Breathing Easier in the Mountains

Well, I’m sitting in the mountains of Vermont and the cool, fresh air feels amazing. And I’m breathing a little easier because I got a call from the dermatologist’s assistant telling me that my biopsy came back benign. I can tell you, I was really sweating during the waiting period. It is a relief to know that right now, I’m in the clear.

I’m super excited to be able to cross off the 48th state off of my list too! As soon as I get off this conference call, I’m going to go out and explore.

Thanks to everyone for the well wishes. It meant a lot to me. And now, I get to celebrate my birthday without any looming dark clouds hanging over my head…

Bullet Hole in My Back

Well, I had my appointment with the dermatologist yesterday and as you may be able to guess from the title of this post, I didn’t get to walk out of there without more bits of my skin going off to pathology.

When I got into the exam room, the assistant asked me if there were any spots of interest they should closely look at. I told them that I had one on my back, on the shoulder blade area that I hadn’t noticed until just a few weeks ago. But it might have been there previously and I just didn’t see it since it’s in a blind spot unless you position yourself just so in the mirror. She looked at it and then left the room. A few minutes later, the doctor came in and said, “what’s with this spot on your back”? I told her that I had just noticed it but it could have been there all along. She got very quiet while she hunched over the spot. And then she started speaking in jargon to her assistant, measuring it, peering at it, and then the iPad was in my face to sign off on another biopsy.

So, I got to flip onto my stomach and get jabbed with the needle for the numbing medication before the doctor came back in to slice it off and stick it into a jar. There was no more joking around. The environment in the room was really thick with tension. The doctor and her assistant went into the nurse station right after but I could still hear murmurs of them talking… “suspicious”, “her arm pain”, and “see if we can expedite”.

(Side note, my arm on that side has been giving me some problems for the last few weeks, to the point that I can’t rotate it behind me – do you have any idea how much you need to do that to put a bra on and take it off? I figured I just aggravated it somehow; but now of course, I’m freaking out that there is something else behind the pain I’ve been experiencing. I have an appointment with an ortho to get it looked at tomorrow – but now I have a bandaid on the shoulder blade of that arm, which I’m sure the ortho is going to ask about – and I have no answer to give him.)

So now, I get to wait on pins and needles for the results to come back. Naturally, my doctor wouldn’t say anything about what she thought it was. And my amygdala gets to run rampant conjuring up worst-case scenarios until I get the results call, which will likely happen while I’m up in Vermont next week… cross your fingers for me to get good news.

Counting Down…in more ways than one

So, I have my every-6-months follow up appointment with the dermatologist this week. I already wrote about how stressed I am about this one, mostly because I am paranoid. I have no reason to be, but sometimes my amygdala likes to hijack the rational part of my brain.

I’m also counting down to my upcoming birthday. Unlike most people over the age of 23, I actually look forward to my birthday – even before the appearance of my pink spot. Instead of mourning that I’m no longer young, I choose to look at my birthday as validation that I’m awesome for making it another year. And honestly, not having children, I’m not reminded every day of how old I’m getting. In my mind, I still feel 27 (which was a very good year for me). With my resurgent focus on doing stuff for me, I still travel independently, go to concerts, go out with friends for happy hours, and generally behave like someone who’s not entirely a responsible adult (although my bills are paid like clockwork, I rarely call off work, and I am hyper about wearing sunscreen)…

For my birthday 2 years ago, after I got my Loki cut out, I went ziplining. That birthday was one of the best I had had in a very long time. And I decided then that I’m going to make my birthday an excuse to really concentrate on things I want to experience. Last year, I decided to cross a few states off my dwindling list of I-haven’t-been-there-yet and did a combination of Seattle/Mt. Rainier/cross-country train journey. Well, this year, I decided that I want to cross off one more state – my 48th… So, I’ll be headed to New England where I’ll finally visit Vermont. And since it’s really close, I’m also headed to Montreal to revisit a favorite (I know, I know, I don’t normally duplicate but since I’m going back to London in a few months, might as well revisit another). And then before heading back home, I’m going to meet up with a friend in Boston. It sounds like it will be a fun trip and it will get me out of the 100 degree weather we’ve been experiencing here for the last month or so.

