Friday, December 14, 2007

I'll Take the Second Opinion

Melanoma is not something I take chances with, knowing full well that an incorrect diagnosis would probably be a death sentence. On the other hand, I am reluctant to let anyone cut off even a tiny piece of my body unnecessarily.

I see two doctors who specialize in skin cancer a total of 4 times a year, alternating between Dr. Braun, who pioneered Mohs surgery for the removal of basal cells, and Dr. Peck, who heads up the National Melanoma Center here at the Washington Hospital Center.

This week it was my turn to visit Dr. Braun, whose politics are 180 degrees from mine but who has for many years helped me search out things gone wrong with my skin. He has removed a number of basal cells, 4 melanomas, and a slew of other things that turned out to be benign. On Tuesday he noticed a large mole near my left ankle that he found suspicious because of dark spots in the center. I told him that mole had been there unchanged for years and that he had repeatedly checked it in the past. He reminded me that anything can go bad at any time and recommended that I schedule an appointment for excision.

Then he asked if I was still seeing Dr. Peck and when I said yes suggested that I get his opinion before scheduling the surgery.

I went in today to get that second opinion, fully expecting at least a biopsy to be performed. I feel so strangely calm about these incidents now, as opposed to my first experiences with skin cancer, when I was so terrified that I was going to die.

At Dr. Peck’s office I am always seen first by his current student, who just happened to be a very pleasant young man, Dr. Singh, probably from India or Indonesia. The biggest difference today was that I could remain fully clothed instead of wearing one of those skimpy gowns that leave you cold, ugly, and uncomfortable. I had to remove only my sock for the exam.

Dr. Singh applied his dermatoscope to the dark mole on my ankle and pronounced it benign. He also said it was fortunate because it was in a difficult place for surgery.

Dr. Peck came in soon thereafter and concluded the same thing, describing it as having lacy edges and actually fading in color. I don’t really care about the edges or the color as long as it is not a time bomb waiting to go off.

So I felt relieved that 2 out of 3 doctors told me to put on my sock and go home, reminding me that they would continue to monitor it and the hundreds of other such places that adorn my skin.

Dr. Braun and Dr. Peck are an integral part of my health plan at this point, having so far helped me beat the odds of succumbing to skin cancer. As they both talk about possibly retiring, I am wondering who will take their places. Maybe it will be one of Dr. Braun’s three children, all of whom have become dermatologists and now practice with him. Maybe Dr. Singh, who Dr. Peck told me today would be the perfect replacement for him.

I feel fortunate today for getting a second opinion that says I am healthy and for having doctors who will continue to help me be vigilant.


Blogger Richard said...

It made me laugh to read that got to keep your clothes on, less the sock.

I often wonder why they make you disrobe into that awful blue paper gown. It often seems so unnecessary.

Glad your checkup went ok.

8:02 PM  
Blogger Barbara said...

Richard -- The awful blue gown must come off for the doctor to do a complete check -- a check that also includes a thorough look at your scalp and in between your toes. So the useless gown is just an unnecessary formality that gives at least the initial semblance of cover-up. I'm always ecstatic to put it on again when the exam is completed.

I've given serious thought to buying a dermatoscope ($700) and having Dr. Peck teach me how to use it. It would be good to be able to see for myself instead of having to put the responsibility completely in the hands of my doctors. With the use of alcohol, the dermatoscope lets one see into the skin in a way that can (hopefully) sort out the bad from the good lesions.

8:18 PM  
Blogger Mother of Invention said...

I am really glad they found nothing. You must always live with the fear that it could come back and once you have had it, it pays to be vigilant about thorough and regular check-ups.

I get paranoid with all my moles because they all seem weird-looking to me, but I do get a mole check once a year and have only ever had one removed.

9:51 PM  
Blogger Pauline said...

I know that terrified feeling of the first suspicion that you might have skin cancer. I've had one spot removed, a full facial peel done (painful and nasty looking for a three week duration), and since then have had a number of suspicious spots blasted with liquid nitrogen. I am hoping to expire in my bed from advanced old age :)

7:41 AM  
Blogger Barbara said...

MOI -- A regular skin check with a good doctor is a prudent thing for everyone to do. Their eyes are trained to see things we might miss.

Pauline -- It sounds like you are being proactive. I did come to realize, however, that basal cells are usually not a cause of death; they just erode your skin. It's the dark ones you really have to be cautious with.

7:51 AM  
Blogger Reya Mellicker said...

Good doctors are rare. So good to appreciate them! Glad to hear the good news, too. Bravo!

8:44 AM  
Blogger Barbara said...

Reya -- I think it would be a daunting responsibility to be a doctor, knowing bad advice could cost someone a life and the doctor a job!

9:18 PM  
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4:00 AM  

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