Good news; but no added value ;)

Thank goodness today finally arrived.  Doing research, looking up cases, worrying, planning without knowing the plan, would finally be a thing of the past.  I was anxious to see the plastic surgeon to see what his plan was for my face, for my skin cancer.

His first words of "oh just a small nodule" were reassuring and after him having me scrunch my forehead, multiple times, look up at him with my face pointed down (to scrunch it at him again), he drew an eye shaped mark around the basal cell nodule and assured me that it will be a simple excision, in his office (yeah!).  His aim is to have the scar eventually look like just another line in my forehead.  However, yes, for a short time one eyebrow will be raised; but he assured me that as things relax it should come back into line.( Perhaps I'll have concentrate on this picture's look again?)  When I asked him the "what if they find at the lab that the borders aren't all clear?" he simply replied that it would be a conversation we would have if indeed that happened.  However, he felt pretty good about what the plan of action is. Bad news:  I was unable to convince him to give me some "added value" with a breast augmentation at the same time...at least not yet ;)

Two weeks from tomorrow, a chunk of skin will be removed on my forehead, down to the muscle.  I feel fortunate that the procedure should be quite simple. He wouldn't tell me an estimate of the number of stitches that would be needed, probably not wanting to scare me.  I however, assured him that I had him beat no matter how many he used.  When he asked how and I told him about my back surgery for scoliosis, he said he definitely wouldn't use that many stitches. I'm in hopes that this surgery will be the last of anything to do with this recurrence.  However, I know from the sun damage I have had over the years I will probably be facing other surgeries over the course of the years to come.  A relative of family friends is not so lucky this time around.  She has been battling basal cell carcinoma for years.  The current area of recurrence is on the top of her head.  She has had it excised, it won't heal, and now she is looking at a skin graft on top of her head.  Skin cancer isn't fun, it isn't pretty and can become an ongoing battle.  Why not battle the sun and it's rays BEFORE the damage is done?

In updating my company's HR manager about what the process will be, she was very relieved for me.  In talking about preventing skin damage she told me she is the whitest person around and that she "embraces her whiteness".....smart smart lady. 

Many friends are telling me that they are using their sunscreen because of this blog....YEAH!  Please, don't YOU forget to use your sunscreen today, too!

Gut Reactions

When one gets a dose of reality, there usually is a different perspective on life that results.  My dose of reality is that my skin cancer is back; and this time the surgery isn't going to be simple.  The appointment with the plastic surgeon has been moved up one day to Wednesday, April 28th at 9 a.m. I'll be glad to have the appointment out of the way and know what we are looking at for the surgery.  With my skin cancer recurrence, I look at other areas on my face and wonder what is next...my cheek? Nose? Chin? From what I have heard, if you have recurrent Basal Cell Carcinoma, it is likely to continue to recur.  Will my face eventually become a mass of skin cancer scars?  I certainly hope not.

My gut reactions in life have truly changed since starting this blog, since my skin cancer returned.  Last night a friend was tagged with photos on facebook from their trip to the Caribbean.  As I looked through the photos of my blond haired blue eyed lifelong friend, burnt to a tan, blond hair glowing, I felt sick to my stomach.  I wanted to scream "DON'T DO IT!" "Burns are not worth it!" Will looking 'good' by burning your skin now make up for how destructive skin cancer will be later on? Here are some skin factor facts from the American Cancer Society.  I am certainly hoping this friend reads my blog and realizes that she wants to keep her beautiful face in one piece; and that she wants to be around to raise her young children.  Why chance fate?  Both she and I certainly got enough skin damage growing up, sans sunscreen.

