Fast forward to March of this year, just a month and a half ago. I was at the dermatologist with my daughter, as we were finishing up her appointment the Dr. said to me, "Would you mind if I took a look at a couple spots on your face before you leave?" I was a bit surprised, but said, "sure, that would be fine." One of these spots that the Dr. wanted to look at was the bump from six years ago, which over the course of the past six years had changed and grown slightly. After looking at it up close, she immediately wanted to pull my chart, compare the notes from before about this bump on my face, and immediately wanted to do another type of biopsy, a scrape biopsy, before I left the office that morning. So, with my two youngest children in tow, I laid down on the table, put on my big girl brave pants, told myself not to gasp out loud or cry (because my two children were watching me) and got about four shots in my face to numb it up. Next the doctor came in and cut a good part of the bump off my face to send to the lab to be checked for the "C" word. The nurse bandaged me up and sent my children and I on our merry way for the day. As I left the Dermatologist's office, in my mind, I was still a bit shocked as to how the events had all transpired so far that morning...not exactly what I had planned for that day, and now I was waiting on results of a biopsy. I just knew in my mind that it would all come back fine. I would be living with a bump on my face, just like I had been for the last six years.
About ten days later I received a phone call from the dermatologist's office to discuss the results of the biopsy. In short, it was a Basal Cell Carcinoma, Cancer. The lady on the phone gave me lots of details, but the biggest detail was that I would need to schedule myself to have something called Mohs Surgery and then have plastic surgery after the Mohs surgery, soon. I did not get it at first. I must have been in a happy place that day when I got the call because I didn't grasp the seriousness of what was coming my way. Or maybe I just didn't realize yet I was going to have big fall in my outer appearance...something out of my control was happening. And, here it is, for those of you that don't know this about me... I love to be in control of my life, my schedule, my life, my kids, my life, my appearance, my life, my home, my life, my family, my life. That is a lot of my's which can easily be translated to I's and me, and maybe I am a bit independent and somewhat selfish. Whoa, I think there may be several things God wants me to take a look at on this little detour in my life that I am now stumbling down..... #1 It is not all about me.
Basal Cell Carcinoma is the most common form of skin cancer. Each year, millions of cases of BCC are diagnosed. I am one of the millions this year. Nearly all are cured with treatment. Most BCCs develop on skin that gets repeated sun exposure, such as the scalp, neck, and hands. BCC is especially common on the face, often forming on the nose, cheeks, and forehead. People of all skin colors get BCC although it is much more common in light-skinned people like me. When the sun's ultraviolet (UV) rays his a person's skin, these rays can damage the skin. UV rays can penetrate the skin when we go outside during the day without sun protection. UV rays also penetrate the skin when a person uses a tanning bed or other indoor tanning device. I am happy to say I have NEVER tried tanning in a tanning bed or other indoor tanning device, but I have however been outdoors in the sun REPEATEDLY in my life, many times with little or no sun protection on. As the damage accumulates on the skin from the UV rays, the risk of developing skin cancer increases. BCC is serious. It rarely spreads to other areas of the body, but treatment is important. BCC can grow deep enough to affect tissue and bone. A deep or invasive BCC can be difficult to treat. Early diagnosis and treatment can prevent disfigurement and difficult treatment. #2 Wear sunscreen and a hat. #3 Put sunscreen on your children. Make it part of your family's routine.
So, my treatment method was Mohs surgery. Mohs micrographic surgery is performed in the surgery center of my dermatologist's office. Mohs surgery differs from other skin cancer treatments in that it permits the immediate and complete microscopic examination of the removed cancerous tissue, so that all "roots" and extensions of the cancer can be eliminated. Due to the methodical manner in which tissue is removed and examined, Mohs surgery has been recognized as the skin cancer treatment with the highest reported cure rate. -The area to be treated is cleansed, marked, and injected with a local anesthetic. The Mohs surgeon removes the visible cancer, along with a thin layer of additional tissue (stage 1). This procedure takes only a few minutes, and the patient waits while tissue is being processed and examined. -The removed tissue specimen is cut into sections, stained, and marked on a detailed diagram (Mohs map). -Tissue is frozen on a cryostat, and technician removes very thin slices fro the entire edge and undersurface. These slices are then placed on slides and stained for examination under the microscope. -The Mohs surgeon carefully examines the entire undersurface and complete edge of the specimen, and all microscopic "roots" of the cancer are precisely identified and pinpointed on the Mohs map to direct the removal of additional tissue (stage 2). Additional tissue is removed only where cancer is present. -This process is repeated as many times as necessary to locate any remaining cancerous areas within the tissue specimen (stage 3,4,5,etc.). -When microscopic examination reveals that there is no remaining tumor, the surgical defect is ready for repair.
