Even Faeries get moles

In three weeks I turn 30, 21 days left of my 20's. I'm rather excited to be honest, I think the 30's will be good years. I also know that the only alternative to aging is not desirable at all.

I think I am most shocked to realize that 10 years ago today I was an exchange student at the University of California, San Diego. I had not yet changed apartments to get a single room, so I had not yet met a lot of the people I became good friends with in the last 12 weeks of my exchange year. Ten years ago today I was also in the final healing stages of my first tattoo: a crescent moon with roses on my left hip bone. My tattoo is almost old enough to be out of primary school! This faerie is my other tattoo, I got her/it on my lower right back in January 2001, so she's only 9.

I've had a love/indifference relationship with the faerie tattoo. I had carried the pencil sketch for this design in my planner since I was 15, but not long after getting it I discovered a variety of faerie art that impressed me even more, and having it on my back meant I didn't get to admire the artist's work every day like I have with the crescent moon. There is also an unfortunate cult of Tinkerbell fans, women who enjoy the bitchy princess spoilt brat persona, and adopt Tink as their mascot. As I grew up with peter pan, the flower fairies, and mythology involving the wee folk/sidhe, my impression of the Fae is that they are forces of nature, neither kind nor cruel, a symbol of the harsh beauty of nature. Definitely not a squeaky little female sprite who stomps her feet all the time and obsesses over human boys. I've been toying with the idea of expanding her wings, darkening the green, giving her an owl or a raven as a companion, or even choosing a slightly larger design and having her covered over by an acanthus leaf or a William Morris style peacock.

Matt took a closeup photo of the ink work so that I could study it, and decide what I wanted to do, but while cropping it and brightening it up a bit on photoshop I noticed something not part of the original design. An oval mole on her right upper wing (left as we look at her). Of course it's not on her wing, it's on my back, and I'm pretty sure it wasn't there when I got inked. Especially since the outline of her wing is broken at that point.

With my history that means time for a biopsy. I only just had a screening with my dermatologist, but the tattoo does disguise the mole, and she relies heavily on me spotting any changes. I'm waiting to hear back on a biopsy she took from my leg, a tiny but very dark mole we decided to investigate, but I think I'm going to call and make another appointment to show her this offender as soon as possible. I'm sitting here wanting to tear it off myself!

Of course there is a certain amount of self blame for getting tattooed at all, though who knows if I'd have spotted a new pointy mole back there at all if I wasn't studying a photo of my own back for planning purposes. I'm really done with the constant vigilance thing, though I know I don't get to choose, I have to keep an eye out for skin changes for the rest of my life.

Besides all this, I need to submit review board approval of my thesis project, get my Master's committee officially listed (I've got them lined up, but they're not on file), and apply for graduation. Instead I'm scanning through a few years of photos to see if my lower back shows up in any of them, in case I can find an earlier comparison.

All Clear

EVERYTHING came back all clear. All five moles were normal, no melanoma in the lymph node, no melanoma left in the margins they took (which means they didn't even need to take out as much as they did, but it's done now so...oh well).

Whew.

So now I can just focus on trying to look after my healing incisions. No chemotherapy or further excisions needed! I was actually very surprised that I didn't even have a whacko mole, they've been following a trend of being "abnormal", I'm glad they're gone now so I don't have to be super vigilant of 5 different odd looking moles on my face. That was making me a little crazy already.

On Friday, when the stitches came out, I wasn't too happy with how it all looked. I was also pretty busy being relieved that I got off so lightly, and celebrating with Matt (there was wine, and congnac, and chocolate, on saturday there was peach lambic and more chocolate) But by Sunday the upper half of the loooong incision had healed and is already starting to vanish. It's just a LINE now, a thin line at that, if that's what it looks 1.5 weeks post op, it'll pretty much vanish over the next few months. The lower half...I'm not examining too closely yet, it's still healing up, and I know it'll be more visible, a thicker line, but it'll probably look a lot better than my paranoid imaginings.

Sunday, Matt and I went up to the nearby mountains in search of snow, on the way up we took an offroad trail, so we got MUD and SNOW in one day trip. Yesterday was a public holiday, and I was in bed, napping and reading until about 10.30. With both cats flaked out keeping me company. Then my parents called and I spoke to them for about 2 hours. Lazy day.

