My experience with skin cancer, part 1: The Diagnosis

 Well, it has been such a while since a blog post, and I'm sorry that this one has to bring a somewhat sad story with it, but although we haven't quite reached the end of the story yet, I'm pretty convinced that ending will be happy.  As you all know, I believe it's important to write things down, so I'd like to bring this story to you all while at the same time keeping a record for myself.  Perhaps I will have more time for family updates after writing this all down, but as you know it's gonna be May pretty soon and blogging seems unlikely.  Anyway, on with the story!

This story actually begins several years ago when I began noticing a spot on the side of my nose that was behaving differently than anything I had previously experienced.  I call it a "spot" because that's really all it was-- it wasn't a freckle or a mole or even a pimple.  It was simply a reddish spot.  It was the summer of 2020 and I began to notice that when I had been outside a lot, especially during our camping trip that year, the spot would get more red and a little bit raised, and would often bleed.  Although I didn't know too much about these types of things, the aforementioned attributes of my skin spot seemed like cause enough for concern.  So I called up my doctor at the time to book an appointment to have it looked at.  But, well... you know... that was 2020 and do you think I was going to get an appointment any time in the next century for something as "minor" as a skin spot?  So I booked the appointment for December of that year and decided to wait it out.

The trouble was, the existence of this skin spot seemed to be directly related to sun exposure.  So by the time I saw my doctor about it in the winter darkness of December, it had all but disappeared.  I remembered showing her where the spot had been and she couldn't even really see anything.  And so, we determined together that if it had gone away, it probably wasn't anything to worry about.

But then, come the next sunny season, it came back, and started doing the same things it had done before.  I had a hard time finding "before" pictures because a) I am never in family photos since I'm always the one taking them, and b) this spot is so small you can barely see it, and I have to be turning my head a certain way for it to be visible, and even if you zoom way in it's still hard to notice.

In these photos taken in the summer of 2021, you can see a veeeerrrry slight pinpoint of redness on the side of my nose-- that's my spot.  So yeah, we're talking small.

I let the summer of 2021 go by without thinking much about it, since my doctor hadn't seemed concerned in the winter months.  But yeah, the redness, raised bumpyness, and bleeding related to sun exposure all continued through that summer.  Then as soon as fall came, the spot again disappeared.

In the summer of 2022 we were so busy that I wouldn't have had time to get anything checked out even if I had wanted to.  We were also still in the process of switching doctors and transitioning health care after our move for the whole family, so I think I had been trying to book a physical for myself that summer but was on a lengthy waiting list.  Anyway, I finally booked an appointment to see my {new} primary care physician in December, and I planned to mention the skin spot to her then, since it was still following its usual patterns and I figured a second opinion wouldn't hurt.

Again at my December appointment with the new PCP she could barely see anything on my nose-- the spot had performed its usual winter disappearing act.  However, her feeling was that based on my descriptions it was worth having a dermatologist look at it.  So, after two different reschedules of the appointment due to my always-busy schedule, I finally ended up seeing a really great new dermatologist about two months after my PCP appointment.  Although after a quick look at my nose she said it was "probably nothing", she recommended we do a biopsy because the skin spot was "speaking to us and letting us know it wants to be checked".  I loved her!

They were able to take a sample for the biopsy in the office that very day, and although having a shot in my nose so that they could numb the area was an eye-wateringly painful experience, the procedure itself was very quick and painless, so much so that I didn't even realize they had done it.  I had a small band-aid on my nose for that day that I was able to remove the very next day without any noticeable scab or anything.  So, I figured we'd do the biopsy, the dermatologist's hunch that it was "probably nothing" would be confirmed, and I'd move on with life having checked off that box.

The biopsy took place on a Friday, and she had said they would call by Monday or Tuesday with the results.  When it was getting to be Thursday and I hadn't heard anything, I remember having a passing thought that it could mean bad news, but I didn't really think too hard about it, because as I say, busy life.  Then finally Friday morning (one week after the biopsy) I got a somewhat cryptic voicemail from my dermatologist.  On the voicemail she told me she had the results of the biopsy, and instructed me to call back, and if I called back and she was busy with something I was to tell them to interrupt her so she could talk to me.  Yikes I thought.  Of course I didn't even have a chance to listen to this voicemail until after my teaching day was over around 4 PM, and I couldn't call until even later than that.  By the time I called back she had left for the day.

I mentioned it to M and he tried to reassure me and tell me not to worry about it.  I figured that even if it was bad news there wasn't anything I could do to find out until Monday, so no use worrying since it was "probably nothing".  I did do a pretty good job of putting it out of my head that weekend, I think.

Come Monday morning (my day off), I got another call from the dermatologist.  She apologized profusely that I had had to wait the weekend, and then broke the news that my spot was a tiny basal cell carcinoma... meaning skin cancer.  She reassured me that it's the kind of cancer you want to get if you have to get cancer, since it's treatable with a 100% survival rate, and is less aggressive than other skin cancers (like melanoma).  Although she said it wasn't the type of cancer to spread quickly, we would want to treat it as soon as possible, and her recommended treatment was a procedure called Mohs surgery.  She then gave me the very good news that one of the top Mohs surgeons in the country was practicing at the same office as my dermatologist.  The way she put it was "if ever any of my children had to have this procedure done, I would fly them from across the country to have him do it."