I had the opportunity to take my youngest son, Logan, to see the Broadway production of CATS that was on tour.  Logan is fifteen years old and theater is his passion.  He has acted, been back stage, done the sound and most often is the light board operator for the local theater's productions.  While many of my friends' husbands were begging to go home, Logan was taking the whole show in with amazement.  After the show, Logan and I went through the local Taco Bell drive thru for some "cheesy double beef burritos"....all three of my growing boys' favorite cheap fast food.  I decided to have fun at the drive thru and added multiple cheesy and beef amounts such as "6 double cheesy triple beef cheese burritos"....followed by ordering the most difficult item I could quickly see with of course, having fun with being unable to pronounce the "Salsa.....totada....bodata" or something like that.  Logan burst into laughter and kept giggling as we were driving off with our food.  I asked him why he was still giggling and he said "I just didn't ever picture you pulling pranks"....WOW...what a huge gut reaction for me!  I've been so busy being "mom", and "dad" and "provider" and "nurse" and "disciplinarian" that my boys don't know that "Dawn" can get a room into tears from laughter, and does so often.  I've vowed that my guys are going to get to know "Dawn" and feel badly that they haven't already because I've been so busy taking on all the other roles in their lives!

In the midst of all that is going on, life does go on; and as a single woman, that sometimes means "dating" might be on the agenda.  Prior to my appointment with Dr. Prokop I had started talking to a gentleman online. When I found out the skin cancer had returned, I felt like I needed to let this guy know that this probably wasn't going to be the best time for me to get to know someone. Besides the fact that was under more stress than usual, the prospect of what this surgery might entail seems like a not so fun thing to become involved in if you don't have to.  So, I sent this gentleman a note telling him such, with a link to this blog.  I told him I'd understand if he didn't want to continue to get to know each other at this point.  I expected his gut reaction would be to run.  Much to my surprise, he told me he first of all was sorry to see what I was going through; but secondly of course he wanted to continue to get to know me and to let him know if he could help out in any way.  We proceeded to schedule our first date (the picture from the mountain top that he drove me to-where most other vehicles dare not go) is at the top of this entry.  We've had multiple dates since and it's very comforting to know that I have someone else in my corner ....Thanks B!

Thanks for reading my blog, friends, and please, remember to use your sunscreen, today!

What's Most Important

In the last few days I have been trying to concentrate on other things than the skin cancer on my forehead.  I've been to the latest Penobscot Theatre production with friends; and celebrated another friend's birthday by going to see an amazing local band, Overdrive.  The house and the kids have needed my attention; and then there are the dogs.  If having three teenage sons wasn't busy enough, I also have three dogs...a lab mix named Molly, a peek-a-poo named Jasmine and a pug named Rocky Balboa.  Let me tell you, when all seems to be falling down around you in the world, man's best friend takes your worries away.....at least for me!

Last night I found out that a friend's husband had just been laid off. This wasn't from a company that laid of a percentage of it's work force, this was from a company that recruited him heavily from his other job a few years ago.  They have two daughters, a mortgage, credit card debt, car payments: the American "dream" and they are scared.  I know that my friend's husband wouldn't be complaining about the weekend coming to an end if he could just have gotten up this morning and went to work and the layoff was just a bad dream.

Another friend, @maggiemoo , is in the hospital with her two year old daughter in isolation.  Maggie has been fighting a very rare blood disease for most of her life.  The hospital is a common place for this young family.  What they wouldn't give to have a day without worry...a day to be a normal family of 5 getting the kids ready for school, grocery shopping, homework, trips to the park.  Instead this family is watching blood counts and planning a trip to Tufts in Boston for their daughter to have an MRI before starting an intensive treatment for her blood disorder.

So in the whole picture of things, I am really pretty fortunate.  I have this thing on my forehead that doesn't look like much; but upon closer examination it is.  Here is the "dermoscopic" photo Dr. Prokop took of my latest basal cell occurrence.  The close up shows the little capillaries that have developed within it-the big tell tale sign they look for.  Without a close up, it doesn't look like much. But in reality, it is something quite significant. Thank goodness for the diagnostic tools we have access to now that weren't around years ago, or this could have spread far beyond what it is now.

