Yet another link

Melanoma information on About.com

Logan and I went and bought half price calico fabric at the Rite Aid today, and some non-calico too. She is interested in having dresses like Mary and Laura do in the Little House books. (Wilma, patterns on their way to you! Fabric too if you don't mind.)

Logan and Papa

Trying on a dress from Grandma


demonstrating matching father daughter hair styles

Today is the last day of summer art school. Logan asks how soon we'll be able to go back, and I'll get to see her painting and the sail boat she's worked on when she brings them home today. Yesterday she brought beeswax that she had shaped in to a small ball.

Logan has opted not to have her hair cut, saying perhaps after she's five or six she'll do it.

Scapula Tuck

This is a slightly closer up version of the Oncologists sketching on my back. If you click on it you can see an even larger picture.


Close Up of dr's sketching

The shape is because that makes it easier to close the incision again. Did I say that last night? I don't remember. If you look closely you can see the dots out equal distances from the existing scar, showing the skin that the Dr feels needs to be removed. The angles at the edges are to help with closing. I don't even know how long it will take to heal to the point of the current scar, but I'm remembering some lovely pictures I've seen of women with tattoos on their mastectomy scars. I could get a tattoo making the scar into the base of a flowering vine or something, although I don't know when anyone would ever see it, since my shoulders are already usually covered if I'm outside. I guess I could wear a halter or something indoors only. :-)

I'm continuing to learn more about melanoma. I was right that I'm preliminarily at stage 2a, until my sentinel lymph node biopsy is done and it can be determined whether I'm really at "a" or "b".

I'm wondering why the oncologist will be removing such a margin. I think he measured one cm from the scar in all directions basically, but it could be slightly more than that. Between one and two is what the internet research said to expect. But what does that do? Did the melanoma have too-tiny-to-see "roots", or emit evil cancer rays, or what?

I ran in to a page talking about the genetics of melanoma(s). It says:

How common is melanoma?

In the United States, there are about 59,500 new cases of melanoma each year. The risk of melanoma is slightly higher in men than in women. Men over age 50, young women, and teenagers are at particularly increased risk. People with certain inherited traits, including those with dysplastic nevi, with fair skin, who burn but do not tan, and have freckles, blue eyes and red hair, are all at increased risk for melanoma. Although these characteristics are genetically controlled, they are not yet fully understood.

Which led to me looking up dysplastic nevi (turns out to mean non typical moles, like I have!) and says

• If you have a family member who has had a melanoma and you have atypical moles, you should have a complete skin exam each year.
• People with many atypical moles should have a complete skin exam each year. You should also check your own moles once a month. If one mole seems to be changing more than your other moles or is marching out of step with your other moles it should be removed immediately.
• Use sunscreen daily on exposed skin areas.

Note to my mom, dad, Cheryl, and Erin, who may have fair skin or atypical moles or both, please follow up -- dermatologist who you inform that you have a family member with a melanoma, for a complete skin exam each year! Any of the rest of you too - related to me or not, see if you fit the criteria. It puts you at higher than normal risk to have very fair skin; atypical moles; freckles; red or blondish hair; or blue eyes.

And a note on the dermatologist part here, my former general practitioner looked at this mole back in November and told me it bore watching. Then proceeded to never look at it again. If she'd sent me to the dermatologist right then, it could have been removed eight months ago, and I probably would not be having to see an oncologist now, only a dermatologist for close watching. Don't trust your doctor if you have a mole or moles you are concerned about, see someone who really knows about them! I'd had almost all these moles all my life and never had a problem either. This was a new one. But they'll be keeping close watch on all of the rest from here on out.

In the par for the course department, the chest X-Ray that was done one week ago today didn't get to the oncologist or the dermatologist in time for yesterday's appointment. Nor did the blood work. The dermatologist's office now has a copy, or a report, or something on the X-Ray and were trying to find out what had happened to the report for the blood work. I got my first bill today - $150.00 for the pathology on the mole that was removed. The insurance marked it as to be applied toward our deductible. I have a feeling we'll meet that deductible before this is done.

Scar in progress

Stitches at the two week point.


Post stitches.


