Saturday, August 27, 2011

The power of laughter

I was lucky enough to be invited to celebrate a girlfriend's 40th birthday in wine country yesterday and today.  I would only know her and two of her other good friends slightly, but the others were complete strangers to me.  It made me nervous. Would I have fun? Could we relate to one another? Would it be weird especially since we (the 7 of us) were sharing just 2 hotel rooms?

On the way up, we ended up with 6 women in one car. The 7th came up later due to work.  The trip started with us discussing how we knew the birthday girl. It ranged from 20+ years of friendship to 2 years. I started to notice the the 6 of us had a lot in common.  The youngest woman was 38 and the oldest 42. Obviously, we were good friends with the same woman and it became apparent why as we sat in the car.

The final piece for me was the discussion later that night that started with, "do you remember.......?" I don't think I've laughed that hard in a very long time.  And definitely not since June's news.  These ladies and I were born and raised in a small window of time.  And the 70's and 80's created some very .......ummm.... interesting cultural phenomenom.  Need proof?  Think neon paint splattered parachute pants, "16 candles," or rat tails.  If you don't know what these are then you are obviously younger than me. Google image them.

Ironically, some of our training this past week at my school site centered on stress, its effects on your body and brain.  A very powerful documentary.  Here it is.  Anyways, one of the "solutions" that the researchers talked about was how to alleviate this stress and its effects on our bodies. Of course, no surprise, one was laughter.  I believe the timing of this weekend was no accident. Call is Karma, God, or any thing/power you believe it.  I honestly think this weekend was as beneficial for me as it was for the birthday girl.  I laughed so much stress out of my body that I was in tears. Real, huge, non-stop good tears.  Trust me, I've cried a great deal since hearing the word melanoma but these tears were different.  They were healing tears. Stress relieving tears. And most importantly, connection tears. I was part of a wonderful group of woman who came together to celebrate a mutual friend's momentous day. That laughter was more powerful than any drug and I'm grateful to have gotten a two month dose.

Thursday, August 25, 2011

Funny things we say

The people who know me the best will tell you that I can say the oddest things at the oddest moments. Sometimes it is being shy, sometimes it's a mispronounced word, sometimes it's because I linked one thought in my head to another seemingly random thought, and so on.  This melanoma journey has made me say things I'd never thought of and I'm sure I'm not the only melanoma patient who has said these and better yet, found them funny.

Here's just a short list:
Can I swim with an open wound?
Is this going to hurt later?
What about vaginal melanoma?
Why did this happen at 40?
Will my kids get melanoma?

And this is just the beginning. I can explain the rational behind all of the questions but as a list they are pretty darn funny.  Some make me shake my head. And laugh again.  The brain and thought process is an interesting thing when you find out you have a potentially life ending disease.  This is part of my maturation process as a patient though. I learned to not be afraid to "ask the dumb questions."  Sometimes the questions aren't so dumb.  And sometimes, they just are.  You consider yourself lucky when the doctor will answer them anyways with a smile on her face.  Right before she asks if you were pulling her leg.

Who knows what other Einstein inspiring moments and comments I'll have. I'm sure there will be some gems.  I'll try to remember them and write them down.  This will show how the brain reacts under intense pressure and how funny it can be when dealing with a decidedly unfunny diagnosis.

Wednesday, August 24, 2011

Going back to work

Today was my official back to work day. Just ignore the week I spent last week setting up a classroom and the two days this week tearing one room apart and moving to another room for a different grade level at a school about 1/2 mile away. Welcome to education. Teachers are very, very, very flexible in these budget times. In more ways than you can imagine.

Anyways, today was my first day with the ENTIRE staff of my new school.  The old school knew of my melanoma diagnosis. Some I told directly and the rest found out through the caring and sharing that family members do.  The support they gave me made last week and this week so easy to tolerate and deal with.  There was no over-the-top sobbing and sympathy.  You know how I feel about that. There was the general consensus of "Do you need anything?" and "That sucks."  I loved the staff I was with because of that reaction alone. They are willing to help and brutally honest that melanoma, indeed does, totally suck. Not a single person said, "Well, I knew someone who...." or "I heard that...." Call me totally selfish and cruel, but I didn't really want to hear that.  I just needed to know that I had support if I needed it and they understood "it sucked." And that's the important part. They were there for me without smothering me. And the district I work for said I needed to move.  Sigh and double sigh!

