Melanoma update

The healing from melanoma surgery on my upper arm went very smoothly--I had hardly any pain.  I went back to swimming a few days after two weeks on the advice of the lymphedema specialist, and I think my scar may have ended up a little more stretched out and raised than it otherwise would have been, but I didn't lose any range of motion in my shoulder, which is what I most cared about.  And I didn't use the scar sheets to minimize the scar because they didn't stay on as much as I move my arm. I had tightness and cording keep starting up in my arm for the first 6 weeks but I kept swimming and it went away.

Hearing that I had several long plane flights coming up, the lymphedema specialist (occupational therapist) ordered me a custom compression
 sleeve.  She warned me that lymphedema can develop when only one or two lymph nodes have been removed and often takes more than a year to appear.  I haven't worn the sleeve full time, but I wear it for 2-4 hours most days and for air travel.  She says she feels some fluid retention and I notice my arm sometimes feels strange (heavy maybe fits) so I want to be cautious.  I did see another lymphedema specialist (this one a physical therapist) who didn't think I had a problem at all, but she gave me the exercises I wanted to fight cording.

It doesn't feel over because at my 3 month appointment with the dermatologist he removed two moles, one of which came back atypical.  And that one was at the edge of the scar from the melanoma wide excision.  So I had a wider excision of that mole a few days ago. 

It was done by the dermatologist with local anesthesia only, so it wasn't a big deal.  But it is bigger than they had made it sound and hurts more than the first one did.  I think he may have cut more than expected in order to not leave tissue cut on both sides, but he didn't say anything.  My guess is that the surface stitches, which I didn't have the first time, make it hurt more.  They come out after 9 days.

 

It is not serious--there is still no evidence that the original melanoma has spread.  But it does make me worry, make me feel I can't count on my health.

 



Apple Souffle

two apples peeled and sliced
2 tblsp butter
2 tblsp maple syrup
5 egg whites
1/4 teasp cream of tartar
3 cups apple sauce (we used homemade)

Preheat oven to 450.  Cook sliced apples in butter in a deep straight sided saute pan until both sides are browned. Drizzle maple syrup over the apples.  Beat egg whites with cream of tartar until they form medium stiff peaks.  Fold applesauce gently into the egg whites.  Pour over the warm apple slices and place immediately in oven.  Cook at 450 for 15 minutes or until brown, then turn off the oven and leave souffle in the oven for at least another 20 minutes. 

Winter squash au gratin

3/4 cup pine nuts
2 tablespoons melted butter
1 large onion, chopped
2 teaspoons minced garlic
1 large winter squash (3-4 lbs)
1 1/2 cups whipping cream
1 1/2 cups whole milk
1 teaspoon fresh thyme
1/2 teaspoon coriander
1/4 teaspoon mace
Salt and pepper
1/2 cup grated Parmesan

Toast pine nuts.  Melt butter and cook the onion until soft and beginning to brown. Add the garlic and then put aside in a bowl.  Deglaze the pan with the milk. Add cream, squash, and spices and simmer until squash is soft.   Season to taste with salt and pepper.  Preheat oven to 425.

Mix in onions and transfer to lightly greased baking dish. Sprinkle with cheese.  Bake at 450 for 10 minutes.  If it is not browning on the top, turn on the broiler for a few minutes, watching carefully.  Sprinkle with the reserved pine nuts.

From James McNair's squash cookbook, with minor modifications.

strawberry rhubarb sauce for duck

2 cups duck stock (simmer neck, gizzards, half an onion and a stalk of celery while the duck is cooking)
1/4 cup white port or brandy
1 cup strawberries cut in half (or quarters if large)
1 cup cooked rhubarb with minimal sweetening
grated rind and juice of one lemon
1/4 cup cut up mint leaves

Combine stock, port, strawberries and rhubarb, bring to a boil, and simmer until strawberries are soft.  Stir in lemon rind and juice, then remove from the heat and stir in mint leaves.  Serve over roast duck.

Lymphedema prevention

As I feared, I have been caught up in the medical world.  I'm supposed to wear a lymphedema compression sleeve all day every day.  If I want a second opinion, Dawn Modzell at St Francis is recommended--864-255-1987

Good news!

I went for an early followup because I have some lymph swelling and bruises that are traveling down my side.  The surgeon had no concern about those, but he did have the great good news to give me that the lab found no cancer in either my lymph nodes or the wider margin removed around where my melanoma was. 

 

 Pretty good for four days after surgery!

 

He continued to give me as little information as possible.  One example:

• P: Can I please have a copy of the biopsy report?
• Dr. T: Why would you want that?
• P: Can I please have a copy of the biopsy report?
• Dr. T:  Of course, it is your medical record, it belongs to you.

So the whole thing is over now, except for getting a body check twice a year.  I am also relieved  that I can now put salve on the healing wounds, which had started to get itchy.  The stitches are under the surface and will dissolve.

 

I am so thankful for the people who have prayed for me and brought food.  John has not been able to step up and do anything more, though he accepts I can do less.  He says "that's ok" when I say no to something he asks me to do.

 

What I have most learned from this is to put myself first more. To do things while I can.

Surgery went well

Two lines of stitches under the steristrips.  The one on my arm is less crosswise to my arm motion than I feared.  The armpit one is the lymph nodes--the radiation procedure in the morning to identify the sentinel nodes took less than an hour and two nodes lit up.  In pre-op they had to bring in the expert to start the IV, but I don't have a big bruise from the unsuccessful attempt.

When the surgeon came to talk to me before the surgery I reminded him I was a swimmer.  He again said he preferred to have me completely out with inhaled general anesthesia.  I again said unless there was a strong reason, I preferred to have IV deep sedation (they gave me both Versed and Propofol).  He didn't argue, and he took my iPod to play my calming music during surgery (his view was while I would not be conscious, my unconscious would react).  During my pre-op appointment last week I asked the anesthesiologist about whether he was comfortable with deep sedation for the procedure and he said "we do it all the time."

I am so happy that I was able to do the surgery with the deep sedation.  No general anesthesia hangover, no sore throat from the breathing tube.  The surgery was at 1 pm.  I got home around 6 still feeling a little unsteady, but I was hungry for dinner and by the time I was done dinner I was feeling good if I didn't move much.  I woke up early this morning when the pain medication wore off, but Naproxen is all I needed this morning--no pain unless I stretch the arm (which I try to remember not to do).

I can shower once 24 hours have passed, but the instructions are very strong that I am not to put anything on the wounds.  I regret that--I've been convinced by the newer practice of keeping wounds moist.  But I will follow instructions at least for the first week.