Monday, August 8, 2011

My Dermatology Appointment Wasn't Supposed to be "A Big Deal": Instead, I've Got Skin Cancer

First, I have to say that this morning the topic of this blog was going to be how great I felt wearing heels for the first time after my hallux rigidus correction surgery, which is a fancy way of saying that my Ortho doc removed arthritis from the big joint in the great toe of my right foot on May 19th. However, an appointment with a Dermatologist this afternoon has changed all of that...and it's changing some other things too.
I've been taking a medication for 6 or 7 years and one of the side effects of this med is hyperhydrosis, which is a fancy way of saying it makes me sweat...A LOT. Especially in my face, which is very off-putting when I introduce myself to a new client and after I shake my new client's hand, I pull out a wad of paper toweling and mop up my face. At one client's first appointment she asked me if I was nervous and wanted to know how long I had been a therapist, statements I'm positive were related to my hyperhydrosis. The relief I get from taking this particular medication is remarkable and has had an incredible positive impact on my overall health, so the sweating was (and still is) something I'm going to have to live with. I've tried prescription anti-perspirants, including ordering one from Canada on-line, all with little to no relief. So about six months ago I started thinking about seeing a Dermatologist to investigate alternative treatments for my super-sweating problem. Four months ago I got the name of a Dermatologist from a doctor I know who knows this Dermatologist personally and came highly recommended. About 3 weeks ago I finally called and made an appointment with said Dermatologist, and that appointment was today at 2:30pm.
Dr. Dermatologist is a very nice, informative doctor and we talked about various treatment options for my hyperhydrosis. Just as he was getting up to shake my hand and make his way to another exam room, I said, "Before you go, can you look at this 'thing' on my forehead?" About 6 months ago I noticed this "growth" that sprang up out of nowhere on the left side of my forehead, almost right on my hair line. Dr. Dermatologist squinted at the "growth", put on a pair of exam gloves, and examined it further under a magnified light. Then he said, "I'm 99 percent sure, just by looking at it, that it's basal cell carcinoma. You've got skin cancer."
Umm...WHAT!?!? We grew up with a swimming pool in the backyard and my mother and sister would both slick themselves up with baby oil and lay out in the sun on the deck for hours on end all summer long. I would estimate that my exposure to the sun is at least 30% less than my sister's and 15% less than my mom's. Those are both conservative estimates, especially for my mom. And yet I'm the one that ends up with skin cancer? Really??
So Dr. Dermatologist's assistant numbed my forehead and he took a "shave biopsy" which is literally him taking a straight-edge razor and shaving off the newly-named "tumor".
The sample will be sent for examination under a microscope by a Pathologist. On August 17th I have a follow-up appointment for a procedure called Mohs Micrographic Surgery, which the American Cancer Society's website tells me is a process of the doctor cutting out a layer of skin, looking at it under a microscope, and if the margins and depth aren't "clean" (free of cancer cells), the cutting and microscope examination process keeps repeating until the margins and depth are both clean. The website warns me that it can be a lengthy process if the cancer is either wide and covering a larger area than just the site of the removed tumor, and/or deeper into the various layers of skin. I will also need follow-up visits to the Dermatologist every 6 to 12 months for the next 5 years, I'm at a greater risk for a recurrence of cancer in the same spot, for developing skin cancer in new areas, and that recurrence is most common in the first 2 years post-diagnosis. On the upswing, basal cell carcinoma is the most common form of skin cancer, is not likely to metastasize (spread to other organs), and the cure rate is approximately 98%. Those are all very encouraging words to read, but I think my brain stopped really absorbing any information after the doctor said, "cancer."
I'm 40 years old and I've got skin cancer. Statistically, I'm fairly confident that after the Mohs surgery everything will be fine and this diagnosis won't haunt me for the rest of my life. Emotionally, however, I'm still stunned, shocked, and in a bit of dis-belief. I know those are essentially all the same thing, but that's the only feeling I can put to this right now. Plus, the site of the excision is really starting to hurt, which is not helping my mood.
Where do I go from here? I need to tell my parents, other family members, & friends at work. I have been reminded in a really big way that today is all I, or any of us, have. The future is unknown to me.

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