The pathology results came back on my lymph nodes that were removed - NEGATIVE FOR MALIGNANCY! - no further treatment is needed.

I had my first post-operative appointment this afternoon.  I was unsure if this was just a check-up or the results would be back.  I waited for an hour - this place is always busy, as I've said - and was finally brought in and met by a USF Resident in Orthopedics.  He took off my nasty bandages, asked me a few questions, said the site looked good and that he would go and get Dr. Cruse.  He would double check for the pathology results as they were not back when he checked the computer the first time.

I waited another five minutes and they both came back, said "Hello," and started looking at some paperwork.  When they told me the lymph nodes were negative, I was so relieved - the results had just come in!  I knew there was a chance of a false negative (meaning, the nodes come up as a negative, but the cancer has spread anyway) and he explained to me that there is a 1 to 5% chance of that being true.  At this time, no further treatment is warranted.  I asked if they could run any further tests, but the answer was the same.  I go back in one month for another check-up, and then again after five months, after which I will be referred back to my original dermatologist (the one that decided to send the mole off for tests in the first place - we like her!) and start regular dermatological screenings.  Go see a dermatologist!!!

I can shower as normal, treat the area with lotion, and start scar massage in another nine days.  I will need to trade out my work shorts for work pants, get a better hat, remember to use sunscreen every day, and possibly get some type of sunblocking agent with which to treat my clothes in the wash.  I can start running in a week, which means I miss this Saturday's 14 miles, but I will be good for February 23rd's Gasparilla Half Marathon and certainly for the London Marathon in April.

Many thanks to everyone for their support, kind words, thoughts and prayers.

(Funny) side note: I included a photo of my bracelets from all my Moffitt appointments.  After my first visit, I got home and went to cut the bracelet off and cut my 'Stop Rhino Poaching' one off too.  Oops.  I have since replaced it.  The green one is the surgical allergy bracelet.  10 points to Gryffindor if you know the acronym.  ;)

I had my vitals and blood taken yesterday - I was there 45 minutes before my appointment time and was admitted another hour after that - so, I think they're always busy.  After the wait, I was in and out relatively quickly - I spoke to a nurse practioner about my anesthesia.  Of course, when they drew my blood, I asked about what gauge needles they were using (21) in order to compare with what we bleed the rhinos (23).

Today was my lymphoscintigraphy - a process by which the lymphatic system is mapped through use of a radioactive isotope that was injected into my neck/jawline in four areas proximal to the melanoma.  The needles here were 25 gauge.  After several minutes passed - letting the isotope spread through my lymphatic system - a few five minute scans were taken using a SCENT CT (google failed me on that one) in order to find the sentinel lymph nodes (lymph nodes closest to the site of the melanoma and if my cancer has spread, the most likely to indicate as such).  I will not know if the cancer has spread (or not!) until the tissue and lymph nodes are removed during surgery and tested (I've been told results will take a week).  The technologist marked the two sentinel lymph nodes with blue paint (as shown below).  I then had a 20 minute 3D full body scan - during which I fell asleep...hehe.  This gives a much clearer image...blah blah blah.  I asked questions, but it was a lot of information.

Surgery is tomorrow at 7:15 am.  We have to be there at 5:15.  Yay!  My parents flew in just before my appointment today and we had a great dinner at Gino's.  I'm very glad they will be there tomorrow.  Time to pick out some cute underwear for tomorrow in case a nurse gets curious.  ;)  Who knows?  Maybe I'll meet the love of my life.

I'll post another update as soon as I'm home.

I suppose the alternative title for this post could be "I Had Cancer, Part 1," but that remains to be seen.  My surgery has been scheduled - it will be Friday 1/31 at 7:15 am.  My parents should be getting here on Thursday.  I have two pre-operative appointments this week - one on Wednesday for bloodwork and normal pre-op tests, and one on Thursday for lymphoscintigraphy - a procedure involving radioactive staining of my lymph nodes, so the surgeon can detect those closet to the melanoma site.  It appears to involve multiple stinging injections, so that sounds fun!  In any case, I'm glad I was scheduled so soon and hopefully all goes well and they do not find anything in the removed lymph nodes (though that apparently does not mean it hasn't spread...going to have to ask about this).

