Sunday, July 29, 2018

It's a Long One

So much for aging gracefully.

I knew I’d never look like Jane Fonda with her amazing face and killer body at age 80 for goodness sake, and I certainly didn’t expect to ever have that creamy, soft and smooth complexion that I see on Ponds Face Cream commercials, but…really?   

It’s been an unusual few months for me, with a gamut of emotions all swirling around, most of which have to do with self-image and an unhealthy focus on how I see myself when I look in the mirror.  I credit my eons of free time for feeding into this new obsession.   

Ten years ago, by comparison, David and I would have had five kids plus friends coming in and out of our home on a regular basis, and we were working full-time. I didn’t have a second to think straight, let alone look in the mirror and analyze my findings.

In January, I went for my annual dermatological checkup, and nothing concerning was identified.  The year before, the doctor had taken off several “precancerous” lesions.  She assured me these removals were common; they come with age: the catch-all for everything that changes—and not for the good—over time.  She was nonchalant about it, so I was too.   

Several months after my check-up, and again with lots of time to scrutinize myself in the mirror, I noticed new activity on my face—specifically my left cheek—and it was itchy too.  I assumed that either I was having an allergic reaction to something or maybe my face always looked like this:  freckles and spots everywhere, with rosacea picking up where my acne nightmare left off.  
My face hadn’t calmed down much after a couple of weeks, so I thought it prudent to make an appointment with the dermatologist; however, I also debated (with myself) whether I was being a hypochondriac and should just wait the 8 months until my next checkup.  But I’d never let my kids get away with that; I’d torture them to death if they alluded to waiting so long.

So, I went back.

“Just burn it off like you did before,” I said to my dermatologist matter-of-factly about the area most questionable.  My thoughts went directly to what I’d pick up for dinner when I left the office.  

Not so fast, she said, “I’m going to take a biopsy.”  I shot back with “why?” which was a perfect example of reacting without thinking, because of course I knew the answer.  Once she had the results, she said, she’ll decide how to approach the other areas on my face; perhaps instead of doing multiple biopsies, she would prescribe a cream that, in essence, would present a glow on my face to highlight all my abnormal cells.

I’d probably want to plan to stay in for a week or so because my face will light up, she said...WHAT???  I never heard of such a thing.  I thought she had to be joking, but she had a straight face.  I pictured the Lite Bright toy my kids had or Ross in Friends with his glow-in-the-dark teeth. I wasn’t thinking about dinner anymore but rather stopping on my way home for a comfort drink, which for me would be a milkshake. 

As I was leaving, she told me I’d get a call from the office in a few days informing me of the results.  I tried not to think about it, basically tuning out the fact that I’d find out later in the week whether I would be able to enjoy the beach—a.k.a. my happy place—this summer.

I was sitting in my home office and saw the dermatology number come up three days later.  The woman identified herself in a very businesslike manner.  I got very impatient, thinking enough with the niceties; just get to the point.  

She then said “you have skin cancer.”

I’ve long felt we’re all sitting ducks and that eventually my number would be called, but still, I was shocked.

She proceeded to explain that I have basal cell carcinoma, a relatively simple skin cancer and “a good one” to have because it’s the least serious of the skin cancers. I felt lucky, but I’m not going to lie.  I also wanted to cry.   

She briefly mentioned the procedure called Mohs, named after Frederic Mohs for micrographic surgery that has been utilized with great success removing cancer, and she didn’t miss a beat in giving me the names of dermatological surgeons.  I got an enthusiastic two thumbs up from a few people I spoke with about one woman in particular, some of whom had had skin cancer and went to her, so I scheduled a consult.     

The surgeon explained she wouldn’t know the depth of the cancer until she got in there, and the fact that I had “infiltrative” basal cell carcinoma could make the removal more complex.  Plan to be in the office for several hours, she advised, while assuring me that the Mohs procedure is the most effective out there as it will eradicate my cancer better than any other alternative (over 95% cure rate), while conserving the greatest amount of healthy tissue.  She also looked into my eyes and told me she will do her best to minimize the scar.   

