Surgical Oncology

Or, “Why I Disappeared From the Internet For 2 Months”.

It’s hard to create anything with any heart when life sucks. I know some people can really draw from “pain” or whatever, but unhappiness just drains me so much…I feel like an empty husk of skin for the past two months. If you’re wondering why I haven’t really updated lately, this is the reason. Nothing seems that fun anymore. When I get home, I just collapse on to my bed and don’t move until the next day.

UPDATE: Recap of the actual surgery, here.

In early March, my dermatology appointment came up. I was referred there by both my regular (new) doctor and my new gynecologist. Although I don’t have the best insurance, my new program is already worlds better than Medicaid – doctors will actually see me!! They don’t mysteriously cancel my appointments without telling me! It’s a nice feeling, not being rejected. Anyway. It’s weird to say this on the internet, and I’m really uncomfortable revealing this. But I had a mole in in the vulvar region. Let me clarify…that doesn’t mean the vagina…this is like, the regular skin on the outside, it’s not an internal surface. But obviously it’s a sensitive area that doesn’t see the light of day! It’d be covered in a bikini, and that’s how close it would get. So yeah…it’s weird to have a mole there, and even weirder that it just showed up maybe a year or so ago. Maybe a little before then. Previous doctors (who suck and kept dodging me for MONTHS on Medicaid) told me that it was nothing. The latest one almost dismissed it as nothing too – but she mentioned why she thought it was nothing. She thought it was a birthmark. I told her no, it’s new. She referred me to a dermatologist who specializes in patients with skin-related issues in this region.

I’ve got other moles on my body that I wanted checked out. Ones that every regular doctor I’ve seen has told me to get checked out. But they all “passed” the dermatologist’s exam….all except the one down in my groin area. Hooray…:( Even my blue mole on my bicep passed! Biopsy one was scheduled; the mole was to be removed. I was pretty nervous about this, but this dermatologist has tons of awards, an extremely cool Russian accent, and really great reviews online. She’s got to be around 40 years old, but with zero wrinkles and a pretty good looking body. I say that as a straight female! Well. This biopsy was excruciating. Local anaesthetics just never work like you think they should. They did give me a numbing cream, but that’s even less effective than the injection it failed to dull. So…numbing cream. Big needle injection to possibly some of my most sensitive skin. Then the razor blade came out, shaving off pieces of my skin. Tweezers pulled at my flesh; I could feel the pressure of the sharpened scissors snipping pieces of me away. I could see the bloody bits that went in to the sample collection. Sometimes I just felt pressure. Sometimes, it was sharp pain. The nurse winced in sympathy as she held the samples, staring at whatever horror was between my thighs. I was glad that my head is on the other end of my body, and I don’t have to actually look. By this time, the local anaesthetics wore off. She charged up the cauterizing machine, and I felt a burning, searing, horrible pain. She touched a metal plate to my skin to burn the tissue shut. Because it was just touches and over in, realistically, 10 seconds, I’d say it was an 8/10 on the pain scale. If it were sustained pain? 20/10. Easily. I screamed, and I never scream…I didn’t even scream during my IUD insertion, and regular checkups at the gynecologist (like pap smears) already cause me pain and discomfort. I healed without a scar, with no way to tell that anything was done to my skin.

Biopsy #1 results came back in. I got a phone call, and had to schedule for biopsy #2.
Prognosis? Atypia cells, everywhere….all over the samples….the doctor needed to cut wider, and deeper. Atypical cells are as they sound….cells that are not typical. Cells that might turn in to something terrible, if left alone….like skin cancer. Melanoma. There’s a possibility nothing would happen. But this is cancer we’re talking about…it isn’t worth the risk. So another appointment was made.

Numbing cream. Big needle injection. Razor blade. Tweezers. Scissors. There was now a bit of a notch in my skin now. But it healed decently.

Prognosis…still not enough. The doctor called me, told me the news. I almost cried on the phone with her. Friends had told me that going in for a 2nd biopsy at the same site is not uncommon for mole removals. But what about a THIRD excision!? I didn’t want to go. I remembered the pain of the surgery and the pain of the healing process, which lasts weeks, and I really didn’t want to go through it again. But my mom talked to me, and she re-oriented me. Got me to see the big picture again. This is temporary pain…this is pain I won’t remember or care about in a month. But cancer? Melanoma? That can actually kill me. And apparently….melanoma in the region where my mole was is known to be ‘agressive’.