Immediately after stitches were out.

The appointment with the oncologist went well. The waiting room was packed, evidently Tuesday is the only day for appointments, so they just cram them all in. Someone else we knew from Roseburg was there. A baby was there (with her mother, and I think grandmothers) who was very happy to watch Logan bounce around. We got in around 5 or the three pm appointment.

I saw a nurse, a resident Dr, and Dr Vetto, and another Nurse who did scheduling. The plan as it stands now is to go back on Aug 4, for pre op stuff, and then on Friday the 5th they'll take a much bigger chunk of skin from my shoulder (some people have face lifts, some have tummy tucks. . . I'm having a scapula tuck I think!) And one or more lymph nodes that are the first ones that patch of skin connects to. The lymph nodes appear to be like tiny bunches of grapes, and they will remove one or two grapes from the cluster.

If those test free from melanoma cells, then I'm done except for follow up with the Dermatologist. If they don't, I get more surgery, and something like interferon as well. It will be a week or more after this surgery before the results of the SLN biopsy are in.

I signed consents to be part of a database of cells, and part of a study trying to identify what may mean cancer will be present.

Dr Vetto says that 25% of the people have cancer in their lymph system, the other 75% don't. And it's just wait and see to find out which group I'm in.


ball point on new scar hurts!

Dr Vetto sketched the area he'll be removing for me -- I didn't realize why it was so uncomfortable when he was doing it until I looked at home and John mentioned the line right along the existing scar! Ow! The shape is because it's easier to close the incision that way.

I didn't expect to even post this tonight, but John asked for a head start on going to sleep, so that my snoring doesn't stop him from falling asleep. I figured I should humor him. :-) I'll update this post, or post again in the morning (Oregon time) when my brain is more awake.

Oncologist Today:

Check back tomorrow for what I find out, and if I'm lucky or clever and remember to do it I'll ask the Dr to draw a circle around my current scar to show what he expects to remove. But me posting depends mainly on how late we get home again tonight. Appointment is at 3pm or later (work in), drive home from Portland is three hours. Dinner is likely to take up some time. So I don't know how late it will be or how tired I'll be. For now, in case you need to be entertained while you wait, here is a picture of Dr John Vetto who I'll meet today.

John was able to see the beginning of Logan's Waldorf Art class this morning, and was, I believe, favorably impressed. We talked with another mom on our way out who said her son had tried a Montessori school and it had not worked well with his personality, but that he loves Eugene Waldorf. Another mom mentioned that her daughter (similar size to Lady Logan) had announced that she wasn't going back to her old school because she planed to stay at this one. John and I will go talk to a school administrator today before going to see story time with Logan's class to find out if there is even room in the kindergarten class, if we wanted to enroll Logan.

Goats in the Shower

Well, I was in the shower. From there I can see the barn with a bit of effort, if the trees aren't in full leaf. Or I can see the goats and sheep passing by as they go around the ditch type area that is close to the pasture fence. Except today they'd discovered the ditch type area again and were out there finding more to eat in it. Which was fun to see.

No pictures yet. This is the first week of Logan's two weeks of Waldorf Summer Art Class, which starts at the freaking hour of 9 am, causing us to leave home between 7:30 and 8 to get there and have time for Logan to settle in if she needs to, and not miss any class. Previous to this, on a good day, Logan slept until 9 am. And I wasn't up this early either. Ugh.

The Art Class is a good match with Logan. I stayed better than half an hour the first day, but not because of Logan clinging to me. She settled in and ground wheat with a teacher (her own idea) and then found the corner set up like a small house and started to play. After telling me that yes, she'd come to say good bye soon. After checking in with her once and being told she was very busy but would come shortly, I finally gave up and went to her. At the end of the day (which is 12:30 leaving us half an hour to eat lunch in the car get to swimming class and get Logan in her swim suit and out by the pool), she was disappointed that I was back already. There are two teachers and a dozen or so four or five year olds. Because it's Waldorf, there are pictures in place of words for things for the small children -- the bathroom had a hand washing sign done in lovely graceful crayon, showing a pair of hands washing, and also a dog cleaning its paws. Everything is sized for someone of Logan's size, tables, chairs, logs to put in the wooden, wood burning style cook stove, pots and pans on the cook stove (also wooden), and so on.