Today, at the Bangor Daily News, where I work, we were all given a reminder as to what is indeed most important.  A bomb threat had been called in and we had to evacuate the building. In an unusual turn of events, I was actually told about the bomb threat by the publisher himself.  I then notified my department and everyone at the paper gathered outside while the police and the bomb sniffing dogs did their job.  When we were all given the thumbs up that it was safe to re-enter the building, everyone sighed a sigh of relief.  Not only did we have our jobs, there had not been a bomb and nobody got hurt.

The happenings mentioned here remind me of how fortunate I really am. Yes, I'm going through a bit of a scary time but I have my job, my kids have their health, and fortunately the bomb scare was just a hoax.  No matter how bad things seem, if you listen to what's going on around you, you realize how much worse things could be.  Everyone that has a job needs to be happy they have someplace to go on Monday that will lead to a paycheck on payday.  Parents need to be grateful that their healthy kids are eating them out of house and home. And those trying to "look healthy" by tanning need to look closely at what the damage it will do to their skin.  Please, don't forget to use your sunscreen tomorrow.

Friends with Skin Cancer

On a recent night out to the Sea Dog with friends, I overheard a conversation in the ladies room.  The words that jumped out at me were "my skin cancer" and the young female voice didn't sound the least bit concerned.  When I saw the young lady who was talking, my jaw dropped.  She was "tanning bed" tanned...without a worry in the world.  Young people do not see or realize the dangers of skin cancer and this young lady talked about having it as if she were talking about her ring finger- it's there, no big deal.  I've heard stories about local young mothers dying from melanoma. The common factor in the stories is the fact that they "faked and baked" all the time, the maximum time allowed; and in one case, the young mother was so addicted to tanning that she had multiple packages at multiple tanning salons so she wasn't held to the limits that salons need to limit tanning to!

In recent days I have been reminded of friends who also have battled skin cancer.  When I was in college a high school classmate, Matt, died of melanoma. I remember the shock well when I heard; and now being back in touch with Matt's twin brother Mike, I hear the pain of Mike's loss of his identical twin brother whenever we discuss Matt, or my current diagnosis.

This is "us" at our high school graduation. (Matt and Mike were so identical, there is no way of knowing which one was marching beside me in this picture)  Notice the similarity....both of us were extremely fair, and notice also that I was graduating as pale as pale could be.  I didn't "fake and bake" in high school, I didn't lay out in the sun with baby oil slathered on my body or on those reflective sheets to make the sun's rays STRONGER, and yet today, I am dealing with Basal Cell Carcinoma.

Another friend, Holly, has also battled melanoma.  When I asked Holly if I could share her story, here is what she told me:

"I went in for a mole check and had a couple suspicious ones removed. One was melanoma. I had a HUGE chunk surgically removed from my back a few days later! Looks like a shark bite, and that was for a small melanoma." Holly has promised a picture of the scar on her back but maybe it is better I see that AFTER I go through my surgery?

At the same time I was making appointments to look into the spot on my forehead, a friend of mine, Kathy (on the right), was also dealing with sun damage on her skin:

"At first I thought the spot on bridge of nose was dry skin. Then maybe a zit that wouldn't come to a head, and finally had to be an age spot...When a couple people noticed spot and made reference to it, I looked closer and didn't like the little red streaks through it. Immediately looked at pictures online and had myself convinced it was squamous cell carcinoma and they were gonna have to rip my face apart. Tried to make an apt w/dermatologist first only to be told needed referral no matter what kind of insurance. Then drs office informed me I had to see my primary care physician and no one else in the practice because I hadn't been to their office since 2004--that took a month (of non stop worry and obsessing) Finally get to drs for him to tell me he didn't have the right diagnostic tools and I would need to see the dermatologist--big surprise...It was there that they diagnosed me w/actinic keratosis and immediately I started treatment w/chemo cream 2x daily for 3 weeks. I'm about 2 1/2 weeks into it and am itchy w/red patches all over my nose. I can't use sunscreen or other creams while treating and feel like there's a big beacon in the center of my face. I'm taking comfort in knowing it's short term and I won't have scarring or cancer"

Here is a link to the Skin Cancer Foundation's information about Kathy's precancer, Actinic Keratosis








Closing thoughts:  PLEASE, think of those you know who have battled skin cancer, and don't forget to use sunscreen, today.

