More Dithering About Scars

Last year I was a little freaked out when I needed to schedule surgery to remove a stage one melanoma on my leg, and the doctor started talking about plastic surgeons and skin grafts.

According to my dermatologist, the leg—especially the ankle—is the worst place on the body when it comes to healing with the possible exception of the lip. I guess it’s a circulation thing. (Leg is also the most common place for women to have melanoma. For men, it’s the back.)

But what made it harder to make a decision was not really knowing what to expect. I automatically turned to the Internet, which was an additional challenge thanks to the six months of computer crashes I was gifted with at the time. I had Googled “melanoma scar on leg” and was scared witless by the most severe cases that popped up—and none of them on the ankle, like mine. I was genuinely afraid I’d end up looking like Frankenstein. Still, I decided to forgo the really special specialists and just had the dermatologist remove it in her office. When I left my surgery, I was bandaged from ankle to knee. All for something that was about the size of a grape seed.

What I discovered under all that mummy wrap was really no big deal. So forgive me if you feel it’s tacky of me to flash my nasty legs at the world, but I am going to post pictures of the scar for those people who may be doing an image search for “melanoma scar on leg” or “melanoma scar on the ankle” like I was.

It should be noted that I required another biopsy in October which turned out to be benign. So the newest photo includes a scar that’s about 16 months old with a punch biopsy at the bottom (the darker, rounder part of the scar) that’s about nine months old. Again, I skipped the plastic surgeons and grafts and just had a wide excision (with 1 cm. margins for a .03 mm. stage 1 melanoma with no migration, no mitosis per visual field and no ulceration) in my dermatologist’s office. I can easily cover the scar with cosmetics if necessary, but at this point I usually don’t bother.  

About two weeks after wide excision of stage 1 melanoma

About a year later with punch biopsy on bottom

As always, reduce UV radiation. Wear sunscreen. And remember that you know your body better than anyone; don’t take take a doctor’s word for it (or four, in my case) if something doesn’t look right to you. Demand, don’t request, a biopsy.

The good news is that the best of your life can be ahead of you no matter what your age or circumstances—if you choose to make it so—because 90 percent of your potential is not only untapped and unused, but also undiscovered.  That’s not just good news it’s incredible news! ~Tim Hansel

A Lesser Known Monday Holiday

Tomorrow is…Melanoma Monday! Woo hoo, you say. I’m sure I can hear you say that. Some people will be wearing orange tomorrow, and possibly a black melanoma bracelet. I haven’t decided yet if I will participate only because I don’t own a lot of orange. It’s one of those cruel ironies that I do happen to look good in orange if I have a tan—and I really haven’t had much of a tan in years.

In honor of Melanoma Monday, I’ll tell you the story of getting mine diagnosed. I hear more woo-hooing, don’t I?

It’s pretty well known that it’s important to have “ugly duckling” moles checked out. But mine wasn’t terribly ugly. And it wasn’t what I’d call a mole. It was just a tiny, figure-eight-shaped spot that appeared several years ago and was different from everything else I have—and there’s a lot to choose from. It had two melanoma markers right off the bat, though: asymmetry and uneven color distribution.

What shook me awake—in more ways than one—was the nightmare. In it, I was sitting on the porch of an old college roommate on a warm summer evening in shorts when she very gently told me I had something that I needed to have a doctor look at. When I looked down, I had two, four-inch-long mushrooms sprouting from my leg in the shape of that figure eight.

It was the nightmare that spurred me to make an appointment to attend one of those free skin cancer checks sponsored by a local hospital.

The doctor took a quick glance and told me it was nothing.

“Are you sure?” I asked. “Because it doesn’t look like anything else on my body, and clearly I have a lot on there. Do you mind looking again?”

She was probably in her late twenties. I know what it is to be young and not taken seriously by patronizing people over 40, so I’d tried to be very, very polite. But she let me know by not looking at the skin thing again that she was offended that I’d question her abilities. “Really,” she said. “It’s nothing.”

“But it’s asymmetrical,” I said. “And varying colors. And it just appeared and is getting bigger.”

She carefully explained, in a tone that let me know just what she thought of doddering middle aged laypeople with weird things on their legs, that discolorations such as mine can appear “even as we age,” and they are nothing. “It’s okay. Really.” Clearly I was overreacting.

Except I was reluctant to leave. It slipped out. “But…I had a nightmare.”

“Oh.” she said. “A nightmare! Well.” The look on her face let me know just what she thought of nutbags like me and our nightmares.

