On the same day that I read this quote last week, I got a phone call from my doctor that would leave me trying to find my way through something new. Let me back up a few weeks to July 29th.
On a Monday in late July I went to see a dermatologist for what I thought would be a routine visit. I noticed a suspicious mole and my primary care doctor wanted me to get a second opinion. I totally expected the dermatologist to reassure me that it was nothing; instead, she said she wanted to remove and biopsy the mole for melanoma that day. I was a little shocked of the suddenness and possible severity of this. Melanoma is the rarest, but deadliest of the skin cancers. I agreed to have the mole removed until I heard that I wouldn't be able to exercise or, specifically, swim for two weeks and would need to be seen 10 - 14 days after to have stitches removed. I then went on to explain how I had a two mile fundraising swim to tackle and a week-long family vacation in Nantucket to enjoy and that getting a biopsy would interfere (Hello Dawna. Having cancer would interfere with life! But I had my mind set.). The doctor reluctantly allowed me to leave the office without a biopsy, but with one scheduled for as soon as I got back from Nantucket. I proudly did my first two mile swim while raising some money for The Scott Rigsby Foundation and I thoroughly enjoyed my time with my family and in the water in Nantucket, though well slathered in sunscreen and covered up. I gambled it would be nothing and that four weeks would not make a difference. I don't think my mother was too happy with this decision.
Four weeks later, on a Thursday, I had the biopsy and left the office with several stitches in my shoulder, a melanoma pamphlet in my hand, worries in my head and my mom by my side. The doctor told me not to exercise for two weeks. I told her about teaching bootcamp and training for a my first 31 mile trail ultramarathon in October. She could tell that I was not going to let stitches stop me from most of this. Two days later I ran 18 trail miles with my friend and ultramarathon mentor, Jim. I told him that I'd bring the needle and thread in case I popped a stitch, which is what my doctor said might happen when I told her I wasn't going to take her advice and not exercise for two weeks. Jim said he'd bring a stapler instead - much quicker and more efficient. Staple me up and get back on the trail. Popping a stitch became the least of my worries on that difficult 3 1/2 hour run, which was a convenient distraction from a possible melanoma diagnosis. Then I waited for the results, which I was told might take up to two weeks.
After a week of waiting, I called the doctor's office last Thursday morning. She called me back that evening and started in with a lengthy explanation of what I had. She told me that the mole was "severely atypical," which is one step away from melanoma and that she wanted to do another, larger excision of around four inches within the next few weeks. Although, from what I've read, most severely atypical moles do not become melanoma, they are often treated as such by aggressive dermatologists to account for what my dermatologist called "a margin of error." This is gray area. It's the best of bad news, I suppose. Now I am uncertain about the next steps. Do I get the next excision? Probably. My mother would likely kill me if I didn't! When do I get it? If I get it prior to October 19th, I likely won't be able to do the ultramarathon since the incision will be larger and take longer to heal, which means a recommended four weeks of no exercise (but now you see how I deal with doctor's recommendations). Can I time the surgery during one of my low mileage weeks and get back on the trails after a week? Can I find a way through and around this? Should I use this as an excuse to relax on the weekends and not do my 3+ hour training runs that I struggle with and postpone becoming an ultramarathoner another year? I just don't know. I don't like the gray areas without a clear answer or path. A few friends and family are advising me to get it taken care of as soon as possible, including, interestingly, my ex-husband who reminded me that it only takes one melanoma cell to begin to wreak havoc on the body. Tina is solidly supporting whatever decision I make. My mom has started calling on mutual friends to lobby me to do what she wants me to do - to get it taken care of as soon as possible. She's as stubborn as me.
Stupid cancer. I didn't think navigating decisions around detecting and preventing cancer would be one of the adventures I'd write about in this blog because, really, cancer isn't much of an adventure that anyone enjoys. Alas, it seems that cancer is breathing down so many people's necks these days, including mine. Stupid cancer is quietly knocking at the door. I do not want to let it in like Rumi's guest*. It will sit on my front porch determined to teach me its lesson - to be fully engaged and grateful, to be humble, to reassess my priorities, to redefine myself, to find another way.
*Guest House
by Jelaluddin Rumi
by Jelaluddin Rumi
This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.
Welcome and entertain them all!
Even if they are a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.
The dark thought, the shame, the malice.
meet them at the door laughing and invite them in.
Be grateful for whatever comes.
because each has been sent
as a guide from beyond.