The day I got the news was a bit of a tough day.  Although the prognosis is good for this type of cancer, it's still never easy to be told you have cancer.  I had to kind of sit with the news a bit, shed a tear or two, and... well... just be shocked for a little while.  I knew that I would get over the shock and feel better about it with time, but it did hit me kind of hard initially.  Of course all of the regrets run through your head-- the countless afternoons of marching band practice in the Texas sun with no sunscreen, the tanning beds before my wedding, the always putting sunscreen on my children at the beach and often forgetting myself.  But after a while you realize the past is the past and all you can do is learn from those mistakes and move forward.

I struggled a bit with how to tell the girls.  Having had a teary moment myself when I heard the news I didn't want to scare them too much with the word "cancer".  But I also wanted to be completely truthful.  It ended up being a pretty quick conversation one morning while we were all at breakfast together.  I basically said that I had a small spot of skin cancer and had to have a surgery to remove it.  I reassured them that I wasn't going to die.  They seemed to be content with that and didn't have too many questions to ask at the time.

About a week later the dermatological surgery office called to schedule the surgery.  I was sort of hoping they would have something over the April vacation so I could get it done and recover without having to take time off from work.  But wouldn't you know it, the first appointment they had was the Wednesday *after* April vacation.  I didn't really want to wait, so I booked it, figuring I could take the day off.

Later that day after I scheduled the surgery they called again to give me instructions on what to expect.  I guess I had sort of thought this would be an in-and-out thing similar to the biopsy procedure, but as they explained I realized it would be much more involved than that.  The way Mohs surgery works is that they do an initial scrape of skin and send it to the lab to be checked so they can make sure they got all of the cancer.  The waiting for lab results can take an hour or more.  Then if they discover that they didn't get all of the cancer on the first scrape, they have to scrape again, then you wait again, and on and on until the cancer has all been removed.  So the procedure can take as little as an hour or as many as seven hours, depending on how many rounds of scraping it takes.  The idea is that they are removing as little tissue as possible to keep your body (and face!) as intact as they can.  On this call they also mentioned that I would have stitches on my face and would need to keep them bandaged for at least a week, and that I should expect pain and swelling for at least 24 hours after the surgery.  She also said I wasn't to do any bending or lifting for 4-5 days.  It became more and more clear to me that this was going to involve several days off.

After that phone call I sort of sat with all the news and absorbed it.  My current surgery appointment was in the week following April break-- not too close to spring concerts.  Pushing the appointment any later in the school year probably would have involved disrupting my concert schedule in some way.  The only other option was to wait until the end of the school year, which this year will be June 23rd because we have had six snow days!  It seemed a long time to wait.  I knew I could get approved for the three days of time off that it would probably take for me to recover from the surgery, but it would use up all my sick time-- and even if I wasn't working, how would we do all the things needed to run our family, like cooking meals, driving girls to all their activities, laundry etc. if I wasn't able to bend or lift?  Basically, I knew there was no "good time" to get this done-- and so after many discussions and ruminating with M and other friends, I decided to keep the appointment as it was.  I gave a call to my Mom and Dad to see if they were able to come stay for that week and help us, and like the wonderful parents they are, they said yes!

The whole process of scheduling the appointment and getting ready to take time off was a lesson in being able to set aside the needs of others and concentrate on myself-- which goes against every instinct of a teacher and mother.  It felt somewhat selfish to make the decision to go ahead with it, but gradually as more and more people approved my choice and said I was doing the right thing, I got used to the idea.  It was also a huge amount of work to find subs, make lesson plans, and communicate with all the necessary people to let everyone know that I was taking a few days off, and the reason why.  The date of the surgery fell right on the final rehearsal for L's Central Districts orchestra, for which I was to be the chaperone and chauffeur, and just a few days before her final concert... so in addition to my regular school-day teaching, after school rehearsals, and private lessons to arrange for, there was all of those events to make a new plan for as well.

I had a few conversations with the girls about the fact that I would be taking time off after the surgery, that I had been instructed not to bend or lift, and that they might need to do a few more things for themselves than usual.  L seemed slightly disappointed that I would be missing her Districts Orchestra rehearsals but was reassured that I would almost certainly be able to attend her concert.  We went about our daily lives and kept busy, and the girls didn't seem too concerned or worried, which was good.

Finally, it was the night before surgery and all the preparatory work had been done.  My parents arrived from Delaware, I finished teaching my last private lesson, and we sat and chatted and worked out final plans for everyone getting where they needed to be the next day.  I felt a lot of relief just having gotten all of the work done that was needed to get ready for the surgery, and I felt ready to just get it done and rest afterwards.

To be continued...

Move on to part two here.