Sunday, August 28, 2011

The beginning...

I'm a 37 yr old nurse, daughter, sister, wife and mother, I never imagined the "C" word would be attached to my description - never.
This is my story from the beginning, in my own words (unless otherwise quoted from someone else). There will be days that you will read inappropriate language - as this is my story - my journey and I refuse to sugar coat any part of it. Being newly diagnosed I have feelings of anger, sadness and fear so I'm full of cuss words right now and I do apologize in advance if anyone feels offended. Hence the warning before you started reading my blog - you were warned.

Ok, now on to my story from the beginning.

I've always been an indoor tanner - I'm not gonna lie, I can honestly say at one point in my life I was certainly addicted to indoor tanning. I started my tanning rituals as a young teen (I'm gonna guess around 13). My mother tanned when I was younger so I thought "hey I'm gonna tan too"! I've tried to go back and remember just how often I tanned in my teen years and I truly can't give a definite answer. I know from the age 13 to probably 19 it wasn't an everyday ritual (I may have went a period of a week or two going daily but nothing like I did in my 20's). My 20's were a different story, at one point I was going to 2 tanning beds per day! Yeah, pretty stupid! I did that for probably a month or 2, but the daily tanning continued for a long time. This past year I have slowed down tanning, I may have went in "spurts" of daily but mostly 1 or 2 times per week. My last tanning session was the week of August 8, 2011. I will never step another foot in a tanning bed as long as I'm alive. To me I didn't tan to be dark it was more for the relaxation and the "light" therapy - I always felt so much better (my mood) after a tanning session. Now, I'd rather take a Celexa to help my moods or just be a bitch:)

I had noticed in early July, a mole on my abdomen that had been there as long as I can remember would start to itch just for about 10-15 minutes after I tanned. I showed it to a co-worker / friend and she demanded I get it checked. It wasn't a raised mole but I did notice it had changed (irregular, black with an area of red) it didn't bleed or wasn't "crusty". I work at a Family Practice office so I asked Dr. E (whom I work for) to take a look at it on Wednesday August 10th. He was sitting behind his desk and as I raised my top up so he could see it, he said "yeah, I can take it off - it's probably nothing but you don't want it to become something" - Ok, I'll add myself to your schedule for tomorrow. So, Thursday came and I climbed up on the procedure table so he could remove it. He raised the table up and lowered the light down on it and was able to get a good look at it (better than the day before sitting in a not so well lit room with a desk between us). "Yes, Billie, it definitely needs to go". I had been feeling nervous all day thinking the removal was going to hurt! I had myself so worked up... Well, all I can say is, he was excellent! I didn't even feel him numb it! He closed the area with 1 stitch that would dissolve and applied Dermabond - he said scarring would be minimal. I laughed and said that scarring really didn't matter considering I already have a road map to Iraq on my stomach (stretch marks from my 3 children) - this tiny scar was just gonna be a small detour. We all laughed and continued on with our day.

Mole before removal
 After; ready for pathology

Friday, August 12, 2011 - I just got back from picking my lunch up at Chick-fil-A, I sat down at my desk and another nurse "D" came in to see if her recent lab work results were back, I looked on the computer and said "No, but my biopsy results are in..." We both read the report and my mind went blank - "D" said to go show it to Dr. E! I hit print and grabbed it off the copier then hurriedly marched in his office as he was eating his lunch... he could tell something was wrong as I laid the report in front of him asking with a shaky voice "what the hell does this mean?" I don't really remember everything he mumbled - something about I needed a re-excision, but he couldn't do it, I need to refer you to a specialist... blah blah blah "Billie, you have Melanoma"... Ok, now I'm listening what does this mean - Superifical Spreading Melanoma, Clark's level 4. All I could hear was Melanoma (Cancer) level 4... I didn't know what the clark's level meant, I was just hearing level 4 so in my mind I was thinking I had Cancer Stage 4!
Clark's level refers to how deep the tumor has penetrated into the skin layers, there are 5 levels:

  • Level I: confined to the epidermis (top-most layer of skin); called "in situ" melanoma; 100% cure rate at this stage
  • Level II: invasion of the papillary (upper) dermis
  • Level III: filling of the papillary dermis, but no extension in to the reticular (lower) dermis
  • Level IV: invasion of the reticular dermis
  • Level V: invasion of the deep, subcutaneous tissue
So, Dr. E tells me I need this re-excised quickly and he goes on to tell me I will probably need a Sentinel Lymph Node Biopsy (SLNB). Yes, I'm a nurse but my specialty is not dermatology and all these words he was throwing at me were foreign! When you are struck with an illness your nursing goes out the window at that split second - everything is gibberish until you fully take it all in and get over the initial shock!

Sentinel Lymph Nodes is defined as the first lymph node to which cancer cells are most likely to spread from a primary tumor, sometimes there can be more than one sentinel lymph node.
A Sentinel Lymph Node Biopsy is a procedure where the sentinel lymph nodes is identified, removed and examined to determine if cancer cells are present.
A negative SLNB result suggests that cancer has not developed the ability to spread to nearby lymph nodes or other organs. A positive SLNB result indicates that cancer is present in the sentinel lymph node and may be present in other nearby lymph nodes (called regional lymph nodes) and, possibly, other organs. This information can help a doctor determine the stage of the cancer (extent of the disease within the body) and develop an appropriate treatment plan.

