See Your Dermatologist

May 28, 2019

See Your Dermatologist

dermatologist

Mark Rubin

I fell off the “every six-months dermatology appointments schedule” in the spring of 2018. My dermatologist and I can’t figure out what happened. Regardless, she and I did not meet up for about 18 months.

I’d been a faithful patient for years. I’ve lived in Tucson since 1961, spent my formative summers burning and peeling in pools and on tennis courts, and I have had at least a half-dozen dysplastic nevi removed. ‘Tis a race, between me and the melanoma, and this month I almost lost the race.

I get an annual physical. Lots of old-fashioned stuff like touching toes. Can’t. The reflex hammer. I wish I knew good from bad, when it comes to responding. Touching my nose. Easy.

There’s also a review. Did you do this? That? The appointment comes soon, and for reasons I wish I better understood, I thought fleetingly about not having had my skin checked, and about my doctor asking. Then, days later (on May 6), the thought revisited my consciousness. I called the dermatology office. “May 9 at 3:30.” Pure luck!

On May 9 I stopped in. New office. (Only open for almost two years, but new to me.) Very efficient place. I figured I’d be in and out in 20 minutes, with time to swap travel stories and plans.

In a few minutes I was being examined, from the head down, with what seemed like lots of attention to my head. One place in particular! Then, more people arrived, including my doctor’s partner. Ever had that sense that what seemed simple isn’t? Even a little.

The thing got removed, with assurances that it might be just a mole with a hair follicle, making it look bad. Or more, but surely nothing to worry about. Right!

Well, on the 15th I got the call, late in the afternoon. Melanoma, but just a little bit. Don’t worry! Top layer of the skin only. Really, don’t worry! The plan? Come on the 20th, my partner will cut away the center, along with margins, and we’ll let the lab review everything. If we need to take more, we will take it on Tuesday; either way, you’ll get closure—literally, the wound will be stitched shut—on Wednesday morning. Along with a few more “don’t worries” was this message: the closing will hurt more than the tissue removal.

Leigh came along Monday to observe and support me. She rocks!!!

I did us proud, I think. (It helped that the doctor described a roughly centimeter-square something. I assumed the measurement described the expected evacuation site.) I got bandaged up, went home, did some work, and worked more on Tuesday.

Late Tuesday my doctor called. Clean margins; all gone. “So minor, I wish we had a name for it other than melanoma.” Don’t worry, really!

“Can I see the wound,” I asked, after I got settled in on Wednesday morning. Big effing mistake! A square centimeter equals about a sixth of an inch. My wound? The size of a quarter. How deep? Two-bits, four bits, six bits, a dollar. Four quarters measure about a quarter inch, which was the wound depth.

Closure recalled a too full suitcase, where you must bring together the two sides to get to the end. Lots of poking (numbing agents), tugging and pulling, and stitching. Some Xanax, too, which helped. (The doctor, describing Xanax, asked me if I’d had a half a glass of wine before. “No,” I responded truthfully. After a bit of back-and-forth, she got the real picture.)

Last week seems blurry. Drugs. No alcohol. Lots of sleep. One butt-ugly do up top. But … I feel luckier than I can imagine. Why?

I faithfully watched my skin for decades, but I slipped up. Why did I think about the dermatologist? The second time? How did I score an appointment three days forward?

Then there’s insurance. Yes, I will pay most or all of the cost due to a high deductible, but many among us face Go / Don’t Go decisions routinely, because in the Richest Country the World Has Ever Known, too many people must choose between health care and other basic necessities like food and shelter.

At least for now, a barely-there melanoma has gone to its final resting place. Imagine, Leigh and I have noted, if I was dealing with the post-closure pain and a bad diagnosis with lots of treatment opportunities, or worse. (Melanoma treatments have improved markedly in the past few decades but it’s not a disease you want to deal with.)

I’m blessed to have Leigh, who helped me through what seems, with hindsight, a little bit silly. (I guess I’m a cancer survivor, but using that label insults people really challenged by it.)

As the new week arrives, I’m wearing hats, always. And sunscreen, which came with a monitor to make sure I’m using it. There will be a challenge for my hair stylist soon. Lots of work to get caught up on. And, finally, a message: See Your Dermatologist. Don’t wait. Call now!

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