skin cancer Archives - A Mommy Story

Because I Know You All Care About My Health

June 20, 2013 By Christina

You do care, right? Or at the very least, you’re interested in learning about my health woes so you don’t make the same mistakes. Hey, I’m OK with that. I’m a giver.

Not only did I have a big area of skin removed from my back last week, but on the same day I had an appointment with my primary care doctor as well. During the appointment, I mentioned that I have been feeling so tired all the time, even when I try to get enough sleep, and nothing seems to help. She decided that it would be best to have bloodwork done to check if something might be imbalanced and causing my fatigue. Tuesday really was human pincushion day.

I expected that maybe my thyroid was out-of-whack, which was why I was tired and struggling to not gain weight. Or maybe I was anemic.

The results were back on Friday, and for the most part they were normal. Except for one line of the report: Vitamin D. Last year when she checked my vitamin D levels they were very slightly low, and she recommended including more foods with vitamin D in my diet and taking a multivitamin. I’ve been doing that as much as possible, but the new test results showed my vitamin D levels were much lower than last year, outside of the recommended levels and into “deficient” classification.

I’m not quite sure how my vitamin D levels managed to go even lower after I started taking a multivitamin more regularly. But if it’s related to feeling tired, well, I can’t question the results. I’m sluggish all the time. Exercise will give me energy, but finding the energy to get started is hard. And once I do start moving, my muscles want to give out on me far sooner than they should.

Since getting the blood results, I’ve been reading more about vitamin D and it’s link to different health issues. I knew that being deficient in vitamin D could lead to weak bones, but there’s also solid research linking it to muscle weakness, metabolic disorders (including weight gain, increased risk of type 2 diabetes, and having difficulty losing weight), and fatigue. Huh. I didn’t realize vitamin D was the super-vitamin. Look out B-12 – vitamin D is coming to take you out of the spotlight.

I now must focus on getting more vitamin D. And this is where it gets ironic. Vitamin D supplementation is good, but the best way too get vitamin D is from the sun. Spending time in the sunshine is the easiest method for building up vitamin D in the body – the skin soaks in the sunshine, which triggers the body to make it’s own vitamin D in large quantities. Supplements work, but the body’s natural production is far more efficient and requires less time to raise vitamin D levels.

So spending more time with my skin exposed to sunlight would be a big help. However, wearing sunscreen blocks 95% of the vitamin D production. Which means to get my vitamin D sun therapy, I’d have to be in the sun for 15-30 minutes a few days a week without sunscreen. But because I’m a high risk for skin cancer, sunscreen is a must for being outside.

I’m damned if I do, damned if I don’t.

(And we won’t even discuss the fact that 15-30 minutes in the sun without sunscreen would have me a painful shade of pinkish-red, because this pale girl gets a pink flush just thinking about the sun.)

My doctor knows sunlight therapy isn’t an option for me, and didn’t even recommend it. I’m now on 5000 IU of vitamin D a day for at least the next six months. That seems like a lot to me. For reference, the average recommended daily value is 400-600 IU a day. She believes that getting my vitamin D levels raised should give me more energy and an overall better feeling of wellness. I’m willing to try just about anything to give me the energy to get more done.

I’ve been taking my supplements (they’re itty-bitty liqui-gels, so they’re easy to take) for five days now and I’m not sure when I’m supposed to notice any difference. I’ve been more awake the past couple of days, but that could be just from having the kids at camp and not being distracted when I work. I’ll re-assess in a few weeks to see if I think it’s making a difference.

I wouldn’t be surprised if more people have lower vitamin D levels now that sun safety has become such an important topic. We’re all wearing more sunscreen and trying to cover up in the sun to avoid skin cancer, but are we possibly setting ourselves up for other problems? I doubt many adults drink a lot of vitamin D fortified milk, and there aren’t a lot of foods with high levels of it.

Here’s hoping this is the key to what’s been dragging me down.

Holy-Moley update:

The incision from having my mole and surrounding area removed is healing nicely. I’ve had to remind myself not to twist or bend too much, or it pulls at the stitches and hurts.

A few people have asked what it looks like. I’m not going to insert the photo in this post, because I respect that there are some squeamish folks out there who really DON’T want to see it. But if you do want to check it out, you can click here to see the incision. It’s about 3″ long with several stitches, just an inch or so away from my spine. It hurts if I lean back on it the wrong way, and sometimes the stitches poke me. I can’t wait to get them out next week.

The photo is, for me, a fantastic reminder of why sunscreen is important. If you or someone you care about has any moles that you’re concerned with, the image of my incision can be great motivation for making an appointment with a dermatologist.

Early screening saves lives – this will leave a nasty scar on my back, but I also feel good that we caught it before it had any chance to turn into cancer.

Edited to add: Just in case you think I’m endorsing the brand of vitamin D in the photo – liqui-gels were recommended, and this brand was selected because I recognized the name and it was on sale when I was at the store. I mean, I’m happy with it so far, but it’s not sponsored in any way.

No Really, Wear Sunscreen

June 12, 2013 By Christina

It was just last month that I was reminding all of you to check your skin. Back in April I had a small mole removed, and when the pathology results came back, it was revealed that it was abnormal, but not cancer. I’ve had several moles removed that came back like that, so there was no surprise there.

But when they called with the results of this one, they said they’d like to take more of the edges just to be safe. That was a first for me, but this was a new dermatologist, so I figured she just did things differently. The man on the phone told me that this time it would be stitched closed. I’ve seen others who have had moles entirely removed, and they usually had one or two stitches in place – no big deal.

