Consider this an "update post" and the title of the post "the best question I was asked" this week. It's been a bad couple of weeks around here and it has ended quite well.
With continued fatigue from the wedding (and I suppose from growing a baby), I broke one of my rules about how to stay out of the pit and I got involved in a political issue. Symptoms that have plagued me this summer got bad enough that we all got a little bit panicked. My fatigue was terrible, I had a lot of uterine pain, possible contractions, headaches, edema, tingly hands and feet, and high blood pressure. I had most of the symptoms associated with preeclampsia, a pregnancy condition that can result in premie babies (and really much worse). I moved my midwife appointment up ten days to get some wisdom. We scheduled it for an afternoon last week when we would be in civilization anyway to see a dermatologist.
(Nitty gritty continued...)
Technorati Tags: basal cell, depression, melanoma, preeclampsia, pregnancy
The dermatologist
The dermatologist was my husband's idea. In late winter he spoke to a friend who showed him a massive scar on her forearm. She explained that she had a "spot" on her arm that her general practitioner told her to "keep an eye on." Another friend recommended this particular dermatologist who has about a six month wait period for new patients. Our friend scheduled an appointment and ended up with a melanoma diagnosis. Melanoma, by the way, is the type of skin cancer you do not want. It can metasticize, spread all over the place, and kill you. In most cases, if they catch it in time, you're good to go. Another friend was diagnosed about a year ago, just after having a baby. My cousin was diagnosed about three years ago. In each case, there is a painful wait between the initial diagnosis and the determination if you will need any sort of radiation treatment or chemotherapy. In each case, they needed none. The more common form of skin cancer is "basal cell." It might eat off your nose if that's where it's growing, but it grows slowly and does not spread outside of its little area.
When our friend told her story and showed her giant scar, my husband took the doctor's name and drove immediately to the office to make an appointment for both of us. That appointment was last week.
As I waited for the dermatologist, my skin health was the farthest from my mind. The nurse had just taken my bloodpressure: 138 over 90. I sat in the examine room cavalier about any dermatological concerns.
"What brings you here?" the dermatologist asked.
"Primarily my paranoid husband."
I described the friend of ours who was her patient, the friend's massive scare on her arm, and her melanoma diagnosis. "I just have this spot on my arm here," I added.
Her eyes became saucer-like and she said, "Ooooh. We need to biopsy that."
I realized only later that she was generally excitable. She asked if I wear sunblock. "When I work outside, I wear a hat." She went bananas. I thought I should get a pat on the back for that hat. After all, I could be nude sunbathing on my roof everyday. I'm just gardening with a hat on. She explained that even a polo shirt provides only an SPF of 15. She gave me a brochure for some high SPF clothing. (This started a discussion around here about the SPF for jeans and leather chaps, but that's really a story for another day.)
In any case, I was sitting there with probable skin cancer and, up until that point, I had avoided the dermatological strip search, but the spot on my arm changed their mind. I was put in a paper gown and my body's entire surface area examined. They took two biopsies all together after they worked to reduce my blood pressure and pulse.
As they were taking the biopsy, I learned an important lesson: Do not fish for the answers you want if you don't know what the answers are.
I said, "You can do these biopsies but I only want good news."
"Well, I have been wrong before."
An expletive formed in my brain and rose up in my throat before I was able to take a deep breath.
I worked hard to focus my brain on the positives: "Better to know about cancer sooner than later" was the most successful.
My husband had been told of my "condition" during his appointment and we both met in the hallway concerned primarily about the same thing: me going bananas.
A cloud has been looming lately around here -- the beginning of the third trimester begins in about two weeks. It was in the third trimester that things got very bad before. This time around, I've worked to finish contracts before that magic date (I'm only partly successful on that) so that I can take time off if I need it. It's hard to imagine throwing a cancer diagnosis into the mix, possibly on top of preeclampsia.
The midwife
By the time we got to the midwife, my big goal for the appointment was not to cry in her office. I was reasonably successful. My blood pressure was still in the range of 140 over 90, up from 125 over 70 in my previous pregnancy.
"You don't have preeclampsia," she said, "you have no protein in your urine. But let's look at what might be causing your hypertension." She then described some delicate data and I expect was bracing herself for a lash-out from me.
I felt such relief that I said, "I feel so inspired. You are telling me I'm older and fatter than last time. I knew that already. I don't have to go on complete bed rest? Do you mean I can actually exercise?"
I called my mom later. "Mom, great news: I'm just old and fat."
Demons (and then a party)
I headed home and started an exercise regimen, but fighting the demons in my head about "melanoma" was difficult. My concern was actually less about the melanoma than it was the likelihood that a melanoma diagnosis would send me over the edge and I would face another three years of psychosis and depression.
In my waiting, I began (again) an exercise program, a light-weight interval training combining cardio and strength training. I'm up to a whole forty minutes and working up to sixty. I watched episodes of MI5.
Early Tuesday morning (after a Thursday biopsy) we got "the call." Calls are never good from people like dermatologists. The nurse was extremely somber and reported that both biopsies were positive and that they had an opening that afternoon for an excision.
It is a very bad sign when they want you to come in that day for an excision.
I took a deep breath and said one word: "Melanoma?"
"No, basal cell."
"Really? My God, that's great news. We may just throw a party."
The dermatologist reported later that she knows of no other patient who has reacted quite that way to a skin cancer diagnosis.
She also asked, "What blood pressure medication did your midwife put you on?"
"None, it's all me," I responded.
That morning my blood pressure was 105 over 62. An hour after the diagnosis call and just after working out it was 114 over 67. I expect the high blood pressure diagnosis should have been "AIH": Amanda-induced hypertension.
"Maybe I am not that old or fat after all," I thought, with the blood pressure of a non-pregnant teenager.
