Cottage Cheese and Cancer

I absolutely adore my husband, but he is not necessarily the most observant person in the world.  Patrick loves cottage cheese (which I can't stand unless I'm pregnant) and kept asking me what I did with the container of it in the fridge.  I didn't even know we owned cottage cheese and if I did, I sure wasn't responsible for its disappearance.  After he asked me about it for the fiftieth time, I opened the fridge to see if I could find it.  I kid you not, it was the first thing I saw when I opened the door.  It couldn't have been in a more prominent place.  It was on the highest shelf, at eye-level, right smack in the center.

So you can imagine my reaction when I was brushing my teeth sometime at the end of June and Patrick noticed that a mole on my neck looked a little bigger and darker than he remembered it.  Ooookay.  I looked at it and it did seem a little different but I figured it was fine and eventually forgot about it.  I had a questionable looking mole removed after I had Camden and although it turned out to be pre-cancerous (something called a dysplastic nevus), it wasn't cancerous.  I figured this one was just like that one and who gets skin cancer in their twenties anyway? Patrick kept bugging me to get it checked so I finally made an appointment with my dermatologist.  I went in, my doctor did a quick check of all my other moles and freckles, and said he would biopsy the mole in question but he didn't think it would turn out to be anything.  He left the room, the nurse came in and gave me a shot with the local anesthetic, and the doctor came back in and took off the mole.  It took about 5 minutes and we were out of there.

My mom came to visit for a few days and help me make some pillows for Fin's room.  She was cutting fabric when my phone rang.  I answered and when I heard my doctor's voice, my heart sank.  I had completely forgotten about my biopsy and when I realized it was him calling instead of one of his nurses, I knew it was bad news.  He told me that I had melanoma and then I freaked out.  I am so glad my mom was there.  He told me that he wanted me to come in that afternoon so he could talk to me about what we needed to do.

An hour later, Patrick met me at my doctor's office.  It's amazing how fast things can change.  One minute, your biggest worry is what size pillows to make for your daughter's room and the next minute, you're sitting in a cold little exam room waiting on a doctor to talk about what needs to be done about the cancer on your neck.  My dermatologist is also a plastic surgeon and has had whole bunch a bit of work done himself.  Let's just say it was hard to read his expression when he walked in the room.  He always looks a little surprised.  In his defense, he is probably one of the sweetest men I have ever met and is a fabulous doctor.  Anyway, my doctor came in and after my futile attempt to evaluate the situation by reading his expression, he sat down to talk about my mole.

He told me that what I had is called "Superficial Spreading Melanoma."  I breathed a little sigh of relief when he told me that.  Superficial?  Doesn't that mean that it's just on the surface? That can't be too bad.  And then he told me that this type of melanoma is the leading cause of cancer deaths in my age group .  WHAT?!  I must have given him a look because he immediately followed that statement up by saying that since we caught mine early, it shouldn't be that hard to treat.  Whew.  Way to scare the crap out of me.

Because my melanoma was less than a millimeter thick, more than likely it hadn't had time to spread to my lymph nodes or any other parts of my body.  If it had been closer to or over a millimeter thick, I would have had to have something called a "sentinel lymph node biopsy" to see if the melanoma cells had spread.  They inject a dye into the mole to see what lymph nodes the melanoma drains into.  Then they take out those lymph nodes and examine them to see if there are melanoma cells present.  Luckily, my doctor was pretty confident that this surgery wasn't necessary and that my melanoma could be taken care of by a different type of surgery.  I am so grateful that my sweet husband was so persistent in bugging me to get this mole checked.  If I had waited a few more months, my melanoma could have spread and this would have been a completely different ball game.

My doctor explained that the type of surgery I would have to have is called a "wide local excision."  In other words, I needed to have the mole and a big chunk of skin taken out to make sure the melanoma didn't spread or come back.  He drew a picture on the back of my file to show me what the surgery would look like.  Basically, there was a little dot about the diameter of a pencil eraser (my mole) and a bigger circle around it about the size of a quarter (the area he needed to take out to get a clear margin around the mole).  Then he showed me that in order to stitch the area up without having it pucker on the ends, he needed to remove a triangular area above and below the quarter-sized circle.  What he ended up with was a football shaped excision that was about 3 inches long.  Eek.  I had NO idea that such a tiny little mole would leave such a big scar.  Luckily this was something that could be done in their office the next day and I wouldn't have to be put under for it.

