That one day...

One Sunday about 2 years ago, I started working in our yard--I think I was going to just fix a few of the  rocks I had used as edging along the side curb.  I'm pretty sure I wasn't wearing a hat, and it was hot and sunny.  I didn't plan to do much.  But I got carried away, and ended up digging up and resetting every rock along the side (several yards).  I've done the same with weeding--pulled up a weed with my bare hands, because I saw it as I was walking or looking and couldn't resist.  But then I would keep at it--weeding without gloves--and more than once discovered too late that poison ivy was growing under the weeds.  I'm horribly allergic to poison ivy, but that's a different story.  And I've never seen any poison ivy at our new house.

I believe I spent several hours in the sun, redoing the rock edging.  I noticed soon after that I had developed grooves at the left corner of my lips--and they have gotten deeper since.  Not very far from where the melanoma developed.  So I'm thinking I may have done enough damage to the left side of my face that day to hasten the aging of my lips and cause the melanoma.

Maybe I'm lucky with my bout of melanoma in situ--now I can't do my spur of the moment yard work, as much as I enjoy it.  I'll have to prepare and cover up each time I go out--and consider the appropriate time of day (early morning is preferable).  But then I had already become more careful about pruning, to avoid further straining hands already taxed by my flute playing.

I don't like having to be cautious and careful--but at least I still have that option.

Butterflies

I now have butterfly suture strips (3M Steri Strips) covering the stitches on my cheek.  The surgeon put three strips on yesterday, after removing the bandage that had been in place for a week.  I looked at my cheek in my compact mirror after the assistant had taken off the bandage; the area looked a bit swollen and red.  The Steri Strips don't cover the whole area--they're very thin--so you can see redness and some rawness where the lower part of the bandage was.  That's where some blood seeped and stayed on the bandage.

 The edge of the Steri Strip near the corner of my mouth never really adhered--I push it down, but it pops up again.  He said the strips should stay on for a week, until next Friday; the assistant said they would be on about 4 days.  So I asked him what I should do if the strips fall off before next Friday.  He said that was OK, I shouldn't try to put new strips on.  Once the Steri Strips come off, I can put makeup on the area.  And of course sunscreen.

He didn't recommend using silicone or vitamin E oil or anything else I've read about on the Internet to reduce scarring.  He said I should wait 6 weeks, then take a close look at the area and if there was anything about it I didn't like, I should see him and we would discuss what to do.

I'll take my morning walks, but will otherwise try to stay indoors until I remove the Steri Strips (or they fall off).  Both because I can't really put sunscreen around the area--I don't want to have to wash around the strips too much, because they're not supposed to get wet.  But also the sun and heat could loosen the strips.  I'll be happy when I can finally wash my entire face without worrying about getting bandages wet.

Yesterday my son came home from a doctor's appointment and asked me what kind of cancer I had--that he didn't know.  I said I had told him--melanoma--and he looked distraught.  I think he discussed it with his doctor, and probably had been told melanoma was the "bad" skin cancer.  Even though I had already told him that.  He hugged me hard and said he loved me.  And then he said "even though it's over, I'm still really upset about this".  I gently told him it wasn't over, since I have to now watch for other places on my skin that might turn into melanoma.  But then I let it go; I didn't want to dwell on that.

But I do look at a splotch near my wrist on my left arm, and a splotch on my left leg, and wonder.  And I wonder whether I can prevent splotches from becoming melanoma.  Or is the die already cast?

This is getting old...

Wearing the same bandage for a week, on my face, is getting old, literally and figuratively.  I feel self-conscious venturing out, since the bandage is so large and has dried blood at the edges.  And I haven't been wearing foundation because it's difficult to keep the rest of my face clean without getting the bandage wet.

I ventured out to Starbucks this morning for the first time, then to CVS.  The CVS guy asked me what happened--only the 2nd person to ask in 2 weeks--I just say I had some surgery that required stitches.  The only other person who asked was one of the women cleaning our hotel room at the beach.  But that week the bandage fell off a few days early, so I was in the process of replacing it with a nonstick pad and tape when she saw me.  That didn't work--the tape seemed to have no stick to it at all.  So I ended up using a regular Band Aid, which (barely) covered the wound area.

I ended up taking my normal 30+ minute walk this morning; I walked a bit more slowly than I usually do, but I don't exactly power walk anyway, so I didn't think I would get flushed in the face (which is what the doctors want you to avoid the first week after surgery/sutures).  It felt good to move my legs more.  Next (after a break and snack of black grapes and almonds) I'll vocalize for 1/2 hour, then take another break and do yoga to a DVD.  This afternoon I will try to play the flute and see how that feels.

