You’ve been warned. The photos I mentioned before you clicked to come here are posted below, as promised. This is your last chance before scrolling past the following paragraphs to avoid seeing them.
But, to be truly impactful as a cautionary tale, you need to see the photographic evidence of my dermatologic adventure.
So, here we go.
I see a dermatologist every six months since I was treated for melanoma in 2017. As the surgeon said at the time, “If you have to have a melanoma, this one was shallow and small, the best-case scenario.”
Now that we’ve started spending summers in Illinois, I decided to establish myself with a dermatologist up there. I met with her in June of this year for a full body scan. Three women now see me naked. One of them is my wife. I got the all-clear, though she liberally blasted me with liquid nitrogen on a number of sun-damaged spots. Freezing the affected areas causes them to scab, fall off, and heal before turning into something worse. For the record, Florida is a great place to live if you collect sun damage.
About two months later I noticed a small spot on my right shin. It looked like a pimple or an infected hair follicle. I didn’t think much about it until it refused to go away later in the summer. By that point, I also had an establishing appointment scheduled with an Illinois primary care physician. I pointed out the growing bump on my leg when she asked if I had any concerns.
“Oh, that looks like cancer. You should see a dermatologist.”
Ok, then. We were heading home in a few days so there was no time for a return visit to the doctor I’d seen just a few months earlier. I thought I had an appointment with my Florida dermatologist a few weeks later, but didn’t want to wait. I called and asked to have my appointment rescheduled with her as soon as possible.
There was no availability. I even played the “C” card, conveying my Primary’s assessment from a few days before. I was put on a waiting list but never got a call. If you’re not familiar with my earlier death-by-receptionist tale, click here.
I searched for another dermatologist, one willing to see a new patient as soon as possible. I had an appointment within three days.
When a physician’s assistant came in to greet me, she looked at my leg.
“Oh yeah, that’s cancer,” she said.
The offending bump was “shave biopsied,” and cauterized to prevent further growth. I made the mistake of watching this procedure and was horrified to see a razor blade slicing off part of my leg. Note to self: don’t watch next time. It’s better to lay back and think distracting thoughts.
The pathology lab confirmed that my “pimple” was in fact a squamous cell carcinoma that required a MOHS procedure to be fully removed. This is a micrographic surgery that was named after Doctor Mohs in the late 1930s. I’ve had this done before with great success.
My procedure was scheduled three weeks later. In hindsight, that may have been too long to wait. The cauterized biopsy wound appeared to develop further during that time.
When undergoing MOHS surgery, an attempt is made to cut out all cancerous growth, quickly examine it in a pathology laboratory, and then stitch the wound closed, or go back and cut out more cancerous tissue if the results demand it. My surgeon had to visit the leg buffet twice, sampling shin meat in a widening hole each time.
I texted my wife in the waiting room while I ruminated about the eventual outcome. The doctor told me not to panic. There’s nothing like being told not to panic to put you at ease. The other calming statement, after being shot full of anesthetic, is, “Let me know if you feel anything,” just as a knife is about to be plunged into your flesh.
To shorten this story a bit, the little bump on my leg turned out to be a large, aggressive, deep tumor that got disturbingly close to the bone. As you can see in the photos, I discovered a way to lose weight—the old pound-of-flesh method—but immediately gained it back in staples. Lots of them. The doctor took great pride when he drew the outline of Madagascar on my leg in order to successfully close the incision with a flap rather than by simply using sutures that would have pulled out. He trusted this method to work better than a skin graft. I hadn’t even thought about that possibility.
My message to the reader is, RUN to the doctor when something suspicious arises on your largest organ, your skin. If it turns out to be nothing, great. And of course, use sunscreen.
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