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Wednesday, September 7, 2011

Scary post radiation skin spot

In early August I found a scary skin spot right about where my right nipple used to be..... so in a place that never gets sun but that got a LOT of radiation a couple of years ago. I waited a week or 2, as we had discussed in support group (when you get funky new symptoms, wait a week or 2 to see if they go away or were something non-cancer related before alerting the oncologist.)

I frankly thought my spot might be from trauma, a small well defined bruise-type thing from a poke, maybe.... my nerves were cut during my mastectomy and I don't feel much in the skin of the right side of my chest. I feel stuff in the ribs, but frankly, I'm pretty oblivious about pokes and bumps ..... I always have unexplained bruises, and it wasn't til I was in my 20s that I figured out that I don't in fact bruise that easily.... I just ADD all the trauma! (Sometimes I walk into doors and actually THINk to myself That did not just happen! and then I edit it out.... and then I really forget!!

But when it didn't go away in a week or two I showed it to Alan and he looked alarmed, which got me really worried..... so the next day I sent this email to my radiation oncologist, who I hadn't seen in a good while (almost a year - since the cellulitis, which he dx'd.)

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I have a large discolored spot I'm concerned about, just above my mastectomy scar -- in the area that was radiated. I noticed it maybe a week ago and was thinking it might be a bruise, because it's so large and appeared out of nowhere (and in an area where I'm numb, so wouldn't notice if I poked myself.) However, it's still there, and my husband doesn't think it looks like a bruise. I was thinking I should see a dermatologist, but my husband thought it might make sense for me to have you take a look at it first.

The spot is ~3-4 mm, irregular, spotty, red, and a little bit raised. It's just under 1" to the left of my top tatoo dot (to the right of it from your POV as you look at me.) Would you like to take a look at it? Maybe you'd be able to get me in to see a dermatologist more quickly than I would myself, if you think it looks concerning.....

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This miraculous doctor answers email so fast that when I didn't hear from him within a couple of hours I knew he was out of town. I called G-town and sure enough.... so I scheduled a derm appt for just before I left town....

I guess I should back up and explain what was going on at the time...

All this was happening in the middle of my LIFE of course..... We were getting ready to drop Matthew off at UVA on Friday 8/19, which was, um, kinda surreal. (He seems happy though. And it's not halfway across the planet, which is nice for us.) Em and I had planned a road trip starting the following Monday. (Alan couldn't take time off work to come -- if he wants to have time to do the family Christmas. I felt a little bad about it but he actually sounded happy to have the time to himself. Said he'd defrost the freezer and give the dog a bath. Hey whatever blows your hair back.... I do have to say, Pinky smells NICE! We were getting to the point where we were thinking we'd have to change her name to Stinky...) Anyway Em and I traveled first to Ithaca and then Boston -- and back in time to spend labor day weekend with Alan before Em started High school.

We ended up having to delay our trip start til Tuesday so I could see a derm first, in Bethesda, and we left from there. By then the spot had faded to a light benign looking age-spot-type thing with regular edges, and I was thinking it probably HAD been trauma.... So when the derm said it was benign and due to radiation changes I was already unworried about it.

But when we were in Ithaca it got dark and scary again. WTF??? It was dark for a good week or so and then it faded again (mustabin when we were in Somerville) and then it came back again. Who ever heard of THAT??? By then my radiation onc had returned and answered my email and asked me to come in, so I planned to come in on Tuesday -- yesterday.

Well I still don't understand exactly how he knew it was benign..... but the doctor's relief was so palpable -- and I trust his judgement -- that I guess it must be benign. He was laughing and happy and kept congratulating me..... (It must suck to have to give someone a bad diagnosis..... I remember well having to give people HIV+ results....) OH yeah and did I mention, he had asked me to call his scheduler and schedule a visit with him, but I hadn't - I was waiting to make sure the spot stayed dark and scary, and thinking I'd call Tuesday am. But instead the doc emailed ME on Monday night and asked if I was coming in, and what time. I guess he accessed his schedule online, because when I came in I had a bona fide appointment.... What a guy! (Now if I could just get my medical onc to do email -- or even answer calls. The nurse answers calls and she's good, but sometimes it's a multipart question for the doctor, and then she says "Do you want to come in and talk to him about it?" and sometimes I was just THERE, so NO.... Anyway, that's another story, and not as nice as this one.)

Anyhow about the funky spot -- I had really been hoping to have it OFF because I don't want to repeat what happened with my breast cancer (negative mammogram in 2006, negative mammogram in 2008 -- followed by a diagnosis of stage 3 cancer, and BTW I probably had it for 8 years, and most definitely during both mammograms.... my breast surgeon has shown it to me on the old mammos and even I can see it now....) On the other hand, this doctor is really good and they are likely to be more careful with me because of my history of cancer.....

Anyhow.... at this point if I really want it biopsied my radiation onc wants me to see my breast surgeon to take care of that. THIS I hadn't thought of, but because the spot is in my no-lymph-node area, it's better to have HER (breast surgeon) do it than a dermatologist..... Anyway I have to think about that. Not sure if I will schedule an appt with her for sooner or wait til i see her in December....