Over the years, doctors two, three, and four said something similar, though most weren’t quite as snide. 

So when I thrust my leg at Doctor #5 and she used the “M” word, I felt like someone had knocked the wind out of me. When I told her about the four other doctors, she said it probably wasn’t cancerous then. Apparently benign stuff can and does just become cancerous. I didn’t tell her that Doctor #4 was only a few months ago. I was afraid she thought I was being litigious or something. I wasn’t. It’s just been frustrating is all.

What I’ve learned is to tell, don’t ask, for a biopsy if something doesn’t look, feel, or seem right on your body.

So anyway, happy Melanoma Monday. Whether you wear orange or not, please do wear your sunscreen. And remember the melanoma markers are as simple as a, b, c, d, and e:

• A is for asymmetrical shape.
• B is for irregular border.
• C is for changes in color.
• D is for diameter (but don't wait until it's bigger than a pencil eraser if it's of concern to you—I think no one took mine seriously early on because it was so tiny, but obviously catching it early is what saves your life).
• E is for evolving.

If you find out next week that you are terminally ill—and we’re all terminally ill on this bus—what will matter are memories of beauty, that people loved you, and that you loved them. ~Anne Lamott, Plan B Further Thoughts on Faith

The Fault, Dear Brutus, is Not in Our Scars

I was recently at a singles’ function, and a man I know was talking about surgery. He commented that women shouldn’t ever have surgery because “it scars them.” I just stared at this man, as I frequently find myself doing, wondering if it’s worthwhile to say what I’m thinking. I always decide it would be pointless. More and more with some people I find myself thinking you just have to appreciate the good in them and ignore the idiotic unless it’s clobbering you over the head, which idiocy is wont to do. This particular man can be nice in ways, even though he was at this point showing a disturbing lack of concern for the health, comfort and well-being of slightly over half the population, because apparently women are purely decorative objects who have no value if we are marred.

 Shortly after this conversation, I learned that I have melanoma, a highly metastatic cancer which I will be writing about more in the future only because The Big C has a way of sort of steamrolling all over everything else in your life. So I apologize in advance. People always ask the size, and this was so tiny, it’s hard to find something to compare it to. You know in birdseed, there’s always a ton of that little tan seed that seems to be in there only for flinging purposes? No animal actually seems to eat it. In fact, as a former hamster owner, I’ve noticed it’s in hamster food, too, and hamsters fling it with just as much disgust and hostility as birds do, if distance is an indicator. I just looked it up: millet. It was roughly the size of a grain of millet.

Mine was thought to be a stage one, which means no radiation or chemotherapy, but they do remove a chunk of flesh that will leave a sizable scar. In fact, I just got home from surgery and am simultaneously administering writing and chocolate therapy. I haven’t seen the actual scar yet, but I think it’s two or three inches long, though some of that is because of the way they have to cut a circular incision for stitching purposes—as an ellipsis.

I am such a dork that I actually took a picture of my pre-surgery legs because suddenly they were more beautiful than they’ve ever been. Oh, they were never anything to look at really. I’ve never had those thoroughbred legs that some women have. In fact, they tend to bring to my mind uncooked poultry, especially chicken wings—you know, the chunky, rounded ends. But this is just up from my ankle, so there will be no hiding the scar, and this makes me ache to wear dresses the way I ached to wear a belt in the advanced stages of pregnancy even though I rarely wear dresses these days because the shoes are uncomfortable. I nonetheless dressed up my library-paste-colored legs, biopsy and all, in an old pair of red heels that I can hardly walk in anymore. I wonder—would picturing other body parts severely scarred improve those as well? Maybe. Maybe I will employ this technique and become gorgeous.

The truth, of course, is that I’m already plenty scarred as it is—we all are. That’s life, and living is serious business. It’s not always pretty; that’s why some of us seek out the arts. Maybe I’m only trying to comfort myself, but I don't think so. Even before the steamroller hit, I've found myself gravitating more and more to people with the most battle scars. I like to think the best part of us is our scars. They show that we’ve survived.

And I intend to do that.

Alice: From the moment I fell down that rabbit hole I’ve been told what I must do and who I must be. I’ve been shrunk, stretched, scratched, and stuffed into a teapot. I’ve been accused of being Alice and not being Alice, but this is MY dream. I’ll decide where it goes from here.
Dog: If you diverge from the path—
Alice: I make the path!   

~2010 Alice in Wonderland