Tag Archives: lymph node biopsy

Appointment details for September!

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Friday 19th July

The next steps for me have been have been set in motion.

I received an email this afternoon from my consultant’s secretary.

I have my pre-op on Wednesday 4th September ~ two days after we land from our summer holiday ~ the same date as the first day of term!!! Yikes.

And then I’ll be admitted on the 10th for the sentinel lymph node biopsy procedure.

Scared? Anxious? Relieved? Worried? Frightened?

All of the above!

But, I’m going enjoy my summer vacation!

Have fun, relax, chill, enjoy, laugh, rest, recharge . . . . . .

Worrying won’t make a difference to the dates of the appointments. The decision has been made for me, and I know I’ll be looked after by a great team.

Eye ointment for my foot!

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Wednesday July 17th

So this is probably the last time I visit the practice nurse at the surgery for a check up on my foot. Plus, I needed a couple of things on prescription to take away on holiday with me. When I had my appointment with the consultant on Monday, he suggested that as the skin graft wasn’t fully healed between my toes, the best remedy was antibiotic eye ointment! Eyes and toes, hey? Almost at the opposite ends of one’s body! But, if it does the trick, I’ll not argue 🙂 One prescription for the cream was duly issued.

The nurse was really pleased I had been given the all clear to fly and go away for six weeks; yay! We talked about gentle exercise on the plane and the wearing of compression stockings ~ very fetching!

Later on in the afternoon I received a telephone call from the secretary to the consultant I saw on Monday. A quick catch up to explain the next course of events, and to check our holiday dates, so that the surgery can be fitted around those times. I will need a pre-op consult with a nurse, plus some blood tests, then I’ll be all set for the operation a few days later; a general anaesthetic, but I should be able to go home that same day ~ hopefully! She sounded really friendly, and very reassuring, and wished us well for a great holiday. She took my email address to make sure that I was kept up to date with details of appointments and hospital visits.

I can now relax for the rest of the summer, and enjoy our time away. Yes, I know I’ll be returning to more surgery, worrying about results and yet more time off work, but for now: “Here comes the summer!”

Holiday ~ Go or No?

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Monday 15th July

Plans for our whole summer hinge on today’s appointment . . . .

Just arrived home after meeting with a super, consultant plastic surgeon at Exeter. I had been dreading this appointment, wondering what he was going to say. He explained that he is going to carry out the staging procedure by injecting the radioactive dye into the site of my malignant melanoma, on the top of my foot, at 9am and in the afternoon, carry out the sentinel lymph node biopsy to see which lymph node this has drained to. If all goes well, I could be going home that same day. And then wait for the results.
(He commented that my scar was healing nicely, but my toes were still a bit swollen; looking like pork chipolatas!)

My big question to him was “When!!!!??? When would you plan on carrying out the surgery?”

He looked at my notes and saw that his colleague had written that we had booked our summer holiday. “No problem, we’ll wait until you get back ~ I do have a space tomorrow, but you wouldn’t be able to fly next week!”

Oh my goodness, I had come to this appointment fearing the worst. Lots of emotions flying around my head!

He explained that he has operated on pregnant women, to remove the melanoma, and then three or even six months later, after the baby is born, carried out the sentinel lymph node biopsy.
He could see no problem with waiting until September, and reassured us that I wasn’t being foolhardy or selfish in wanting to go on holiday. If there are any microscopic cells in the nodes, or in transit, they’re not going to get markedly worse in the time we’re away. Plus, as my CT scan had come back clear, he was really positive, and said we should go and have a good time!
Feeling much better, for the moment!

I have been using the internet to find out as much as I can about this disease, and the proposed next course of events for me.

Much of the information states that the sentinel lymph node biopsy should be carried out at the time of the wider local excision, so that the route to the draining lymph nodes can be tracked accurately.

There is a school of thought though, that thinks maybe some of the microscopic cells are still in transit, and so, could be missed.

I had the MM removed on 2.5.13, and then the WLE on 7.5.13. (6mm, Stage 2b). The CT scan was on 5.6.13. My consultant said he would get me on his theatre list for September. He said it probably wouldn’t be that much sooner anyway, (unless I had it done tomorrow), as August was looking busy for him, and he was probably off to Florida for a couple of weeks too.

I’m being looked after by the NHS, but two of the three consultants (male), I’ve seen have private practices, and I certainly feel as if I’m being treated as a private patient. I feel really lucky, and totally reassured.

The long-awaited letter arrives

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Friday 5th July

I received a letter this morning from the consultant plastic surgeon in Exeter for an appointment a week Monday. The letter says it will just be an initial consultation, so I will go along with all sorts of questions . . . . the main one being, if it’s not life-threateningly desperate, could he hold off any surgery (a delayed Sentinel lymph node biopsy procedure), until after the summer holiday ~ do you think that’s cheeky or selfish or foolhardy on my part???? We booked our flights to America way back in January, for a five and a half week road trip.

I’ve been thinking so much about the arrival of this letter, that when I did open it, it made me feel a bit sick/scared/worried. It’s the prospect of not knowing what they might find, plus the actual procedure itself.

A number of fellow melanoma-ites have suggested that not many surgeons carry out a SLNB unless it is done at the same time as the original WLE.

Still, needs must, if that’s what the consultant thinks.

I have just over a week to wait . . . . .

Follow up appointment

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Friday 14th June

It is now exactly four weeks since I traveled to Plymouth for the second operation on my foot. Painkillers, dressings, infections, antibiotics, appointments, a scan, compression stockings, crutches, silly foam and Velcro shoe/boot have all been a part of my daily life!