I know some people dread their birthdays. But I’m definitely not one of them.


One More Reason for Radon Detectors

You may have heard of radon. It’s a colorless, tasteless, odorless gas – meaning if it’s around you, you really have no way of knowing it’s there without a detector. Why do you need to be concerned about it? Well, for one thing – it’s radioactive. It’s on par with plutonium in that it releases alpha particles. (I know way too much about the types of radiation thanks to a previous job for a company that makes radiation detection equipment – don’t even get me started because I turn into radioactive Rainman…remember, science nerd over here.) Anyway, alpha particles interact strongly with matter and while a piece of paper can stop the path of an alpha particle, if it gets ingested it can cause serious damage. Breathing in alpha particles (like those that radon releases) can severely damage lung tissue. In fact, radon has been shown to be the second leading cause of lung cancer in the United States.

I can hear you now, “but Nicole, this is a blog about skin cancer…why do you make us read your ramblings about radon?” Well, dear readers, a recently published study suggests that residential radon exposure increases the risk of developing malignant melanoma.

Swiss researchers analyzed 1900 deaths caused by malignant melanoma between 2000 and 2008, in patients 20 years and older. Why the Swiss? Well, Switzerland has the third highest incidence of malignant skin cancer worldwide (a fact I did not know until today). And it has increased significantly in the past few decades.

Taking into account housing characteristics and the geological conditions of the area, the study analyzed the total population of the country and modeled the effects of radon for every single household. (I cannot imagine the math involved…) The study’s author Martin Röösli said, “Our study shows that, when radon decays, radioactive alpha particles not only destroy lung tissue but can also affect the skin. This has rarely been researched in the past.”

The other disconcerting discovery – the younger you are, the greater the impact of radon on developing skin cancer. The study’s author didn’t suggest a mechanism, but suffice to say that radon is shaping up to more insidious than even imagined previously. How do you avoid radon? Well, really you can’t without leaving the planet. Radon is a naturally occurring gas due to the breakdown of certain types of rock. It can also be found in well water. Test your home to see if you have a problem. One in 15 U.S. homes have higher than acceptable levels of radon (and apparently the Swiss have a big issue as well). It doesn’t matter if you have a brand new home or a historic property. It primarily builds up in the soil under the home, although it can also dissolve into groundwater or well water – meaning if you use well water, you could be introducing radon into your home every time you turn on the faucet. If you find that you have radon levels that are high, there are a ton of websites that will tell you how to mitigate in your home if you are handy, or provide information on getting a reputable contractor if you’re not.

So, if you needed a reason to check the radon levels in your house, your lungs and your skin will thank you. (And those of your family and pets too!)

Saving the Lymph Nodes

A recent study shows that the standard procedure of removing all of the lymph nodes located near a tumor actually doesn’t help melanoma patients live longer. Ordinarily, if a patient presents with melanoma in a lymph node, some doctors would opt for a procedure called completion lymph node dissection, which basically means all of the lymph nodes near the affected one would be removed as well – even if there were no melanoma cells present in those locations. (This procedure was way more common before the sentinel surgery option became more widespread.)

The patients who had completion lymph node dissection usually had it to see how far the melanoma had spread, which is an important consideration. However, it didn’t help survival rates; and nearly 25% of those who had the surgery had complications as a result.

This study is helpful because it demonstrates that the sentinel node biopsy option is safer and just as effective as completion lymph node dissection for most melanoma patients. The sentinel node biopsy procedure involves injecting tracer material so surgeons can see which are the first lymph nodes that the tumor drains into. They then remove only those nodes for further dissection. If those nodes don’t show cancer, then further surgery and lymph removal are not necessary.