So, I am now with a new staff. A staff that has absolutely no idea what my summer was like. And to be totally honest, I'm not sure how I feel about that.  One part of me is completely thrilled that this new staff sees me as a new teacher who comes "highly recommended" from the bigwigs. (Yeah, that was good for my ego to hear on Tuesday).  The other part of me wants the staff to understand why I am not so quick with hugs because I still have two sets of stitches and I managed to "bruise" my arm incision yesterday.

I thought long and hard today about this conflict I was feeling. It seemed to come down to whether they see me as a new teacher on their staff or as a teacher who has melanoma (aka is fighting cancer).  Ok, big breath...... I'm not sure how I want them to see me right now.   Part of me is done, totally done, with being a patient but the other part knows I cannot ignore what has happened the last two plus months. I will never, ever be free of the melanoma diagnosis. I just want to be NED (No Evidence of Disease).

So, I am at a stalemate as it were.  I am NOT inclined to inform my new "family" of my melanoma status but I know that news will filter to them eventually.  The good and bad of the school district I am in means that we are truly a family. Some times dysfunctional, but mostly good and loving, albeit on the smaller side compared to surrounding communities (aka San Francisco and San Jose).  I would like for their initial judgement to come from how I am as a teacher, how I educate the most important members of our community, and how I work with them as fellow educators.  When the news comes that I have/had a disease that is life altering, I want it to be an asterisk to my label as a teacher. I want to be known first as a teacher and second as someone who got dealt a crappy set of cards in the cancer poker game.  After two full, heavy months of being a "patient," I'm ready to get back to being a "teacher."

Maybe it's Karma that I changed schools. Maybe it's a higher power caring for me. Maybe the kids at this site truly needed me more or I needed them more. Who knows?  The next 190+ days will tell me. At least, that's what I am counting on when I went "back to work" today. I was a teacher today. Not A Patient. Not A Melanoma Target. Just simply a teacher.

Tuesday, August 23, 2011

And the results are in

I saw the doctor yesterday and got the stitches out of my arm.  This scar has a slight S-curve to it now that the threading is gone. Pretty cool. At least better than a plain 'ol line.  Apparently, I've become a scar critic with my 7 new ones from this summer. It's funny the lessons that melanoma can teach you.

The results of the biopsies were the same as before and expected, but with one twist.  The lower area was completely benign and the upper one was dysplastic.  I was positive it would be the other way around based on the appearance alone.  This just goes to show you that this disease in sinister and doesn't play fair.

The stitches come out next week and I'm already thrilled with my decision to stick with closed wounds. I am able to avoid bandages and the pain is negligible compared to the open wound sites. Speaking of those first two, they itch like nothing I've ever experienced.  It's enough to drive you crazy and keep you up at night, literally.  I know it's a sign of healing but I just wish it'd go away soon.  All it takes is a slight brush of my shirt to set off the itch again.  I spend the next hour doing anything I can to not touch the area, even to rub it, trying to sooth the itch because I've learned that only makes it worse.  It's that phenomenon that makes your nose itch when your hands are full.  Next time you have an itch, try not to scratch it. See how long you can make it.  And let me know what worked for you if you can survive. I'll take all suggestions right now.

Friday, August 19, 2011

Biopsy results

I had my 5th and 6th biopsies done yesterday.  Luckily, she was able to close both of them with stitches. I've learned that when you mess with one area of your body over and over again, it doesn't like you much.  I like to think I'm tough and can handle pain but having these two biopsies done were the most painful.  My back has just had enough.  And so have I, but this fight isn't over yet.

Also yesterday, the doctor looked at my arm stitches and said today was too early to take them out.  The window for biopsy stitches is 9-12 days. I had the ones from the surgery in my back for 14 days, and looking at my arm showed that I need to be on the high end of the window. So, no appointment today and I will go in Monday to get them out. It's actually kind of a relief because every day this week, I've had an appointment for this disease.  Today, I get to be free...at least as much as you can be with a sore back. I can't tell you how many times I've said, "Gentle hug" to my friends lately.

