Week 2

Fear is sneaky.

It comes in unexpected places.

Like, the book that I have been on the waiting list for at the library for months, only to finally receive and realize that it's about a mother with cancer, who I'm getting the impression will die.

Or the episode of The Closer two weeks ago--which Justin and I sat down to watch eager for some relief after finding out that the diagnosis was in fact skin cancer, only to realize that a major sub-story in that particular episode was Brenda's father being diagnosed with thyroid cancer.

It's in writing my monthly Letter to Lizzy, and the brief thought that appeared out of nowhere, "I wonder if I started doing these because I would die when Lizzy is young. I wonder if these will be the only thing she remembers me by."

Or, it's in having a stomach ache, and wondering if I ate something that didn't agree with me, or if the cancer is just more advanced than they knew.

The trouble is, that once that fear is there...it can be hard to banish. But sometime last week, I decided that my fear is just not going to encroach on the joy that this time of year brings. I just will not allow myself to linger on it. Thankfully, I can usually count on sleep to help, and to feel calm when I wake. Immersing myself in fiction also helps. Consequently, I'm doing a lot more sleeping and reading than cleaning house or making dinner lately. Our house is a disaster, but the trade-off (my mental health) has been well worth it.

Also, last week, my dermatologist spent over a half an hour on the phone, answering every question and concern that I had. Thank GOD for her. I remember finishing the conversation with her, and just feeling confident and at peace...but how quickly that confidence can be shaken! Even later that same day, I found myself worrying and doubting again. I wrote my questions and her answers down while we were speaking, but I'm the type of person that learns by writing. So, I'm going to type up some of my questions and her answers here, just so that the knowledge can sink even further into my bones and my soul. Also, I hope it will answer some of the questions that have been asked by all of you!

Me: As far as going to Portland for the surgery, was it just that the local doctor doesn't handle this type of skin cancer and/or that the hospital there was just more familiar with it? Not necessarily that it is a bad type of cancer, but just that it needed to be addressed quickly?
Dr: A little of both--the local doctor couldn't get you in until March, and it just can't wait that long. Also, the local doctor wanted you to have the procedure in Portland because DFSP is sometimes an iceberg--it can be bigger than you might think initially. I've actually seen cases of huge DFSP tumors quite often because I trained at Mayo Clinic, and sometimes it can be no big deal, but you never know for sure until you get in there.

Me: Is there any reason to worry or suspect that I may have more of these DFSP's elsewhere?
Dr: No. These come singly. I've never seen a case with more than one at once. Occasionally, they may come back right where they were, but not in groupings.

Me: Because of the small size, is it your guess that it was caught early?
Dr: What I could feel felt small. What I cut out felt about the size of a lima bean. I didn't feel more beneath that that seemed like DFSP, but it can occasionally send out tendrils, and the cancer cells were close to the edges of what I cut out, which is why we need to do the Moh's procedure, to make sure it is all gone.

Me: Are there any follow-ups to make sure that the clear margins were achieved with the Moh's procedure?
Dr: You'll come back every 4-6 months for several years. I have had a patient who had a recurrence of DFSP--she I could both feel it right away in her skin exam. You can usually see or feel recurrences. Moh's procedure gives the best protection against recurrence.

Me: So just to confirm, the prognosis is good?
Dr: Yes, as long as it is taken care of quickly.

Me: Before we found out about the DFSP, we had been talking about possibly having more kids. That's off the table for now, but would you be able to let us know when that's something that we could start discussing again?
Dr: As far as I'm concerned, you could be trying now. I don't think there would be any reason to worry if you became pregnant--it wouldn't affect your treatment, and the DFSP wouldn't affect a pregnancy.

The pregnancy talk is still tabled for the moment--I would just feel better waiting for now. At least until Portland is done. But, my doctor's comments that she would have no problem okaying us to start trying is helpful to me in putting this all into context. She must really consider the prognosis to be good if she was ready to okay trying to conceive.

Thank you guys so much for your thoughts, prayers, and encouragement. It means so much.