Surgery - Friday

This morning, my husband and I met with my surgeon for a consultation. I didn't see the need for a consultation. I just wanted the darn thing out already, but that's not how they operate (pun intended). I imagine it growing on and in my skin like a well-watered Chia Pet placed in the sunniest window of your home, even though mere days probably don't make the biggest difference. Thankfully, they can see me this week and and I'm scheduled.for Friday.

My melanoma depth is 1.37 mm and we learned that anytime it is over 1 mm in depth (for some surgeons, the threshold is anything over .75) they need to biopsy the closest sentinel lymph node to see if the cancer cells are already in there. This crushed any of my "we caught it early!" hopes. We didn't catch it early. And while I try to refrain from using foul language in my writing, who knows how long that bastard has been growing there on my back, undetected. Over the past few days, I have spoken to a few people who have either had melanoma or know people who have, and all are alive and well. But I have yet to hear from anyone whose depth was like mine, or deeper. Most were surface level, and removed in office.

I'm not saying that there are no treatment options if it has spread, but the survival rate is poor even with treatment.

If it has not spread, prognosis is good.

So there is a lot riding on this. It really is a matter of life or early death.

My next appointment is the day after tomorrow, Wednesday at 3pm, for a whole body PET scan. We should receive these results the following Monday the 9th when we meet with my oncologist. The scheduler expressed empathy for my diagnosis and was explaining what to eat the night before and day of (protein, but nothing after 9am). I was dutifully taking my notes, and wrote down that it was at the "Advanced Technology Pavilion" on the lower campus of Hoag hospital. "Oh, is that by where they do the gamma knife surgery?" I asked? "Yep! Same building!" She responded, and I just unexpectedly lost it. I could barely compose myself enough to thank her and quickly get off the phone. That's where we took Mom for her gamma knife procedures. I'm going to the same place that I took her to. Without her.

That's the thing - I can be doing (relatively) fine and something unexpected triggers sadness. Or anger.

My thoughts go to the worst so often, even when I'm trying  my best not to let them. One of my current favorite things to counter them with is planning for Autumn's 1st Birthday party. This has been working, as my husband was kind enough to let me order us our matching outfits for her party and a lot of the decorations on-line. But the thoughts still creep in. Like when I was pulling into the parking lot of Hobby Lobby and thought "What if this is the only party I ever plan for her?" I had to sit in the parking lot for a good ten minutes before I could compose myself enough to go in.

Displacement of anger has also started coming out at unexpected times. Just because I have the training to recognize that's what it is, doesn't mean that I can stop it from happening. But it does help me get it in check. Just having learned that sugar feeds cancer cells a few years ago, I was livid after I left Starbucks and found out that my unsweetened passion fruit ice tea that I ordered was loaded with sweetener. Two illegal u-turns later, I was really upset with the person behind the speaker. But it wasn't their fault. By the time I made it to the window for the exchange I just sat there, Can you imagine what the employee thought? Jeeze lady, it's sweetened instead of unsweetened, get ahold of yourself!

This coming Friday, I check into Hoag and will be given radioactive liquid to drink to help them map out and find my sentinel lymph node. It sounds like an involved process that can take awhile. Since the radioactive dye is invisible, my surgeon said that he will then sometimes use a Geiger counter or blue dye. Once that biopsy is complete, they start on excising the skin on my back. He said they take a lot, and sometimes grafting is involved. I asked if he takes into consideration the patient's wishes to take even more, and he smiled and said yes, he would remove more.

I'm trying to increase my faith during this time because I so desperately need it. I'm also trying to be in the moment with Autumn, which of course comes naturally to her; what babies worry about the future? Seeing what a joy she is becomes hard because my thoughts again turn to not wanting to leave her as a young child. We had a busy weekend, but made time for mass, and I emailed a priest from St. Michael's Abbey who gave the Mass and I really like. He said that he can meet with me and also perform an anointing of the sick.

Though I do not currently have a positive attitude, my husband is being incredible and tomorrow is a new day. This is by far the toughest trial I have ever faced. But it's not as tough as what Mom faced, and I have her toughness in me.

