Melanoma and GPA

In every photo including my right lower leg, you can easily see a dark spot.  A dark spot that I have had for a few years.  Not my whole life, a few years.  It's a spot strangers will ask me about or express concern.

I'm fair.  I grew up on a farm and worked or played outside year-round.  I've never really been a sunbather or "tanner", probably because my success rate on getting a nice tan has always been almost non-existent; but, I was a runner and an avid golfer for many years.  Being outdoors has always been my lifeline to sanity... to health... to happiness.  It is where I feel closest to God... most thankful... most alive.

I have had multiple lesions frozen, biopsied, excised and/or "watched" on my forearms, hands, face.  I've had one mole (that I'd had my entire life with NO CHANGE whatsoever and no concern to me) on my leg removed in a excisional biopsy... because they were concerned (it was benign). 

The ONLY place I have been really concerned about in these years has been this dark spot on my lower leg.  The ONLY spot the dermatologists (2) and the Physician Assistants (2) and the surgeon (1) have NOT been concerned about is this one.  It had never been biopsied, measured, or photographed.  No concern.   At one point, I had asked a dermatologist to remove it and we scheduled the procedure.  45 minutes into an hour drive to have the procedure, her office called and said she was sick and could not do the surgery that day.  I took it as a message that I was just over concerned about a benign spot and decided not to pursue it any further at that time... I decided to go with the "it's nothing" diagnosis.

As recently as February 29, 2012, on a visit to a plastic surgeon's office regarding a basal cell lesion that would need to be removed from my right ear, I whipped up my pant leg to once again say, "No one thinks this is a problem, but this is the spot that worries me."  He looked at it and said, "Well, think of it this way:  if it had been melanoma, you'd be dead by now."  Dismissed... again. 

Strangely, that comment gave me a sense of peace for the first time... a way to let go of the sniggling fear that had been floating so long in the back of my mind.  I did ask for a referral to a new dermatologist, preferably a woman.  They set an appointment for April 6, Good Friday.

Eight AM Good Friday morning found me sitting in an exam chair meeting a bright, young dermatologist.  Very personable and kind.  She examined my face and ears and hands (the referral was for dealing with those in particular).  As she finished this exam and was about to discuss a plan, Evan asked me to show her my leg (AGAIN to whip out this dark spot).  I told her that the other dermatologists (one of them in her clinic) had dismissed it as nothing and I told her what the surgeon had told me a month before.  I had given up.  She said to just let her take a look.  I pulled up my pant leg and her face gave credence to all I had ever feared (she is young... perhaps she will grow better at her "game face" as time goes by).  She stated she was very concerned.  We told her we had been too... for a long time.  We told her that every time we had sat in an office and looked at the ABCD posters for detecting skin cancer, it seemed to have met every one of the criteria.  She absolutely agreed... for the first time.

A biopsy was done.  It is melanoma.  By a miracle, it is still in an earlier stage.  It is right on the border of excision v. excision and much more aggressive therapies.  I see a surgeon (a different one) at 12:45 today.

I don't know what my message to you would be... I want to say:  if you think something is wrong with your body, keep looking until you find someone who will see it with you.  But, after working in health care for so long myself, I know sometimes... as humans... we just look for things.   And, we need to trust that when they say we don't need to worry, that they are right... and we really don't have to worry.  My new dermatologist (note MY, I'm keeping her), told me that she hoped I wouldn't be angry about the missed diagnosis.  I told her it was nothing close to anger that I feel... just a loss of confidence... a loss of trust... and a fear that has left me unnerved. 

Several years ago, one of the worst arguments my daughter and I ever had was over the GPA of physicians.  Stupid thing to have a serious argument over, huh?  At that time she was dating a young man, who wanted to be a doctor.  I was hard core into believing that if I could have control of medical schools, only the 4.0s would gain acceptance or graduate (I worked in surgery 25 years... I had some grounds for having that opinion).  I argued with her that on a test of 100, if you miss two... that's two lives impacted by your wrong answer; if you miss 15 out of 100... that is 15 lives that may be lost or otherwise negatively impacted.   Multiply that by a lifetime of decisions and you see my point.  She took it as a personal insult to the young man... it wasn't personal for me, it was and is how I think.  Seems logical.  The answers and decisions they make are about lives... yours and mine and the people we love.

Yesterday, after calling Amanda with the news and the plan, I was cleaning off my desk and noticed the information packet the dermatologist's office had sent... and, I noticed among other accolades: Graduated Medical School with Special Distinction for 4.0 GPA.  It was like some special message just for me... of hope... and trust.  I know even if you have a 4.0 GPA, you will make mistakes.  We are human.  But I when I see that GPA, I know her work ethic... and I know she's are smarter than the average bear.  And, I still think it was a special message for me... of hope.

I immediately called Amanda back and relayed this information to her.  The lengths a mother has to go to prove her point... to win an argument YEARS later!  Ha!  She did concede and we had a good laugh.  Laughter is good medicine.  ;)

 Maybe that's the advice I'd give... check their GPA. 

blessings ~ tanna