Clear Borders!

YAY! After five rounds of incisions on my thigh, I was told yesterday I have clear borders. Meaning, all that evolving melanoma, both colonies, are gone. Good riddance! So, now back to real life. Other anxieties can now have the front burner. What a relief. Thanks to everyone for your kind thoughts, prayers, and love. I am grateful for the power of prayer, fasting, and blessings.

Not to be gross but......

Here's my scar. I don't know what is wrong with me, but I feel the need to drop my pants and show people the scar on my leg. There is a certain satisfaction in having a scar. Now I just need a good story to go with it. Any good ideas?

So, I had my appointment with Dr. Leachman on Tuesday. She said she would cut a cm on each side of my other scar. She then drew a football shape, and gosh darnit, it looked like a football with my previous scar right in the middle. She must've been gearing up for game day this Sunday.

Then she made a 10 cm incision going down my thigh. She went down to the muscle, cutting everything out within the football. My husband was absolutely fascinated. Blood makes me a little ill, but I learned that my husband missed his calling in life. He should've been a surgeon. He was chatting it up with the Dr., she was pointing out my muscle, and explaining everything. He loved every minute. It also didn't hurt that they are both from Texas, so there was lots of "Texas talk", which of course I didn't quite understand being a Northerner and all. I decided since she was doing surgery on me not to mention that we won the war....hee-hee.

It took 2 1/2 hours, as she went so deep, she had to make about 10 runs of stitches going from the bottom and stitching one row of fat at a time, or whatever is there under all that skin. In the end, on top, I ended up with 25 neat little stitches.

The good news: there is a good chance that my two colonies of melanoma-evolving cells are gone. (We will find out for sure next Tuesday). The bad news, as the Dr. told me, is I will have quite a big scar and a big permanent dent in my thigh. I guess my runway days are over. I will need lots of therapy for that. Actually, I could not care less. Especially if the melanoma is gone. If not, well, that's another story.

Anyway, I love Dr. Leachman, I love my sweet husband for being there with me through it all, and love modern technology and great doctors.

So, want a picture? Even if you don't, here goes. I have got to show off my wicked cool scar.

I am also grateful for super supportive parents who watched my five kids while I was gone in Park City. My Mom also gave me some spending money to have a little fun in Park City since I was there. How sweet. I love my folks and appreciate all their prayers and kindness. Also for all the prayers, fasting, and caring from everyone.

I have one word of advice. Oh, I guess two. Wear sunscreen. Although, to be fair ----ha-ha (get it? sorry, I am corny, can't help it much), my upper thigh has not seen a lot of sun in my life. Although I have a perfect body, I have always been quite modest about that and didn't want to make everyone else jealous.....so I always covered up real well. (Ha-Ha). They actually told me this is most likely very genetic. So, dear cousins and family members, remember that those cute little brown moles can give you a lot of grief. Go to a specialist. Make sure it is a derma-pathologist who looks at the results. Cause, this is round 5 of getting this mole and it's melanoma-evolving cells out. From the same spot. 2 years ago I went to my normal care dr. who sent the sample to a (normal)pathologist (not derma-pathologist). The results came out clear. Well, guess what. Dr. Leachman got those initial samples, and they really weren't clear. That's the difference between a dermapathologist and a regular pathologist. Go to a specialist, and not a botox-ish skin specialist (which is hard to find as all the money is in the botox!). I would HIGHLY recommend Dr. Leachman. But since she is head of the Huntsman Cancer Melanoma stuff, etc. she can be hard to get into. You know what's so cool? My sister in law Diane went to med school and studied under Dr. Leachman. Thanks for that referral Diane!

Another funny sidenote: Dr. Leachman was talking about how her Mom tried to teach her to sew.....but she always cringed at the thought of that as she wanted to be a professional. And look where she is now....sewing skin. I told her that her Mom would be proud. We all had a good laugh.

And Diane, next time you are in town, Dr. Leachman would love to go to lunch. (If you still have an appetite:)

Dr. Leachman Revisited.

So, I got back some results from Dr. Leachman. Her pathologists have looked at the original specimens from the lab tests.

