We had the surgical consultation with the plastic surgeon this morning and I think it went as well or better than we expected. I really like and trust the surgeon and he was clearly committed to making sure steps were taken ASAP. In fact, we are moving even faster than I had anticipated, which is good. We didn’t learn much more about prognosis, etc., which I had expected, since we won’t know how big the actual lesion is until they do the surgery to find the edges of it (all we know is that the original biopsy did not get all of it), and we won’t know if it’s spread to lymph nodes until then either.
Long story short, we have the surgery scheduled for next Monday, May 2, although we still don’t have a time yet. I have several other appointments tomorrow and Thursday to prepare for the surgery.
Tomorrow, they’ll do what’s called a lymph node mapping where they inject a small amount of radioactive dye (which is less dangerous than just being outside in Colorado) near the original mole, and then they will do some imaging to see which lymph node the dye goes to. On the surgery day, they will take out that lymph node and check it for melanoma cells. This is WAY better than the alternatives, which included waiting until the baby was born to do the procedure, or else just going in and looking at ALL the lymph nodes in that area (in the cheek near the facial nerve, which controls facial muscles, and in the neck). No thank you.
On Monday, I will be put under general anesthesia (safe for baby, they do this all the time), and they will do what’s called a “wide local excision (WLE)” to take out ALL of the melanoma in the original site. This will tell us how deep it goes, which will tell us a lot more about prognosis. Let’s hope they’ve already gotten most of it, because that would be great news. Because of where the mole is on my right temple, just below my hairline, there isn’t a lot of skin to be able to pull together to close the incision. So I will also be having a skin graft from skin taken from behind or in front of my ear (unexpected news, but a small price to pay). At the same time, they will go in and biopsy the “sentinel lymph node” that was identified in the lymph node mapping I am having tomorrow, which could be in my cheek or neck.
After that, I get to wear some kind of attractive head gear which will compress my skin graft against the old skin to encourage better growth. I think it’s going to look awesome. I’ve had lots of recommendations for Kate Middleton-like fascinators or other cute hats, but we’ll have to see what it looks like before we can appropriately camouflage.
Thankfully, my mom is able to fly out this Saturday to be here for the surgery (and the week after, since she is staying in town for my shower on the 7th!), and Peter has been able to take time off of work as well, so we are doing well. My work has also been wonderfully supportive, which is great with all of these unexpected appointments.
Other good news: I got a copy of my pathology report from the original biopsy, and with the help of Dr. Google, I’ve been able to decipher it and have found some moderately good news (i.e, not bad) news in it. One, the original growth was 1.02 mm thick. Less than 1 mm is very good, and since we know they didn’t get it all, I’m not in that “very good” category, but at least the original wasn’t 2-3 mm or more! (The deeper it is, the less-good it is). Two, there were cells present that indicate my body is trying to fight it. Not a ton, but more than none! And finally, they found cells that indicated a “low” rate of cell division (2 per mm2). Less-good than 0, but much better than “high” which is 6 per mm2 or more.
So now we have our plan, Stan, and all that’s left to do is go to my bajillion appointments and pray/hope/send good juju that we’ve already gotten most of it and that nothing has spread to lymph nodes.
Thanks so much for all your love and support! It truly helps us keep going!
Shannon and Peter