My whole family is breathing a lot easier now. I'm so lucky to have been going to a dermatologist regularly and caught it early enough.

Question

This morning the glue on my dressings loosened enough for me to take off the surgical tape and replace it with fresh tape. So I got my first look at all the stitches and everything. Quite honestly I think it'll heal up really well but it freaked me out for the rest of the morning seeing so many stitches all over my face, and especially realizing how LONG the incision is from the melanoma.

I took a couple of photos for posterity. I think it will be good to be able to look back in a few months or a year, if I get down on the whole scarring issue. I think it will be good (if a little wierd) to have a photo I can look at and say "yeah...but I survived looking like THIS!".

So here's the question: you wanna see my new, temporary, bride of The Creature look?

Poor Taliesin. They didn't find anything wrong with him at the vet, so they decided to give him all his boosters while he was in there. I'm not sure this was a good idea, since I got him home last night he's been all sulky and out of sorts. Not even the mighty pull of a spoonful of yogurt tempted him out from under the bed this morning. So I left him to carry on hunching in dark corners looking miserable. I know how he feels.

I can't just muscle through this, I can't get up the day after surgery, pretend nothing happened, and go back to work and be PRODUCTIVE. I'm not allowed, in fact I've been told I might need help walking to the bathroom, and that I should not be left unattended for 24 hours afterwards. Probably it's the general anesthetic that will have the effect of making me groggy etc. Matt has to work, and luckily one of our closest friends, who also lives in the building, has that day off and will be on supervisory duty. I'm not sure if he'll be hanging out at our place, or just on call. I left Matt to sort that out because the thought of asking for that kind of help makes me feel sick. I hate helplessness, absolutely hate it. Realizing how much I wanted my boss to give me work to take home with me for while I'm resting up was quite a shock.

Somehow in the past 5 years I have become the kind of woman who will keep pursuing work when she's sick, even if it might make her sicker longer. I think of public holidays as a great chance to catch up on household chores, I have actually caught myself considering "doing extra laundry" as a good way to spend a "me day". I'm sure I used to be much more of a skiver, any chance to get away with not doing stuff. I used to be so bored with school, or I couldn't see much importance in getting projects done, that I'd procrastinate until the last minute and then tearfully cobble together some crap, making excuses to myself all the way.

After I graduated and met Matt, and especially after I moved jobs to this one, a job well done became such a great rewarding feeling. Perhaps I learned that hard work does pay off. Hard work paying attention and learning on the job, and also hard work fixing myself up after a long bout of depression. I'm coming to realise that work, doing stuff, being proactive, becoming a go-getting let-me-at-it kind of person is what pulled me out of the hole I was in. It also made our whole wedding planning thing work pretty well. Now all of a sudden I'm faced with a huge challenge: being able to stop.

Even as I type this I realize it's pretty ridiculous. I'm not loosing a LEG. this isn't a permanent stop. I have to face being a gibbering wreck for about 24 hours or so after surgery. Maybe not even gibbering, just disoriented and sick feeling.

I feel that I've spent far too much of my life already hiding under the covers feeling sick. I wasted somewhere between 2 and 5 YEARS not taking care of myself, crying a lot and feeling sick to my stomach just existing. Often it was helplessness that I felt. Helplessness to "fix" my life. Yay anxiety. I hope I'm just spaced out all day after surgery, the fear that is looming is that it will feel just like the pit of depression and then somehow I will get stuck there again.

Of course, I was feeling depression rear it's head before I got this diagnosis. I could go all Medium on the facts and try to convince myself that I felt this coming and was mourning it in advance... or I could skip the BS hokey pokey and admit that maybe go! go! go! go! go! go! go! go! go! go! wasn't working that well as a long term life solution and I'm getting overdue for seeking a little, you know, balance.

One of the signs of this need for balance is that the day I learned the biopsies had shown melanoma, after about an hour of freaking out I started to feel good about the new challenge to overcome, because it would distract me from the lingering depression that had started to really scare me. You know something's wrong when a cancer diagnosis turns into a welcome battle with the world.