While warm and genuine but matter-of-fact, the doctor had my trust; yet, I couldn’t get past the fact that the conversation centered on cutting my face open. I was mortified wondering if I’d end up looking like Herman Munster.  And then I felt guilty and embarrassed by my thoughts which zoned in on my feelings about how I look vs. my health and how fortunate I happened to be with the treatable nature of this particular kind of cancer.  And, that I have health insurance to cover the surgery. 

I made my appointment for the first date offered:  July 17, which actually made me smile, as it was my middle daughter Allison’s birthday. A few weeks later, I learned that Amy, my youngest, had a job interview that day too. I chose to believe that these two occurrences would funnel positive vibes my way (she got the job, too).

When I got home from my consult, I succumbed to my natural urge of researching online, which I had postponed for as long as I could. I stalked various sites, all the while trying to prevent David from seeing what I was doing, because I knew he’d tell me I wouldn’t be any better off after all my google searches.     

I learned all sorts of things about Mohs, the most interesting part of it being the technique itself:  one layer of skin is taken off at a time so as not to remove more than what is necessary beyond the tumor itself, with clear margins.  The process of removing the cancer takes about 5 or 10 minutes but analyzing it under the microscope takes about an hour, per layer.

Many Mohs websites posted warnings about disturbing photos. Depending on my mood, I ventured further, and indeed those warnings were for good reason: I saw many people with actual holes—no exaggeration—in their faces (before being bandaged up).  This is what I pictured when I closed my eyes at night. 
My appointment time was 7 a.m. on the 17th, and I was there until about noon, in part due to another patient’s emergency.  The surgeon said she had to go to the second layer, but she was able to stop there.  I was relieved, picturing her getting awfully close to my mouth and then interfering with all the dental work I had done in the last few years.

Before she closed me up, the doctor asked if I wanted to look at the surgical site on my cheek.  I wished she hadn’t asked, because that was the last thing I wanted to do, but I didn’t want to come off as a wuss.  Everyone was waiting for me to answer – the surgeon, her assistant, and a couple of others in there with me.  I was stalling. I remember asking if other patients looked.  She said sometimes they do, and sometimes their partners look for them.  Immediately I asked David, who had just returned to my room, if he wanted to look – why not put the hot seat on him instead?  He was brave and said OK (I love this man!)   I watched his expression and he seemed taken aback, but then again, he didn’t get the online preview that I did to see how bizarre the actual site—or hole—could look.  However, he did encourage me NOT to look, and I am thankful for that.

Next, she asked if I wanted to take a look at my scar.  No, I didn’t want to look at that either, but I felt I couldn’t say NO a second time.  Plus, I’d be seeing it up close and personal within a few days anyway I figured, so I might as well get the initial sighting over with. 

The scar was lengthy, from about an inch under my eye (over to the side) to my chin.  It was so much longer than I had imagined.  Again, I wanted to cry.

I went home with a huge bandage that covered the whole left cheek. I was afraid to take it off 2 days later as the instructions stated; I even called the office and asked if it had to come off or whether it could stay on a third day, because I was afraid of what was lurking underneath. We were pleasantly surprised; it wasn’t pretty, but it wasn’t as bad as each of us had envisioned it could be.  

It’s been 12 days, and the improvement is impressive overall, although I’m definitely self-conscious when I venture out.  As of today, I have glue, which was used to close it up (dissolvable stitches underneath), hanging loosely around the site. It’s not that I am embarrassed that I look wounded or odd, but rather that I see people’s eyes go to it and then I feel I should address it. Back to too much free time.      

I’d say all this is behind me, but I have an appointment in a few weeks to look at the other spots on my face.

Since I started this post talking about Jane Fonda, I googled her to see if she had ever had cancer.  She did have breast cancer, and she’s struggled with bulimia and osteoarthritis.

Recently, she developed cancer on her lower lip, which was removed during a biopsy. 

She was scheduled to go on a talk show shortly after the removal.  When entertainment host Ricky Camilleri praised her for being willing to go on camera while still bandaged, she responded, “Well the world is falling apart...what’s a lip, right?”

I always loved her exercise videotapes; they were invaluable when I was home with my babies.

It’s clear that I still have so much more to learn from Jane.