Eric and I arrived promptly at 7:30am last Tuesday to check in for my Mohs surgery. We were directed to the surgery waiting area, where we waited for my name to be called for surgery prep. In the waiting area there was a tv, two comfy recliners and a sign on the wall stating that the recliners were specifically for surgery patients, snacks and drinks, and many other chairs lining the walls. My name was called and Eric and I headed back to the surgery room. Eric was only allowed to stay in the room with me while the procedure was explained by Dr. Moeller, the dermatologist, and we went over some paperwork. Then, he was escorted back out to the waiting area. As Eric left the surgery room, doom and gloom gripped me. I was told to lay back in the operating chair and my face was scrubbed and prepped for the surgery. An eye patch was placed over my right eye and a very bright light was turned on and adjusted above me. Next, was one of the very worst parts...the numbing, or local anesthetic was shot into the right side of my face, "Sting and burn, sting and burn." Over and over. It HURT a LOT. I cried. Another nurse came over and held my hand. She told me I could squeeze her hand as tightly as I wanted or needed to. I didn't want to give off a wimpy appearance by squeezing too hard, but it was probably to late to worry about the wimpy appearance since I was already crying. After about ten shots they tested around the surgery sight with a sharp object, asking if I could feel anything sharp? Yes, I did feel sharpness in two spots, I wished I hadn't though because that just meant getting more shots, and more crying. Finally, when my right side of my face was numb the Dr. came back into the room and began to cut a circular area of my face around the cancerous spot. It did not take long. A nurse then took the specimen to be tested while another couple of nurses used an electric needle/pen to cauterize the wound on my face. This stops the bleeding by burning the wounded areas. It smelled SO BAD. I tried to not breathe during the burning of my wound. I counted, I talked to myself, and then I would take another small breath and hold it as long as a could. When the burning of my wound area had stopped and I had gotten some deep breaths of non-smelly air, I asked if I could look at my face. Bad idea, VERY BAD IDEA. I was given a small hand mirror for my viewing pleasure. I was instantly brought to tears again at the sight of my face and felt sick to my stomach. There was now a very large circular shaped hole in my face. I laid still and tried to compose myself as the nurse bandaged my face and I was ushered back out to the waiting room while the specimen was tested.
As I entered the waiting room Eric stood up and came over to me. This may sound silly to some of you, but when someone really loves you, you can see it in their eyes. I am sure he could immediately tell I had been crying, or maybe I still was a little. His eyes shown with love and compassion for me. He hugged me sweetly as he said, "It went that well, huh?" Ha! He could tell I was a wreck and he hadn't even seen my wound yet. But I had, and I wished I hadn't. I told him that I had looked at it and it was huge, and then there I was crying again in the waiting room. Poor little wimpy me. By now, there were more people in the waiting room with us, mostly elderly people, probably all thinking to themselves, "Get it together lady. Oh and by the way wear some sunscreen." I sat down in one of the comfy recliners, feeling exhausted, I must have looked like a hot mess. One of the elderly ladies, who was there with her husband noticed me in all my glory and told me I should lay down in the recliner. She told me twice, and I finally did what she had nicely suggested while I waited to see if I would be able to leave soon, or have to be taken back for more specimen removal. I waited about 30-45 minutes until they called my name again, and was told the exciting news that there was more cancer found, so we needed to go back to the surgery room, numb me up some more, and cut even more of a hole into my face. My heart and stomach sank.
Back in the surgery room for stage 2 removal. My whole right side of my face was still numb but the nurses needed to make sure it remained that way, so I was injected with about 3-4 more shots of local anesthetic. The Dr. came in again and removed the second layer of skin and tissue to be taken and examined and tested. This time I did NOT ask for the mirror to view the second round of making my hole bigger in my face. What I did do though, was talk to God. I started talking, in my head, to him when the Dr. started cutting. God listened to me, and he helped me remain calm. He took my worry away. I knew He would take care of me. I kept right on talking to him in between taking small breaths of air during the cauterizing of my wound again and as I was bandaged up then taken back out to the waiting room again for round two of the waiting game. I was greeted in the waiting room by my husband and an even fuller room of elderly people. This time I did not sit in a comfy recliner, even though I was encouraged to by the same sweet elderly lady. I decided that someone elderly probably needed that chair more than I did. I wanted to sit by my husband. I wanted to hold his hand, and maybe lay my head on his shoulder for awhile. I wanted to rest in God's love while I sat by my love. #4 Talk to God often. He is your friend. Tell him your needs.
When my name was called for the third time, all I could think was, Oh great, here we go again.... but #5 God is faithful. He listens. He hears my prayers. He is a God of comfort. As I walked over to the nurse and started back down the hallway to the surgery room again the nurse told me that was it, the Dr. did not need to take anymore skin and tissue. Hallelujah! The Dr. came in to talk with me for a minute and to let me know that he had gotten all of the cancer removed from this spot on my face. The nurse did a final cleaning and rebandaged my wound. I was ready to leave. My next step would be a meeting with the plastic surgeon at 12:30 that afternoon. It would be his job to fix the hole in my face. I have to admit I was still down and on the verge of tears just thinking about the size of the hole in my face and wondering how this could be fixed. I also knew that no one but the Dr., the nurses, and myself had seen this wound so far. What would my husband think, and my parents, and my children, and strangers think and say when they saw this unbandaged? Even with gauze and tape all over my face people were going to stare, and wonder, and whisper.