"We rejoice in our sufferings, knowing that suffering produces endurance and endurance produces character, and character produces hope." ROMANS 5:3-4

I Have Cancer

I have cancer. Melanoma. I'm still reeling from the news I received just over 24 hours ago. For the past two mornings, I have just a few seconds after waking when everything is okay. And then it hits me: I have melanoma. Has is spread? We don't know, and won't for a few weeks.

Nuclear war, Trump becoming president (or, Hilary, depending on your political affiliation), bankruptcy, divorce, unemployment, earthquakes, all pale in comparison to the fear that even just the word cancer evokes. Not that those events aren't worse - certainly nuclear war or earthquakes are, but they're so abstract, so distant. When you're told you have cancer, it is inside you. Growing and spreading.

Many of you reading this have been touched by cancer in some way. Some of you may be survivors, or are close to those that are. But even when it has already invaded your family, or you have come face-to-face with it yourself, it still has a way of bringing you to your knees when you're told you have it. Or that it's back. Maybe even more so, because you have seen first-hand the destruction it causes, especially when it has killed someone you love so dearly.

A week or two ago, I had an appointment with a new primary care physician. As part of my exam, she looked at my moles and thought three looked a bit atypical. Most likely the basal cell carcinoma that I've had taken off, cut out, or frozen a few times. She removed one on my left breast, my calf, and my back. None of them looked too concerning, she said.

On Thursday, as I had just picked up Baby A from daycare, I received a call from my doctor's office, and they wanted me to come in for the results of my biopsies. A bit annoyed with what I figured were just the new office's procedure to inform in person, I said "Can't I just see her on Monday when I have my stitches removed?" No, she needs to see you. "Well, I've had skin cancer before (basal and squamous cell carcinoma ) so I'm okay with being told over the phone." Still, they insisted I needed to come in.

I began to get worried, and my husband called them to see if we could drive down right then, instead of waiting a day. I wouldn't be able to see my doctor, but there was a doctor who could see me. I'm going to be upset that they made us drive down here just to tell me its basal cell, I told my husband.

When we were called back into the room, nothing prepared me for being told I had melanoma. Knowing that it was one of the worst cancers to have because it is so fast-spreading and aggressive, I was speechless. Just a few years ago, my husband and I and I attended a wedding and sat at a table with a couple in their late 20's. And I knew she had since died, from melanoma.

The doctor I had never seen before reached out and held my hand. "I'm so sorry" she said. I looked at my husband, who had a look of shock on his face, and then as if she understood, my sweet baby began to cry.

Questions swirled in my head: What stage? Had it spread? They don't know. This was just a biopsy. All they knew was that it was melanoma, at a depth of 1.3 mm. Not just on the surface. There was talk of a referral to an oncologist and a surgeon and then I really knew it was serious. Oncologist. They treat people with cancer. This isn't just removable. It could have spread.

Tears started falling down my cheeks as I asked her to give me a check again, for any moles she thought might be suspicious. Was there anything the other doctor missed? As she did this, my thoughts immediately turned to my daughter. To this precious girl, who just a few days prior, I realized I had fallen even more in love with than when she was born. I thought I was too young to loose my Mom just over a year ago....what if she was going to loose me before she even had a chance to form any lasting memories of who I was?

We left the office in shock and started making phone calls to family. Everyone says to stay positive and that it probably has not spread. They're probably right. But the fear and the idea that it could have is so gigantic that it dwarfs any "we've got this" ideas. It is also the fear of the unknown.

That night, my husband started calling our insurance and looking up the doctors who I was referred to. They had both graduated from USC and were affiliated with Hoag. Although I'm sure USC turns out some average doctors every once in awhile, it was somehow reassuring.

I played with my now 9 month-old and gave her a bath. I thought interacting with her and seeing her happiness and smiles would help. But it filled me with such joy that the possibility of loosing all of that seemed sharper. Her happiness made me more sad, and tears streamed down my face as I smiled at her, and she smiled back, flashing that beautiful dimple.

I awoke at 3 am for no apparent reason and it hit me all over again. Although I have no sick time left due to taking time with my baby, I chose to go to work rather than sit home all day with my thoughts, webMD and Google. I tried to stay busy and am pretty proud of the fact that I made it through the entire day without one tear. Being an 11 or 12 year old student and going in to see your counselor for help, only to find them sitting there crying is like being at a kid's party and finding the clown sitting in a corner, crying. But I felt like that clown. My smile was painted on but inside I was dying.

