May16

A phone call from the Macmillan nurse

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On Thursday afternoon, 16th May, the Macmillan nurse phoned whilst I was on the computer doing some school work. She had the results. As far as my back was concerned, the results came back negative, but they would probably err on the side of caution, and carry out a further, wider, deeper excision, at some point.

She then asked me if it was alright to continue talking over the phone about these results. There was something in her voice that told me it wasn’t going to be good news. And it wasn’t. The alien blob from my foot, was indeed a melanoma.

I couldn’t speak, I didn’t know what to say, nodding my head and tightening my fist until my nails dug into my palm.

I should be going to Derriford hospital tomorrow for a wide local excision with skin grafting. But she continued to tell me that I would probably just be going to Plymouth for a chat with my consultant, and then come straight home. It was unlikely that I would have the operation.

Continuing with her outlining of events, she said that the MDT had met the previous Tuesday morning, with my results appearing that same afternoon. It was probable I would be sent to Exeter for further surgery, but not until the team had met this coming Tuesday, and discussed their cases.

I would have a sentinel lymph node biopsy at the same time as the surgery on my foot, along with the skin graft. The biopsy meant injecting a blue, radioactive dye at the site of the wound, and then looking for an offending nodes that had turned blue. These would then be removed in the hope of stopping the spread of the disease. The nearest lymph nodes to my foot were those in my groin.

It was a long phone call, where she did most of the talking. It left me scared, confused, unsure, and made for quite a sleepless night.

What should we do?

Will the operation go ahead?

Will it be worth driving to Plymouth at all?

And what of the melanoma, what were the implications for me?

May15

Post-op #1 ~ more dressing of the crater

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Following on from Wednesday’s visit to the surgery, I was back there on Friday ~ no better, no worse ~ was the state of the infection ~ keep taking the pills!

On Sunday the district nurse came to the house to clean and dress the wound. As it was still a bit stinky, she advised me to go back to the surgery on Monday.

I’ve never visited the place, on so many occasions, in so short a time! Back on the Monday, as the infection was still present, I was put on another set of antibiotics.

The swabs that I had taken for MRSA all came back negative, so that was some good news!

My last visit to the nurse was on Wednesday 15th May, when it found that the infection had  cleared up, yay! All systems go for the skin graft operation.

May10

An appointment with the Macmillan nurse

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Friday 10th May

We drive to our local hospital hoping for answers; but we come away confused and scared.

The results are not yet back from histology for either my back or my foot. The one from my back is being tested again, as it has proven to be inconclusive, and needs a second opinion. The nurse asks if I want her to phone me if she can find out the results. I say I would like to know.

The conversation then turns to looking at possible courses of action. She said the South West is in the forefront of new research, trialling new drugs and managing the disease. She said I would probably have a sentinel lymph node biopsy, to see if anything had spread. By then I think I had switched off, I didn’t want to hear anymore, I just wanted to go home.

May8

Post-op #1~ wound dressing #2

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Wednesday 8th May

I was dreading this, I really didn’t want to go through the pain again. However, it was so much easier this time, nothing had stuck to the wound tissue ~ breathes enormous sigh of relief! But, there was an infection. My notes read: malodorous today, sloughy wound bed, periwound erythema. Bleugh. Antibiotics were prescribed. If the wound were to remain infected, the skin graft couldn’t go ahead.

May6

Post-op #1 ~ wound dressing

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Monday 6th May

Three days after the operation I had an appointment to visit the nurse in our local surgery. My wonderful next door neighbours had borrowed a pair of crutches for me, making it easier to cross the road to get to the car.

If I thought it was painful before, I wasn’t prepared for this!

Upon unwrapping the bandages, the wound, actually more like a crater, was filled with gauze. The wound had to be kept open, in preparation for a skin graft, two weeks hence.

Using saline solution and plastic tweezers, the nurse, as gently as possible, began to prise the dressing away from my skin. Forty five minutes of crying, hyperventilating, hanging on to my husband’s shoulders, and finally the wound was clear.

It did look quite scary and very deep. Having cleaned and re-bandaged my foot I felt a lot more comfortable, plus I was armed with a box of much stronger painkillers!

And they worked! If I timed it right, taking two, 40 minutes ahead of time, I could hop-hobble to the bathroom in a little less pain!