The first/second excision by Dr. Poor (2 years ago) showed that I had an atypical spitzoid.
My second excision done several months ago (was it Nov? 2010ish?) (in the same spot) showed the cells from the atypical spitzoid, and then another population of cells; trending toward melanoma.

Then, about a month later, a second excision was done, and already that second population which was trending toward melanoma, showed there was more melanoma which was worse-looking. I know, don't you love my technical terminology?

She said she would call what I have "evolving melanoma". For life insurance purposes (hint-hint) I don't have a diagnosis of melanoma. Unfortunately, not enough was taken out to get clear borders, so I get to have more taken out. Dr. Leashman also warned me that because it has been a little while (and it was quite aggressive) that perhaps this may not be the end. Great.

Anyway, I am hoping that this next excision will get all of it out. Dr. Leashman said this next excision might result in a clear melanoma diagnosis. We shall see. At least I have an incredible doctor, who calls me personally and keeps me very well informed. I love her. So, pray for me. I am a bit scared. Just say no to melanoma.

Here's to next Tuesday morning at 8am and more excision on my leg.

The good news:

1-The Doctors office is in Park City. I may need a cheer up shopping trip?
2-More taken from my thigh. It's like free liposuction.
3-So glad I have signed up for Aflac. If I do happen to get a melanoma diagnosis, I will get $5000. We won't talk of the down side of such a diagnosis.

Seriously, not kidding. IF you ever suspect a diagnosis of any kind or health problem of any kind, call Aflac immediately. You often have some lead time which could save you LOTS of money. Cancer ain't cheap. They have insurances for a variety of health problems. Jump on it immediately. Do not delay.

Dr. Leachman

I have a testimony of her. I love her. But that's another story. Anyway, I got to go to Park City to see her at her clinic there. She also has another office in SLC at the Huntsman Cancer Institute. She is amazing. (It doesn't hurt that this office is right near the Outlets:)---darnit, I will now have to go every 6 months:)

Anyway, Brandon met me there, we gave her all my past records. She did an all-over body check, found a couple other moles that we need to watch. She took one out on my shoulder which they will do another biopsy of. I have to laugh. My thigh has been cut into now 3-4 times, a nice big scar, then my right arm also has a nice scar from pre-cancer, and now my shoulder. My nose is still healing from having it froze where that pre-cancer was at.

The Dr. is going to have all my old slides retrieved and she will have her own pathologists look at them and re-interpret. According to my other Dr., his records showed that they wanted to excise my thigh once again. That would be the third round this month, meaning I must not have clear borders. She doesn't want to cut again if it is not necessary. It may take a while to get all this done, so we will be waiting. For insurance purposes, I do not have cancer....I am sort of in the gray zone where we are still waiting to see for sure. Whether I have had melanoma or not, they have treated it as they would, by getting it all out....so all is well. I will have to have a full body check every 6 months for at least the next 5 years. But wow, I feel so good. I know I am in great hands with this Dr. I feel confident that everything is being taken care of as it should. What a difference a good Dr. makes. It makes me realize the importance of good care. It inspires me to be better in my work/job. I feel SOOOO much better. This last month has been one of the most anxiety-ridden months of my life. I would not recommend this to anyone.

And once again, if you EVER are worried about your health, call AFLEC immediately and sign up for their secondary insurance. It's fairly minimal in cost for all it offers. I am now signed up for their Cancer Coverage.....if I get a diagnosis ever, I will get $5000 on the spot. We can celebrate by going to Disneyland:) Just kidding, but it does make me feel a little better to know there is some preparation for the future....just in case.

Doin' the happy dance.

So, on Monday, I went back to my Dr. Maybe I will just call him Dr. Prick, for anonymity sake. The name I chose for him is NOT necessarily how I feel about him personally. (Sorry, I am feeling a bit spicy today.)

Anyway, after being on pins and needles for several weeks after being told I had either melanoma or cancer....we were so nervous to hear the news.

Well, we get in the office, and I am told to get ready for them to take out the sides. (I forget what it's actually called, but they are making sure borders are clear and cancer free.)

