November 21, 2018

I’m beginning to look like the wife of Frankenstein. It seems like every 2 weeks, I’m being diagnosed with something else or I’m being chopped up into little bits.

November 8th: Stitch removal day.

Thank God; because these stitches were beyond irritating. My body clearly did not like the stitches. The area had been inflamed since day 1, fluid continued to draining from the area, and the incision started to re-open and bleed as the nurse performed the stitch removal. I also had a stitch that got embedded into my new skin growth that had to be removed by reopening the area with a scalpel (ouch).

While the nurse removed my stitches, Dr. Wangia noticed two more strange looking moles on the right of my back (both near my original melanoma site). “We should biopsy these just to be safe”, he said. “Agreed. Cut-me-up-Doc” I said. “You’ll have the results in about two weeks” said Dr. Wangia. Great. Another waiting game.

November 13th,

My cell phone rings in the middle of my morning class. I recognized the number immediately – My CT results are in !! Without hesitation, I answered the phone in the middle of class.

The diagnosis: “There were no tumors visible on the CT scan and your lymph nodes are of normal size. However, we did find something on your ovaries”. Fucking great. “You have an engorged ovarian vein also known as pelvic congestion syndrome. You’ll need to schedule an appointment with your OB.” Just fucking great.

Pelvic congestion syndrome is caused from an engorged vein that begins in the ovaries and travels down into the left leg. The engorged vein is usually a result of multiple pregnancies or having a job that requires you to be on your feet all day. Check and Check. The one symptom of pelvic congestion syndrome that I’ve experienced is that during my monthly cycle, this vein causes a great-deal of pain in my left leg, making it uncomfortable to walk. It also isn’t visually pleasing as it looks like a thick, blue and purple roped thrombosed vein that begins in the upper-inner-thigh and travels down to my calf.

Scheduled OB visit: December 12th. More than likely another surgery is to follow to fix this new diagnosis.

I’m literally falling apart.

On a positive note, it wasn’t cancer.

November 20th,

My cell phone rings in the middle of my morning class (again) – lol. It was Dr. Wangia. My biopsy results must me in. Without hesitation, I answered the phone.

“Mrs. Kozma. Your biopsy results have returned. Both spots removed from your back are severe dysplastic nevi – precancer. We need to schedule you for another surgery right away.” ARE YOU FUCKING KIDDING ME. “We have availability this afternoon at 2:30” the nurse says. I took the appointment.

Trying to finish class in good spirits was quite challenging. My students could tell something wasn’t quite right, but were too afraid to ask.

After class I messaged my husband and my mom. I then had to find a ride to-and-from the doctors office as driving after surgery would be very uncomfortable; so I called a very good friend of mine to take me as my husband needed to stay home with the kids. Without hesitation – and even canceling plans with his girlfriend – he agreed to take me to the doctor. Patrick, you are an amazing person.

The procedure that was done to remove the precancerous tissue was very similar to the surgery that was done to remove the melanoma; except this time, they only needed to cut to the fatty tissue layer rather than cut deep to the muscle layer. Both locations required between 12-14 stitches each and took about 1.5 hours to complete. Laying on my stomach for that long trying not to move was quite challenging. Especially since Patrick tried to cheer me up with laughter during the procedure. Not to mention that the numbing medication continued to dissipate throughout the 1.5 hours and I continually had to be stuck with needles to remain numb.

Once the procedure on my back was complete, I pointed out another spot on my stomach that had been removed years prior and was diagnosed as severe dysplastic nevi in 2015. Within the last year or so the dark coloration had returned; so before leaving, the doctor decided to do a punch biopsy on my stomach – 4 more stitches. Hopefully this new biopsy will return clean. Otherwise, another repeat surgery will be required.

I am literally turning into the wife of Frankenstein  

November 21st,

As the Thanksgiving holiday quickly approaches, I am doing my best to focus on how thankful I am for so many things. I am thankful that God spoke to me 6 weeks ago and sent me to the doctor to investigate the initial spot on my arm. I am thankful that an amazing neighbor of mine referred me to a doctor who found my original melanoma and is now finding other precancerous lesions. I am thankful for my family and friends who would drop anything to care for me; and I am thankful for continuing to be considered Stage 1 Melanoma. It could be so much worse.

For now, I’ll just continue to pray that this NEW biopsy on my stomach comes back clean and that my OB can find a good solution for my pelvic congestion syndrome.

I can do this. There will be light at the end of the tunnel. 

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November 12, 2018

A lot has happened since that dreaded phone call on October 24th…

• October 26th: Wide Local Excision surgery was performed to remove the primary melanoma. 
  