Well, it’s not bad news!

I had my first appointment with my oncologist – Dr. Wayne Cruse – this morning at “9am.”  Sara, my friend and co-rhino keeper, picked me up at 8am.  I showed her my newly painted apartment wall and we headed to get some breakfast.  There was a little traffic, but we hit up Panera and headed to the  Moffitt Cancer Center – just a few miles down the road from my apartment.  They have valet parking – invaluable, as the place is enormous and busy.  It felt like we were on the streets of Boston's medical district.  I will bring a camera next time – it’s really quite beautiful.  But, we were slightly late – supposed to be there 30 minutes before the appointment - so as soon as we entered the front door, I asked the receptionist where the cutaneous unit was.  We had an escort show us the way there –though he didn’t quite give us the right directions, we were close.  I signed in, filled out the paperwork 30 minutes later and was finally called to go in just before 10am.  I guess it was a busy day.

So…down to the details.

He told me that my skin cancer is a nodular melanoma and it is 1.95mm deep – an “intermediate depth, not great news, but not the worst news.”  I will be receiving a call from the surgery scheduler in the next few days to schedule my procedure.  He will surgically remove the skin and underlying/surrounding tissue – about 1-2 cm in diameter – and also the sentinel lymph nodes (10-20 nodes).  There will be a significant scar, but he is also a plastic surgeon, so that’s something.  It’s kind of ironic that I got the mole removed because I didn’t like how it looked and now I may have a worse-looking scar – but I believe not having cancer is the better of those two evils.  The removed
lymph nodes will be sent off for cancer screening.  There is a 10-20% chance that they will have cancerous cells (i.e. the cancer has spread) and further surgery (remove all my lymph nodes) and treatment (TBD) will be needed.  This also means that there is an 80-90% chance that the lymph nodes are clear and I will need no further treatment.  For those of you that are like “What the hell are lymph nodes?” – I googled it for you and found this on Wikipedia.

A lymph node or lymph gland is an oval-shaped organ of the lymphatic system, distributed widely throughout the body including the armpit and stomach and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immunity cells. Lymph nodes act as filters or traps for foreign particles and are important in the proper functioning of the immune system. They are packed tightly with the white blood cells called lymphocytes and macrophages.

Lymph nodes also have clinical significance. They become inflamed or enlarged in various infections and diseases which may range from trivial, such as a throat infection, to life-threatening such as cancers. In the latter, the condition of lymph nodes is so significant that it is used for cancer staging, which decides the treatment to be employed, and for determining the prognosis. When swollen, inflamed or enlarged, lymph nodes can be hard, firm or tender.

Lymph nodes are not part of the body's system for handling illnesses stemming, for example, from environmental toxicity or personal injury— those tasks are handled by the liver and kidneys in the former and the muscular-skeletal system in the latter. The lymphatic system is structured to address biological infection by other organisms as well as biological breakdowns/ errors within the same body (i.e., cancer). 
 
So….not sure how they’d remove all of them since they are throughout the body - that doesn't seem pleasant.  It is also odd to find that lymph nodes help combat infections like cancer…but are also possible hosts for my cancerous cells.  But, I don't write this stuff, so...?  I’m not sure what would happen to my immune system if my lymph nodes were removed, but I can cross that bridge if I get there.

There are still a few “What if…”s, but on the whole, it is relatively good news.  I will post an update when I have surgery scheduled.  It should be just day surgery– in and out – and my parents are coming down for it.  I had sinus surgery in 2011 (my 5th one) and they did not come down for that – mistake on my part (I told them they didn’t have to).  I had to wait so long to go in for surgery – I had too much time to think about possible bad outcomes and my parents getting a terrible phone call.   Long story slightly longer…I had a mini-breakdown though I was also drugged at the time, in a state of hyper-emotionality and hitting on the male nurses via the female nurses, so there’s that.  I do think I look good in a hospital gown (pretty much like the image below - I'm in the next bed over) and those little socks they give you are wonderful.