My son came with me when I saw the surgeon who delivered the news from the pathologist.
It was an all clear. The cancer had been removed with good margins around and beneath both lesions. No need for follow up. I'd had a lucky escape. Those microscopic cells had been contained in the dermis and headed off at the pass, probably by the second nurse and perhaps the bots as well.
I was very fortunate and also confused.
Both the fourth GP and third dermatologist had expressed their concerns about the pain I felt when the lesions were touched. They'd refer to it as 'perineural invasion' but I wouldn't because, as I've previously mentioned, I prefer to connect with my reality by not talking the talk. If it helps, I'm referring to the sort of pain you might feel when the dentist probes around with a long spiky thing to see if anything happens. That's right. The sort of pain that indicates a nerve's been brought into play.
I therefore asked the surgeon what could cause this intensity of pain if the cancer hadn't spread beyond the dermis. After a short pause for thought he replied that the dermis can sometimes be quite sensitive. I wasn't too reassured by this. He then took another look at the lab report on his computer and confirmed that he knew the pathologist and had done quite a bit of work with him. This interested me and left me wondering what he would have said if he hadn't known the reporting pathologist.
Needless to say, we then had a chat about safety in the sun. This was always going to be inevitable. He went through all the usual bits and pieces but also acknowledged my history and predisposition. Simply put, the damage had been done throughout my life but precautions still had their place.
He then brought things to a close with this upbeat comment that was no doubt intended to reassure: "We're not asking you to live in a box."
Good thing too, I thought to myself, because I'd far rather live in a nice safe dungeon.
My son and I then headed off for a celebratory coffee. He could see I had my doubts and understood where they came from. We then discussed the possibility of a second opinion but I knew this wasn't for me. I think there are times in our lives when we just need to put our concerns aside and get on with things. Taking everything into consideration, my outlook was extremely good. Why bother with questions that didn't need to be asked?
But there is a question that in due course will probably need to be asked. Would I go private again?
If the funds were available, I'd say yes. Even though I waited for two months on the NHS red flag list before approaching the private clinic, everything was done and I received the results a week before the date when I was due to hear from the NHS about my first consultation. My appointment could have been weeks later, with surgery and results potentially adding several more months to that.
But it might not be as clear as I'm suggesting. While chatting during my final wound check, the nurse happened to mention that the clinic receives referrals from my NHS trust for patients that have been waiting on its lists for too long. That came as a surprise. I could have stayed put with the NHS and had exactly the same treatment at the clinic for free.
But would I have wanted to wait?
I count myself lucky that my personal experience has been of such a visible form of cancer. I could see it right from the start. As the lesions grew and transformed, they hid nothing from me. But luck and timing were on my side and I'll certainly avoid any future waits if I can possibly work out a way to do so.
I need to give this serious thought, because I've had a type of cancer that's not only likely to return but also likely to get to work more quickly when it does so.
I'm therefore more preoccupied with avoidance. If at all possible, this cancer must be avoided. I need to run away from it and keep on running. I'll worry about the waiting side of things after it's caught up with me and arrived.
Is there anything in my personal experience that I can call on to help promote my avoidance strategies? There are two things, actually.
Firstly, wide awake skin flap surgery is best avoided by all possible means. You won't be able to see anything because your eyes are closed and covered for protection from the intense brilliance of the theatre lights, but you'll certainly feel it.
People talk bravely about it being okay after the local's gone in. But they don't tell you what that'll feel like. Try to imagine being repeatedly hit over the head with a brick for the best part of a couple of minutes. That might help. And don't be lulled into a false sense of security when the theatre nurses stand on either side of you to offer a comforting hand to hold while calmy reminding you to breathe. They're also correctly positioned to restrain you, should you decide to postpone the procedure and head for home.
But eventually the agony stops and in no time at all you'll hear the surgeon telling you the lesions are out. You don't actually need to be told that, because by then you will have felt someone pressing so hard on your scalp to stop the bleeding that you could end up with a broken neck in the process.
And then the head block is produced. Just think of it as a softer version of an executioner's chopping block and you're on the right lines. The problem is, you won't know where to place your head on the block as the surgery proceeds. Not to worry, whenever your head needs to be moved they'll do that for you, offering more opportunities to see how far your neck can be twisted before it snaps.
By this point you'll be in no doubt about the amount of blood you're losing because the theatre drapes that soak it up have been changed so often they're in danger of running out.
No problems there. The surgeon's just about ready to open up your scalp and rearrange it. I don't want to imagine what sort of equipment is used at this point and you shouldn't either. Whatever it is, it stretches and twists scalps with astonishing force that's beyond brutal. Your neck takes the strain yet again but by then you'll probably have lost the will to live.
Surrender has its advantages.
Presumably the scalp stretcher keeps everything in place while the stitches go in. There are plenty of them. I must say the surgeon timed things to perfection for me and I didn't feel any pinpricks until he was almost finished.
It's been strange to have a cancer so visible, so painful, so disruptive to my everyday life, and yet so quickly defeated by the surgeon's scalpel.
When I later told a friend about that day she aptly remarked: "Medieval."
And what about my second reason for avoidance?
In a previous post I mentioned the girl in the café. She could tell you all about it. She's probably still having nightmares about it.
In the months before surgery I'd become severely disfigured by those disgusting lesions. It was awful. They were always there, utterly gross in appearance and nauseating to behold. Two enormous black and crusty eruptions bursting out of my head and forcing me to withdraw from people as well as daylight.
But sometimes an online delivery, bin collection or other form of social contact was unavoidable. On those occasions there was nothing else for it and I was compelled to conceal my shocking appearance with the embarrassment and shame of a leper.
And that's the other reason why I'll always do everything I possibly can to avoid this horrible, toxic, life altering, soul destroying disease called skin cancer.
