I dearly hope I haven’t offered too much advice in previous posts, as I’m probably the last person who should be dishing that out! I advised against buying into homeowners associations, and just trust me on that one! Trust me on this one too, two words you never want to hear, skin cancer. On September 4, 2012 I heard those words.
In early 2012 I noticed a small black dot above my lip. I began referring to it as my beauty mark, but frankly, it wasn’t really all that beautiful. I’m not one of those naturally gorgeous people who roll outta bed with beautiful skin. No, I’m forced instead to spend 60 minutes each morning crimping and primping, which includes a heavy layer of foundation and powder. Neither substance completely concealed the odd black dot but that wasn’t really my purpose at that stage.
One evening when I was washing my makeup off before bed the odd black spot started to bleed. Not horribly, just a bit, almost as if the top layer of dark skin had peeled off that area. I’d been using a soft washcloth though, so the bleeding was a bit unexpected. I continued to experience this bleeding a few evenings each week for the next several months until I casually mentioned it to my mom on the phone one day. If I remember correctly, she about jumped down my throat and said I needed to see a dermatologist, STAT!
A few weeks later in March of 2012 I saw my regular dermatologist in Coralville who said, after examining it, we’d wait a few months and watch it for changes. Pictures were taken as documentation to be kept in my chart with the physician’s notes.
After Eric and I married in May of 2012 I switched to his insurance which, for the most part, dictates we be seen at the University. Not a bad thing by any means, as the level of care is excellent and it is provided to us at no cost. So, I was set to meet with a dermatologist at the University in September… Yes, great care comes with great waiting lists…
At my appointment in early September the resident who examined me felt it was necessary to biopsy the black dot, which, since it was so small, essentially removed it. They performed a ‘punch’ biopsy I believe they call it, which is really like cutting a cone shaped area from the skin, which left a narrowing hole above my lip. I’d been given a local anesthetic, a couple injections near the site, which can I just say, hurt like hell! Four stitches were placed and I was sent on my way. Wait, yes, four stitches. In my face. I had not been prepared at all for that. I had gone alone to the appointment, as I figured there hadn’t been a reason for concern, I mean, the previous doctor was still ‘watching’ it! After I left the dermatology clinic at the University I stopped in a restroom before heading back to my car. I sat down to pee and started crying. The had cut my face! I had stitches, in my face! I have no idea why I took it so hard… but I did. I called Eric and he assured me it would be fine. So there I was, sitting on a toilet, crying to Eric on the phone, with a half numb face. I could hardly talk, much less cry correctly from the numbing agent!
The following afternoon, September 4th, my doctor called with the pathology results… The black spot was basal cell carcinoma, skin cancer. And worse, I’d need another procedure to remove a larger portion of my face to ensure all the cancer cells had been removed. I was devastated.
A procedure referred to as Mohs was scheduled for the following month. The except below is taken from http://www.skincancer.org/skin-cancer-information/mohs-surgery/mohs-overview
Mohs surgery has come to be accepted as the single most effective technique for removing Basal Cell Carcinomas and Squamous Cell Carcinomas (BCCs and SCCs), the two most common skin cancers. It accomplishes the nifty trick of sparing the greatest amount of healthy tissue while also most completely expunging cancer cells; cure rates for BCC and SCC are an unparalleled 98 percent or higher with Mohs, significantly better than the rates for standard excision or any other accepted method.
The reason for the technique’s success is its simple elegance. Mohs differs from other techniques in that microscopic examination of all excised tissues occurs during rather than after the surgery, thereby eliminating the need to “estimate” how far out or deep the roots of the skin cancer go. This allows the Mohs surgeon to remove all of the cancer cells while sparing as much normal tissue as possible. The procedure entails removing one thin layer of tissue at a time; as each layer is removed, its margins are studied under a microscope for the presence of cancer cells. If the margins are cancer-free, the surgery is ended. If not, more tissue is removed from the margin where the cancer cells were found, and the procedure is repeated until all the margins of the final tissue sample examined are clear of cancer. In this way, Mohs surgery eliminates the guesswork in skin cancer removal, producing the best therapeutic and cosmetic results.
The procedure itself wasn’t horrible, but not anything I want to repeat! I was awake, but heavily drugged with something amazing! I remember parts of the procedure, particularly when the numbing agents were injected into my face and lip, which were quite painful. Eric was allowed to sit with me while the pathologist studied the extracted cells. I remember talking a lot and the surgeon repeatedly telling me to hold still. God only knows what I was talking about!
Eric returned to the procedure room once all the stitches were in place. He was given care instructions for my wound and then I was asked if I wanted to see my face before I was bandaged, which I did. I was again devastated. They had cut from just under my left nostril all the way down and through my upper lip. I had been given the impression the incision would be small, and perhaps to them, this was small, but not to me. I think I had many ten stitches. I didn’t cry, as I was still quite drugged, but I remember a feeling of panic, as if my face had been disfigured. Looking back, I realize disfigured is much too strong of a word, but at the time, under the circumstances, that seemed quite real to me.
Eric stayed home with me for a few hours that evening before he had to catch a fright to Florida. He was schedule to present some research of his at a conference and apparently wasn’t able to cancel. Yes, can you believe it, he left me, my face bandaged, I couldn’t eat, I was in pain, the pain pills made me sick… All I wanted was for him to comfort me, but duty called…
I stayed home the rest of that week to recover. I probably could have returned to work the second day after surgery, but my face was still very swollen at that point and I wasn’t able to eat well, plus, the pain pills were still taking the edge off. It’s amazing how many nerves we have in our face and lips! I was allowed to shower 36 hours after the surgery when I was to remove my bandage, as long as I didn’t allow the water to directly flow onto my face. Once the bandage was removed I’d been told to keep the area moist with Vaseline to aid healing and minimize scarring.
Two weeks later my stitches were removed, which was far more painful than it should have been. The doctor checked my wound after and determined I’d formed cold sores along the suture line. No wonder it was so tender! They explained it was actually quite common, as our bodies tend to form cold sores at stress sites, and obviously this incision was a stress to my body. The good news, the additional blood flow to the area due to the cold sores was thought to actually improve the healing process. Score!
That was a year and a half ago, and I’m still healing, both physically and emotionally. Physically I’m do really well. Most of the feeling has returned to my lip and face, although it’s still tender at times. I’m able to drink from straws again, which was impossible at first, as I couldn’t form my lips. I definitely have a scar, and while I’m not pleased with it, I’m not displeased with it either. I’m guessing most people don’t notice it, as I wear makeup daily, but I know it’s there… The scar tissue on my lip is especially sensitive, very different from normal lip tissue. It’s difficult to apply lipstick or gloss, as the scar tissue doesn’t hold the product and ends up accentuating the scar.
Emotionally, I don’t know. If I say I’m not over it, does it imply I’m superficial and value looks? Cause I’m not sure I’m over it. For some reason, it’s the first thing I see when I look at myself in the mirror. I feel as though my smile is tainted, as if I’m no longer normal, or whole, or gosh, I don’t know the word. I used to think I was a pretty person, and sure, I know I’m far from unattractive, but at the same time, I don’t really feel the same about myself anymore. I’m different. I’m scarred.
So here is what I ask of you. Please, whatever you do, eliminate tanning beds from your life and your vocabulary. Invest in sunscreen. Lots of it. Make sure your lotion and/or foundation contains sunscreen, and apply them. Daily. Please. Do it for me. If you have any concerning spots, see a dermatologist. I’m required to be seen every six months now for full body skin checks, but honestly, it’s a great idea for anyone. Please.