I have a bunch of questions for the doctor when I see him tomorrow morning, but he doesn't hang around--he's in and out so fast that I don't even remember what he looks like.  I looked at the photo of the doctors in the surgery practice on their website, and wasn't sure which one he was.  He's one of the two guys with the beard.  I think.  Anyway, I hope someone can answer my questions--mainly about wound care and scar prevention going forward.  One web site suggests that one should wear the silicone strips for 3 months.  That's a long time to have something on my face.  But maybe it's better than having an exposed scar.  I'm assuming they'll say I can resume normal activity as tolerated, but I'll ask.  I do so many things that involve physical exertion--walking, bicycling, weight lifting, yoga, fitness classes, flute playing, singing...I'm not sure what's considered "normal".  But I know I'm tired sitting around on my butt for nearly 2 weeks--in fact I do get tired easily--not sure whether it's from the inactivity or the aftermath of surgery or both.  Funny how doing nothing seems to be more tiring than being physically active.

It's swell...ing

I slept partially upright, propped up on pillows for 2 nights, as recommended by the surgery center, to prevent bleeding.  I was relieved to be able to sleep normally last night, but had a fitful night.  I woke up around 4am and my face felt very tight.  I touched it, and could tell it had swelled.  So I sat up the rest of the night (until 5am, when I get up), and put ice on it after I got up.  I'm not sure ice helps with swelling if you don't apply it during the first 24 hours, but the outer bandage on my face was so thick I don't think ice would have helped that first day.  Even if the ice doesn't help the swelling, my cheek and lip feel better with ice (inside two twist-tie bags for insulation).  Sitting up helps the most, to keep the blood flowing away from my face.  I'll probably prop myself up again tonight, to try and keep the swelling down.  My face didn't swell much at all after the first surgery--must be all the stitches that are causing the irritation.

I taught my yoga class today--I already had a sub for last week's classes, and didn't want to have subs 2 weeks in a row since I'm already the sub for these classes.  I felt shaky and nervous, but had mentioned to the class that I was having surgery so they weren't totally surprised.  I didn't say much--just that I'd had stitches a few days ago.  I felt fine guiding the class--I was afraid I would get spacey and mislabel directions or body parts.  But it went fine--I could tell I was already less flexible after not doing much for over a week.  I was worn out by the time I got home, and have rested (watched new PBS Mystery series Silk, which was rerun from last night).  Well, I slept through part of it, but saw the last hour.  I thought if I stayed up, I would try to do too much.  I keep wanting to play my flute, but know that's a really bad idea, with a swollen lip and cheeks.  I'll go a good 2 weeks without playing it.  Maybe not a lot in the grand scheme of things, but I'm more aware that the time I have to learn the flute could slip away from me if I continue to have physical health issues.  I may try to play it later this week and focus on the fingering without working the embouchure.  Is that possible?  It's not like the piano, where the sound comes from the fingers only.  Maybe I'll try tomorrow afternoon...

Two surgeries later...

I try not to think about how much my surgeries interfered with our vacation--we still got to the beach, but for fewer days.  And a lost half-day in between.  I had, in essence, two surgeries--the first to take out the melanoma, the second to stitch up the wound.  Everything would have worked out if the stitching had been done at the same time as the cancer surgery, but since there was a chance that I had more cancer, the surgeon wanted to wait to do the stitching.  The family plan was that we would go to the beach as scheduled (the day after the first surgery); then my husband and I would drive back on Tuesday for the scheduled stitching.  We left a day later--I wasn't feeling well enough to travel the day after the surgery--and I was pretty sure I wasn't going to feel like going back to the beach after the surgery on Tuesday.  But I didn't say anything about that--my husband would have to go back to the beach since my son was there without a car, and I was hoping they would stay the few final days without me.

I knew there was a chance that the test results wouldn't be back in time for the Tuesday stitching--the surgeon had said there likely would be only a few hours to spare--and I thought about checking my voicemail as we were driving back (about a 4 hour drive).  But I didn't check the voicemail until we got home (I hadn't given them my cell phone number, which I should have done).  The test results weren't back, so they wanted to postpone the surgery until Friday.  It was about 11:30am; my husband said he wanted to go to the beach that day, so we got right back in the car and drove the 4 hours back to Virginia Beach.  And I still didn't know whether I had more cancer.  It didn't even feel like I'd been in the car for 8 hours--I had to sit around anyway, so why not in a car?  I just wish I had checked our home voicemail while we were driving; they called around 9:40am, which means we could have cut out half the trip.

We decided to leave Va Beach Thursday evening after dinner, so my son and husband could get in one more day at the beach.  The surgery center had called to confirm the Friday surgery, but I still called Thursday morning to confirm that the surgeon had the test results.  They left a message for him to call me back, and he did; the results showed that all the cancer had been removed.  I was overwhelmed and teary-eyed with the news; I had been anxious about the thought of more cutting, more areas that would have stitches; and maybe even a more invasive cancer.  So we were quite relieved.