  • Results: There were some lone-wolf cancer cells found in the tissue, however, the margins were clean. Praise God
  • BRAF Gene Results: I am still waiting on the results of the genetic test for the BRAF gene. Dr. Wangia said it could take between 1-2 months for the results to return. I hate the waiting game. 
• October 30th: My very FIRST visit with a primary care physician. Is it sad to say that I’ve never had a primary care physician before? Anyways, upon her examination she requested two things:
  
  • CBC Blood Test
  • CT Scan of the Pelvis to see why my left groin lymph node is much larger than my right  lymph node. 
• November 2nd: CBC Blood test.
  
  • Results: Normal 
• November 8th: Stitch Removal
  • Results: My body clearly did not like the stitches. The area had been inflamed since day 1, fluid continued to draining from the area, and the incision started to slightly re-open and bleed as the nurse performed the stitch removal. I also had a stitch that got embedded into my new skin growth that had to be removed by reopening the area with a scalpel (ouch).
    
• November 8th: Two more suspicious looking moles were removed from my back.
  • Results: I am still waiting for the biopsy results of these two new areas; praying that these two moles come back benign. In the event that one or both moles return as melanoma, then another Wide Local Excision surgery will be performed and lymph node testing will be performed.  

    

• November 9th: CT Scan of the Pelvis to examine why my left lymph node is larger than my right.
  • Results: I am still waiting for the results of the CT scan.
    

• My Experience: The CT scan is a very intimidating piece of machinery. Before I could take the exam, I needed to drink 32 oz of this thick, white, chalky-textured, vanilla-flavored crap in 20 minutes (trying not to vomit this stuff up was a challenge). Once I finished the oral contrast liquid, I was then escorted back to the room where they hooked me to an IV. The liquid that was to be dispersed into the IV (iodine contrast) wasn’t going to be realized until halfway through my scans. When the iodine contrast was finally released and flowing through my IV, it burned as it entered my arm, but it made my head, back, neck and groin area feel very warm. It kinda felt like I was peeing my pants; definitely a very awkward and unpleasant feeling. The scan itself took about 30 minutes as the technician controlling to machine outside of the room continued to pull my body in and out of the small tube, asking me to hold my breath for every scan as the machine swirled around me like a loud washing machine. Overall, the experience wasn’t too terrible – but I can certainly see how many people can have anxiety attacks when having a CT scan.

• What’s Next…  

The waiting game…. Waiting for the results of my genetic testing, waiting for the biopsy results of my two newly removed moles, and waiting for my CT scans to be reviewed by my doctor. For now, I’ll just continue to pray for favorable results; I will continue to check my skin and encourage others to do the same. No one should have to bare these scars.  

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October 24, 2018

“You have cancer” were the 3 words uttered to me over the phone by a nurse. Is it strange to say that I wasn’t surprised? I knew something wasn’t right; I felt it in my gut the moment I laid eyes on a strange-looking mole on my arm.

October 12, 2018

I immediately texted a neighbor of mine, who 5 years ago was diagnosed with Melanoma; and with glowing recommendations she referred me to her dermatologist. Without hesitation, I phoned Dr. Michael Wangia to make an appointment. I was expecting to wait a few days/weeks for an opening in his schedule, but was surprised to find out that he had an opening at 11:00 AM that morning. Needless-to-say, I jumped at the opportunity and booked the appointment.

As I sat in the exam room waiting for the doctor to come in, I told myself that I was NOT going to mention the strange-looking mole on my arm; I wanted to see if he could find it during my full body exam.

When the exam began, Dr. Wangia started at my feet; he looked in between my toes, at the soles of my feet, and even at the coloring of my toenails. This was strange I thought. I’ve never had a full body exam where the doctor examined my feet in this much detail.

He then moved up my body and examined my legs where he found a discolored mole on my left knee. This mole had been there forever; since I was a little kid. He then took out his medical marker and circled it. He then moved to my back and found another discolored mole on my right side; and again he circled it with his marker. Then he moved upwards to examine my arms and chest; and his eyes made a beeline for the mole that I was concerned about. Oh shit I thought. My suspicions must have been right. Without saying anything, he took out his marker and circled the mole.

In total, I had 4 moles removed (one from my right knee, one from my groin, one from my back, and the one from my arm). Upon finishing his exam and the removal of my moles, he encouraged me to have my husband study and learn my back. He said “your husband needs to know your back like he knows your face.”

As I put my clothes back on and walked  out of the exam room, the nurse informs me that it will take about 2-3 weeks for the results to come in. I seriously hate the waiting game. I can assure you that I’m one of the most impatient people I know.