A much better sleep was had that night.

May3

Post-op #1

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3rd May 2013

Oh my goodness! The anaesthetic wore off at 2:30am, and the pain kicked in.

I had only taken a couple of paracetamol, and that certainly wasn’t enough to stop the awful throbbing.

When I tried to get out of bed a little while later, the blood rushing to my foot plus the actual weight placed on it as I attempted to stand was unbelievable. It felt like my foot was exploding, spurting blood and gore everywhere.

I had to get to the bathroom. Crying, hopping, sliding, bum-shuffling, hanging on to my husband; it seemed to take forever, but finally I was there. The pain was excruciating. And then followed the long journey back to bed; I must have looked ridiculous!

May2

Operation One

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Thursday 2nd May.

OK, so the day looms; overnight bag packed (just incase), phone plus charger, trusty Kindle, all ready to go. I’ve had nothing to eat since yesterday dinner time, not even a cup of tea this morning!

Soon after arriving at the hospital, we go for form filling, blood pressure and MRSA swabs. I have a name tag bracelet and a great big black arrow pointing to the offending blob; as if it needs an arrow!

Going into theatre is a breeze, anaesthesia takes over, and when I come round I don’t realise it’s all over.

Water, cups of tea and a ham salad sandwich are brought to me. Wonderful, wonderful after-care.

I finally hobbled out mid-afternoon, no pain, no ill effects. We stopped briefly for a cappuccino, and drove back home, whereupon I went straight to bed, feeling a bit groggy.

I was told to keep my leg elevated for at least 48 hours. Sleeping with my leg outside of the duvet is a little tricky, but I managed it.

On my discharge notes it said I’d had an excision of a lesion dorsum, left foot with dressing. Recommend rest and elevation and off duties.

In the first 24 hours I mustn’t cook, use electrical equipment or tools, not to drink alcohol nor to sign any legal documents, ie cheques. Any of the above may endanger you or others!

Apr26

First consultation ~ plastic surgeon

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Friday 26th April

I visit the outpatient’s department of the local hospital to firstly have the stitches removed from my back, a simple, painless task, then to meet the plastic surgeon consultant. He breezed into the room, crisp, white, open-neck shirt with cufflinks, stuck out his hand to shake mine, not looking at my face, but down at my foot. “Ooohhhh, aaahhhh, hhmmm” Right, not sure what it is, but most likely a melanoma. It has to come off, and quickly. He made a hurried telephone call to his secretary, and I was booked in for the following Thursday.

He was efficient, professional, and incredibly caring and I knew there and then, I was in the best possible hands.

Things really were beginning to move along fast.

Apr16

How the journey began

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I’ve always had a small mole on the top of the fourth toe of my left foot. It’s been there since forever. I’ve also got quite a moley back and tummy, but nothing, I thought, of any major concern. My husband and I check our bodies regularly.

(Back when I was about 11 years old, I had a mole removed from the right side of my jaw. This was carried out in Singapore, at the British Medical Hospital. I think I stayed in for a couple nights, and came out with about nine stitches. The scar is barely visible now.)

Anyway, playing in the garden last Autumn, next door’s dog nicked my toe with its claw, and just caught the side of the mole, causing it to bleed a bit.It seemed fine all through the Winter, I was wearing tights and shoes to school, no problem. Then in the New Year it began to get bigger, it would weep a bit, and I took to wearing a plaster over it. Soon I could no longer wear proper shoes, and took to wearing FitFlops to school. It was then I made an appointment to see my GP.

Things moved very quickly after that.

My first appointment at the Dermatology Department was on Tuesday 16th April 2013. Photographs were taken, but the consultant there thought the alien blob was too big and too serious to be removed then and there. I would be referred to a specialist plastic surgeon as soon as possible.

However, on further inspection of my body, I pointed out a very dark mole on the lower right of my back. Well, that can come off right away! Arghhhh! We went away for a coffee, coming back an hour later to have the procedure carried out under local anaesthetic. Whoa! Too many injections of anaesthetic and adrenaline later, my back was being stitched up, with deep, disolvable ones, and then a line of surface stitches. The offending item would be sent away for biopsy.

I had that day off school, plus the following one, as I was still somewhat sore. Back to school on Thursday and Friday.