My husband and I had carpooled and I drove to his school less than two miles away. He was waiting out front. I parked and gave him the longest hug, the kind of hug you give someone when they return from a long trip. And all the tears I had been saving up came out.

He had worked very hard that morning securing appointments for me, and started to fill me in on the ride to pick up our daughter and head back to my doctor's office. Most doctors' first available appointment was mid-March. Can you imagine? But he was able to secure an appointment for me with a surgeon for Monday morning. Unfortunately, it is just a consultation, and then they will schedule the surgery. One week after that, I will see the oncologist, who needs the results of the surgery to come up with a game plan. They will also order a PET scan, which will show if the cancer has spread anywhere else.

Melanoma can spread through the blood. So it can pretty much go anywhere.

We drove to my doctor's office and were able to see my doctor, who had removed the malignant melanoma. We were anxious to know what the mole she removed looked like. You hear that melanoma is dark black and irregularly shaped. Nope, not mine. She said it did not really look suspicious, and was not black. In fact, the mole on my left breast which came back fine, looked much worse.

This was a game changer for me. Hoping this melanoma mole was something "new" that we caught early, I asked her if Dr. Lee, (the dermatologist who had been checking me twice a year) would have detected it. "Probably not. It just looked slightly atypical, and most dermatologists just watch and see if moles change in size or appearance before removing them." Bewildered and scared, I asked her: "Why did you remove it?" Because I am a cancer survivor (breast) and I am not conservative when it comes to mole removal. If it looks slightly questionable, I take it out.

Searching for hope and reassurance, I asked her "Does the fact that it didn't look bad, or wasn't big mean that we caught it early?" No, not necessarily. My heart sank.

Suddenly, all my moles started to become concerning to me, since this one was melanoma and didn't look that bad. Also, it had clearly been there awhile...since surface melanoma can be removed in office, with no need for a referral to a surgeon and oncologist. God, I hate that word. She agreed that all my moles should be removed and sent for testing, and took 4 additional ones off right then, with plans for me to come back every three weeks until they are all gone.

We didn't get home until 7:30pm, and missed our nightly walk and Baby A's bed-time. While many have shared with me that they know someone who has had melanoma and is fine, I now realized that most of them had it on the surface. It was not 1.3mm deep, and they did not have to be referred to a surgeon and put under anesthesia for the procedure. My doctor told me that skin grafting may even be necessary.

If keeping a positive outlook and attitude could kick cancer's butt, my Mom would have done it. It helps you get through the day, sure, but the cancer cells don't know any different. My outlook currently is not positive, and I am scared to death of leaving my little girl. Even if my husband remarried, which I hope he would, this new person just couldn't love her like I do. I hate that this thing is growing in me right now as I type this, and putting out "roots" as  my doctor described not just below, but ones on the surface of my skin, that you can't see. It also can travel in the blood. If I could cut it out myself today, I would.

It is for this reason that I have decided that I want chemotherapy no matter what. The best case scenario is that they operate and tell me that they got "all of it." And then the PET scans show that there currently is no cancer anywhere else in my body. But guess what? Even in that best case scenario, the malignant cells could be still traveling in my blood, just waiting to find a new home. Like my liver, or my lymph nodes. Those are not detected by a PET scan. That is why even if the PET scan ends up being clear, I would still be told to repeat it every 6 months for 5 years. That is why cancer survivors are not really "in the clear" until the 5 year mark.

And that is why I am going to do chemotherapy and fight this as aggressively as possible. Even if insurance won't pay for it, and even if it means we cannot have anymore children. I want to be around for this girl, and I want to see her grow up.

UPDATE: I was given the wrong results. Read more here.

Tabula Rasa

Tabula rasa is a Latin phrase often translated as "blank slate" in English and originates from the Roman tabula used for notes, which was blanked by heating the wax and then smoothing it. 