So, you're wondering how they do this SLNB procedure...
A surgeon injects a radioactive substance, a blue dye, or both near the tumor to locate the position of the sentinel lymph node. The surgeon then uses a device that detects radioactivity to find the sentinel node or looks for lymph nodes that are stained with the blue dye. Once the sentinel lymph node is located, the surgeon makes a small incision (about 1/2 inch) in the overlying skin and removes the node.
The sentinel node is then checked for the presence of cancer cells by a pathologist. If cancer is found, the surgeon may remove additional lymph nodes, either during the same biopsy procedure or during a follow-up surgical procedure.

Dr. E called a local Dermatologist that specializes in Melanoma and set up an appointment for me. August 24th - OMG, thats 2 weeks from now! All I can think is "I can't wait that long". So I was going to have "D" call their office Monday morning and move my appointment up - sometimes if you talk to the nurse they can move the schedules around and get you in quicker:) That was my plan!
That plan didn't last long, my 6 yr old son crashed on an electric scooter the next day and broke his Tibia! Dr. E wanted him seen by a Pediatric Orthopedic Surgeon so off to Riley Hospital in Indianapolis we went! My health issues was slapped on the back burner while we took care of my lil' man. I couldn't have my appointment moved up due to not knowing what was going to happen with him, so I just waited. Anyone that knows me, knows I hate to wait!

Wednesday August 24th
I went to see a specialist that specializes in Melanoma. I didn't sleep but maybe 2 hours all night because I was so worried about today's visit. I arrive for my appointment, the nurse takes me back and hands me 3 brochures on Malignant Melanoma... the first sentence in the first one I opened: "Melanoma is the deadliest form of skin cancer, whether called malignant melanoma or simply melanoma, this cancer can metastasize (spread) rapidly.
What a smack of "this is really happening to me"...
The doctor comes in and within minutes I'm feeling so much better - she says the size is just .1 mm so I will just clean it up and it should take care of it. I'm thinking OK awesome... then she proceeds to say "Oh wait a minute, the biopsy report says .10 CM this can't be right" then she leaves the room to call the pathologist. She comes back and confirms the report is correct and there's no way possible she could do the re-excision (WLE) because I definitely need a sentinel lymph node biopsy to stage the melanoma. She said she will need to refer me to a general surgeon due to the depth involved and the need for the SLNB. Well.. there just went the air out of my balloon! My moment of victory fell back down to complete depression!

BTW - a wide local excision (WLE) is a surgical procedure to remove a small area of diseased or problematic tissue with a margin of normal tissue.

So, she does a complete skin assessment (and when I say complete - I mean COMPLETE, every inch) The first mole she finds - BOOM, it looks suspicious "I need to remove it for biopsy"... I'm thinking oh great, I'm gonna leave this place looking like a mouse has been nibbling at my skin. Thankfully, only one mole had to go! Now, I'm praying for it to be benign! I don't think I can go through having more areas of my body cut on! Please let this be benign!

 Sorry, no before pic just this ugly after pic!

Thursday, August 25th
Biopsy is back - junctional melanocytic nevus with architectural atypia, non malignant! Woohoo!

Now, I'm in waiting limbo. I have an appointment with Dr. V a surgeon on Thursday September 1st at 2 PM. I hope he sets up the SLNB and WLE for the follow week so I can get this over with. I'm the kinda girl that likes to know exactly what I'm dealing with. I don't like things sugar coated, I want the straight answer regardless if it's news that will hurt me, I have to know. All I can do is pray and ask others to please send prayers and positive thoughts. I refuse to let this cancer kick my ass! I have my beautiful 19 yr old daughter to see graduate from college, her wedding and birth of my future unborn grandchildren, my 6 yr old to graduate high school, (hopefully) college and him starting a family and to see my 20 yr old achieve happiness and stability in his life. I'm not ready to just lay down and die, I'm too fierce and determined for that!

Some may wonder "why a blog?" I have chosen to keep this blog to share my experiences with others who may be facing the same unknown fears as I am. If I can help just one person by keeping this blog then hey, I have achieved something. I want everyone to know the dangers of indoor tanning use and exposure outside as well. It's all good fun in the sun until the damage is done! I never thought I would be advocating against indoor tanning - here I am with thoughts of my life passing before me, IT'S NOT WORTH IT! I'd rather be as pale as a vampire than not see my children's beautiful faces and hear them say "I love you mom" ever again! It's not a joke, this my friend, is reality.

XOXO, Melanoma Diva


Anonymous said...

Prayers for the toughest diva I know.!! Love, Your PIC

Melanoma Diva said...

PIC - you are the greatest! I owe you so much for being so persistent in me having my mole checked. U Rock Diva!

Anonymous said...


Anonymous said...

Wish I could be there with you during your surgery sis. Sounds like you have an awesome Doc. Luv and miss you!!

David Haas said...

I have a question about your blog. Please email me!

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