No Really, Wear Sunscreen

It was just last month that I was reminding all of you to check your skin. Back in April I had a small mole removed, and when the pathology results came back, it was revealed that it was abnormal, but not cancer. I’ve had several moles removed that came back like that, so there was no surprise there.

But when they called with the results of this one, they said they’d like to take more of the edges just to be safe. That was a first for me, but this was a new dermatologist, so I figured she just did things differently. The man on the phone told me that this time it would be stitched closed. I’ve seen others who have had moles entirely removed, and they usually had one or two stitches in place – no big deal.

I went back to the dermatologist’s office yesterday, ready for a semi-repeat of the last visit. I suited up in my oh-so-stylish paper gown.

Rocking the paper gown!

The nurse sat down with me and started to explain the results again, only her explanation seemed more…heavy. That abnormal mole was a special kind of abnormal mole. There are three types of abnormal: mild, moderate, and severe. Mild and moderate are often just watched with no further action needed. But severe, well, that’s abnormal cells that are as close to melanoma as you can get without actually being melanoma.

It’s not skin cancer, and might not ever turn into skin cancer, but there’s a much higher chance that it could. And since there was a very large mole (I’ve named it Bertha) that this smaller mole was now touching after hovering near it like a moon before (I’ve now named the smaller mole the Death Star), they needed to take both out, as well as a decent border around all of it.

So this wasn’t going to be a tiny spot with one or two stitches then? No, not at all. The nurse explained that there was going to be a scar, and due to the position on my lower-mid-back, it’ll likely be an ugly scar. It’s impossible to keep the scar small when that part of the body is constantly being twisted, stretched and pulled.

The nurse left, and I sat in the room alone, my mind racing with this new information. Suddenly I wasn’t feeling so “no big deal” about this anymore. This was serious, and this was seriously going to be a minor surgery. That abnormal mole was setting off the cancer spidey-sense for my doctor, so I possibly dodged a big bullet by getting it removed now. What scared me even more is that she had looked at that one back in the fall and wasn’t concerned, and didn’t seem too concerned when she biopsied it back in April after I insisted that it looked like it had changed a little more in six months.

I understand why they didn’t tell me all of this on the phone when they set up the appointment. I would have been a nervous wreck for the next three weeks.

When the doctor came in, she went over everything again, telling me much of what the nurse had explained. Football-shaped incision to remove all of the skin down to the fat underneath, with a double layer of stitches – the inner layer would dissolve, the outer layer would be removed in two weeks. The doctor demonstrated how she’d pull the surrounding skin together when stitching it up, and I joked that it was a good thing I lost so much weight in the past few years so she’d have plenty of loose skin. She also made a point to tell me that this would likely be an ugly scar. I replied that I didn’t have any plans of being a back model anytime soon, and I’m far past any years of wearing a bikini, so it was fine. Humor – easy to use as a shield when dealing with hard news.

The whole procedure lasted about 45 minutes. I expected one or two shots of lidocaine to numb the area, but it was more like 10-12. The bee-sting feeling slowly faded to nothing, and they were then ready to begin. I laid on my stomach, wondering if I needed to not breathe too deeply so I didn’t affect the depth or direction her scalpel was moving.

(Warning: This next paragraph is graphic – if you’re easily squeamish, skip to the paragraph after it.)

I felt the nurse pressing against my back several times, and when she sat the gauze on the tray I realized she was dabbing away all of the blood coming from the area. Then the doctor pulled out a little tool that made several beeping noises. I wasn’t sure what it was at first, until the smell hit my nose. She was cauterizing blood vessels – the smell of burning flesh is hard to mistake with anything else. There was a lot of blood.

(OK, the worst is over, squeamish people continue reading.)

As she was finishing the stitches – and that part took awhile, too – I realized this was likely going to hurt when the numbing wore off , and started asking about restrictions while it heals.

Clean it daily, apply petroleum jelly to keep it moist and keep it bandaged. No ibuprofen or alcohol for a few days because of a risk of bleeding too much. If it starts to bleed, apply pressure and call the doctor or go to the ER if pressure doesn’t stop the bleeding.

Limited movement and no lifting for the first couple of days, too, then slowly allowing more movement, but cutting back quickly if it starts to bleed. No stretching or strength training exercises for several weeks – yoga is right out. Running/walking is OK in a week or so as long as I don’t twist too much in my torso when I run.

I realized my plans for exercising more have been temporarily put on hold because of this.

The new section of skin that was cut out will be sent to pathology again to confirm that there were no abnormal cells around the borders, and to take a closer look at any remaining abnormal cells in the sample. If the borders are clean, then all is well and I can go back to regular skin check appointments. If not…well, then I’m guessing we do this whole process again and take more out.

I have a large pressure dressing on my back that I’ll be changing for the first time today, and finally getting the first look at the stitches. As I got dressed in the doctor’s office, the pressure dressing was solid white. Two hours later I had already done too much, as I could see the blood in the gauze. It hurts, and I forgot just how much we use our backs for practically ANY movement.

Still…there’s a bright side to this story, and it’s an important one. It wasn’t cancer. OK, I guess I can’t say that for certain until the pathology report on the new skin cells comes back, but we’re pretty sure I’m good. Regular dermatologist skin checks are important for detecting changes early and removing anything suspicious before it could become cancer.

And wear your sunscreen. All the time. Especially if you’re a fair-skinned Irish-blood like me. My skin might not be trying to screw with me had I been better at applying my sunscreen and didn’t try to be tan as a kid.

My childhood summers, summed up in one photo.

The sun worship is long over in this house. I’ll admit to being more than a little scared of my own skin now. Will it decide to turn on me? Will I catch it in time? Could I have prevented this by taking better care of it when I was younger?

And if ever I need a reminder to wear my sunscreen daily and put it on the kids as well, I need only look at my back and the ugly scar that will be forming there.