I was neither the first nor the last parent to leave on Monday. Some had much more distressed children than I did, I'm not sure most of them could tell which one was my child. I was able to see one of the teachers holding and rocking a little boy who was sad to see his mother go, until he was ready to be out playing (as opposed to when she could have been ready to put him down.) It's a good place. It makes me wish that I thought I was up to making the drive daily for the school year.

Swimming is going well, The pool doesn't use levels the way the other one does, so I think Logan, now in "Advanced Tots" for two weeks, moved up a level after all. But the teacher thinks she's doing fine and is a little challenged, which works well for Logan. The pool would like us to pay $8.50 to be able to stay for rec swim -- $4 for Logan and $4.50 for me, even though I am under doctors instructions to stay out of pools. So we aren't doing that. And while Logan would like to, she also falls asleep on the drive home.

My Monday and Tuesday mornings got filled in with dental work, first identifying two teeth with problems, and then getting one of them repaired. It was the worse of the two, and turned out to have a horizontal fracture. And a vertical fracture. Which are now cleaned and stabilized, and appear to have fixed the pain I was having from chewing on that side of my mouth. The other tooth has a worn spot and fractures that don't need repairing, yet. So I'm instructed to use fluoride gel after brushing, and see if fixing the other tooth takes some of the stress off this one. Otherwise there is a crown or gold on lay in my future. Oh joy.

Today I'll go have blood drawn for the dermatologist and oncologist, as well as the GP who wants to know what is happening with the blood pressure medicine she has me taking. And two views of a chest X-ray will be done. My quiet mornings of sitting in a coffee shop reading aren't happening! And by the time we're home in the afternoons we're all hot, exhausted and grumpy.

More, maybe with the pictures, when I have a calmer moment.

Misc other links

This page has pictures of melanomas (drawings) and what the different stages mean: people living with cancer. (Then part six of the table of contents.) There's also what appears to be a lot of other through information if you're interested in wading through it. I'm doing so slowly.

From my investigation so far, it looks like my appointment on the 26th is a consultation, not the actual sentinel node biopsy.

More pictures of Logan once I get them sized down to fit here.

Skin Cancer risk factors

Risk Factors Info the short version is that risk factors are: people with a light complexion; having had a bad blistering sunburn (ever); a family history of melanoma (this page says a relative with melanoma, another one I saw said a relative with any skin cancer, and some things seem to say first degree relatives like parents, children or siblings, while others aren't specific); and having a weakened immune system.

I was in more than one of those categories -- my immune system has taken a beating just from stress in the last couple years. You can see what your own life stress level is with this quiz, which only scores itself in internet explorer, not in firefox. Or with this quick pictorial one. My score on the first was nearly 500, and it doesn't take in to account things like moving three times due to the fire.

Another page with risk factors for Melanoma is here.

And, if you're interested in the LiveStrong stuff, there's the link to information about it too. There's a 10, 40, 70 or 100 mile bike ride in Portland with them, in September, that I'm thinking I could probably participate in. Well, at the 10mile level at least.

Added later -- Sentinel Lymph Node Biopsy in Patients With Melanoma Heavy duty reading, but looking very informative.

Pictures

"Face in the water, big arms" Note Logan's face isn't actually in the water.


One of the bigger kids showed Logan how to go under on her own though.


Healing stitches as of 7/14/05


me, on our way out to get to swim class yesterday, in purple to make me feel better about the Derm. Appointment later on.

Still no pictures,

Sorry, I just woke up I haven't started formatting them yet. I ended up back looking at a counted cross stitch pattern. I like this one. Don't look at it if you're offended by four letter words. Subversive Cross Stitch Pattern So mom are you back to cross stitching yet?

There's a link to the Lance Armstrong Live Strong foundation, which I followed and started reading about. The cross stitch kit has half it's profits donated to it. It looks like a good place. I haven't been following the Tour de France, beyond knowing it is/was happening.

There's a LiveStrong foundation bike ride in Portland in Sept, and another in Austin Tx in October.