For a brief history, I had a "punch" done of a mole I had two years ago. That report came back fine. A couple months later, I had it all taken off and re-tested and it came back abnormal. Then it grew back. I went about 9 months ago to a specialist, that will be hereby known as Dr. Prick, and he wasn't concerned about this re-growth. After another visit 5 weeks ago, he decided to remove it. That biopsy report took FOREVER to come back (about 4 weeks). They had several pathologists look at it as it is a rare issue that I have. When I went to Dr. Prick 3 weeks ago, to get my stitches out and hear the results of the pathology test, I was told I most likely had melanoma or cancer, they just couldn't decipher which yet.

So, when I returned this last Monday, he began talking, but wasn't really clear. I finally asked him if I had cancer or not. I specifically asked, "If Aflac asks if I have ever been diagnosed with cancer, what do I say? He said no. (Not that I now have cancer insurance from Aflac.... He made it seem like I was fine, cancer free. But I did not feel very good about that visit. It's never good when the Dr. has no clue who you are, and his assistant is telling him, "
Yeah, this is the patient whose sample we sent to the lab in Ohio."

Another not so good thing to hear from your Dr. : "So, we haven't called you to let you know the results?" Hell no, which is especially troubling because I specifically asked to be told as soon as any results were found. It would help to know these things so the ulcer in my stomach doesn't get much bigger. Please. And, my kids have been spoiled rotten the last couple weeks out of my cancer fears....and they have been off track, which is not the funnest scenario for any Mom. I mean I want to be able to yell at them again...duh. (Just kidding).

Anyway, Brandon and I both got the feel that all is good from this Dr, but it was Dr. Prick, which came with many reservations.

I asked for a copy of the pathology results, and they only wanted to give me the newer results, not the results from 2 years ago, which they also had. Seriously? I am wondering what type of damage I can do with these ever so precious papers. I don't know why they want your firstborn child in order to give you your medical records. HELLO people. I also reminded them of my record request from about 2 weeks ago, and after much conferring, they finally decided to give me my records.

So, after reading the report, I decided to do what any law-abiding American citizen would do. A google search.

On my pathology report (newest) it says the IMPRESSION: is an "Atypical Compound Melanocytic Proliferation." I didn't think much of that, I mean I especially didn't understand the microscopic description: Histologic sections on a fusiform excision of skin with adipose tissue at the base show an acanthotic epithelium with subjacent well developed stromal angiofibroplasia, consistent with mature scar. The scar is transected at teh opposing margins centrally. WIthin the central portion, there is epidermal erosion overlying a junctional and dermal proliferation of nested and single melanocytes showing areas of moderate to severe cytologic atypia and slightly epithelioid cells features. Rare dermal mitoses figures are noted.

Whatever that means.......

This article better explains to me the situation....
This was what was written on my report:

Excision...with 5 1/2 x 7 mm firm nodule dx:? residual nevus with scarring. HX of precancerous lesion at this site removed by another md, now regrown.

Microscopic Description: Histologic sections on a fusiform excision of skin with adipose tissue at the base show an acanthotic epithelium with subadjacent well developed stromal angiofibroplasia, consistent with mature scar. The scar is transected at the opposing margins centrally. Within the central portion, there is epidermal erosion overlying a junctional and dermal proliferation of nested and single melanocytes showing areas of moderate to severe cytologic atypia and slightly epithelioid cells features. Rare dermal mitoses figures are noted.

The impression of my current biopsy: Atypical Compound Melanocytic Proliferation and Mature Scar

The melanocytic proliferation is not transected, however the associated scar is transected at the lateral margins. This specimen is reviewed in conjunction with outside slides and reports (1) and (2)---(From 2 years ago) The 1st of which appears to represent a partically sampled atypical Spitz nevus, with scattered dermal mitotic figures. The second specimen represents a re-excision and shows persistent atypical nevus, which is focally transected. In light of the recurrent nature of the lesion, and the transection of the scar, additional excision to ensure complete removal of the lesion and scar would be considered prudent.

Blah, blah, blah, but I found an article about what my diagnosis is, which I think explains what I am dealing with:

http://www.dermpathmd.com/diagnostic_terminology/dermatopathology_atypical_melanocytic_proliferation.htm

Anyway, that helped me understand better. I MAY have melanoma, maybe not. This "whatever" is in an in-between category which is often tricky to diagnose. So, I have not known what to think of all this.

