Saturday, October 9, 2010

The C Word

Part 1
Some things are just difficult to talk about, even for me. My friends always say, “Go ahead, tell us how you feel,” after I’ve blurted out some intimate detail that most would never mention. Friends are accustomed to me, though, and some have been around since 1972. That’s tenacity!

I despise circumlocution. “Just get to the point,” is the thought that spills past my lips. But the point that follows hasn’t dribbled out as a public display—till today, because now it’s happened four times. It’s the C word.

We probably all know others who have heard the word directed toward them, but when it’s aimed at you, its implications deeply permeate the soul. The word pierces the mind like a knife, and there it remains, knowing that once impaled, the knife can turn again. But I believe, with good planning and luck, you can avoid receiving C news. Read on.

Strike one was in late September 2008 when I had an abnormal Pap: atypical, squamous cervical cells. My mom had a hysterectomy at a young age, though she was never clear about the disease causing such a drastic excision, e.g., cervical, uterine, or ovarian dysplasia, so naturally, I became concerned. But being a healthy person with a positive attitude most days (I was hiking when my doctor delivered her news), I figured my doctor scraped the only dysplastic mass in my body. After all, I was 49, and not all 50 trillion cells are going to be perfect at that age.

Three weeks later I went to a nurse at a gynecological facility for a colposcopy, a surgical procedure that mimics a Pap test but is less fun. Additionally, without my knowledge or my primary care physician’s order, the nurse took cells for another Pap test that I later had to pay full price for. That still burns me.

The costly Pap results were negative (good), and the colpo indicated two sets of my cells were mildly to moderately suspect and should head directly to the executioner: in this case, surgery again (strike two). Initially, the nurse wanted me to have LEEP (loop electrosurgical excision procedure), which I heard as a razor-sharp, bloody, scalding, scraping procedure with an anticipated healing time of six months. I slept little for two weeks contemplating this torture. When I met with the gynecologist himself a week before excoriation, I asked what he would recommend for his wife, also a gynecologist, and he said, “Cryocautery.”

Sold. In mid-November I wiggled in to be frozen like a Popsicle in the hottest part of my anatomy. Though this was considered surgery, it didn’t feel like it, particularly afterward when my face flushed like a lobster in boiling water. I hoped the carbon dioxide snow killed any nasty cells, but it probably took a bunch of healthy ones too. Unfortunately, four days later my body reacted negatively, but I stayed away from the doctor anyway. One appointment alone cost $800, and that was with insurance, so rather than calling on my guardian angel, I treaded alone.

Seven months later at my follow-up colposcopy and Pap, more atypical, squamous cells were discovered: this time, glandular uterine (strike three). How many organs can be squished into such a small area, anyway? So two weeks later I had my fourth surgical procedure, one I would only wish on a couple of people, and they’re guys. Oh my God, what an immense, excruciating pain. Gals, if you can avoid having an endometrial biopsy (EMB), do. If you’d like details, click the link on your right, Stirrup Queens, where I met Melissa, head stirrup queen, who extended her kindness and love from New York all the way to Colorado, wishing me well before and after surgery.

The results from that removal proved negative (good again!). So now I shall share with you why I believe women can avoid hearing the dreaded C word. This has not been proven by anyone but me, to my knowledge.

As we age, our cells have more potential to form and grow abnormally. If we expose ourselves to unhealthy habits for extended periods of time, our chances increase that we will acquire a disease. Now think about the menstrual cycle. Monthly, women slough off unneeded cells that are dying, so chances are, they will appear dysplastic, particularly from a more mature woman—me, on most days.

Around day 14, our body begins tidying things up again, so our cells tend to be cleaner, healthier—even at an older age. My recommendation, therefore, is to have Pap tests done after day 14 and before day 26 in your menstrual cycle.

When my cells were taken on days 7 and 11 in my cycle, dysplastic cells existed.

When my cells were taken on days 21 and 22, my cells were fine.

An interesting note is this: The nurse who performed my colposcopies and endometrial biopsy said, “We can send your cells to four different labs and get three different results.” It depends on the person testing cells, the cleanliness and newness of chemicals, and other factors. Imagine that!

I firmly believe, after comparing notes with other women, that we are overtreated. I believe that had I not endured any of those surgeries and additional tests, I would still be fine. Why wouldn’t your doctor tell you these things? It would muck up their schedules and provide them and the labs less income.

Part 2
In early 2007 I noticed that a white, waxy dent, resembling a scar, had formed on my upper right forehead, seemingly overnight. For the next three and a half years I treated it with a friend’s precancer elimination ointment, vitamin E, triple antibiotic, and a dry-skin prescription. The dent grew.

