Medical I need some help with coping with a biopsy

[Scarlet13]

Ok, so I have a sun spot/freckle on my nose. It was checked 7 yrs ago and was benign.
I then got preggo right after that appt and during the pregnancy it darkened but stayed even.
I then had a less than qualified esthetician perform a couple of microdermabrasion treatments on my nose.
I should have went to someone better as the results once the scab had peeled off was that it had lightened but she had not removed pigment at the edge so the spot was now uneven in color and also had an irregular border and so now looks like cancer.

It has remained unchanged, though, for 6 yrs.
I went into have it checked. It got biopsied twice.
The first biopsy, a punch biopsy, showed "atypical cells" but no melanoma.
The second biopsy was taken to see if there was melanoma in the other half of the spot. I am still waiting for these results.

I had an advanced dermatologist look at the spot during my second appt and he told me the second biopsy result will either reveal very early melanoma or still just an atypical spot. He did not see any signs of invasive melanoma.

In either case, I have to remove the spot.
If it is early cancer, this is a more involved surgery. In the OR, plastic surgeon, general anaesthesia, more advanced skin graft.
If non cancer, this can be done in the office with local and a less intense skin graft. Also, I can wait and do this in the summer when I am not in school, but if it is cancer I have to do it right away.

So, obviously I want the non cancerous option because:
A. I don't even want even a little of potentially life threatening melanoma. Also, what if my doctor is wrong and really they come back and say, "Actually, you have stage 4 melanoma "
B. I want the easier surgery that can be done in the summer.

Really, I am ultimately ok with either possible result that the doctor gave me. Very early melanoma or atypical spot.
I just negative filter and catastrophize. My T says I can trust my doctor with the choices he laid out. Could the biopsy be worse than what he thinks? I guess.
It could also be better.
I just negative filter.
The problem is that all of this is triggering.
The actual biopsy is making me crazy.
Having someone look at my skin, create a report, and call me with results is just really triggering. I fear the phone call. And the talking.
I have some medical trauma, but mostly I just hate doctors and their Latin terms for everything and the front desk people.
I also don't really think its melanoma because the first biopsy was of the darkest area, and that was just atypical. It has not changed in 6 yrs. But he tells me it could be a slow growing melanoma. They have to basically treat you like you have cancer in order to be preventative.
They called me fri afternoon but did not leave a message.
So now I just feel filled with dread with having to call back monday.
I am ok really if there is an early melanoma.
I am just catastrophizing it and very triggered because I have PTSD.
Are there any suggestions for coping?
Please don't respond and tell me you have terminal cancer. That would be triggering.

 

[blackemerald1]

Hey @Scarlet13 - where to start :/

Ok I have been in your position three times before... and required surgery each time. The latest being last year. BUT I am fine now!!

But I do relate to how you are feeling. I am not going to suggest.. 'try not to feel the way you do because... it won't work!

I too hate the doctors, the medical terms, their coldness etc. I guess they see these things day in and day out and forget the huge impact that happens with this. Idk..

I've come to the mindset that surgeons have no personality at all and I think they are made of cardboard... weird I know. lol Essentially I just see them as one dimensional which is the only side I see of them anyway! So I don't care about them not caring... so long as they do the surgical part excellent!!

I take my needs for caring to other people who hopefully will give that to me! If not, I suffer alone.

The waiting for results is very hard. With all of my biopsies, and there have been a few, I too hated the waiting. It is very easy to catastrophise and I don't blame you for doing so.. I think it is natural. I think everyone does it.

Distractions work well, and every single time I began to catastrophise about the result and what might need to be done I reminded myself that: I was strong enough to deal with anything that happened or needed to happen... over and over in my mind - every single time..

Then when the bad news arrived I was at least able to process it with something similar to dignity and attend to the practicalities and plans.

I think the post op stuff did my head in more because there was a lot of stiches and pain and being facial surgery, grafts etc., it takes time for everything to settle down... a lot of time.

You mentioned that you missed a phone call from them on Friday? Are you going to hear from them Monday or are you going to call them yourself? I think that them not leaving a message has a positive element to it because if it was really bad they would have called back or left a message asking you to call asap?

You have had this spot checked several times and yes it is a big concern but the main thing to remember is that once you get rid of it.. that's it! It's gone and gone for good! No more wondering or worrying about it changing from benign to anything else. And that's a really good thing for you! With the skin grafts etc., scarring can be kept to a minimum too.

Whilst I am sure you'd rather not have this medical health issue, a slow growing melanoma, found very early, is the best of the best if it has to be melanoma at all. And anything not melanoma is even better. It's the aggressive tumours that make my heart race because every single day counts. From what you have described this doesn't sound like that type of tumour.

You are correct, until they have looked at it under a microscope they will not even bet their lunch money on what it is, will side with caution and give you the very worst case scenario but that's the usual practice.

So right now I know you are thinking the worst but the worst is not as bad as it could be.. so keep things in perspective and yes I understand the ptsd makes it all the worse to try and handle but be strong and hang in there till you know.

Let me know how it goes hey? Many ((hugs)) and know that despite all of your fears you will be ok.

 

[Scarlet13]

Hi,
Thanks for your response that helps a lot!
My dermatologist looked at the spot and said he didn't see any signs of invasive melanoma.
But still my brain counter acts this with worry anyways.

