Friday, March 14, 2008

Just a Little Brown Dot

This little brown dot about 1/8 inch across was the focus of my semi-annual visit to see Dr. Peck, one of my trusted skin doctors. It was the dark irregular portion that sent up a red flag.

The drill at these visits is I’m always seen by his student-du-jour at first and then Dr. Peck comes along afterwards to check on the student’s findings. Some of them are shy and almost apologetic about the fact that they have to look at every bit of your body. But today’s student Meredith was confident and reassuring at the same time. After a thorough exam, she had determined the little brown dot to be the only suspicious thing on my entire body.

I found myself already thinking that an excision on my right inner thigh would not be nearly as bad as the last one on the inside of my left knee.

Dr. Peck is quite cautious when it comes to even taking a biopsy. He agreed with Meredith, but after looking at the little brown dot through his dermatascope thought there was a good chance it simply represented an aging mole that was not all aging at the same rate. He asked me to come back in 3 months or if I noticed any change in it. Fortunately it’s in a place I can easily observe.

Even as late as several years ago, I would have blanched at the idea of having a melanoma and opted to have it removed even if there was the slightest chance it was malignant. But after so many such surgeries that did turn out to be benign and even after the 4 melanomas I had removed, I would rather not rush into what might be unnecessary surgery.

Dr. Peck knows EVERYTHING that is going on in the world of melanoma. He thinks big and thinks in the future. He would love to see a screen on the wall where he could project an image of what he was seeing as he looked through his little scope so the patient could understand what he was doing better.

He said the latest finding is that melanoma is always associated with a change in DNA. If there could be a topical gel that would mark such DNA change, the guesswork in diagnosis might be eliminated. I jokingly said, “Maybe that’s how you can make your mark before you retire.” He replied, “I’ve already made mine. Maybe Meredith can do it.” As the N.I.H. researcher who discovered Accutane, he has already made a significant contribution to the field of medicine.

He and Meredith were somewhat concerned about the many pre-cancerous spots on my face. Instead of continuing to freeze them, they prescribed Retin-A, which I will now have to use several times a week forever. The unexpected pleasant side-effect of this medication is that it removes wrinkles.

My skin will no doubt continue to be a challenge, but it’s doctors like Gary Peck who give me the confidence that I’m really doing just fine.


Blogger Ruth D~ said...

How nice that you have such a trusting relationship. I take this post as a push to get my own speckled body to a dermatologist . . . soon.

11:19 PM  
Blogger Pauline said...

Ah yes - the precancerous sun damage spots - I had a full facial treatment to catch as many of those as possible. It was a painful and dreadful looking process but I have new skin on my face and very small spots now that can be frozen periodically. I've had two biopsies, one with a danger signal, and go every six months for checks as a precautionary measure. Better to be safe than sorry and while my own specialist is not renowned for anything save his less than winning bedside manner, he is at least thorough.

7:22 AM  
Blogger Reya Mellicker said...

I think too that you've worked very hard these last few years to come into a more trusting and comfortable relationship with your own body. when I met you, you were awfully suspicious of every little hiccup, what it might mean. Now you of course still pay attention, but you're not so worried.


9:26 AM  
Blogger Barbara said...

Ruth, Pauline -- It's reassuring to have a professional's eyes helping you be vigilant!

Reya -- I have been far better off since I quit worrying so much. At this point, I simply trust that all will be well if I see my doctors every few months and use sunscreen in between! Life's too short to ponder what might be.

9:41 AM  
Blogger Colette Amelia said...

wow that is scary! So glad that you are managing the ongoing struggle with calm. Knowing very little but the warnings about the sun and its dangers is this the culprit?

Funny how in the past we thought that a burn would tan us faster. Then we were scared to stick out heads outdoors and now we must in order to get the valuable vitamin D. I can't keep up, but I guess like everything moderation and balance is the key.

1:47 PM  
Blogger Barbara said...

Colette -- I have a love-hate relationship with the sun. It is indeed those years of unprotected skin on the Florida beach which are responsible for the sad state of my skin. But we still need a certain amount of sun. It's a real balancing act.

Truthfully it's not nearly as scary after the first diagnosis.

10:45 PM  
Blogger Richard said...

The ability to take pictures with dematoscopes exists, so I am pretty sure that someone sells one or has an attachment for one that connects to a wireless transmitter to allow displaying on the computer or a projector.

There are always so many skin changes going on, it is hard not to be concerned about them. Just imagine all the changes going on inside our bodies that we are unaware of and cannot examine.

Yesterday, we took JJ to the doctor for a fairly large red blob on his skin. Turns out it is a cherry angioma. Now it will be weeks if not months before we can get it removed.

2:10 PM  
Blogger Mother of Invention said...

Glad you're okay! I've been on accutane for acne but could only tolerate it for 6 weeks. Too bad since it is really effective and cleared up my skin for a little while.

3:38 PM  
Blogger Barbara said...

MOI -- Skin has all sorts of problems, yes?

3:45 PM  

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