Early Detection

"You have two strikes against you," my dermatologist told me as she sliced off the top of a suspicious-looking beauty mark on my upper back. "One: you have fair skin and a lot of moles [I've always preferred to call them beauty marks]. Two: you live in San Diego, where it is always sunny."  Then she handed me a pamphlet filled with hideously colored photos of blotches of skin with asymmetrical borders and strange greenish pigments. I had never spotted any of those anywhere on my body, but my daughter had noticed a scary-looking patch of skin under my bathing suit strap while we were lying in the sun a few months ago, and so now I was finally getting it removed.

There is good news and bad news for every event in life, and when my doctor called with the biopsy results, this news was the worst. They had found malignant melanoma, stage 1A. The slightly better news was that it was very shallow, less than a millimeter deep, and the only treatment at this point was surgery - a wide lesion excision one centimeter around the edges of the biopsy wound. In plain English, they would be removing an oval piece of skin approximately one inch by four inches from my back. Everyone told me how lucky I was, lucky that my daughter made me get it looked at, lucky to have caught it early, and lucky to have such a supportive boyfriend who adored me.

I focused on being thankful for the good things in my life instead of worrying about what the pathology report from the upcoming surgery would show. If any melanoma cells were to appear in the skin surrounding the original mole, the next step would be removing the sentinel lymph node (closest to the site), and from there, I couldn't even think about what might come after that. Farm Boy and I celebrated our 6-month anniversary the same day that I received the diagnosis, and he sent cards every few days and flowers to take my mind off the surgery. I kept my outlook positive and did the right things. I went to my therapist to deal with my fears. I made sure to ask my boyfriend how he was doing, too, because I remember how hard it was on me when a previous boyfriend was diagnosed with colon cancer. Farm Boy assured me that he was fine and I was going to be fine and we would be together for a long time.

The surgery itself wasn't bad at all - I was awake throughout the procedure with just a local anesthesia, and it took less than an hour. Although there was a lot of bleeding, I felt good enough to go shopping with my daughter immediately afterwards to celebrate our days off work with some retail therapy. The following day, Farm Boy had a busy day planned. I went over to his house very early that morning, and we had activities scheduled all day until dinnertime. I was doing OK until mid-morning, when I discovered blood seeping out of my bandage. My daughter drove me back to the hospital to have the stitches checked. The doctor on call changed the dressing and gave me some stronger pain meds. I probably should have just called it a day at that point, because Farm Boy was not happy upon my return to his farm. When I asked him what was wrong, he said he was stressed about being late to the next event we were attending. He had invited friends over, and lunch ran longer than he expected, and he was grouchy about having such a busy day. I took some pain pills and hung in there, but just before dinner I went home to get some rest, wondering if I had overdone it.

  Farm Boy and I had dinner together the next day and all seemed well, but a few days later, on the evening of my first day back to work, he called and asked me to do some work for him.  I declined, not feeling up to it after an exhausting day, and he didn't take it well at all.  A few hours later, he called back and began listing the things I had not done lately to support him. He angrily told me all the ways that I was simply not caring and loving enough towards him.  I had been about to go to bed and had taken a pain pill just before he called, so I wasn't sure I was hearing his words correctly. I couldn't believe he was getting irate with me simply because I didn't agree to do a minor task which could have been done by any of the other people he is working (on a volunteer project) with. He continued his rant, on one hand asking what I had to say in my defense, and on the other saying that as far as he was concerned the conversation was over. I was confused and shocked by his call, but most upsetting was his horrible timing. It was as if he had waited until the worst possible moment in the world to dump his list of complaints on me. I remembered our only other argument, about 2 months before this. He came over one day and did virtually the same thing he was doing now.  One day everything had been fine and he loved me, then the next he had a laundry list of things I was doing wrong and making the relationship not work for him. I noticed that a pattern had emerged, which (combined with his severe depression and other issues) added up to a bigger load than I was willing or able to carry. "It's good that you found this out early on," my therapist pointed out to me the next day. "You are getting better able to detect which things you can and cannot tolerate in your partner's behavior." I realized she was right. Farm Boy's anger is more than I can tolerate, now or ever. I broke up with him, even though he is the best boyfriend I've ever had, even though we had travel plans during the holidays, and even though he so sweetly sent me love cards in the mail all the time. Even though I found the perfect Thanksgiving card which I've been waiting to send to him for weeks. Even though I bought two expensive Christmas presents which I've been saving for months because they were perfect for him and when I saw them I knew he would love them.  I still love him, and there are so many good things about him that I really hope that he will let me be his good friend when I am not his girlfriend. I suspect he will, because he's that kind of person, and that would be some really good news to round out the sad news of our breakup.

And finally, the good news about my surgery - the pathology report came back clean. No cancer cells were detected in the surrounding skin! I'm a survivor. Also, I will get a complete scan of my skin every two months for the next 3 years, which will hopefully prevent the growth of more cancer. Early detection is everything.