But the stitching surgery is actually a more difficult recovery.  I have another week of needing to stay quiet and not exert myself, but the stitching hurt more than the cutting did, and my left cheek and upper left lip have swelled up, which didn't happen with the first surgery.  I'd only expected to need a week to recover, and I am scheduled to teach 2 yoga and 1 pilates classes this week.  I find it difficult to talk--it hurts when I open my mouth--so tomorrow's yoga class could be difficult.  And I don't know when I'll feel up to trying to play the flute.  Not until toward the end of this week at the earliest, so I'll have to cancel Friday's lesson.

At least the stitches dissolve on their own.  I have two layers of stitches--4 or 5 stitches inside, and then a continuous stitch, like a baseball stitch, on the outside.   And they feel itchy and they hurt and it feels like my cheek is swelling as I write.  Lying down doesn't help as much as it usually does, because I can't prop my feel up like I usually do--that would cause more swelling.  Ah, well, this is all temporary; each day will get a bit better.

It Ain't Over

One of the questions on my list was "what about the splotches near the site where I've been diagnosed with melanoma"?  (OK, the question just said "what about the splotches," but I felt I needed to elaborate).  I explained to the surgeon that my dermatologist had done a biopsy somewhere in that splotcy area over a year ago, and the results came back negative, but now the splotches were starting to look a bit scary.  He explained that the margin he would use in cutting out the cancer would include some of the splotcy area, and that the lab would be able to determine whether that area also had cancer.

So my surgery isn't done--he gave me a temporary stitch until Tuesday, when I have to go back in.  He said he should have the lab results back--probably with only a few hours to spare--but wanted to move quickly either way.  If the splotchy are also is cancerous, he will do more cutting; if it's not, he will stitch up the original wound.

But I didn't realize he was asking me to come back this Tuesday--3 days from now.  I had in my mind the "5-7 days" for the return visit, and assumed he was allowing a little more time.  It wasn't until the third time the date was mentioned that I indicated I thought he was talking about a week from Tuesday.

This matters because we were supposed to go to the beach this morning.  I didn't mention to the doctor that I was planning to be in a car for several hours less than a day after my surgery--I knew what he would say.  But having to go back in for surgery on Tuesday clearly threw a wrench into everything.

So we've been discussing as a family what to do about the beach.  For one thing, I don't feel well, although am getting slightly better.  For another, the would extends to one corner of my lip and covers a fairly large area of my cheek beyond that, and I can barely open my mouth.  The assistant had said not to eat anything like a burger for last night's meal.  I had trouble eating tuna fish and spaghetti.  Basically had to eat with my hands to shove the food into a small area.  And brushing and flossing my teeth was tough on the left side, where the would is.  If I open my mouth too much or too wide, I think it increases the bleeding.

The reality seems to have set in more for my husband and son, seeing me with a bandage over half my face.  My husband was confused about the whole Tuesday issue ("I thought it was supposed to be 5-7 days"); I had explained it, but explained it again.  I may have more cancer.  They may have to cut more.  I didn't mention the other thoughts that are in the back of my head--what if the splotchy stuff is melanoma, but not in situ?  And how much will he have to cut, since the splotches are spread out?  I'm trying not to think about that.  But it's there.

My son's having difficulty dealing with the uncertainty of the trip, but is trying to be adaptable.  And before he left this morning he said he loved me and hugged me--very long and very tightly.

 

Are We There Yet?

This week is inching by.  I wake up and try to remember what day it is, and whether it's a yoga teaching day, and if so which one, so I can orient myself to the class time and location.  But this week it seems like it should be later--today should have been tomorrow, or Friday.  Friday, when I have my surgery to remove the melanoma on my face.  Friday, when the cancer that seems to grip my cheek will be scraped away.  I keep thinking ahead to all the things I want to take care of before the surgery, since I'm not supposed to bend over, lift anything, or do anything strenuous for a couple of days.  Here's what the surgery center website says:

If your wound site is located above the shoulders, you should be cautious not to stoop or bend over for the next 48 hours. For example, we urge you to lift your foot up to you rather than bending over in order to change or tie your shoes. No lifting, straining, or exercise should be done over the next two days. Any of these activities or anything that rapidly raises your blood pressure will put pressure on the healing blood vessels causing them to bleed. Also, keep your head elevated while sleeping.

I know it's only 2 days, but staying upright and doing very littie will be a challenge, since we're planning to travel the day after my surgery.  Who goes to the beach the day after they have melanoma removed?  Oh, well, I didn't want to disrupt the family plans.  But I also didn't want to wait any longer to have the surgery.  Waiting until Friday is already too long.