Today I went to see my awesome plastic surgeon consultant at Treliske (he was running over an hour late!), but he still took a considerable amount of time talking to me.

He is really pleased with the way the skin graft is taking on the top of my foot. We discussed all the procedures he had undertaken, and being an 8mm tumour, that means I have Stage 2B melanoma, with a five year survival rate of 70% (good odds, or not?)

For now, I must focus on being as healthy and sunsafe as I can. The recouperation process from two lots of major surgery is still ongoing, taking in physical, mental and emotional recovery.

He is referring me on to his friend/colleague at Exeter for Sentinel lymph node biopsy. (“He’s a good bloke!”) and we talked about what might happen. I’ve a feeling the letter may come through pretty soon, as he dictated the request there and then. He really wants to push me to the front of the queue, bypassing time consuming paper-work.

Also during the consultation he spoke of my talking with an oncologist, but was wary of too many specialists each having their own take on the situation, and advising one course of action without communication with the rest of the team! He told me quite vehemently that I am his patient, and he makes the decisions! (I believe he was making reference to the original Macmillan nurse who gave me conflicting, confusing and wrong information: he seems very possessive about his patients.)

We also talked about our proposed summer holiday, and whether it was likely that we could actually go, bearing in mind his request for SLNB for me. He said if the appointment came through for late July/August then I would be a fool not to accept it. I can always book another holiday, but my health and enjoyment of my life comes first.

I left the hospital feeling quite upbeat; lots of information to take in and process, but I know I am being given the best possible care, and that I am truly being so well looked after.

My GP called

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Wednesday 12th June

Lying in bed, on a dreary, grey June afternoon, I am roused from a nap by the telephone ringing. It is my doctor whom I originally saw back at Easter time, about my foot.

He wanted a quick catch-up, as he had been absent from the surgery for a while. He understood that I had been through a lot since he last saw me (understatement!!!), and wanted to know how I was doing. As he had the scan results infront of him, he was so pleased that they had come back clear. We talked of my upcoming appointments and surgery, the infections and antibiotics, and also of the lymph node biopsy procedure. He would try to see me tomorrow, when I go to have the wound dressed. He was also concerned that I wasn’t at work, standing up, teaching all day, and would write me out my fourth sick note, for collection tomorrow.

It was great to speak with him, knowing he had taken time out to enquire about my health and well-being. A super caring and concerned GP: so lucky to have him as my doctor.

The Results

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Monday 10th June

The CT Scan results have come back clear. The melanoma has not spread to other body organs.

The big black cloud that has been hanging over me for months has now turned into a fluffy little white cloud.

Not totally out of the woods, as it looks likely I will have the Sentinel lymph node biopsy at Exeter at some stage ~ will know more on Friday when I see the consultant who will refer me. I’ll also have check ups every 3 months. BUT this episode has now passed, and I am so relieved.

Husband and I went to the appointment with hearts beating overtime, pulses racing, and tummy doing flip-flops. We also cried when we went in. Scared, not knowing what to expect, I somehow assumed the worst. All I could think of was the accepted thickness indicator, the fact that my melanoma measured 6mm, and a prognosis of survival being 37 – 50% for staying alive for the next 3 – 5 years. Not good odds at all. Having been told that the scan came back clear was the greatest feeling in the world. The massively heavy weight bearing down on my shoulders had been lifted. I was being given a second chance. Having arrived crying, we also left the appointment in tears; but these were tears of relief, of happiness, of joy.

Son was so happy and elated, too: the best news ever. His partner texted the following:

We are both so relieved. Just get the biopsy done and dusted, for peace of mind, then you can totally move on feeling blessed. Make sure you do learn from this awful experience though. It was a gift so you could fully realise you need to actually start enjoying your lives together now. We’re here for a good time, not a long time. Love you very muchly xxxx

Such lovely, tender, thoughtful words.

I still keep my leg elevated, and have it dressed twice a week. I have further appointments coming up. I will not be going back to work soon, and certainly will not be spending a week on the beach with a group of students, learning to surf.

I need to fully recover, to get back to feeling ‘normal’, before going back in the classroom. The nurse told me today that there is no point returning too soon, and undoing all of the healing process.

I feel so amazingly well looked after. Today’s consultant has rearranged her theatre list, and will do the wider excision on my back on Monday, 9am, just because I said I would prefer her to carry out the procedure and no-one else

Positive, positive, positive all the way.

A truly amazing end to the day.

Blessed.

Macmillan nurse phones again

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Tuesday 21st May, late afternoon

I’m on my way to the loo, hopping and shuffling, when the phone rings. The nurse wants to touch base, and see how Friday went with my trip to the hospital, what happened, what was said.

When I told her that the operation had gone ahead, I’d had a wider excision and skin graft, she was really taken aback. Oh, but, but, but . . . My case had only been discussed that morning, in the weekly meeting, by the Multi Disciplinary Team. They/she assumed I hadn’t had the operation, that I had just gone to Plymouth for a quick chat, and then come home.

I felt I was being told off for having the skin graft. I recounted to the nurse that my consultant said I could always have a delayed sentinel lymph node biopsy at that hospital, as they carry out the procedure there. No they don’t, she snapped. And then ended the conversation saying she had a number of calls to make further enquiries.

I felt as if I had done something wrong. It was quite upsetting.

It feels l am in a power struggle; my treatment action plan seems to be part of a game. Who is better qualified? Who has the greater clinical knowledge? I trust my consultant, and will listen to his expertise and advice. I really want my glass to be half full, rather than half empty. I think that there should be greater communication between the two hospitals. I would like continuity of care from supportive professionals. It’s not too much to ask?

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?