Reading someone's cancer diary is usually depressing and heartbreaking, and, if you're like me, scary, because you eventually start worrying that you'll soon be going through the same thing. So you'll be happy to know that this cancer diary isn't the kind where the patient has months to live and gets weaker by the day until there are no more posts, and you end up sobbing over someone you never met.
October, 2015. My doctor's office has been sending me letters and robo-calling me for weeks to inform me that I need to make an appointment. No specifics, like it's time for your rabies shot, just get in here, we haven't seen you in months, and business is a little slow, and you could have a disease with no symptoms and we prefer healthy patients because we don't have to worry about getting their diseases and now's the perfect time, unless you think you might have Ebola, in which case, never mind. So screw it. If I make an appointment, they win. On the other hand, the only way to get them off my back is to make an appointment, so I do. Fuckers.
November 3, 2015. My appointment. I've brought a list of everything that's wrong with me so the visit won't be a waste of time. My nose is reddish, my lips have a blue tint, I have what I think is a skin tag on my neck and a small area under my eye that I think is a chalazion. I made that diagnosis after looking up "sty" on the internet, and finding it was similar to a chalazion, which I'd never heard of, but when I Googled "lower lid chalazion" and clicked on "images", a few of the less-gross pictures resembled what I had. Anyway, chalazions usually go away by themselves, though they can hang around for months. My doctor doesn't care about my red nose or blue lips or skin tag, but he gives me the phone number of a dermatology clinic, telling me to have my eye thing looked at, as it might be something. I think he mentioned the word "squamous" in there. He doesn't seem overly concerned. He doesn't say, Get thee to a surgery.
November 4, 2015. I phone to make my dermatological appointment. The person I speak to says there's one opening next week, so I say I'll take it, and she comes back a minute later and says someone else beat her to it and the next available opening is November 30. I'm thinking, November 30? I could be dying of cancer and you're booked solid for a month? You need to hire more doctors if business is that good. Maybe you should open on Saturdays until you get caught up. I take the appointment, figuring if I stall another minute it'll be gone and I'll be pushed into 2016.
November 30, 2015. As I'm being led back to the room where I'll be seen, I can't help noticing that all the nurses and interns and receptionists I pass have perfect skin. I figure they must know what they're doing in this place. They probably treat all their employees for free and pay for it by upping everyone else's bill. Eventually my doctor comes in and asks why I'm here. I mention my red nose and my chalazion. He looks at me through a giant magnifying glass and says, "That doesn't look like a chalazion." I say, "What does it look like?" and he tells me it looks like skin cancer. I argue that it's a chalazion, and that he'd know that, if he'd ever even heard of a chalazion. He searches for chalazion on an iPad and shows me that my chalazion isn't one because it isn't quite touching the eyelid. I'm not sure I buy it, but that's probably because I'm still in the first stage of my cancer diagnosis, which is denial. (The other stages being demanding a second opinion, reluctant acceptance, life passing before your eyes, booking that vacation you've been putting off, pricing burial plots, scheduling a future appointment with a lawyer to change your will cutting out everyone who doesn't visit you when you're in the hospital dying, and getting religion, just in case.) I ask the doctor if I'm gonna live. He says Yes. I'm thinking, Thanks for burying the lede. You couldn't have opened with It looks like easily treatable, run-of-the-mill, harmless skin cancer? He does a biopsy, gives me a prescription for my red nose, which I know will have no effect, and says he'll be in touch with the results.
December 2, 2015. The dermatologist phones, says he was right, it's cancer. Like he would have admitted it if it turned out to be a chalazion. He says I need two operations, the first to remove it and the second to graft some replacement skin in its place. They can remove it in the clinic, but because it's so close to my eye, there's a specialist who'll have to do the graft (something to do with the possibility that the cancer is close to the tear duct), and the specialist doesn't work there so the operations will have to be done on consecutive days in different cities. Finding two consecutive days convenient for the two surgeons apparently proves difficult, but they book me for January 25th and 26th. I'm thinking, Are you people kidding me? That's like two months from now. I got cancer. I can feel it spreading into my pancreas and lymph nodes and lungs, and you can't move me ahead of all the wart treatments and eyebrow tucks and chalazion removals? I say none of this, because I trust that they know what they're doing and because it's not a good idea to antagonize someone who may soon be in a position to "accidentally" stab your eyeball with a scalpel.
