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ADVANCE Perspective: Nurses

Lessons Learned

Published July 18, 2011 6:54 PM by Candy Goulette

As I write this, I'm preparing to go back to Michigan (from California) for my 40th high school reunion. In addition to thinking about seeing old friends (pun intended), I've been taking stock of some of the lessons I've learned in the last 40 years.

Some have been helpful (learning how to drive a stick shift) while some have been fun (I can do a 5-mile hike up a mountain to see a roaring waterfall). Many have been tough (from leaving my hometown to saying good-bye to loved ones) and others have lifted me to a higher plane (giving birth to my children).

But a recent lesson has been on my mind the most: Always use sunscreen.

In June, after months of nagging from my husband about a little sore that wouldn't heal on my nose, I went to see a dermatologist. I was sure it was just a scratch from one of my cats that kept getting re-scratched. As I was leaving, hubby yelled after me, "Make sure you show him those spots on your shoulders and your legs." I promised I would, knowing they, too, were nothing to worry about.

The dermatologist seemed a little bored when he finally came into the exam room, but he brightened up considerably when he took a look at my nose. "Looks like basal cell carcinoma," he said, barking measurements to his assistant. Surprised, I tentatively pointed out the half-dollar sized spot on my left shoulder that was sort of crusty and weepy (more cat scratches, I concurred) and another, quarter-sized spot next to it. At last, the doctor looked interested. "Could be a melanoma, or a pigmented basal cell," he exclaimed, again followed by measurements. "Do you have more?"

Indeed I did. Another oozy quarter-sized spot on my right upper back, three pencil-eraser sized spot on my legs (that I had long declared were keratoses, despite the fact that they occasionally bled) and a couple tiny spots on my chest. He didn't just take my word for it, though, and did a very thorough exam himself, even looking at the soles of my feet.

"We'll start with the ones on your left shoulder and nose," he said while taking aim with a syringe filled with lidocaine. After numbing everything, he did shave biopsies on my left shoulder spots and nose. Saying he was pretty sure they were "just" basal cells, he left the room promising to call me with the results in "a week or so."

He called in 2 days. The news wasn't good - two of the spots (including the one on my nose) were basal cells, but the largest one was melanoma. I needed to have Mohs surgery as soon as it could be scheduled on both my shoulder and my nose. In a daze, I called the Mohs surgeon and set up appointments. The melanoma was the most pressing, so that had to be done first.

The surgeon got everything from both spots on the shoulder in the first pass and was able to pull them together during the repair phase of the surgery into a beautiful, 6 inch modified blanket stitch scar. I took a lot of pictures (and posted them on my Facebook page to share with my nurse friends) and felt very lucky the melanoma had been caught early. I scheduled the nose Mohs for after the reunion - I didn't want to face everyone, well, without my whole face - but I've already learned my lesson: Sunscreen, lots of it, every morning, reapplied during the day, even when I don't go outside. My strawberry blonde hair and pasty white skin are better complimented by a few freckles than a tan that's not natural to me, so good-bye iodine and baby oil, and hello SPF 50.

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