So, after some suggestions from my sister in law and brother, I made a phonecall to Dr. Sancy Leachman. She is an expert in melanoma, a Dr. and is in charge of melanoma cancers, etc. at Huntsman. Not the worst resume.

I left a message on her voicemail with my diagnosis and my request for a second opinion, also asking if there are any studies going on in regard to this right now. Then I called to one of the clinics where she sees patients. After some insistence, etc. I finally got an appointment in July with Dr. Sancy Leachman.

Well, after reading about her, I was very impressed and excited about this appt., even if I have to wait until July.

So, I was on my way home from an errand today and my cellphone rang. I almost didn't take it as I didn't recognize the number. But I did. Who called me? Dr. Sancy Leachman. Who was SOOOO nice? Who was so helpful? Dr. Sancy. I cannot believe she returned my call, and talked to me, and helped me. She was SOOOO great. I now have a girl crush on her. Can you blame me? It's nice to have some answers, confirmed by a Dr. rather than an internet article:)

I think I may end up showing her some skin:) OK. I will stop now. I can't resist.

Or maybe I will offer to show her some skin if she shows me some skin. OK. I really will stop now.

Anyway, she did say that I may or may not have melanoma, this condition is hard to say. She said she would recommend coming in for a second opinion with her pathologist people. She also thinks it's time to get in with the next level, like a Huntsman Cancer group or something. She also told me to tell her office I had been diagnosed with Melanoma to get in early, but she was careful to let me know that I don't have melanoma/that is unknown. She also said to call her again if my borders didn't come out clear, and if they don't I need to get in soon. She also clarified that if I do have melanoma, the right tx has already been taking place. If you have melanoma, they just take it out, and look for clear borders. So, as long as the borders are clear, I should be fine even if my appt is not until July. She was SOOOO nice. I do have a girl crush. So here is some info on her: http://www.huntsmancancer.org/patientInformation/bios/leachman.jsp

Isn't she cute? OK. I'll stop. It just felt good to have some answers, and have such a knowledgeable great Dr. call me back. Someone in her position is so busy, I was so impressed with her taking the time to talk to little 'ol me.

So, bottom line, I am so happy. Knowledge is power. I feel like I have a plan, I know what I am doing, and I have good Doctors to help me out. I just have to go back to Dr. Prick to get my stitches out and make sure my borders are clear. That's in 2 weeks. Then I am done with Dr. Prick. YAY! And on to the lovely Dr. Sancy Leachman.

Have I bored you enough yet? I am doing the happy dance!!!!! Who knew a phone call would make my day today.

Oh. And just some advice....if you ever fear you have a serious medical condition, call Aflac immediately. I am now paying about $42/month, and if I don't get a cancer diagnosis in the next 30 days, then I will be in a good situation if I am ever diagnosed. My friend Traci gave me this great info, and I am excited about this. The key is to get on it at least 30 days prior to a diagnosis. So next time you are planning out your cancer, think AFLAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAC!

On another note: During all this stress time, coincidentally, I have had so many people comment on my weight loss. How have you done it, etc. Just for fun, I have wanted to say, "Cancer." I have refrained. But it is tempting. It's a much more interesting answer than the boring, "eating less twinkies" answer.

On another funny note, my husband is always very comforting. He tells me that if anything were to ever happen to me, he would have me stuffed and keep me in the upstairs bedroom. So I will always be around one way or the other......

My husband always keeps me laughing.

Another good reason to keep a blog. I was able to go back and read entries about my "stupid mole" to remember what has happened prior.

Gray sucks!

I just have to say. Gray sucks. Maybe because I am an all or nothing person. Another reason, because gray was what came out on my biopsy. Which means probably cancer. I am also irritated by the gray area....they don't know if it is melanoma or skin cancer of some other sort. I am almost certain it is melanoma. They set an appointment for 2 weeks to do some more digging. They will get more out, just to get out as much as possible. They also got permission to get records from my other Dr. I can tell. Fun times ahead. I have been bawling all day, as melanoma scares the crap out of me. And now, I may have it. I asked the Dr. what he would feel if a family member of his had these results. He said he would be concerned. I guess the gray can be good news, as perhaps it is not melanoma. I can hope. So, let's hope for the best. I should have more conclusive info in 2 weeks when I get another chop taken out.

Holy Moley!

