was done, I was left with 4 stitches and about a 1-inch horizontal "pleat" in my lower calf. He said it would take 7-10 business days to get the results, and that "this was a good one to have checked out."
Still somewhat oblivious to the whole thing, I made an appointment to have my stitches removed two weeks later, left the office and headed home. The rest of the week, I kept thinking about the whole situation. I was anxious for the results, but really could not imagine what they would find. Sure, the poster on the wall in the exam room that seemed to best illustrate my spot said, "Melanoma", but that really couldn't be what it was. It couldn't be. I didn't feel anything. It didn't hurt. It couldn't be that.
A week and a half later, we found ourselves being transported to Children's Hospital with our 6-year-old, where we spent the next two nights and he had his appendix removed. We came home late on a Wednesday evening. Glad to be home, thrilled we had avoided an emergency situation, so happy to be all together again. The next afternoon, I got a phone call from the dermatologist.
"We got the results from your appointment last week. The test showed Melanoma."
Somehow, I was able to ask questions. What does that mean? Now what?
He said he had already referred me to the cancer clinic, and I would be getting a call to schedule an appointment to have more tissue removed. He called it Melanoma In-Situ, meaning "in the surface of the skin". "Yes, Melanoma is bad. But if you're going to have it, this is the one you want to have." I was stunned. I hung up the phone and called my husband. We sat in silence on the phone for a bit when he asked, "what next?" The only thing I could think was that we should get a list of questions together. Anything and everything that we wanted to ask. Now was going to be the time. I looked up Melanoma In-Situ on my phone and saved this image. It helped, a little, I guess. Melanoma of any sort is not an easy pill to swallow.
My family has a history of diabetes. Breast cancer. This wasn't one that hit my radar on "things I need to consider" in regards to my future health. On September 12th, we went to the cancer clinic. The Dr. was excellent. He answered all of our questions. Some of the bigger ones were...
What causes this? How could I get skin cancer on the Back of my leg? Why not my shoulders, knees or face? It is a skin cancer, but not sun caused. It's Genetic. Your immediate family needs to be made aware and have any odd changes in their skin checked out immediately.
How bad is/was it? If you had waited another 6 months to a year, we would be having a very different conversation. -- Seeing how much the mole had changed on the surface of the skin in the course of about 5-6 weeks, I believed him. I didn't like it, but I believed it.
This was, without a doubt, the hardest news to grasp. I had to be completely honest with my husband, and myself. If it had not been for the black spot appearing, I probably would never have made the initial appointment to begin with. I would have let it fade, change shape, disappear, whatever it wanted to do, and never thought twice about it.
Is it really just in the surface of the skin? He was confident that the Melanoma (also referred to as Stage 0 Melanoma) was confined to the surface of the skin, as In-Situ defines, but they needed to do a pathology report of the surrounding area to be sure.
How does this relate in terms of other cancers? It doesn't. Your chances of getting breast cancer are 1 in 9 women, so this won't increase your risk of that. Cancer is the #1 killer - next to car accidents - of people ages 25-45. Holy Cats! Are you kidding me?! Not believing him, I Googled this little fact as soon as we were back in the car - he was right. Wow!
What now? You are now at increased risk of having more spots develop, so you will need to have regular checks for any changes that need attention.
He stated would go by the 'textbook" and take an 8 mm area surrounding the previous incision and about 1/4" deep. The tissue would be examined by UCSF pathology and we would have results in another 7-10 days. The biggest decision before me that morning, was which kind of suture I preferred...
Option A: After removing the tissue, he could cut triangular shaped incisions above and below the "spot", and then pull the skin together to cover the wound. The scar would run nearly the entire length of my calf and I would have to be off of my leg for at least a month while it healed, so as not to pull at the sutures and rip it open again.
OR
Option B: He would remove the tissue and leave it open. I would need to maintain a wet-dry pack until it healed, which would take some time. The extremities, especially the lower leg, heal slowly as they are 'far away from the heart' and other bodily vitals. Leaving it open would not keep me from doing anything, he even said that I could even play our co-ed softball game that very night, with no problem.
We agreed Option B and he then proceeded to numb my calf, and remove a circle of tissue surrounding the "effected area." In the midst of this procedure, I felt a wave of emotion, and began to cry. I was overwhelmed, after spending 3 days and 2 nights in the hospital with our 1st grader and now learning that I had a medical condition that was completely out of my control. I just let it go. The tears streamed down my cheeks as he performed the 5 minute procedure. I was So thankful to have my husband there with me, I am pretty sure I would have completely lost control if he was not there to hold my hand and tell me everything was going to be alright.
We left the office a few minutes later, with instructions to soak the wound in a vinegar solution for 10-12 minutes, twice a day, then apply a wet-dry pack and wrap. At 34-years-old, I learned that the definition of true love is vet wrap in every color. No joke. My sweet farmer came home with vet wrap in blue, green, purple, red and pink! The boys got a kick out of picking which color he should wrap, and even insisted he label a red wrap with the school logo on a spirit day!
Just a week after my appointment, when I was on my way to Children's Hospital with our little guy for his two-week post-op appointment, I got a call from the dermatologist's office.... "We just got your results back and you are Melanoma free!" I was beyond thrilled! The pathology report from the large piece of tissue that was removed from my leg showed that all of the Melanoma tissue had been removed. It was such a relief, such a weight lifted from my shoulders to know that, for now at least, I was in the clear.
October 9th, 27 days after the procedure, the area had 'healed' to this point. Not pretty, but you can see why I didn't want any photos taken before this. To be completely honest, this was the first "good look" I had of the wound. It's a good thing that it's not in a place that I can see it easily, I was not even able to remove the bandage on my own for the first week or so. Strange. When it comes to our boys, or the cows, I can handle just about anything. This one, not so much.
And this photo was on October 14th, 5 days after the last. The healing has finally kicked into high gear!
I am Really looking forward to showering without the wrap. The soap and running water burns quite a bit, so I've only just started to take the wrap off from time to time during a shower. The doctor anticipates the wound will heal to a "smaller, pink-ish circle" type scar.
Sure, it's not pretty. It will be visible anytime I wear shorts or a skirt, but what's the alternative? A rapidly progressing skin cancer? No thank you. I'll take the 'beauty mark' any day. I can not thank my husband enough - not only for the fantastic array of colored vet wrap, but for soaking and re-wrapping my leg twice a day, every day, for the past 6 weeks. After sending both of our boys into surgery in the month of September, one for his appendix and the other for a hernia, and going through this scare of my own, I know now even more than ever, that there is no one else I'd rather have by my side. He's an amazing rock, and for him I am truly blessed and grateful.
In a few weeks, I'll pay another visit to my dermatologist, for a complete check. The first of many regular visits to come, where any odd looking skin spots will be removed and inspected.
The largest lesson I've learned from this experience - Do Not Wait. If you have a mole, or other marking on your skin, that seems odd, get it checked. If it changes shape, size, color, whatever, have it looked at. Knowing that a short 6-12 months could have made the difference between an annoying hole in the back of my leg and a much more serious situation, requiring much more aggressive and extensive treatment, makes me think much more seriously about my health and things that seem like "no big deal." We've got two little guys that depend on us, I need to be here for them, to see them grow, to wipe their tears, to sit with them when they are sick, to watch them get married.
Hopefully, taking care of these kinds of things right away will insure that I won't miss a thing in the years to come.
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