So, the arm results.  It was another mixed bag.  One of the two spots, the pink one actually turned out to be a form of a wart. Weird. I have/had no warts that I know of and it sure didn't look like one. Leave it to be to be the exception to the rule again.  Unfortunately, the brown mole next to it was dysplastic.  Low-Intermediate Grade.  The doctor and I again talked about how frustrating it is to not have a "time line" for moles that are changing. She and I (and probably all melanoma patients) wish that there was a way to say, "Low grade dysplastic moles take 1 year to become cancerous, Intermediate grade 6 months" or something nice like that.  Unfortunately, our bodies don't give us convenience. Heck, I of all people should know that since I am the exception to the melanoma rule in multiple ways. I sure wanted 6 benign results and so far, I'm batting 50%. Don't get me wrong, I am beyond thrilled that no other sites show melanoma. That was my worst fear, still is, but I'm 100% in that most important area.

I'm off to change bandages for the first time. These are the most gruesome of them but I'm not a huge bleeder so the rest should be clean and dry until the stitches come out in 11 more days.

Thursday, August 18, 2011

More pictures


I'm overdue to post pictures. Again, a warning about grossness. It doesn't bug me, I'm way over the scars, but some it might bother some.



I show it because this is really what melanoma is all about....


This was my back two weeks after the open biopsies. The original site scar is healing nicely and only spreading a little, as I hoped. It took two weeks for the other sites to finally fight the infection and look nice and pink like this with new skin forming. The halo around the biopsy sites is from the adhesive of bandages being changed daily. Even the gentlest paper tape causes these new wounds. It is healing too. Wow, do I itch now though.

This is my forearm before.

And after. I much prefer this closed biopsy wound. It is so much easier to treat and recover from. The worst of it is the skin adapting to stretching to cover the now missing section. It took 4 days and I could easily straighten my arm to normal use. I get the stitches out tomorrow.

Off to two more biopsies on my back this morning.

Thursday, August 11, 2011

Biopsy #3 and #4

I had my two biopsies done yesterday like expected.  I keep hoping they'll get cancelled last minute but they never do. And deep down, I don't want them too since I just want answers right now.  Originally the doctor was going to separate the two moles since they were so close together.  She ended up removing them as one single unit and after marking their location first.  I don't think there is a right or wrong way to do this, maybe just a more cautious way.  I trust her decision either way.

I did ask her to do a "closed" biopsy, if possible, because of the healing/infection issues I had with the sites (#1 & #2)  on my back.  She said she could but it'd mean an additional appointment to get the stitches removed.  I told her that was OK with me as long as she didn't mind me taking up another slot.  She said that was a non-issue for her and if it'd help me, she could do it.  So, closed biopsy it was. (Pictures coming in next post)

The numbing medicine is great stuff.  For a few hours after the procedure, I could actually forget, for a few minutes, that part of my skin was now missing.  I lived life like normal.  Unfortunately, it doesn't last forever.  And when it wears off, it all goes together. No warning, no easing into it. Just WHAM..PAIN! You'd think I'd remember this from doing it so often lately, but my mind is being a little too kind to me. I seem to forget in a mere two weeks.  My next biopsy is in 7 days, I won't forget by next week.

I've decided to invest in a flesh colored sleeve, designed to cover tattoos, to wear the first few weeks of school.  I know the stitches will be out the Friday before my first students arrive but the wound will be very visible and still raw.  The sleeve will allow me to protect the arm/wound because most are SPF50 and I'll probably add some gauze for additional padding. Fourth graders are not very coordinated, trust me. And neither am I.

Today, I will walk around like a wanna be Napoleon, with my arm bent about 90degrees to allow the skin to stretch to adapt to the missing section.  I'm tempted to sling it just to remind me to not reach for anything quickly which would make it hurt more and/or rip out stitches.  It may seem like a little much but we are hosting a kids birthday party tonight and I know I will forget, however temporarily, that my arm shouldn't be stretched fully yet.  It's the mom in me. I don't slow down well but I am learning. Some times painfully.

Next post......more graphic photos.

Monday, August 8, 2011

Going public

All of this melanoma battle to date has occurred on my back.  Obviously an area that I can hide easily if I want to.  The only thing that might have given me away was the first 10 days of bulky bandages after the second excision.  Otherwise, going public was something I did by choice.  No one knew unless I told them.  On Wednesday, I will no longer have that option.

My next two biopsy sites are on my left arm.  They are close together so I'll probably just have a single wound.  I'm going to ask her to try to do a closed excision because of the infection issues I had with the last two open ones.  Either way, I will have a very visible injury to my left forearm just below the inner crease of my elbow.  I know I could wear long sleeves but the thought of doing that in summer makes me miserable.  So, my battle becomes public whether I say something or not.