Ten days after my biopsy, I get a call from the pathologist office asking if the spot on my back had been biopsied before. I remember having a mole on my back removed in 2016, and another mole removed in May of this year, but I wasn’t sure if THIS particular mole was in the same location as my past moles. It could be a possibility that it was the same spot but I wasn’t sure. The pathologist responded by thanking me for the information and hung-up the phone. Now my fears were really starting to set-in. Why ask me if the spot on my back has been biopsied before? If the spot on my back was clean, then why would it matter?

October 22nd: The call

Two days later, I finally get the call: Mrs. Kozma. The 3 moles removed from your leg, groin and arm, are benign, however the mole from you back was Melanoma. You have cancer.

I froze. I didn’t know what to say. To be honest, I wasn’t surprised; something in my gut knew this news was coming. I don’t know how to explain it; I just knew. I just didn’t think it would be on my back.

I immediately started to have flashbacks. In 2014 when I was pregnant with my 3rd child, my dermatologist at the time removed a suspicious-looking mole from my stomach. It came back as Severe Dysplastic Nevi (in other words, a very unhealthy mole not yet cancerous but would turn into melanoma if untreated). After the poor biopsy results, my dermatologist did a full body exam 3 days later and found another suspicious looking mole on my back – but due to an issue and miscommunication with my insurance company, he was unable to remove it without a high out-of-pocket cost for me. Instead, he advised me to go see a different dermatologist to have it looked at ASAP. Being that I was pregnant (pregnancy brain), I never called another dermatologist.

Fast Forward to July of 2016: I just finished my mommy makeover surgery and decided that it would be a good time to schedule all my yearly doctor’s appointments before the school year began: OBGYN, dentist, dermatologist, etc. So I made an appointment with a new dermatologist and requested a full body exam. According to him, there was nothing too concerning on my skin. During the exam, I remembered that my other dermatologist in 2014 recommended that I get a mole removed from my back. I ask the doctor if anything looks suspicious on my back in which he replied “No. Everything looks healthy with the exception of 1 dark mole. We can remove it today.” And so I did have it removed. The results – healthy.

Fast forward to May 2018:  I noticed that I had a freckle on my back that hurt to the touch – but not all the time (just on occasion it would feel tender – usually after a workout or a long stressful day at work). I asked my husband to look at the mole as I couldn’t see it clearly in the mirror – he thought it looked normal. However, I still felt something wasn’t quite right, so I called my dermatologist for an exam. He too agreed with my husband in that it looked normal, but he decided to remove it anyway due to my previous history of severe dysplastic nevi. The results – healthy.

Both times I had the moles removed from my back, I never had a feeling that something was seriously wrong. It wasn’t until I saw this strange looking mole on my arm that something inside my gut just didn’t feel right. I was so nervous about this mole on my arm compared to all the other’s I’ve had removed over the years. Come to find out, the mole that concerned me the most was healthy. It was the mole on my back – that had been removed just 5 months prior – that was Melanoma. The Melanoma was 0.4 mm deep. How on earth in 5 months did I go from having healthy skin to developing a Melanoma 0.4mm deep. I know 0.4 mm doesn’t seem like much – but once the melanoma reaches 0.75 mm depth, then you need to be concerned about the possibility of the melanoma spreading to the lymph nodes (Stage 3).

October 26th,

I just completed my Melanoma surgery where they removed a huge chunk of skin from my back where they cut all the way to the muscle (if you have a weak stomach, I encourage you NOT to look at the photos). Because of my diagnosis at such a young age, Dr. Wangia will be sending my tissue sample for a BRAF mutation gene exam. The BRAF gene tells the cells how to make a certain protein (B-Raf). This protein is part of a signaling pathway that regulates cell growth, cell movement, and cell death. When the BRAF gene mutates and fails to give correct instructions, cells can become cancerous; 50% of melanoma patients have the BRAF gene – meaning that future melanoma are difficult to prevent.

As for now, I will be waiting on the results of the 2nd biopsy and the BRAF report. I hate the waiting game. I pray for clear margins on this new biopsy – I feel in my gut that the margins will be clean (my gut feeling haven’t been wrong yet). I’ll be returning to the office in two weeks to have my stitches removed as well as another dark-suspicious looking mole on my back. This is just the beginning of a lifelong battle; but i’m up for the challenge.

If I’ve learned anything from this experience, it would be to go see my dermatologist regularly (no more pregnancy brain excuses – lol). So many people think melanoma is not a big deal; they are wrong. Melanoma  is a big deal. It is dangerous and it is deadly. Catching it early is key. I pray that I’ve caught it early. I pray that Dr. Wangia found my “primary cancer site”. Luckily, he feels confident that he has found the originating spot. But for now, a huge weight has been lifted off my shoulders and replaced with a painful scar on my back. This will serve as a daily reminder to check my skin and to let my guy feelings (God) to continue to drive my decisions.

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