ihavebreastcancerblog

Hello readers. It’s been a while. I was chugging along, living my life enjoying not having medical bills for once, and then life happened.

A visit with the dermatologist a few short weeks ago found more skin cancer. I think skin cancer is officially my second cancer after breast cancer. You know how women talk about getting other cancers after breast cancer? Mine is skin cancer.

I’m feeling a little stormy about it right now emotionally. I’m also dog tired after a day yesterday that was kind of long.

I will start with the dermatology visit as in the regular dermatologist. My original dermatologist retired, so this time I had my first appointment with my new dermatologist. And I think I am as crazy about her as I was about him. It’s really nice having dermatologists that care and take time with you and are thorough. Why? Because if you have skin cancer, it might just save your life.

I am still under the care of Penn Medicine, even if there are things at times that irritate the snot out of me. But that is the business side of it, not the medical care. It’s part and parcel of the problems of the model of healthcare in this country.

And truthfully, the business side of hospital systems is irritating, because you no longer have access to the amazing local people who take care of billing, as one example. You go out of state to talk to people. I think the billing for Penn Medicine was in Texas last time I checked. So, if you have questions, or you are challenging a charge, it’s not as easy as it used to be to find someone to talk to. And that’s the other thing about Penn Medicine that still hasn’t changed – their terrible phone system. However, in fairness to them, I don’t know any hospital system that has a great phone system. It’s like EVERY hospital system make it difficult to talk to the people who are in charge of your care. It’s a complaint that I have heard from people everywhere whatever their hospital system is across the US.

And then, of course, there is the wonderful perplexing pretzel logic filled wonderland of actual health insurance in the United States. Oh yes, we pay for the privilege, we pay indeed. But sometimes I wonder what we’re paying for? This week for example. I feel like in Independence Blue Cross was punishing me for being a little more healthy this year. It cost me $1000 as a deductible to walk in the door before my co-pay for my Mohs surgery.

But let me back up until how we got here with me having another Mohs surgery during Pinktober. And everybody knows by now that as a breast cancer survivor, Pinktober is something I don’t necessarily adore every year.

I went for my annual check up with my new dermatologist in the same practice I was in before in September. I was nervous because I had been with my other dermatologist for years before he retired, and he was a terrific and thorough doctor, who took the time to listen to his patients. And that is one of the things I have always been particular about. I am not a hypochondriac. I don’t waste the time of medical professionals, but I always want to have someone that I can talk to who will answer questions and explain things so I can understand them in every day, English, since I’m not a medical professional.

So at my initial visit to my new dermatologist, this time, a woman, we were talking about that this was my first regular annual visit in a few years. You see, as I’ve written before, they keep finding skin cancer. So I had finally gone for a year without anything. So I was kind of psyched about that walking into my annual check. But as she was giving my scalp a thorough once over, I remarked about this weird little spot in the back of my head. It seems like I must’ve scratched myself or had a bug bite or something and have had this thing there for a while, but it never really heals. So my doctor asked me where the spot was and I use my finger to find it and she started looking at it. And she stepped back and she said she needed to send this out for a biopsy. It might be nothing but she would rather be cautious given my skin cancer history. So a little sliver of it was sent out for biopsy.

The biopsy returned a diagnosis of positive as cancer. Yes, a cancer on the back of my head this time. Fortunately, it’s basal cell. I had a classmate from high school whom I was very fond of die many many years ago now of melanoma, so I’m really happy that it wasn’t anything like that. However, I wasn’t happy I had skin cancer again.

So back to my amazing Mohs surgeon I went. Yesterday was the procedure. And it was an interesting experience this time because from the time I was in the regular waiting room outside where dermatology is, it was a lot of people with very nervous and somewhat negative energy about these procedures. And today for the first time there was a wait because there were just I guess enough people with complicated enough Mohs procedures ahead of me, so it just took longer.

Mohs is a very specific practice within dermatology. It’s actually kind of fascinating. They take off little layers of skin until you get clear margins. It’s kind of delicate so it’s time consuming. Each layer removed is sent to an on-site lab for immediate pathology evaluation. So this morning it was an hour before I made it out of the outer dermatology, waiting room to the inside of dermatology and then further in to where the Mohs areas are. Mohs patients are almost seen in layers for these procedures, as the cancer layers are removed from each patient in each Mohs suite.

They were very busy yesterday in this area of dermatology so I couldn’t hang out in my own surgical room in between them lifting the layers of cancerous skin off. The way to Penn Medicine does it, the area for Mohs surgeries is its own little world.