The Day After

No more "maybe it isn't skin cancer", it really is. My appointment with the plastic surgeon has been scheduled for April 29th. In the world of "cancer" this is a good sign...there is no immediate hurry to get in there to get rid of it as it is slow growing. In the world of "worrying" it prolongs the questions such as: Will it be able to be done in the doctor's office like my last basal cell? Will it have to be done in the hospital? Will it have to be done in stages? Will it involved a skin graft? The question I am hoping for a yes on is "Can you just take out the skin evenly across my forehead and give me a mini face lift?" Of course, the doctors always tell you not to Google what you have; but of course, what is the first thing you do with a diagnosis? You Google it! What I found was an eye opening and very scary account of one amazing woman, Shannon's battle with Basal Cell Carcinoma.

Can you see my skin cancer in this one eyed photo of me from last fall? You can barely see it, but it's there, about one inch above my eyebrow. It looks like one side of a mini m&m is under my skin.  The reality of this picture is that it's only the tip of the iceberg. I now have the clinical photo Dr. Prokop took last week.  After reading Shannon's blog and seeing what she went through on the tip of her nose, I know it could always be so much worse. I've already started the transformation of my hair to have the slanted bang look over my right eye so that if the incision is large and reconstruction is prolonged, I can hopefully keep it somewhat covered (except for when the wind blows :) Yes, the picture is quite freaky of just one of my eyes and yes, it's amazing such a small rise in your skin can cause such alarm. However, hopefully this will remind one and all to remind themselves and those that they love.... Please, use your sunscreen today.

Defining Moments

Most of my life has been defined by things that happened before I had a say in how things happened. I was born to an unwed teen hippie mother, with a man listed on my birth certificate who wasn't my father. When my mother died at the age of 19, I was officially an orphan and raised in the State of Maine foster care system. Fortunately, I was raised for most of my childhood by one family who took me in as their own. The month I turned 18, my grandmother died-leaving me the last living member of my birth family. These facts of my life dictated many decisions I made as a young adult: I couldn't wait to be a Mom, so I married the first man I met who also was ready to start a family. In my early 20's I became a mom to three little boys in close succession: John, Cameron and Logan. I was happier than I'd ever been in my entire life.
 
Unfortunately, the marriage to my children's father didn't work out-I became another statistic being a single mother. I got through each day knowing that "bedtime would come!"; and I somehow got through days of three kids with the stomach flu, three kids' homework, each child's individual needs-all by myself. I finished my college degree and started my professional career at 33 years old. That is when I started juggling three kids needs with the responsibility of working full time. It was during this time period that I first heard the words "you have basal cell carcinoma." I had a small bump on my right temple that the dermatologist really didn't think was anything; but it was. My dermatologist excised the bump and sent it to the lab, only to find out it was indeed skin cancer: but, according to him "if you have to have a form of cancer, basal cell was the type to have." Without really thinking about it, I had become a statistic again.

I had to go into his office to have the skin, around where the bump had been, excised so that all of the skin had clean borders with no cancer cells. I remember lying on my side, in the doctors office as he did his job-it didn't hurt but I could feel liquid running down the side of my face (blood). I also remembered the look on my best friend's face when they brought me to the waiting room--a big bandage on the side of my face. I ended up with a scar a little over an inch long, on my temple. I also ended up with an out of pocket bill that was a bit more than I could handle. Unfortunately, this doctor had no patience or empathy about a single mother;and after a couple of months of my not being able to pay that portion (insurance had paid theirs), my dermatologist sent me a nasty note saying that I could no longer be his patient and my file would be removed from his active patients. This single act alone led to me not going for yearly follow-ups, as I was supposed to, to make sure there were no more recurrences.