January 7, 2016. I have an appointment with the surgeon who's doing the skin graft on the 26th. It's a chance for him to look at my skin and come up with a game plan for the operation. He looks. He tells me the good news is that I have basal cell carcinoma, and it's more a surgical problem than something requiring ongoing treatment. His assistant takes a couple pictures with her iPhone, probably so she can show them to her friends as examples of the gross stuff she has to look at every day. The surgeon seems like a nice guy. He's there about five minutes during which he does pretty much nothing. Later I'll get his bill for $380.00. Which includes $84 for photography.
January 25, 2016. There was a big snowstorm over the weekend, and I was worried they'd call and say the doctor couldn't make it and they'd need to reschedule me for April, but they called Sunday night to say I could show up late if necessary. Which it is, as it takes about forty minutes for an eight-minute drive. After some paperwork and prep, I sit in "the chair." It isn't an operation where they put you to sleep, although I do have my eyes closed the whole time, because the light shining on my face is the approximate brightness of a sun. Not a yellow sun, like ours; a blue sun like Sirius. They numb the area of the cancer, which is about a half inch by a quarter inch. Then the surgeon slices it off. Since my eyes are closed, I don't see if he's using a scalpel or a cheese slicer. They put a patch over the eye. I had been told I might have to wear a patch, but I was thinking a pirate patch, not just a bandage. When I complain, one of the nurses offers to draw a skull and crossbones on the bandage. They send me back to the waiting room while they look at my now-missing skin under a microscope. Turns out the cancer goes all the way to one edge of the skin they'd removed, and I have to go back so they can take some more from that side, but at least it isn't the tear duct side. That's good news because I'll need my tear ducts to be fully operational when I find out how much of this my insurance covers. At one point I hear the surgeon say, "I need someone to hold the skin apart here," and I reach up, saying, "I'll get it," and several people simultaneously yell "No!" We all have a good laugh. Anyway, back to the waiting room and when they come for me the next time it's to tell me they got it all. This time someone offers to draw a smiley face on my patch. I decline.
January 26, 2016. I'm late again, this time because of rush-hour traffic. I'm to be put to sleep for this operation, not the mask over the face way, just the IV, like I'd had done for colonoscopies. First I fill out some paperwork where I have to tell them whether I have a living will or a do-not-resuscitate order, etc. And where the possible side effects of the operation are listed, including brain damage and death. I start thinking the skin cancer isn't so bad. My glasses hide most of it and I'd probably die of old age before it got bad enough to kill me. They lead me into a prep area behind a curtain where I have to remove all my clothes even though they're only working on my eye area. Surgeons have learned that patients are less likely to make trouble if they don't have their clothes. At least they give me a warm blanket to lie under. A nurse comes in and asks how I'm doing. I tell her I need her to remove my patch so I can rub and scratch my eye for about ten minutes. I'm joking, but she looks at me like I'm a giant blood-oozing chalazion. She asks me if I mind a couple people observing the operation. Med students, I assume, or possibly Syrian refugees. I grant permission because it never hurts to have witnesses if you die on the operating table. She starts asking me questions, all of which I answered a couple days earlier when they phoned me, and then she accuses me of looking at her like I think she's crazy. I have a patch over one eye and without my glasses the other eye has blurry vision, so I don't see how she can tell I think she's crazy. She must have ESP. The surgeon comes in, tells me he's going to get the skin for the graft from near my eyelid. The person who was there to put me to sleep finds the IV isn't working because the nurse who hates me put it on wrong. She gets it going, and the next thing I remember it's all over. They let me look at the results. It looks like terrorists attacked me with box cutters. My "wound" and bruising area is about twenty times the size of the cancer.
January 28, 2016. Here's my first-ever selfie:
It looks even worse when I look at it in the mirror because my glasses magnify it. On the other hand it already looks a lot better than it did right after the operation; now it just looks like I've been in a bar fight.
February 3, 2016. Followup visit. My various concerns, such as I can't open that eye as far as the other one and my vision in that eye is blurry and it feels like there's some kind of bone spur or tumor on the edge of the eye and I look grotesque get brushed off as temporary. Also, there's still a swollen area about the size of a cigarette butt under my skin, possibly because the surgeon was smoking during the operation and dropped it in and left it there just to amuse the observers and the nurse who hates me. Better a butt than a retractor or a scalpel, I tell myself. As I'm leaving, they stop me because they forgot to take more iPhone pictures. Can't let me get away without that $84 charge on the bill. I'm guessing they want all these pictures to illustrate a textbook on successful skin grafting. Or unsuccessful, depending. They tell me to come back in a month so the surgeon can admire his handiwork and charge me another $380.00. Technically I think I can call myself a cancer survivor.