So, this brings me to the dilemma of what to say when some well meaning stranger makes comment about the bandaged arm.  And worse yet, what do I stay to my brand new students when they ask.  Strangers I'll be very inclined to be honest and direct. I will probably say something like, "I have melanoma (or skin cancer) and the doctor is trying to find out if I have any more sites."  If I'm feeling particularly preach-y that day I may add in that I think my baby oil suntanning days are to blame.  My students are another matter.  I'm not ready to have that conversation yet.  And honestly, I don't feel like they, and their families, need to know.  I think I'll settle with the most believable stretch of the truth and say I hurt myself out running.  And leave it at that.

Am I in denial? Am I afraid to go public?  Maybe yes to both.  And I'm not sure why.

Friday, August 5, 2011

In sickness and in health

I've been married for almost 10 years, together a few more.  There are different vows for each marriage.  I wanted mostly traditional without the whole "obey" part and throw in some island references since we got married in Hawaii.  I like the traditional part of the vows because it is a reminder that marriage isn't easy for anyone but that you are getting a life partner to help you through those bumps in the road.

When my hubby and I said our vows, we were already in the sickness part. He was facing a potentially devastating and life altering injury. Worst case scenario his condition would worsen and paralysis could continue to develop and become permanent. Best case scenario, he would heal over time and we could delay surgery until technology evolved some more.  I knew this when I promised him "in sickness and in health." And I had no problems or hesitation in saying them. I meant every word and I still do.

So why was I so quick to offer him an out when I became sick with the melanoma diagnosis? I guess I didn't want to hold him to our vows. I wanted to let him out when  he could move on in case it got worse.  And you know what his response was? Of course, he meant our vows as much as I did. He had no intention of not honoring them.  Even with my offer.

I am hopeful that this too will pass and I will heal just as my husband did.  Either way, I'm glad I said those vows almost 10 years ago. And this is a nice reminder of why I said them and why they mean so much to me.  Now just don't get me started on the "until death due us part." I don't plan on enacting that section any time soon.

Monday, August 1, 2011

The good and the eehhh news

I had two biopsies done on Wednesday morning. Both were on my back. One looked weird and one looked like an early version of the melanoma mole. Even after being diagnosed with melanoma and looking at a mole that was similar, I still believed I'd get two "benign mole" reports.  I did...kinda.

The upper mole, closest to the original site was completely benign. No issues, no problems, please pass go and collect your $200 in relief.   The other mole was about 6 inches due south. It was the one that had the tinges of pink around the edges, the "I think I've seen this before" mole, the "this doesn't feel right" mole.  It turns out the news was good with out being so great.  The mole was not melanoma. I should be celebrating right?? Unfortunately, I can't.  The mole was labeled "displastic," (spelling??) which means it had started to change, evolve, morph, whatever but wasn't yet skin cancer. Yet! There's no time line for these things. How long until it turned into melanoma? No one knows.

So, how do I view this latest development?  I will admit to being crushed. Totally crushed.  I had really wanted two benign, don't-waste-our-time moles.  I didn't want a well-we-caught-it-before-skin-cancer mole.  This development does nothing to ease my worry about not catching a bad mole.  I have long told anyone who will listen to me that it isn't the moles that are being biopsied that worry me, it's the one or ones we might miss.  And when you are covered in moles and freckles like I am, that statistical possibility is very real.

I recently found a study that said if you have 50 or more moles or freckles, your risk of skin cancer (any type) is increased.  Reading this study made me laugh. I read it out loud for my husband when he asked what I was laughing at on my computer.  I read it verbatim to him. His serious response was, "What part of your body?"  I answered, "Exactly." You see, I can count 50 moles on freckles on most extremities. Each extremity.  Seriously.  I was blessed in that category.  I would come home from high school some days with dot-to-dot designs drawn on my arms. (My mom always knew I was paying attention that day). So, in statistical sense, in light of that study, I'm screwed.  The simple odds say that we, the doctors and I might miss one.  And that's a crushing thought. Especially in light of these biopsy results.

I was paranoid before about changes I thought I saw in moles.  This latest series of results does not help ease my concerns.  The easiest solution is digital mapping/photography of every mole.  I'm working on that.  It's the best way currently to monitor the changes. It isn't perfect and it isn't guaranteed to keep me from developing melanoma again.  I can never, ever again assume that because I mole might have looked that way before that it can't kill me.  That is the new normal for me.  And it still scares the hell out of me.