Thick Skin - "The Diagnosis"

January 2015:

My bottom lip looked like scales. Dry, flaky, and dead-looking. I booked an appointment with my dermatologist, here in Austin, who was unconcerned. “Oh, it’s just actinic keratosis,” she said. (By the way, actinic keratosis is a fancy word for pre-skin cancer.) We tried burning the one patch off, which didn’t work. I tried waiting it out, which also didn’t work. My attempt to wave it off, to -- if I’m being honest -- procrastinate dealing with it failed, and after three months I found myself driving to Houston to see Dr. Paul Freidman. He tried to do Blue Light Therapy, which resulted in third-degree burns from my nose to my chin. That was one of the most painful two hours of my life. When the scales kept reappearing over the next several months, I decided it was time to see an expert in skin cancer, Dr. Jennifer Segal, who is a dermatologist and founder of the Metropolitan Dermatology Institute in Houston, Texas. She told me what no one wants to hear: You have cancer. Skin cancer that, if not treated immediately, would spread to my lymph nodes and kill me within months. I immediately contacted Dr. Leonard Goldberg, a world-renowned Mohs surgeon for more than 2 decades, Leonard H. Goldberg, M.D., DermSurgery’s Medical Director, specializes in this procedure. In addition, Dr. Goldberg, a fellow of the Royal College of Physicians, is world-renowned in the field of Dermatologic surgery. He is a leader in the field of Mohs surgery and skin cancer and is both a recognized speaker and author of more than 325 publications on this subject.

I waited a week to see him; my mind raced, days felt like months.

WHAT? How can this be? And of all places, my lips?

Then began the questions:

“Did you use tanning beds when I was younger?”

“Did you have multiple sunburns?”

Occasionally, but not often.

My doctors were clueless as to how a young, healthy woman would have Squamous Cell Carcinoma on her lips, let alone recurring cells that lead to countless Moh surgeries every three months for six years.

(Mohs surgery) is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains.)

And that first surgery was brutal. It was hours of Dr. Goldberg cutting piece after piece off my bottom lip. I sat there in the chair, lips numb, trying to stay calm throughout the entire procedure. But once he finished, and once I held up a mirror to my face, I lost it. The swelling, the 38 stitches, the two-and-a-half inches of missing skin all made me feel deformed and almost unrecognizable. A profound awakening happened in that moment, one that made me realize this entire thing was much bigger than tanning beds and sunburns.

To be continued...