Because melanoma (in addition to some types of breast cancer) often migrates to the lymphatic system when it metastasizes, knowing whether or not it has spread is important for doctors and patients to determine the best course of treatment. But it’s great that patients don’t necessarily have to undergo a more invasive surgical procedure to find that information out. Any surgery has the potential for complications and the more invasive a surgery, the higher the risks. Being able to reduce the impact on a melanoma patient’s body is one more way we can help people heal quicker.


No Really, Thanks for the Chemicals

I live in a condo in downtown Austin, which most of the time is awesome. The view is amazing; I’m close to a bunch of restaurants and bars; I can walk to Antone’s – a really cool intimate blues club – to see amazing and under-appreciated musicians perform. The building I live in is undergoing maintenance and yesterday, that caused a significant problem. They were spraying unknown chemicals on the exterior of the building right by my balcony, and more importantly, right by the vent that vents my entire condo.

I left for work smelling it. But when I came home from the office, it was overpowering. To the point of my throat closing up, my eyes burning and watering, a massive crushing headache forming, and a wave of intense nausea. I had to stagger out into the hallway, where I practically collapsed on the floor.

I called the general manager of the condo building who, of course, was already gone for the day. Long story short, I lost my temper – which happens on the same frequency as solar eclipses – and told them that if they didn’t pay for a hotel room where I could sleep without inhaling whatever the hell it was, I was going to call EMS to have them bring out the HazMat crew and then first thing in the morning, pay a visit to one of the myriad of attorneys that live in the building.

And of course, I then lay awake in my hotel room stressing about leaving my cat in that environment. She wedged herself under the bed and refused to come out. And she’s not ever happy about being picked up in the best of circumstances so reluctantly I left her there (and then beat myself up for being the worst kitty mom ever). I’m so worried that my kitty is going to have lasting effects from this (this morning she was eating but seemed really lethargic and did not want to be too close to me). I got very little sleep because I was seething. How it is legal to expose people to chemicals like that without even advance warning? Particularly since they admitted to me that they were concerned about the fumes of whatever the hell they were using but figured they would go ahead with a test – yay me, getting to be the guinea pig.

And of course, I’m really concerned about how my body might react to having this in my immediate environment. Let’s be real, my body already can make cancer. I don’t need any assistance through additional chemical exposure to make more. I’m over here trying to be healthy-ish and prevent more scars. And here my home has been basically contaminated by something I am still fighting to get the MSDS to see exactly what that was. Every soft surface in my condo has absorbed that smell (meaning I have a ton of laundry I have to do in my future – after I figure out how to get the smell out of my dryer since that vents directly where all this crap was sprayed). I’m so incredibly frustrated by this entire situation. And this is exactly what I didn’t need since I’m already freaked about my upcoming dermatologist appointment…

Another Skin Check Coming Up

So, I’ve got another skin check coming up. This one will mark the two and a half years since my excision. For whatever reason, I’m actually worried about this one.

On one hand, a “nothing to worry about” result will give me more peace of mind, I think. I’m halfway through to the five year mark and that’s a pretty big milestone. On the other hand, I’ve got a concern that I won’t have a clean visit. I have no idea why. I’m not stressing about any random marks on my skin. And I don’t know whether that’s because there really is nothing to worry about or hubris. I wrote right after the excision while I was waiting for the results about straddling the line between paranoia and hope; and I’m feeling the same way right now.

But I guess it’s the thought that I’m almost halfway to the “all-clear” mark. At this point, I’m worried that I’m going to get close to thinking that this thing is beat, only to have something rear its ugly head. (And I think it would really suck to be at four and a half years and get the diagnosis again.) But on the other hand, even after five years – I will still have an increased risk and will still need to be vigilant. So, it’s kinda pointless for me to be stressing, right? So my brain needs to get on board with this zen thing…