I knew I should have gone to a dermatologist immediately but was concerned about the costs. When I finally made the appointment for Friday, August 13, 2010, the doctor walked in 35 minutes late, shook my hand in greeting, asked me what the problem was, took an alcohol-moistened pad, and rubbed my dent.

“You’re blue-eyed, blond, have fair skin, and you have cancer,” he said with the bedside manner of a guy who’s seen too many blue-eyed blondes with cancer. Strike four. Tears welled in my eyes as I stared at him in semidisbelief, hoping he’d slap me on the arm and say, “Just kidding.” Instead, he left the room while his assistant began injecting lidocaine into my forehead.

After a while, the dermatologist marched back into the room and declared that I appeared not to respect the medical profession, probably due to the prior shocked look on my face. Again tears erupted, and I cried, “I’m not aging well.”

He proceeded to use an electric grapefruit spoon to scrape away my dent, leaving me with a small landfill. Bandaged head and numb scalp, I paid my $50 copay and left. Cancer. Found in a building right next door to the gynecologist’s.

About a week later, a dermatological surgeon’s assistant called to set up my Mohs surgery for mid-September. The more I talked about my news, the more people shared their Mohs surgery experiences, so though I felt deeply sad, I felt as if I joined a club—one I wanted to be booted out of and not through death.

A friend of 25 years who had also had Mohs surgery offered to take me and stay by my side all day. When we arrived at the same dermatology clinic, different office, I requested a pain reliever for menstrual cramps. Eventually a gal handed me halcyon. Whee! I floated around on a cloud all day. Definitely couldn’t have done my taxes.

When the surgeon walked in, I felt immediate relief. Dr. Sniezek is young, bright, intellectually sharp, and knowledgeable. He patiently answered my list of questions and responded to my crazy comments with his own. I thought of cancer as a growth, yet I had an indent. It is still a tumor that is growing inward. Had I read that fact years ago, I wouldn’t have allowed the cancer to grow further. He asked if I noticed that the cancer was larger than the first dermatologist had noticed. I had.

Dr. Sniezek kindly asked my friend to return to the waiting room then drew lines around the cancer, which his assistant photographed. With lidocaine injected into my forehead and halcyon flowing through my veins, the surgery began.

After the first deep dig, hair cutting, and cauterizations, I floated to the waiting room for a couple of hours with a massive gauze bandage affixed to my head so my brains wouldn’t spill out. The way I was acting, though, I’m sure my friend thought it was too late. When I was finally invited back into the surgery room after noon, or maybe 10:00, he said they needed to remove more of me and that it was the rare, aggressive morpheaform type of basal cell carcinoma, invasive, fast-growing, and potentially disfiguring, since it can seep into and kill muscle, nerves, and bone. Insert halcyon number two.

After that excision, I think I stayed in the chair and thought about heaven and angels. At one point, Sniezek walked in and played with my forehead (pictured left). “What are you doing?” I quizzically blurted.

“I’m deciding how I’m going to put you back together and stitch you,” he answered. He described his artistry plan and left the room to go dig into someone else.

An eternity seemed to pass, so when he entered, I sadly said, “You abandoned me.”

Equally downcast, he slowly replied, “That’s a very strong word,” and he transmogrified into a seamstress.

Looking as if I were nursing a huge hangover, I stumbled to the front desk and scheduled my one-week follow-up visit and headed to Jim’s car.

For five days, frozen peas and my bed were my friends. It’s hard for an active person to rest midday, but I found it better than the dizziness I experienced plucking weeds. My hair has fallen out in sheets for three weeks, a condition Dr. Sniezek termed telogen effluvium, caused by a traumatic event. The guy knows everything. I even missed seeing him this past Friday following two post-surgery visits, but not enough to need him again.

If anyone has any questions or comments, write to ol’ Auntie. She’d love to hear from you. It’s pretty lonely staying at home looking like Frankenstein’s ex-wife.

basal cell carcinoma

Mohs surgery and morpheaform BCC

telogen effluvium

African sky © 2002 Bob Groat


  1. Auntie, this is terrible news. Are you going to be OK? Do you need any help?

    This doesn't seem right. You take such good care of yourself and have been so healthy.

    Hopefully you will get back to being your humorous self real soon.

  2. Thank you so much for writing, Don.

    I've decided I will be fine…and start wearing sunscreen more often. My increased vitamin C intake has helped me heal quickly. My head displays its unsightly red valley, but it keeps the guys at bay ; )

  3. Excellent description of a C procedure. My last surgery left me with a winking boosom! Auntie knows what I'm talking about.

    A new C has been discovered in the other boosom! Auntie, just imagine what TWO winking bosoms will do for me ;)!

    You and you forehead will be just fine. Let Aspen know that those ocassional conflicts could result in a dented head :)


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