Melanoma #5

Those of you who know me, or have followed this blog, know that my husband and I have had recurring melanomas. I started it, with a melanoma (stage 1, .9mm) on my ankle in June, 2003. That followed with one on my shoulder (stage 1, .8 mm) in 2013.

My husband has Parkinson’s, and astonishing as it may sound, those with Parkinson’s are 4-7 times more likely to have melanoma. His first was on the back of his neck (stage 1, .2mm) in 2015. Another followed in his ear (stage 1, .2mm) in 2018. This year, it was on his face.

WARNING! GRAPHIC SURGICAL PHOTOS FOLLOW!!

I post these photos and these blogs because when I was first diagnosed, I obsessively looked at photos of melanomas on the internet. Turns out, it was a good thing I educated myself like that, because I found the one on my shoulder, and all three of my husband’s.  Well, I didn’t like the look of them, so flagged them for his annual dermatologist visit. It is in that spirit that I post the following pictures of Al’s most recent diagnosis and surgery, because melanoma is a real thing. It is deadly, and you (every one of you) ought to have a thorough, annual skin check by a dermatologist. Just in case. 

Melanoma next to right eye

This was the melanoma as of January, 2019. I had seen it, and photographed it the previous year, because I didn’t like the look of it. (Just so I don’t run to the dermatologist every other day, when I see something weird, I photograph it and put it on my calendar to photograph again six weeks later, for comparison. Most things have resolved by then. This got darker and a little larger.) The dermatologist at the VA initially said it was nothing. A year later, I insisted he look at it again, and he scraped it for a biopsy. A scrape should never be done on a suspected melanoma. A punch biopsy is what’s called for, so just in case it is a melanoma, we can get an accurate depth of the tumor. Still, he scraped, so we have no depth. Still, melanoma.

Wisely, the VA declined to do the surgery so close to his eye, so he sent us to a fantastic oncology dermatologist/surgeon. She held a black light to the lesion, and this is the area that glowed.

The melanoma, including in-situ

Then she mapped out a 5mm margin. It looks all puffy in the photo below because she had already injected the anesthetic before I snapped the picture. (Interesting detail: When I asked her if it was all right that I took photos, and told her why, she said that most people do.)

Surgical lines with 5 mm margins

Then she cut.

She was doing what they call “Slow MOHS.” In normal MOHS surgery (for basal cell and squamous cell carcinomas) they cut with a tiny margin, then examine it right in the office to make sure they got it all. If the margins aren’t clear, they cut a little more, put a bandage on it and have the patient return to the waiting room while they test to see if they got it all this time. When they have clear margins, they stitch it up and send the patient on their way. Melanoma is a little different and they don’t have the capacity to test it in the office. They have to send it out to a pathologist.

Melanoma surgery

So they took the skin and sent it to pathology, put a bandage on his open wound and sent him home.

Fortunately, the pathologist said she got clean margins, so we went back the next day to be stitched up. I have to say, she was a master at it.

After melanoma surgery

This is how he looked when we left there, but bandaged, of course. A week later, the stitches came out and they put tape on it, which they said would fall off in a week to ten days. Right on schedule the tape fell off in the shower, and this is how it looks, 18 days after surgery.

18 days after melanoma surgery

Know your ABCDEs of melanoma:

A: Asymmetric. One half does not match the other half.

B: Border. Melanoma is unorganized. It does not grow in a uniform way. Borders have a “notched” appearance.

C: Color. Al’s melanoma had no particular color, but many times moles turn bad, and they can look pretty colorful. Al’s lesion (not a mole) just got darker. (Interesting point: most people don’t get new moles after they’re 30 years old.  In fact, most moles begin to regress as people get older. If you are middle aged or older and suddenly have a new mole, have it checked.)

D: Diameter. Any mole or suspicious lesion that is larger than a pencil eraser needs to be looked at.

E. Evolution. Melanoma is cancer. Cancer grows, changes. That’s why I take photographs for comparison. I would add to this Elevation. My first melanoma was a standard flat mole that grew tall.

Wear sunscreen and long sleeves in the sun.

Be safe out there. 

 

Why do we read True Crime stories?

The world abounds with true crime stories. Dateline, a show on NBC, is all about that. The Epstein horror show is all about that. When people go missing, we all engage about the search, and (hopefully) successful recovery. If the recovery is ultimately not successful, then we obsess about the perpetrators and demand their comeuppance.

But all of those things would continue to happen without all the attention we pay. Why do we pay attention like we do?

My new book, Divorce by Grand Canyon, is all about that. Why? Because I’m as fascinated as the rest of you. I got my start when I was doing research on the famed Lizzie Borden case (still unsolved). I wrote a novel about her.

But that doesn’t explain my (our) fascination.

On my website, I try to explain why writers write, and why readers read. I hold to this explanation, as it’s the best I can do.

Why write?

Writing is a process by which we can answer the unanswerable questions about ourselves. We don the skin of a character (who is of us, but yet not us) and we throw them into situations that we find difficult, challenging, or abhorrent, and we watch our characters (ourselves) as they endeavor to climb their way out. We watch them make decisions that we would never make and watch them reap the rewards, or suffer the consequences. And by so doing, we not only hold the mirror to ourselves, but speak our truth.

Writing is a calling.

We write because we must.

Why read?

We read because we lead lives of desperate calm. We go to great lengths to avoid conflict, yet fiction is all about conflict. When we go to bed at night and pick up a book, we slide into the shoes of a character embroiled in outrageous conflict and we learn about ourselves as we watch that character act or fail to act, in ways we would or we would not, and cheer as they triumph or despair as they fail. All along the way we say to ourselves, “I would never do that,” or “I would love to do that,” all the while knowing we would never, could never. This is the nature of escapist literature; we learn about ourselves as we live vicariously through the thrilling escapades of others.

Reading is a passion.

​We read because we must.

While this addresses an aspect of fiction, I believe the same holds true as we try, in vain, to figure out why killers (particularly serial killers) do what they do. It’s interesting to me, and it’s likely interesting to you, too.

Divorce by Grand Canyon is published by IFD Publishing, as part of their Horror That Happened imprint.

Divorce by Grand Canyon

My new book, Divorce by Grand Canyon comes out today.

Included are eight true-crime stories. Seven are case stories of heinous serial killers, and one is a treatise on forensic entomology (maggots, and so forth) and how they help solve crimes.

My interest in true crime is not new. I was first intrigued when I was researching information for the infamous Lizzie Borden case. Since I’m primarily a fiction writer, I am always interested in the motivation behind peoples’ actions, particularly when they resort to murder. And in most of these cases, one murder leads to the next. What are they thinking? And then, how in the world do they think they’re going to get away with it?

And then, what do they do to get caught? How outrageous (or clueless) is their behavior that they leave a trail behind them that leads the authorities straight to them?

Seven of these stories were written for Court TV’s Crime Library, and one was published as a stand-alone book called “Something Happened to Grandma.”

This book is published under the Horror that Happened imprint of IFD Publishing.

I hope you’ll enjoy these stories, and remember to lock your doors at night.