Pictures Eventually

I know I said to someone I'd be posting pictures. But I think I'm going to go to bed without doing it tonight. With luck in the morning I will.

I have skin cancer.

So, my mole, removed a week ago, turned out to be a stage 2 melanoma. This means it was deeper than 1 mm, and that the Derm. Can't deal with it in his office. So in 12 days (July 26) I go to Portland to Dr something that starts with a V, at Oregon Health Sciences University (OHSU) with Katherine, my midwife, leading the way, and John (I hope) (and maybe Logan) in tow. Logan would have to miss a day of Art class and Swimming class, but I'm not sure if there's any other option.

The OHSU Dr is the same one Katherine saw for her breast cancer -- he does breast cancer and skin cancer evidently. So Katherine already knows the ropes, and will get me through this. The Dr will do something involving radioactive dye in the area around where the melanoma was, and then they'll observe to see which lymph nodes the dye goes to, and remove and test those for signs of cancer as well. PET scans have been mentioned, and the Derm. Is going to find out whether there are any lab work or scan type things done before I go to the Portland appointment. I think this all happens at the appointment on the 26th, but I'm not fully sure. If there is no other sign of cancer, I'm done at that point, except for quarterly checks with the dermatologist for the rest of my life. No special meds, radiation, etc. The outlook from this point is an 80% chance of survival at least five years, which didn't sound like bad odds.

If there are other signs of cancer found, they move on to more invasive treatments. The Derm. Estimated that there was a very small chance of this happening - his guess was maybe 5%, but he's not the expert. I suspect we'll find out more from DR. V. Some options may include actually going to one of the places where they study melanoma and participating in studies or experimental treatments, if I can afford to get to them. So, while it would be much better to not have to go that route at all, I like the idea of being studied if I do. :-)

I'm googling for more information, email me if you want links, or at least what criteria I'm using. The links I posted in comments for Cheryl, which didn't post very neatly, are

signs of skin cancer

checking your skin

And, the first page I've found with basic info on what a Stage II Melanoma is. Mine appears to be Stage IIA, but we'll know more after the appointment on the 26th.

Couple Pictures

Ok, comment from Cheryl Ann here and from my mother in email. It just took me a day to get back and set up for more pictures here.

We have what you've all been waiting for, I'm certain, a picture of stitches in my shoulder where the mole was removed! It's not even gory.


five blue stitches, completely out of my sight

And then, for the predictable Logan fans out there, I did resize a couple of her too. She's thinking about having her hair cut, and if we actually manage to do it today, and she actually wants it (since she also wants curls as described in Little House In The Big Woods) I'll put more pictures up.



John took and liked this shot of Logan's face.


Logan dressed herself up for something, it might just have been feeding the goats, and wanted her picture taken.

John suggested I add a picture of what he's been working on this weekend, and the picture should link to Chocolate Alchemy if we've coded it right.


John's chocolate, molded in a Chocolate Alchemy mold!

Friday:

Set up box of things to mail to mom and dad. Set up thing to mail to Katherine. Look at things to mail to Erin and Peg and think I really should do that too, since those date from christmastime. Set up Logan with dry cereal in a cup to eat in the car. Set up iced tea.

Go to swimming class leaving all set up things at home.

Oops.

Logan appears to be swimming like me this summer -- face out of the water at almost all times. With luck John and Logan will go swim tomorrow to set a good example of face-in-water swimming.

Logan did swim with someone else's mother and another person's pool noodle, so she got to do parent/child swim without me in the water. I hung out and knit and concluded that vicodin may not make me tired but it can make me loopy.

Logan found her face paints yesterday, and put them in to use.


It kind of looks like she needs a shave to me.


Someone commenting and telling me they're actually reading me would encourage me to take and post more pictures, as usual. :-)

And in other news

I don't have any new Sutherlin Fire news. I woke up to NPR relating the bombings in London, which sounds terrible, but what I dread more is whether the US Gov will take it upon themselves to try to Do Something about it, which would make an even bigger mess. I wore my WTF shirt today, and not a single person commented -- either none of them understood it or it was just completely appropriate. I dunno.