My mom came with me to the third biopsy, and she held my hand. I’m 25, but I really appreciated that. i felt like a kid again, having my mom come to the doctor with me. And it was good she came because she didn’t believe me, but believed the doctor when the doctor said “This is not a sign of an STD”!!!!  Seriously, I’ve taken tests and such, I’m totally clean :(  Anyway.  This time, they used a scalpel – 11 blade. I saw the chunk of skin that came out of me, and it was like a big, fat, red slug. They gave me two needle injections this time, so I actually felt less than during the other 2 surgeries.

Results from the lab came back in a week. I got the call at work…..and did shitty work for the rest of the week.
Biopsy #3. It was still not wide enough, still not deep enough. How deep was that damn mole? I was so afraid. My doctor, I think it depressed her too. She referred me to the Surgical Oncology department of Mount Sinai….where I met with another good doctor. She’s very young, but has a good record so far as I can tell online. And she specializes in actual cancer stuff. It was a bizarre feeling to wait in the oncology department. I felt out of place. Before you see a doctor, you see tons of other staff beforehand…mostly nurses and such, taking vitals, prepping you. Doing all that stuff. My mom met me there (I came from work during lunch time) and these people kept addressing her, thinking she was the patient. Well, I can see why they assumed a patient for the Surgical Oncology department would be an older person. But it sucked…giving a weak smile….saying, “Actually….I’m the patient”. Me, at age 25.

Like before, I felt like a kid having my mom with me at the doctor’s, but I was in such a depressed state of mind, I couldn’t think or make proper decisions myself anyway. She supported me, and it really helped to have someone else there to ask questions and listen to things…meanwhile I could sit there nearly catatonic. There was no surgery, which I was prepared to go through when I arrived. The doctor wanted to talk to me first, go over the lab reports with me. We did, and it was decided that the slides of my previous 3 biopsies needed to be transferred over to Mount Sinai’s own pathology lab. They wanted to run their own tests to be sure the prognosis was correct. And really, I trust this hospital’s lab more than the 3rd party lab at the moment. I hope things turn out okay. I’m still waiting for the results. No matter what, they need to cut me up again…and this time, they’ll have to go deep enough for stitches. The doctor suggested having a plastic surgeon present to close me up. She recommended one whom I assume she’s worked with in the past – she spoke highly of his skills – but he’s out of my insurance network. I don’t know what I should do. Should I just pay out of pocket?

My mom doesn’t think I need a plastic surgeon. She says, everything “down there” is ugly anyway. My boyfriend says he doesn’t care, either, and he loves me anyway. Which is really wonderful for him to say…it’s a huge load off my mind. But still, I’m thinking a plastic surgeon would really know how to pull skin back together. I know that sutures in that area are prone to infection, and my hope is that a plastic surgeon would not just make it superficially look better, but I might have a better chance avoiding things like keloid scarring from the surgery. I don’t know. Maybe I’m being too paranoid. But I’m going to meet with him tomorrow….and…I guess I’ll ask how much it would cost to have him there. Just meeting him tomorrow will cost me between $100-500 out of my own pocket….this cost was estimated by the surgeon’s receptionist. I don’t know. I have some savings. But it’s not like I can cover it if the plastic surgeon costs tens of thousands of dollars. There’s a chance my insurance may decide to copay a bit of the cost….but really, I don’t know. There’s so much I don’t know. I have to be prepared to pay it myself. Having a plastic surgeon close me up isn’t medically necessary, but of course I’d rather have his expertise…

Another option is, I could try to find another plastic surgeon that actually is within my network. However….I’m inclined to go with the doctor that my actual oncologist suggested, since it sounds like she’s worked with him before and they probably have a good dynamic in the OR.

I don’t know what to do. I just don’t know.

And what sucks is, there’s a time limit. All of this has to be rushed. Like I said earlier, melanoma is very aggressive. The more time we waste, the more time the cells have to spread deeper in to my body. I hope it isn’t truly melanoma. We still don’t know.