Tabula rasa refers to the epistemological idea that children are born without built-in mental content and therefore all knowledge comes from experience or perception. Proponents of tabula rasa generally disagree with the doctrine of innatism which holds that the mind is born already in possession of certain knowledge. Generally, proponents of the tablua rasa theory also favor the "nurture" side of the nature versus nurture debate when it comes to aspects of one's personality, social and emotional behavior, knowledge and sapience.

What am I do after her 1st birthday when I can no longer post adorable shots like this?

As a psychology major, I took a lot of human development courses. Learning about the Nature versus Nurture debate, I felt like I had to pick a side. After all, "versus" implies that we must choose a side. I fell squarely on the side of nurture, agreeing with the psychologist John Watson, a strict behaviorist who said: "Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select - doctor, lawyer, artist, merchant-chief and yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations and race of his ancestors."

It wasn't until a few years later that I read Nature Via Nurture and realized that both could be true instead of one or the other. Suddenly, to choose any one side seemed a bit too drastic, and unrealistic. Very few psychologists pick a side now, but instead debate over what percentage each factors in. A more current viewpoint is that genes provide a blueprint for the brain, but a child's environment and experiences carry out the construction. 

I see both nature and nurture at play in my little girl. I feel that she has been born with an amazing basic nature that I cannot take credit for. She is calm, easy-going and happy, no matter the situation. In my heart of hearts, I feel that this aspect of her developing personality has been passed on to her through my Mom.

But I can't ignore the nurture side of things either. Surely, how we parent and love her through the years will have an effect on the woman she becomes. The experiences she has now can affect her for years to come, possibly her whole life. Even though she won't remember these experiences, having her needs met, for example, is teaching her to trust and be secure. Her experiencies are also contributing to her brain formation. Between conception and age three, a child's brain undergoes an impressive amount of change. At birth, it already has about all of the neurons it will ever have. It doubles in size the first year, and by age three it has reached 80 percent of its adult volume. Even more importantly, synapses are formed at a faster rate during these years than at any other time.

Her rapid brain development is one of the many reasons she won't be watching any television until she's at least three. It's not just what watching TV can do to harm a developing brain (leading to motor, attention and speech delays) but also what children are not doing when they watch it. This is a hot topic for me, and I'll be writing more about it in a future blog post. But research aside, I want her to have experiences in the real world and real interactions instead of turning into a zombbabie while I do my own things. I want to be with her, really present, and experience things through her eyes.

So in the vein of new experiences for my little blank slate, I signed us up for a baby art class at Granola Babies in Costa Mesa. The cost for the class was $12. It was a small group of four other Moms and babies ranging in age from 6 months to one year. Autumn had a great time, but it wasn't anything that we couldn't replicate at home for much less money, even if we purchased a canvas. 

Since that class, I tried an edible paint recipe with cornstarch that was perfect right after I made it, but solidified while we were on our walk, before I could use it with her. This week, I'm going to try this recipe made with condensed milk.

I think the class setting is good for babies who have limited interaction with other babies. She gets her fill now that she's in daycare, but still enjoyed watching them. She absolutely loved getting messy, and it was a reminder to me to let her do that. 

While the art class was fun, They didn't "do" anything special, other than give each baby a palette with the edible paints and a blank canvas. She doesn't need to be signed up for special classes in order to experience new things. One of her favorite things to is to sit with a box of tissues and take them out and shred each one into tiny pieces, and she still loves to play with paper. New experiences can be had in our backyard. She loves watching the birds on the feeder, airplanes flying over and Trevi playing fetch. She gets so excited when Trevi races back at top speed, and usually lets out a squeal.


The other day, I caught her staring at her hand, as she opened and closed it over and over again. She was fascinated by it, as if it was the first time she had done it. And then I realized, it probably was. And this morning, she found my bag of polly-fill stuffing, and thought it was the greatest thing ever. I had put her with her toys in the living room the night before. When I put her down she crawled herself away from all of them and was focused on the bag, touching the stuffing that I use for her birthday favors. 

She also spent almost an hour playing with her Dad on the floor yesterday with a big box. He would hide in it and she would lift the flap and find him. They did it over and over again and it didn't get old. Classes are fun and can give us new ideas, but they're just as good as hanging out at home, as long as we're together.