Fast forward ten years to 2010. My babies are now amazing young men who are very protective and supportive of me. My career has led to an amazing position with the Bangor Daily News- a company that feels like family. As it turns out, I found out that not only did the BDN feel like family; but I HAD family working there. I have a cousin who works there, Judy, who has two sisters, Angela and Heather. For the first time since I was 18 years old, I have female blood relatives! In talking about how the realization had been made, with a friend of mine, it turned out that that friend, Tanya was also our cousin! My dream of having extended family has been realized this year. Also, a long lost family treasure-a picture of my grandmother interviewing Walt Disney, was also found at the BDN about a month ago. I couldn't be happier with all of the findings that the BDN librarian has led me to. So many things I had dreamed of and wished for were coming to fruition.

Each morning when getting ready for work, I was keenly aware of some areas on my face that I was uncomfortable with. I have a bit of a dry skin patch on the tip of my nose, a couple little bumps on my right cheek, and I had been watching a little flat risen area on my forehead. I finally picked up the phone and called my primary care provider for a referral. After examining them, she thought they were "nothing" but gave me the referral to a local dermatologist (other than my first one) whom she had heard very good things about. The appointment was scheduled-for six weeks later.

Dr. P, my new dermatologist came into the examining room with two cameras around his neck. He was very nice, as well as very thorough. I pointed out my areas of concern and told him my basal cell history as I remembered it. He very thoroughly looked at every area of my skin, with a bright light in hand. From the top of my scalp to between my toes and the bottom of my feet, there wasn't an area of skin not examined. Upon completion, he told me everything looked good, except for that raised area on my forehead. He was quite sure it was basal cell carcinoma because it had the tell tale sign of it's own little blood vessels. I couldn't see them with the naked eye; but he took pictures, one close up shot that had a direct light onto it, and sure enough, the weave of little blood vessels was clearly visible. If you look at this image of basal cell carcinoma, you will see exactly the type of blood vessels he showed me (I am in hopes to be able to add the images of my own cancer to this blog in the near future but a stock photo will have to do for now).

The sinking feeling hit my gut, just as one always feels when they get bad news. He went on to explain I would have to have it removed by a plastic surgeon because it was so close to my right eyebrow. However, he needed to take a piece of it to have it biopsied to have a definitive diagnosis. Down on the table I had to lie while he anesthetized my forehead (not fun with no body fat for the needle or local to go into). He then took a small piece that looked like a hole punch out of the middle of the suspicious area. A band-aid was then applied that I would have to wear for the next three days. When I asked how long before I would know for sure, he told me ten days. As I left the office and proceeded with my day, I knew without a doubt that the next defining moment in my life was upon me. One can't hide a skin cancer on the forehead, especially with fine blond hair. The surgery wasn't going to be simple as my first episode had been; and with the recurrence of basal cell, I knew I had to be diligent about protecting my skin from sun exposure from here on out. Tanned skin was out, fair skin was in.

Yesterday afternoon, 4 business days after the surgery, I received a message from Dr. P. himself. He wanted to know what time would be best for him to get in touch with me and best phone number, as he wanted to discuss the results of my biopsy. I knew then that his suspicion was correct-it was indeed another episode of skin cancer. Now a few things are on my agenda....a consult with the plastic surgeon to see HOW he would remove it (can it be closed on it's own, would it need a skin flap, would it need piece of skin from another area of my body to close the hole?), the surgery itself, AND, to get the word out about the most common form of cancer in the United States. It may be common; but it can be extremely disfiguring and thus very scary. I am not sure what the following months will bring; but I can assure you this. I will share the details for you, for your loved ones, and for anyone who happens upon this blog so that hopefully the world of "tan is in" will start to change to "sun damage is not cool, protect your skin!" I am not going to spend a lot of time editing, I'm just going to write and post so that none of the path I am now traveling on will be missed.

Please, don't forget your sunscreen today!