So that made for a particularly horrible past week. Before returning to work from the hospital, I took a moment to make some phone calls to the labs and other doctor offices. Then I took another moment to cry. Once I gathered myself, I returned to work. The one good thing was that my boyfriend is now working with me…we’re coworkers again. So he saw me walk in like a zombie, and he hugged me, and for a second things felt okay. But then I did shitty work for the rest of the week, and I had horrible cramps for days. Moltron couldn’t begin to soothe my raging uterus. Oh, and then this weekend, we got in a fight over something really, really stupid. I escalated it, he didn’t respond well, then I didn’t respond well to that either. I almost feel like it was a self-fulfilling prophecy moment. Because I had been thinking all week that nothing is going right in my life, that everything sucked except my relationship. And how horrible would it be if that were to blow up too? Oh wait, there it goes!

Luckily I think things are way better, since this morning. But then there’s still that skin cancer thing, and the not knowing, not knowing ANYTHING. Not knowing what the diagnosis is, not knowing what’s going on with my body, not knowing if I can pay for my treatment…at the very least, my insurance should pay for regular “surgery”. I just don’t know about the plastic surgeon. And if general anaesthesia is a separate charge…they have to put me under this time. It’s that invasive I guess, or maybe the surgery just takes that long or would hurt that much. I know I didn’t choose general anaesthesia when I got my wisdom teeth taken out. One reason was because it costs a lot extra…though of course, another reason was that I was too light to receive the amount of anaesthesia they’d need to keep me under for the duration of the extractions.

So…yeah. That’s my awful Spring 2013 so far. It’s scary to think….what if my current doctors again told me this mole was nothing? It seemed harmless to me, I was just weirded out by the fact that I wasn’t born with it. Other doctors, other professionals and specialists also thought it was nothing. If my dermatologist didn’t say, this is the one we need to biopsy, nothing would have been done. No atypical cells would have been discovered. There’s a timeline out there in the multiverse where I die in a year, because I didn’t get that mole checked out. So in the end, in a month, in a week, things are going to be alright. It’s just unfortunate for my psyche that right now, all I have is fear, depression, pain, and so many questions.

Those pics are all from my Instagram.  I don’t know what possessed me to take pictures.  But I spared you all the bloody chair!  As if anything in this post hadn’t passed TMI yet.

On a happier note….my boyfriend traded 3DS games with me today after work!  I’m stuck in Fire Emblem, around Chapter 15 (more like Paralogue 16! Nowi’s stupid kid is too hard to get!), and he finished playing Luigi’s Mansion, which I bought him for his birthday.  He really loved it, so I’m pretty excited….it’s really cute so far, and I love the extra little animation touches they do.  And I thought this was really cute…an antique, still-functional grandfather clock! They just don’t make them like they used to, ha!

  I only started it on my subway ride home, so I’m only 3 missions in.  Might post a review later….once I’m less angsty about life, the universe, and everything.  I mean, I obviously have people who love me, and I have a roof over my head and I’m not starving.  I got a good job.  So…things aren’t the worst.  But somehow it feels like things are pretty damn awful right now.

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5 thoughts on “Surgical Oncology

  1. Hang in there and just breathe. Close your eyes and just breathe and have faith. Faith and hope are graces from God that if you ask for, you will receive. Wishing you all the best

  2. Oh wow thats really harsh!!! *hugs* If you need anything let me know! Well hopefully they can tell you the exact results I am kinda surprised that it already taking that long for results, it is or it isn’t? Plastic surgery for down there? It’s not pretty originally lol so yeah…

    I truely don’t like manhattan doctors because it has to do a lot with the $$$ and insurance, I feel doctors in the outer boroughs tell things honestly and get things resolved quicker.

    Don’t worry about being with a parent when your in a doctors office, as much as it feels weird its actually the best support at the same time, thats when you still feel like a kid and they will get you something yummy usually afterwards.

  3. […] went in to surgery this week, to remove the atypical, pre-melanoma cells from my body, which I was freaking out about a few entries ago.  This is mostly a diary entry, made for my own reference in case I wanted to look back on it. […]

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