I had to go see a dermatologist today about a mole that appeared within the past year. He was not at all happy about it, and more or less immediately provided Logan with a bin of toys, and set me up on a fancy chair/table numbed a chunk of my back and removed a slightly larger than a quarter in diameter piece of skin. Ow. I didn't look too closely. The removal and stitching actually was painless thanks to lidocain. And I have pain meds for the next few days, plus the doctors pager number just in case. As well as instructions to stay out of the swimming pool, which will put a crimp in Logan's parent child swim time after class. Perhaps they'll let me sit on the edge while she plays.

I see my GP in one week so she can play with my blood pressure meds. And then stitches come out of my back in two weeks, except that falls in the midst of the time I'll be driving to Eugene every day, so I told them John would do it for me, barring complications. And at some point I'll hear back from the Derm's office on what the lab decides about the mole, and wehther there is more fuss and bother or not.

Sutherlin Fire Update

There's another News Review article or four. I haven't been to Sutherlin yet. I have to go past the mill, or past the detour area tomorrow to get in to Sutherlin. John says he could see smoke rising still from the freeway as he passed on his way home tonight. I keep thinking about all the people who are unexpectedly home from work, and whose lives are being turned upside down by this. I'm not sure what I can do to make a difference yet, but I expect to find some way to help. When I googled for news, this blog came up fourth on the page -- I'd expect more news and less blog, or even more blogs of people who know more than I do. But I figured that might mean folks end up here looking for information. I don't have any. Read the articles. Keep an ear out.

Another News Review article mentions the explosion in downtown Roseburg that happened 45 years ago tomorrow. This isn't at that scale, but I'm betting a lot of people are going to be reminiscing.

Sutherlin Fire

The Plywood Plant in Sutherlin had a fire on Tuesday. It's about 8 miles away from us on the freeway, less as the bird flies. No people working there were injured by the fire, but I am wondering what they'll do for work until the plant is rebuilt. Assuming that it is. I saw the plume of smoke coming back from Logan's swimming lesson today, but didn't hear about the fire until this evening. Some of the photos are impressive.

What's That Smell?

I woke up to the delicate odor of skunk on the wind. (How does it get on the wind? Because Skunks fly with their ears! Logan age three or so.) Ok, sunk is familiar enough, and not unexpected with skunk(s) living around the house. Then the odor shifted to skunk plus, but it was hard to say plus what. Hot plastic? Burning hair? Old firecrackers? A home perm explosion? So I gave up sleeping and got up to see if John had any clue what I was smelling, or whether the great outdoors was melting, or what.

Yes, he could smell it. No he didn't know what it was, although he'd looked out the door to make sure no outbuildings in sight were on fire. I convinced him to walk a circuit of out buildings just to be sure. He reported back that the smell seemed worse in the shop, but he couldn't find any source of it. So we both worried a bit, but couldn't figure out anything to do aside from wait and see.

John went to feed. In due course he reappeared and suggested I smell the dog. Cosmo was acting off, but he's willing to act off when he's come back from running too, so I didn't think much of it. Sure enough, whether he was the source of the Skunk smell we couldn't tell, but he was definitely the source of A Bad Smell. Maybe he rolled in decaying skunk. Decaying skunk in the middle of a home perm. I don't know.

John and Cosmo are now having a shower. No tomato juice since it doesn't seem to be skunk spray on the dog. John suggests we walk Cosmo on a leash so that he doesn't decide to bolt after the horrid, mistreatment that is a B A T H. Since that should keep him from re-rolling in the evil smell, I'm all for it too.

In the process of trying to find something, anything local on line that would tell me what the smell in the air was, I ran in to ORBlogs, and added (or maybe re added) Dreams and Bones. So now, once the listing settles in properly, our neighbors will be able to find us on line, to some extent.

Logan starts summer swimming lessons today. Sunscreen for both of us, and I suspect some water play time after the class. We'll see James and I expect Debbie there, and who knows who else. Since I'm doubting that there will be wireless internet available at the Drain pool, I'll be knitting.

PS: double coated dogs evidently need to be dried twice after bathing. Once only dries the top-most coat.