Tuesday, August 30, 2011


i have my appointment set for friday sept. 9th to resect the original site.  and perform the sentinel node lymph biopsy (snlb).  i think i am extra nervous this time because i was hoping it was over... my first dr to diagnose the melanoma was a dermatologist (derm).  he specialized in the mohs procedure for the removal of skin cancer.  sounds great, right? except he was an awful communicator.  when i asked questions he either ignored them or made light of my concerns... not what you are looking for in a dr when dealing with cancer in any form.  so i sought a second opinion.  i was unable to find a new derm with skin cancer experience that my insurance covered. 

i tried a new approach... i found a female oncologist (dr s) who has special interest in melanoma.  i thought that would solve everything... it did not.  apparently an oncologist is more like my treatment manager than the actual dr treating me.  so i ended up back at the original derms office for my biopsies... but i dont see that derm, i see his physicians assistant (pa).  i feel more comfortable with the pa who doesnt make light of my concerns.  since the onc doesn't biopsy and i will more than likely be a pin cushion for the next 2 yrs i am making the best of this situation.

that brings me to the majority of my anxiety right now... the new onc surgeon.  he is the dr my onc sent me to for a second opinion of the initial site.  he is very nice, patient and informative.  i will refer to him as dr b.  i saw him for my consult and he determined it is necessary to perform the resection as a wide local excision to verify all margins are cancer free.  and perform the snlb at the same time since the mohs didnt allow for final depth measurement on the intial tumor.  at first i was concerned that the snlb would not do as it is supposed to since the site has already been operated on.  dr b says that "it is not the most desirable timing, but its better than nothing." 

i've been thinking alot about that... and the snlb is supposed to follow drainage paths into the lymph system from the initial site then the dye will settle into the sentinel node (or first node to attract the dye) because in theory that would be the node infected with cancer if any.  makes sense... but if the area has been operated on those lymph channels may not be the same as they were.  so they might just inject me with some radioactive dye for nothing.  i am trying to remain level headed about it, but it isn't easy.  dr b already makes me way more comfortable that the original derm, so thats a plus.  and i think i would rather be paranoid and proactive than passively waiting because i am paranoid... hope that makes sense.

i will be going to the hospital on sept 9th... but that brings me to the part of my anxiety of the unknown.  i really didn't like the original derm at all... but that experience had some up-sides to it. 1) the whole mohs procedure was done at the derm's office (NOT a hospital).  2) i was new enough to this to not worry myself with the details.  3) the derm's office is right up the road from me.  but now, 1) dr b performs the procdures at the hospital.  2) i have worried myself silly with "what ifs?"  3) and the hospital is down south a bit from me.  4) i thought i was at derm's office forever for the mohs (something like 5 1/2 - 6 hrs), but i've been told to arrive at the hospital for 9am and be prepared to be there til around 6pm.  5) the morning of the 9th i can't eat anything... but i am supposed to be in the hospital as a cooperative patient.  i don't know about yall, but to me that is lame.  i will be in the hospital for an entire work day, but may not eat the whole time... 

then there are the differences between a derm's office and the hospital... at the derm's office they put you in a room with a tv so you can watch a movie.  not that the movie was so distracting, but it helped.  i chose 2 comedies to watch because i wanted something mindless to focus on.  and the room was private, so it was either just me or the derm and his team were removing the tumor.  i wasn't able to watch the movie while they were working on me, but thats because i am squeamish.  the tv was angled so you could see my reflection, so i didnt watch the movie while they were with me.  but having some background noise was much better than just the sound of their equipment because the procedure is only done with a local anesthesia.  i doubt i will have a tv for the next procedure at the hospital.  after all it is a hospital.  where as the derm not only works with skin cancer patients, but cosmetic patients too... so his office was plush.  not usually a word i would use to describe a hospital...

even tho i am trying to remain positive i feel like my anxiety is getting the best of me... i feel like once i get a handle on my anxiety about one incident i get thrown another more complicated thing to be anxious about.  since my parents are hippies i know that lacking certain b vitamins can effect your mood and anxiety levels... so i was going to buy a multi-vitamin (because i am also lacking vitamin d, calcium (dont much like milk), and magnesium), but then i vaguely remembered dr b's office saying that multi-vitamins can thin your blood... and i am not supposed to take anything that will thin my blood til i get the all clear.  i tried to get ani-depressant/anxiety meds from my gp (general practice dr), but everything they try to prescribe has side effects i am not willing or able to deal with.  but my hubby has a friend going to med school, so we asked him what i should do... he recommends prenatals because they dont have the ingredient that will thin my blood.  i am waiting for a return call from dr b's office to verify that is ok.

in the meantime i just sit and wait and wonder... and the more time i have to get lost in my own head, the more issues i think i create for myself.  i know this about myself, but still havent figured out how to change it.  if i had then i might not be lacking in so many vital nutrients... i might be able to actually eat a regular meal without my tummy practicing gymnastics... but until that actually happens i continue to give it my best to remaining optimistic.


  1. I feel you are figuring out how to deal with your self created issues, otherwise we would have nothing to read. :)

  2. Hi there! I'm so glad you commented on my blog so I can find yours. I'm Becca (you probably already know that). What's your first name so I know how to address you? I'm SO GLAD they are doing the wide excision and the SLNB. That should have been done in the first place. Where is your tumor located? Mine was on my upper chest. Are they putting you to sleep? I was so scared because I had never had any kind of surgery before, never been put to sleep, so I was freaking out, but it was actually kind of nice. I woke up and it was all over. The one thing that hurt me the most, honestly, was the test to find the SNLB site, where my mole drained to. It was under my right arm, and I was awake. They didn't do the actual surgery until the next day. They injected me twice, one each on either side of my scar where they had taken the mole the first time. It burned like holy hell, and I yelled, but it only lasted a few seconds. Honestly, that was the worst part! Everything else was pretty good. I had the biopsy, the WLE, then later had all my lymph nodes out, because one was positive, and later had a tumor behind my knee out. I was surprised at how well I handled the pain. I hope you will too. I know everyone is different. If you're on Facebook, there's a great group on there called "Bad Ass Melanoma Warriors" that you should join. They are awesome. Feel free to contact me anytime if you want to talk. You can do this, trust me!!!