I know I will need to give myself some "me time" (sans laundry folding), to figure out what I need once I'm done with getting carved up and biopsied. Right now I think it's ok to huddle under the covers seeking comfort. Hopefully Tali will forgive me for taking him to the vet and come and sulk with me instead of at me.

Status Report

OK, the melanoma on my leg was teeny-tiny (less than 1 mm) so they only needed to take out a 5 mm margin, which was done on Tuesday, leaving an incision about 4-5 cm long, with five stitches in it. Just like the first "big" incision I had on my face, which has now faded to a 4cm line that only shows if the light catches it right.

The one on my face was 1.6 mm thick, which makes it on the small side of "intermediate", since I'm on the young side for such things they are going to do a sentinel lymph node biopsy [>] to check for signs of spreading through my lymph system. The margins of this tumor also have to be removed, with a 10 mm margin (eek), which means a circle about the size of a US quarter, or a UK 10p piece, this will be done using the MOHS technique [>]. The Mohs is done with a local anesthetic, which would be kind of disconcerting apart from the fact that I've done this before, and now I won't be lying on the table freaking out about massive scarring, because the first big incision has healed pretty damn well. I bet you couldn't even look at my flickr account and tell me where that first big incision was. Unless you find the photo of me with a pressure bandage on my face.

OK, maybe I will be freaking out a little, but not as much as the first time. I know there's not much I can do but trust the surgeon's skill and take good care of it while it heals. That, and start a fund for laser resurfacing and/or chemical peels.

The lymph biopsy will be done under general anesthetic, which scares me: complete helplessness = baaaaaaaaad. Complete helplessness while somebody works at my throat with a scalpel = fucking scary. I have to keep reminding myself that this is not heart surgery, and that lots of people have general anesthetics for mundane things like wisdom tooth extraction.

Now we get to the part that will probably make everyone think I'm insane.

While I'm "out" under general anesthetic, the surgeon is going to remove five other moles from my face. Yes I have that many, no I don't look like a leopard. They all look pretty much like the innocuous moley that turned out to be harbouring 1.6 mm of cancer. My moles all look pretty normal: even colour, symmetrical shape, not too big, and most of them have been abnormal. Now two have been cancerous. My dermatologist, myself, and the head and neck surgeon all reckon it's a good idea to remove and biopsy the significant moles. If they're normal, we can be relieved, if they're not normal it's better to know now, and deal with it pronto. I am going to feel like the Bride of Frankenstein for a while, with stitches on my leg and on 5 small and one sizeable incision on my face.

I'm all calm right now. Listing off how many chunks of my face are going to be removed, and they might have to go back for more later. The thing with this whole experience is that when I'm freaking out, I'm freaking out WAY too much to type or write coherantly. I've been crying in my car a fair bit, unfortunately my long commute gives my brain plenty of time to run through worst case scenarios to itself. I'm either wailing inside and wanting to run far far away or hide under my bed with a cat, or I'm dealing with life. Dealing pretty well I think. I'm trying to make sure I let myself say I'm scared, and cry a bit, trying to let some of it out so that I can hold it all together enough to feel proud of myself.

Sod's Law

I didn't mention this before, because it's become kind of routine for me to have a dodgy mole removed when I go to the dermatologist for a mole-patrol checkup, but I had another two dodgy moles removed right before Christmas. The incision in my left shin healed wonderfully. By Sod's Law, the incision on my left cheek, right next to my nose was the one that didn't heal well. It wasn't an infection, the culture they took came back negative, but it was inflamed and didn't want to close. So I've been keeping it ointmented and covered to try to minimize scarring.

Waste of time.

Most of the moles I've had removed (3 out of 5 until this crop) have turned out to be "abnormal" in a benign way, and have required further margin to be surgically taken out. Sod's Law made sure that 2 of those were on my face (the other abnormal one was on my scalp).

Sod's Law has really outdone itself this time though. Both biopsies came back as melanoma. Very SMALL melanomas, but melanomas nonetheless. That's cancer, the BIG C. It's the nastiest skin cancer, most likely to spread to other tissues, most likely to recur. It's actually the best cancer to have if you're going to have a nasty spreading type cancer: at least it's highly detectable, and early detection means the only treatment required is excision and vigilance. No chemo. Thankfully.