This is a really crappy picture of my mole after it had been biopsied (I had a shave biopsy for this mole). My actual mole was a little bit smaller, but I wanted you to have a reference for size.

Before I could go home, my doctor sent me for a full lab work-up and a chest x-ray to see if there was any sign of cancer in my lungs.  Luckily, everything came back clear.  I went home to freak out some more get myself together.  All night long, the only thing I could think of was getting that thing--that cancer--off of my neck.  I don't remember much about that morning but I do remember going back to my doctor's office that afternoon, going back into that little room where my life changed, and having the sweetest nurse in the world administer my local anesthetic.  My doctor came in a few minutes later, cranked up his iPod, and got to work.  I think it only took him about forty-five minutes to do the actual surgery but it felt like forever.  The worst part about it (other than when he hit a spot where the local anesthetic didn't quite numb--and the sweetest nurse ever quickly came to the rescue with her little needle) was the fact that I could actually hear him cutting my skin.  I'm sorry.  I know that's gross, but nothing about skin cancer is pretty.

This is what my neck looked like about an hour after my surgery.  The scar goes behind my ear as well.  See, not pretty.  All of that from a tiny mole.

After he got everything stitched up, they let Patrick come back to see me and we talked about the next step in my treatment.  Although my melanoma wasn't alarmingly deep, my doctor still wanted me to go to an oncologist for a second opinion.  He referred me to an amazing melanoma specialist at the Blumenthal Cancer Center in Charlotte who I went to see about two weeks later.  He confirmed what my doctor had told me about not needing a sentinel lymph node biopsy and explained that my cancer was classified as Stage 1B (here is an explanation of melanoma staging from melanoma.org) and that the chances of this particular melanoma spreading to other parts of my body were less than 2%.  I am at high risk of developing other melanomas, so I have to have my skin checked frequently by my dermatologist.  I recently had two more moles biopsied that both came back clear and I go again in March for my next check.

I never in my wildest dreams thought that I would be dealing with cancer in my twenties.  I tanned in tanning beds, laid in the sun without sunblock, and didn't take care of my skin.  I knew it could cause skin cancer, but it was "just" skin cancer (please read this post by my friend Chelsea).  It never occurred to me that "just" skin cancer could threaten to take me away from my babies and my husband.  It never occurred to me that it could leave me with a 3 inch scar on my neck for the rest of my life and worry in my heart.  Please, please, please take care of your skin.  Wear sunscreen everyday (even in the winter!!), be careful in the sun, check your skin for changes, and if you find a mole that looks a little different--get it checked out.

Surprise!

Camden is going to be a big brother!  My official due date is February 17, 2011.  Those of you that know my sweet husband are aware that he is obsessed a big fan of Michael Jordan.  If Baby 2 happens to arrive on its due date, he or she will share a birthday with #23.

We have debated telling family and friends this early on in the pregnancy but we realized that neither one of us could keep it a secret for too long.  That, and I'm already showing a little bit.  I'm hoping I'm just bloated but I've already had someone ask me when I'm due.  Joking aside, the main reason we wanted to tell everyone this early is so that you can keep this little baby and our family in your prayers.  Please pray that Baby 2 is healthy.  Please also pray for an uneventful pregnancy.  We had lots of stuff going on during my pregnancy with Camden (meetings with perinatologists, non-stress tests, high blood pressure, etc) and I'm starting to feel a lot of that anxiety coming back.

We went for our initial ultrasound this morning and Baby 2 is measuring right on track and had a fabulous heartbeat!  It has already learned how to wave hello!  All it needs now are some arms.

Right now, Baby 2 is the size of a sweet pea:

We haven't decided yet if we are going to find out the sex of the baby.  Patrick let me decide when we were pregnant with Camden so it's his turn this time:)    We go back in a few weeks for another ultrasound called an NT (nuchal translucency) scan where they will be able to give us an idea if the baby is at risk for certain types of birth defects.  There is also a sequential blood screening that goes along with it.  When I was pregnant with Cam, my doctor only recommended this test for high risk patients so we didn't have it but this time around it's become routine.  Plus we get to see the baby again!  This pregnancy is not considered high risk but because of Camden's dwarfism we were also offered an amnio to see if Baby 2 is affected.  We declined.  Because Cam's dwarfism was spontaneous and neither of us are carriers of the mutation, there is very little chance that Baby 2 will have hypo. 