It is like the biopsy process just creates the fatalistic thinking despite what my MD says from using his dermascope.

My T says to use check the facts.
I am also using CBT thoughts.
I am telling myself rather than,
"They are looking for cancer cells."
Instead, "They are making sure its not cancer."
They are being helpful and not torturous
My 2 options are melanoma in situ or atypical lesion. Either way it gets removed.
I am actually minimizing the worse case scenario. Rather than thinking, "I may have cancer."
I am thinking, "They may find a few cancer cells which can be removed."
I am calling tom and still it terrifies me.
So I just have to tolerate that.
I hate it.
And it is my own tortuous anxiety that I fear anyways.
What was your results?
Was your surgery bearable?
That's the other part I am afraid of.
I don't know how to stop my life.
I have presentations and travel, so its nerve wracking to have face surgery.

 

[Abstract]

Well done for the methods you are using.? Let us know how you go. It sounds very likely to be very minor treatment that is needed. Dr's usually emphasise the very worst likely outcome. Him saying what he did is a VERY good sign.

 

[blackemerald1]

What was your results?

The results were great. Clear margins and I get to live to fight another day!

Was your surgery bearable?
Yep! The surgery was bearable, probably the easiest part of it really. I was under a general for the skin grafts then woken but kept sedated and responsive for the removal of the cancer etc. They do this to see if they are impinging on any nerves etc., and to make sure they do the best job appearance wise.

But your surgery will depend on how deep they must go and how large the area is.

That's the other part I am afraid of.

Try not to be too scared or at least don't let fear dictate what you do in this instance. They are removing something that has been a pain in the neck! It has the potential to change and become something deadly and they want to remove it. That's truly a good thing for you! No more worry, no more skin treatments to make it look better. You may have a scar but hell that is better than the alternative.

I don't know how to stop my life.

Well you know how you take time out of your busy schedule and life to go to therapy to do things to bring your ptsd back into a manageable place? Same goes for this. You need to do this for yourself. A little time now or as soon as you can, will stop a load of worry or worse later. If I was you, once the decision is made to take it all out - get it done.

You've had the scare but now try to think how good it will feel to have it dealt with.

Don't be afraid - this is completely treatable and curable so that's fabulous!!

You will have a small scar or even a large scar idk but I have some big scars and honestly nobody notices. Not after a while.

If I have to, I can cover them up with make-up if I really want to but otherwise nope... I don't see them anymore. Even the big ones! :)

 

[Scarlet13]

Just got my results.
Melanoma in situ.
So kinda freaking out.

 

[blackemerald1]

I am so sorry @Scarlet13 :hug: Do you have anyone you can talk to in the real world about this? Someone to just sit with you that you trust? Ring that person and bring them into this if you can.

What 'stage' melanoma is it? Did the doctor advise what is the best course of treatment?

 

[Scarlet13]

Its melanoma in situ
Stage 0
Just surgery is needed.

 

[blackemerald1]

Well out of the bad news, that's good.
I am not surprised you are freaking out I would be too. Have a controlled freak out though... don't let it take over. This can be fixed very quickly.
When is the surgery scheduled?
Do you have someone to go with you and help you through this?

 

[Scarlet13]

So by surgery I mean it will be a really long mohs surgery and then the wound will be left open and then I get plastic surgery the next day
I was joking that I should get him to give me a nose job too, but I am happy with my nose, so maybe the muffin top that I have from having babies.
I just set out in the sun a lot when I had anxiety and insomnia after child birth, so yep, gave myself melanoma.
I don't know if I have *Cancer* it's not like I have to get chemo.
But my PTSD means this is all very triggering.
I am very scared of cancer in general.
I also am drug sensitive and so that's nerve wracking all of the drugs I will have to take.
I will be scheduling the surgery soon, but am doing the consult first on next Tues.

 

[Abstract]

So sorry Scarlet. Sending you much support. Not sure it helps but many dr's describe stage 0 as a pre cancer rather than a cancer. Not at all what you want at all of course but it is very treatable and credit to you for getting it early. Also excellent news that you have access to a plastic surgeon. What they can do these days is genius. Also, excellent you have access to mohs surgery.

 

[blackemerald1]

so maybe the muffin top that I have from having babies.

Oh you and me both wish!! :) sigh...

so yep, gave myself melanoma.

Well maybe however.... wasn't it a spot to begin with? Maybe it was always going to turn. I'm not sure you can beat yourself up quite so quickly and hard about this just yet! :hug:

it's not like I have to get chemo.

No. It's a great surgical technique. They mostly keep you o/night or send you home bandaged so they can get the skin tested to make sure there are no further cancer cells. If there is he will take the next layer down. It's a fantastic form of surgery and has an extremely high cure rate with the least amount of 'work' to repair etc., afterwards.

my PTSD means this is all very triggering.

Oh.. I so know how you feel Scarlet. I wish I was there to give you a hug. It's hard when this comes on top of ptsd. Any physical challenge is difficult when you have ptsd.

Be good to yourself and try not to catastrophise the whole thing. That is a very big thing to avoid I know.

I am very scared of cancer in general.

Me too. I'm over it. I think it is dreaded by everyone because there would be few who have not known someone or experienced cancer themselves.