So, back to my lovely dermatologist on Tuesday, to remove margins from my shin. She looks like a prettier version of Janice, Chandler's irritating recurring girlfriend on Friends, so I will call her Dr Janice. Then I will see a specialist in head and neck dermatology and surgery on Wednesday to discuss the offending site on my left cheek, and the possibility of doing a lymph node biopsy. I want the biopsy, I want to KNOW that it's clear, not assume.

Of course, I'm sure I'm sounding (reading?) much too calm. This is because I got the phone call around noon, and have already quietly freaked out about it by myself, then told a friendly coworker, and freaked out a bit more, then told my friendly boss, been sent home, and bought a fancy shower curtain and fuzzy bath mat as retail therapy. I've had 5-1/2 hours to digest this. There will be further freakouts, I may even post during one, they make good reading (if you want to see what I look like freaking out and questioning my existance and role in life etc., just check out 2001-2002 in the archives).

Matt just came home, and I told him right away. He takes my word for medical detail, so hopefully he won't be *too* worried, not constantly at any rate. I'm not going to tell my parents, not until I've had the margins cleared and (hopefully) get the all clear from a lymph node biopsy. My mother's brother died of internal melanoma, it would be such a nightmare to put her through the waiting and worrying again, so I will tell them when it's done and we're in vigilance mode, not treatment mode.

It's freakish and frightening, but it's not the threat-of-death diagnosis a lot of cancers are. More the threat of fear of recurrance and definite need for more bits of my face to get chopped out. I'd been wondering if I should have the remaining moles removed prophylactically, now I'm sure I will.

Shallow though this sounds I'm just REALLY glad this diagnosis came after the wedding. I think I'm going to be looking at a couple of years at least of babying incisions, and then saving up for a laser resurfacing or something. On some level I've been expecting this, you don't have 5 moles removed in 3 years, and have 3 of them turn out ot be abnormal, without something being a bit fishy.

Mole Update

The delayed closing of escrow wasn't the only thing causing me to freak out on Monday, I also had my stitches removed. I expected it to hurt a lot more than it did, based on my experience with the stitches in my scalp from last year's mole. Gah, I really hope this mole-removal thing doesn't become a springtime routine for me. Anyway, I was anticipating brief but significant pain, combined with the general freakiness of my face being messed with, plus the background worry of what the biopsy results would be.

Turns out it isn't melanoma (entire family breaths a sigh of relief), but a less malignant form of abnormality called Spitz Nevus. So it's a mixed bag, hooray for absence of melanoma, but since the cells were still abnormal, I have to have the margin excised. Which means more of my face being removed. A very melodramatic way of saying that they'll take out a slim oval surrounding the original excision site, leaving me with a line about twice as long as the one I have now.

I was not happy about this news at all. The wound on my face still looked pretty swollen at this point, and the indents left by the sutures were still very evident, all I could think of was walking around for the rest of my life with a highly visible zipper-like scar in the middle of my face. As if I don't have enough appearance issues already. My one big self reasurring point has always been that even if by body is ungainly, at least my face is ok, sometimes even more than ok, sometimes beautiful.

I have no way of knowing how much I was channeling all the surrounding tension into the issue of further surgery, probably quite a lot, but I cried most of the way home, and the only reason I didn't continue to cry much at home is that Matt calmed me down and made me feel better.

Tuesday, Mum called me in the middle of the day to say hi. It turns out Dad had called to update her when he got my email saying the mole wasn't cancerous, but they still wanted to remove the margin. It meant a lot to me that from that minimal information she knew it was worth calling to see if I was ok. She has a couple of small scars, one from a broken nose, one from thyroid surgery (on her neck), so I know she understands the worry of being marked.

Today I'm a lot less worried, the swelling has gone, and the stitch marks too, and all that's left is a red line about half an inch long. No zipper, no big pucker marks. If the result of the margin removal looks like this, only longer, I can cope. My dermatologist is clearly capable of lining up the edges properly when stitching up a hole. I'm not ecstatic about the prospect of a further piece of my cheek being removed of course, or about another week of looking after sutures followed by however long it takes to heal fully after the sutures are taken out. At least I feel fairly confident I'm not going to become an investor in copious amounts of cover-up, just a more regular sunscreen wearer.