When we were leaving our ultrasound after talking about all of the testing that's available to us, I couldn't help but wonder how we never found out that Camden had hypo before he was born.  With all of the technology available, it just amazes me that there weren't any clues along the way.  It wouldn't have changed anything if we had known before he was born, but maybe it would have helped us prepare a little more.   

Things like that make me realize how purposeful God's plan is and I revel in the fact that even though it may not be what we expect, it's perfect anyway.  I may never understand why things happened the way they did but I have faith that they happened that way for a reason.  And I'm okay with that.

Our Story

We found out we were pregnant with Camden in June of 2008 when we were visiting Patrick's family in Michigan. We had a miscarriage a month before and were excited to find out that we were pregnant again. I took about a million pregnancy tests just to be sure it was true. Seeing that pink plus sign over and over again was one of the best feelings in the world. I was blessed with a really easy pregnancy until our anatomy ultrasound at 20 weeks. The ultrasound tech saw a white "spot" on Camden's heart that was abnormal. We went to a perinatologist for a more comprehensive ultrasound and he determined that the spot was an area of calcification on his heart that wasn't anything to worry about. We were so relieved.

Fast forward 20 weeks and 2 days and our brand new baby boy arrived. After about 14 hours of labor, a failed epidural, a new epidural, 2 hours of pushing, and a c-section later, Camden was finally in our arms. Everything about him was perfect. All 8 pounds and 21 inches of him. Patrick was the proudest daddy in the world, and I turned into mush when I met my sweet guy.

He grew like a weed and by the time his first month check-up rolled around, he had gained 5 (!!) pounds and grown almost an inch. At check-up after check-up, Camden grew and grew and grew. Then we went in for his 6 month appointment and everything changed. All of a sudden his head circumference jumped to the 95th percentile and his height and weight dropped to below the 25th. His doctor was worried that there was fluid around his brain that had caused the discrepancy so she sent us for a cranial ultrasound a few days later. She also mentioned the possibility of surgery to correct it and Patrick and I were terrified.

They performed an ultrasound through the soft spot on Cam's head to look for any fluid that could have built up. We breathed a sigh of relief when Cam's doctor called a few days later to tell us there wasn't any fluid detected. She went on to tell us that she wanted us to go have a consultation with a neurosurgeon to rule out anything else that could be going on. So we freaked out again.

The neurosurgeon examined Camden and told us that he didn't think there was anything that he was really worried about but that he still wanted Camden to have a CT scan just to be sure.

We went to the hospital later that week and Camden had the CT scan...

...that came back normal.

So we celebrated. But we still knew there was something we were missing.

I took Cam to his 9 month appointment and this time, his height fell to the 10th percentile and his head circumference was almost off the charts. His doctor suggested doing a battery of blood tests to see if there was an issue with his thyroid, or if he was anemic, or if there was any other clue to what was going on.

After more normal test results, we were relieved but still knew there was something else. Cam's doctor called me at 6 pm on a Friday night, an hour after their office closed, and told me she had been pouring over his charts trying to come up with an answer. She told me that she wanted us to meet with a genetics specialist to rule out another possibility. I asked her what that possibility was and when she said "achondroplasia," my heart jumped. As soon as she said that word, so many things made sense. I called Patrick and told him and his immediate reaction was that our doctor was crazy.

Then it sank in and we started researching it. The more we learned about it, the more we felt like we were closer to finding an answer for our sweet boy. Camden's doctor called the geneticist personally and got us an appointment for the next week. The genetics department had a 6-7 month waiting period for appointments so we were both relieved and nervous about getting an appointment so quickly.

December 15th came and Patrick and I took Camden to Levine Childrens' Hospital to meet with the genetics specialist. After a meeting with a genetic counselor, Dr. Spence came in to meet Camden. He took some measurements, looked at Cam's hands, did a few other tests, and told us that he believed our son has Achondroplasia.

It sounds weird, but as soon as he said it, Patrick and I were relieved. All of this guessing and testing and wondering was over and we finally knew the answer. Camden is healthy, happy, and has a life full of possibilities ahead of him, and that put Patrick and I at peace. It isn't a disease. It isn't something that he needs to be operated on or medicated for. It's just him.

We are so lucky to be Camden's parents. We are humbled that God entrusted with such an amazing child and we are so excited start this new chapter in our life.