I went back to the dermatologist’s office yesterday, ready for a semi-repeat of the last visit. I suited up in my oh-so-stylish paper gown.

Rocking the paper gown!

The nurse sat down with me and started to explain the results again, only her explanation seemed more…heavy. That abnormal mole was a special kind of abnormal mole. There are three types of abnormal: mild, moderate, and severe. Mild and moderate are often just watched with no further action needed. But severe, well, that’s abnormal cells that are as close to melanoma as you can get without actually being melanoma.

It’s not skin cancer, and might not ever turn into skin cancer, but there’s a much higher chance that it could. And since there was a very large mole (I’ve named it Bertha) that this smaller mole was now touching after hovering near it like a moon before (I’ve now named the smaller mole the Death Star), they needed to take both out, as well as a decent border around all of it.

So this wasn’t going to be a tiny spot with one or two stitches then? No, not at all. The nurse explained that there was going to be a scar, and due to the position on my lower-mid-back, it’ll likely be an ugly scar. It’s impossible to keep the scar small when that part of the body is constantly being twisted, stretched and pulled.

The nurse left, and I sat in the room alone, my mind racing with this new information. Suddenly I wasn’t feeling so “no big deal” about this anymore. This was serious, and this was seriously going to be a minor surgery. That abnormal mole was setting off the cancer spidey-sense for my doctor, so I possibly dodged a big bullet by getting it removed now. What scared me even more is that she had looked at that one back in the fall and wasn’t concerned, and didn’t seem too concerned when she biopsied it back in April after I insisted that it looked like it had changed a little more in six months.

I understand why they didn’t tell me all of this on the phone when they set up the appointment. I would have been a nervous wreck for the next three weeks.

When the doctor came in, she went over everything again, telling me much of what the nurse had explained. Football-shaped incision to remove all of the skin down to the fat underneath, with a double layer of stitches – the inner layer would dissolve, the outer layer would be removed in two weeks. The doctor demonstrated how she’d pull the surrounding skin together when stitching it up, and I joked that it was a good thing I lost so much weight in the past few years so she’d have plenty of loose skin. She also made a point to tell me that this would likely be an ugly scar. I replied that I didn’t have any plans of being a back model anytime soon, and I’m far past any years of wearing a bikini, so it was fine. Humor – easy to use as a shield when dealing with hard news.

The whole procedure lasted about 45 minutes. I expected one or two shots of lidocaine to numb the area, but it was more like 10-12. The bee-sting feeling slowly faded to nothing, and they were then ready to begin. I laid on my stomach, wondering if I needed to not breathe too deeply so I didn’t affect the depth or direction her scalpel was moving.

(Warning: This next paragraph is graphic – if you’re easily squeamish, skip to the paragraph after it.)

I felt the nurse pressing against my back several times, and when she sat the gauze on the tray I realized she was dabbing away all of the blood coming from the area. Then the doctor pulled out a little tool that made several beeping noises. I wasn’t sure what it was at first, until the smell hit my nose. She was cauterizing blood vessels – the smell of burning flesh is hard to mistake with anything else. There was a lot of blood.

(OK, the worst is over, squeamish people continue reading.)

As she was finishing the stitches – and that part took awhile, too – I realized this was likely going to hurt when the numbing wore off , and started asking about restrictions while it heals.

Clean it daily, apply petroleum jelly to keep it moist and keep it bandaged. No ibuprofen or alcohol for a few days because of a risk of bleeding too much. If it starts to bleed, apply pressure and call the doctor or go to the ER if pressure doesn’t stop the bleeding.

Limited movement and no lifting for the first couple of days, too, then slowly allowing more movement, but cutting back quickly if it starts to bleed. No stretching or strength training exercises for several weeks – yoga is right out. Running/walking is OK in a week or so as long as I don’t twist too much in my torso when I run.

I realized my plans for exercising more have been temporarily put on hold because of this.

The new section of skin that was cut out will be sent to pathology again to confirm that there were no abnormal cells around the borders, and to take a closer look at any remaining abnormal cells in the sample. If the borders are clean, then all is well and I can go back to regular skin check appointments. If not…well, then I’m guessing we do this whole process again and take more out.

I have a large pressure dressing on my back that I’ll be changing for the first time today, and finally getting the first look at the stitches. As I got dressed in the doctor’s office, the pressure dressing was solid white. Two hours later I had already done too much, as I could see the blood in the gauze. It hurts, and I forgot just how much we use our backs for practically ANY movement.

Still…there’s a bright side to this story, and it’s an important one. It wasn’t cancer. OK, I guess I can’t say that for certain until the pathology report on the new skin cells comes back, but we’re pretty sure I’m good. Regular dermatologist skin checks are important for detecting changes early and removing anything suspicious before it could become cancer.

And wear your sunscreen. All the time. Especially if you’re a fair-skinned Irish-blood like me. My skin might not be trying to screw with me had I been better at applying my sunscreen and didn’t try to be tan as a kid.

My childhood summers, summed up in one photo.

The sun worship is long over in this house. I’ll admit to being more than a little scared of my own skin now. Will it decide to turn on me? Will I catch it in time? Could I have prevented this by taking better care of it when I was younger?

And if ever I need a reminder to wear my sunscreen daily and put it on the kids as well, I need only look at my back and the ugly scar that will be forming there.