It’s actually very cool because we have our own waiting room within dermatology. But today, there were a lot of people with a lot of nervous and energy of uncertainty in this waiting room as well. So, although I am not exactly blasé about these procedures, every time I have to have one, it does make it more difficult sitting there. And when you are sitting there with several people who have less than positive energy, it makes it harder on yourself, and therefore more tiring as an experience.

Where I was lucky is it only took two passes to give me clear margins. Where I wasn’t lucky is it’s a really kind of a big wound on the back of my head. I would say it’s a couple of inches so I have some pretty big bandages popping out of the back of my head right now and because it’s the back of my head I’m going to need my husband to help me change the dressings twice a day after 48 hours have passed. I also have very thick hair, so hopefully I can keep everything on that long. It has been almost 24 hours keeping it on, so paws crossed.

Now the bad news. And words, I never thought I would utter: I have to go to a plastic surgeon. I opted to not have breast reconstruction as my readers know after breast cancer surgery 12 years ago. Some days I have regretted it, because especially as I age, my left breast is half gone, and because it was pumped full of radiation, what is left of this breast has shrunk more every year. So I am lopsided. But I wasn’t the boob job kind of person and I didn’t want to deal with more surgery, expanders, and drains and the whole rigmarole of it. For me that surgery was enough and although it messes with my self image somedays I know ultimately I made the right decision for me. But as a woman, I can’t say I don’t look in the mirror some days and feel upset still after 12 years. I am grateful to be alive, but I am sometimes resentful of the scars to your body and psyche that breast cancer causes.

But when I was speaking with my Mohs surgeon yesterday I said, although I didn’t opt for plastic surgery then, if a cancer surgery reconstruction is something I’m allowed to do with my benefits this time I will do it.

And it’s simple: I am not prepared to have a big permanent bald spot, like a bull’s-eye, in the back of my head that will be seen whether my hair is up or down for the rest of my life. I can live with lopsided breasts, but for me, I can’t live with that.

In a few days, I have a consult with a plastic surgeon. And as I understand it, what they do, essentially is kind of bring the two sides of the wound together and stitch it. I don’t know if that requires a skin graft or not. But what it accomplishes is this now wound on my head is pulled together, so I won’t have a glaring bald spot and missing hair. The theory is the hair will grow back in.

And it’s funny. This takes me back to when I was first diagnosed with breast cancer, and I was wondering how I would cope if I had to have a mastectomy if I had to have chemotherapy and lost all of my hair, and I knew I would power through it because the options are far less glamorous and you’re a long time dead. But yesterday I decided I couldn’t live with a permanent bald spot.

Living in my head yesterday, contemplating all of this was not fun.

So once again, I’m finding myself faced with the psychology of cancer in women. Even if it’s skin cancer, because I am sure there are some people who probably think I am really vain and a freak for even discussing this. But it goes to the female self body image and that is something you can’t take for granted, especially in a world where people are just mean.

I mean, remember, when I posted on this blog within the last couple of years of some woman who was politically opposite my belief system, who went and researched and dug out a photo of me in a hospital gown just after the needle biopsy but before I had my breast cancer surgery? Do you remember how she posted it like a wanted poster? That was just pure female bitch tactics designed to upset me what it did in fact, was make me more resolute in believing in myself because any man or woman who will that will do that to someone who was treated for breast cancer during breast cancer awareness month or at any time is a low life form, aren’t they?

My husband is as always my rock and I spoke to two of my best friends and my mother, so this will be a slightly difficult day that will fade. So I talked through the day yesterday at different stages. I woke up today, sore, itchy at the procedure spot and resolved to deal with this like I’ve dealt with the other things I’ve been through involving the not so magical world of cancers and skin cancer. I am tired, but mentally and psychologically. I’m in a much better place. Just like my mother actually promised I would be.

I will note I am posting my photo of my surgical spot and if the people who don’t like me as a blogger want to take that photo and spread it over the Internet and have fun with it that’s on them but it’s Pinktober and they’ll look like jerks.

Now, a brief word about Pinktober. It seems quieter this year. I am not smacked in the face with so many fake pink products that will only give 2% or 3% to breast cancer research. Some company wrapped a car of our local police department in pink. I’m not sure what I think, to be honest. I know this was done with good intent, but once again, I feel the need to remind people that breast cancer, or any cancer in women is not pink and fluffy.

If you donate to anything breast cancer this month, please do so responsibly. Do a little research. Don’t buy pink plastic crap. And for goodness sake, get your mammograms and other tests that you are required to get.

That’s all from me.

#thinkbeforeyoupink