Well, I had a really creepy looking mole as I mentioned in THIS blog entry several months ago. I got a biopsy done then, which came out fine. However, much of the mole was left on my leg.

So, when I went in almost 2 weeks ago to get my blood checked, I asked the Dr. to take off the rest of my frightening mole. I asked the Dr. as he was taking it off if he was going to get a biopsy of it. He said he could do that if that is what I want. I thought, why not, let's go ahead. Well, I got a phone call today, that strangely enough, the new biopsy came back showing abnormal cells. Luckily, he said they got all the abnormal cells when they took off the mole. So, it should be fine, but I just have to watch it to make sure it doesn't grow back.

The moral of the story: don't be shy in getting a second biopsy of creepy moles. Also, you should always (well, at least most of the time) listen to your Mom. My Mom kept calling me telling me to get a second biopsy; she just didn't trust that first biopsy. I kept telling her I would feel foolish as I had just had a biopsy done. So, Mom, you were right!

Melanoma Scare!

Well, a couple days ago I finally made it to the doctor over a fairly frightening mole I currently have. There are five factors in moles that can hint to melanoma. They are:

A (Assymetry)
B (Border Irregularity)
C (Color Variegation)
D (Diameter should be no bigger than 6 mm or size of pencil eraser)
E (Evolving---the mole keeps changing)

I decided it was time to get to the Dr. since this "not so cute" mole on my leg had all the negative issues listed above. It had grown to about 8mm by 9 mm. And, yes, it is raised, and yes it has many colors; dark brown, light brown, almost black in one part. And it is not symmetrical and the borders are almost zig-zaggy. Usually I like getting 100% on a test, but not in this case!

When I went to the Doctor he started listing off all these ABCDE's of Melanoma. He let me know that it does fit all the criteria. So, he took a biopsy, and I should find out the results when I get the stitches taken out next Tuesday!

It also didn't help when I read on the web that the closer you live to the Equator, the stronger your chances of Melanoma. Where did I serve my mission? Oh, that's right. Ecuador. Although I do have to laugh! As a missionary I certainly wasn't flaunting my upper thigh (where the mole is!) or sunbathing.

That is another irony. I am fair skinned, but have never been one to sunbathe. I think the problem, is I have gotten badly burned several times in my life when out swimming. It is strange though----I mean it is not as if I was out at the beach a lot or frequently in the sun. Like I said, especially on my upper thigh. I have never been one for showing off my "fabulous" figure--so my upper thigh has rarely seen any light, except for in my closet (with the light on) when dressing. Strange, strange!

This is my fourth skin cancer scare. I have had 3 other precancerous spots removed (from my nose, and 2 from my arm!) However, none of them have been melanoma-like. Unfortunately, this one looks just like many of the examples found on the web.

Anyway, I will find out the results by Tuesday, and hopefully, it is just a scare. If you happen to have any strange moles with even one of those factors above, get it checked out. Melanoma is not a kind cancer---it is very deadly! Although, is there a kind cancer? I think not. Anyway, I just had to get this fear off my chest.

Also helpful, Brandon and I are going to Vegas this weekend. It will be so fun to spend some time alone. Maybe a little gambling will help. Just kidding!

UPDATE: the mole is fine!!!

This is another mole update that I made in May---regarding my mole!

Well, I had a really creepy looking mole as I mentioned in this earlier blog entry. I got a biopsy done then, which came out fine. However, much of the mole was left on my leg.

So, when I went in (end of April) to get my blood checked, I asked the Dr. to take off the rest of my frightening mole. I asked the Dr. as he was taking it off if he was going to get a biopsy of it. He said he could do that if that is what I want. I thought, why not, let's go ahead. Well, I got a phone call within a week, that strangely enough, the new biopsy came back showing abnormal cells. Luckily, he said they got all the abnormal cells when they took off the mole. So, it should be fine, but I just have to watch it to make sure it doesn't grow back.

The moral of the story: don't be shy in getting a second biopsy of creepy moles. Also, you should always (well, at least most of the time) listen to your Mom. My Mom kept calling me telling me to get a second biopsy; she just didn't trust that first biopsy. I kept telling her I would feel foolish as I had just had a biopsy done. So, Mom, you were right!