Mom and I headed to my consultation with the plastic surgeon that afternoon, while Eric and my Dad took Silas and Phoebe and headed over to Sarah's school to watch her participate in her field day events. I would have much rather been going to Sarah's field day, then back to a Dr. to view my horrifying unbandaged face again. But the good news was the cancer is GONE! In the Plastic Surgeon's office my face was unbandaged by the nurse and Mom and I were left alone in the room to wait for the Doctor. I warned my Mom that the hole was big and gross. But like any moth drawn to the light, Mom looked and then she cried too. I was actually sitting in front of a big mirror on the wall and accidentally looked again too, so I may or may not have tried to swallow the lump in my throat over and over until the tears overflowed and ran down my checks yet again. Darn it, you wimp. Remember the good news...the cancer is GONE! The Doctor came in and examined my hole/wound and looked at other areas of my face for a possible skin graft. I was presented with two options for trying to repair my face. One was to make two incisions on either side of the circular wound, then pulling it closed. This would most likely leave my right upper lip pulled slightly up forever. Okay, next option... a skin graft. This would be a rather large skin graft on my face. The skin would have to be taken from my forehead or on my check, close to my ear. Skin from either of these two areas would have the best chances of matching the skin texture and color of the skin that was taken off. If for some reason the skin graft did not work, we would then have the option of trying something else, whereas if we went with the first option of the incisions and pulling the wound closed, we couldn't ever try the skin graft option. The Dr., Mom, and I all agreed the skin graft option would be our best option to try first. I was given specific instructions for cleaning and bandaging the hole/wound twice a day and sent home. The goal of the cleaning twice a day is to keep infection away, and to get all the burned debris from the electric needle/pen that was used to stop the bleeding in the first surgeries off of the wound. Thus getting the wound ready to receive the new skin and give it the best chance for the skin graft to take. I would see the plastic surgeon again in five days to reevaluate the hole/wound and determine if it was ready to receive the graft.
That evening my husband and my Dad helped to remove the bandages for the first time at home. It was Dad and Eric's first time to see what Mom and I had already seen. I closed my eyes. I didn't want to see their faces when they saw mine. My Dad's reaction was so great. For real. Even though I was not looking at him, I could tell he was loving me by the sound of his voice, because when the gauze was removed he began to rub my arm. He then said to me, "That's not bad." He was happy and he told me why... "they got all the cancer out." #6 Praise God in the storms. Dance in the rain. There it was again and again, and several more times since then. The cancer is GONE from that spot. Thank you God. Now let's dance. My husband has been a rock star. Who knew he could be such a good nurse? My husband has been loving, kind, patient, and gentle. I knew these things before about him, but it has been reinforced multiple times everyday since last Tuesday. Thank the Lord for a man who is able to look at me and the hole in my face and still have overflowing love for ME. He is also able to clean and rebandage the hole for me, something that I am a long way out from being able to do for myself. It is still hard to look in the mirror without feeling physically ill in my stomach, and forget it when it comes to inflicting more pain on myself when trying to clean out the hole/wound twice a day. He is my go to guy and will always be my knight.
Here is a look at the hole/wound Tuesday night, the first night at home, unbandaged.
Dancing in the rain ~ my husband turned 36 on Thursday. Wednesday night I made him a baseball cake. With some cake baking and decorating tips from my Dad I created a round two-layer white cake with red and white icing. It was not amazing, but it did resemble a baseball and it tasted delicious.
Friday night, fourth night at home, after surgeries, and twice a day cleanings. Goal is to remove as much of the black debris/burned areas as we can.
Dancing in the rain ~ Children who love me and need me. Children who want their Mommy no matter what I look like. And, celebrating Mother's Day with my children, my husband, and with my Dad and Mom, whom I love very much and am thankful for everyday.
I received a Mother's Day card in the mail from a lady that I met at our church over three years ago. I have not seen her in months, and I know she did not know what I had going on in my life right now. But her card and words of encouragement were a great blessing to me. She wrote in the card that SHE was thinking of ME. And, she wrote Psalm 121:1-8 The Lord watches over you. The Lord is like a shade tree at your right hand. The sun won't harm you during the day. The moon won't harm you during the night. The Lord will keep you from every kind of harm. He will watch over your life. The Lord will watch over your life no matter where you go, both now and forever. Again, God's perfect timing. Words I needed to hear. Thank you, Judy, for your kindness and thoughtfulness!
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