Day: June 18, 2008

Diagnosis: Invasive Malignant Melanoma

I am writing this to help me remember what has happened to me. One of the most amazing things about trauma is its ability to erase memory.  I’m sure it is a Darwinian survival mechanism.  If you dwell too much on terrible things that have been done to you, you will never be whole again.

But these four months have changed so much about me that if I do not reckon with what has happened to me I might not understand whom I have become

—

On February 22nd, 2008 I received my diagnosis of Invasive Malignant Melanoma, the bad kind of skin cancer.

It was snowing out.

I left my dermatologist and trudged through the greying snow berms of TriBeCa to the offices of a fancy non-for-profit art organization for a meeting about their website.  They have a big website that had a lot of problems, and they wanted my web design collaborator and I to redo it.  Or at least tell them how we would, and how much it would cost.

Straight out of the drs appt I walked into this business meeting for the largest site I had ever bid on, and totally rocked the meeting.  I was totally on point.  I answered every question the right way.  I dropped all the right references.  Made them totally reassured about the right things.  And they had no qualms when we told them it was going to cost $100-125K for their site redesign.

Two weeks later we found out the director wanted us to do it, but their board wanted to go w/ some other more mainstream “firm.”  While it was dissapointing, it was a blessing in disguise.  Because I had Melanoma.

So despite my diagnosis, I held it together.  I rode the train back uptown with my collaborator, got off at the same stop, but turned in different directions, as he went back to his appartment, and I went to the studio.

I held it together until I arrived at the studio.  then i fell apart.

I walked in, stunned, and SL immediately asked me what happened.  “Was Dallas that bad?” referring to a conference I had been at the previous three days.  And I told him.  He was the first person I told.  I think I said “I don’t even know how to say this… I was just told I have Melanoma.”  He made some perfect jokes about cancer that I forget – he has a great way of using humor as a healing mechanism.  And told me that his wife’s mother was diagnosed with Melanoma twenty years ago, and is still alive and well.

I sat down and wrote this email to my parents, my brother S, my roommate P, my good friend X and the woman I was seeing K:

i’ve been having a rly shitty 36hrs.

my flight was cancelled out of dallas.  i had to sprint through the airport in houston.  this time i made the flight, and when i sat down in my seat, the phone rang.  it was my dermatologist’s assistant asking me to come in as soon as possible to speak w/ the derm about the lab results from the supposed blood blister he removed on my right calf.  i asked him to specify, but he said that the dr wanted to speak to me in person.

so i spent much of the flight having horrific visions of me as a chemo patient.  at the same time knowing that was really fatalistic for skin cancer.  but also knowing that i am not stupid, and that the results were most likely skin cancer.

and then when i got off the plane, i got a msg from my lawyer saying that the condo plan was going to be approved in the next day or so.  He had been trading phone calls with the atty gnrl to slow it down two or three days so as to make it go past march 1st, but that was not going to be possible.  to remind, march 1st is the day after which i am on a new lease in the apt w/o J on it.  this is significant, b/c it reduces her claim to a right to purchase the apt.

great, right?  double whammy.  spent the evening in a daze.  not sure whether to email about everything, or not.  whether to talk about the fear of cancer, or not…

yeah, so went into the dr today. yeah, so it was a malignant melanoma.  “i have cancer.”  weird, right?

it was “Clarks Level 3” of 5.  The depth was 1.88mm. Less than 1mm lymph node biopsy is not needed.  More than 3mm, and you go straight to chemo.  There was no ulceration, which means that it didn’t break the upper reaches of the skin, or something like that, which it has to do to spread to the lymph nodes.  So, it could be worse, could be better.

i have apt on monday w/ melanoma specialist who will excise a moderate sized chunk of my right calf, and send me to a different specialist who will biopsy my lymph nodes. if the sentinel nodes (back of knee, groin) are clear, then i watch carefully for two years and am a new man.  if they are not clear, then there is “other stuff.”

at one point i asked him whether i was going to die.  it is weird to ask that question.  he said that people do die from this, but that it was unlikely in my case, and that regardless it was too soon to speak about percentages and outcomes. i have to wait for results from lymph node biopsy.

so here i am at the studio.

i just arrived.

im ready to go home.

i haven’t cried yet, but it will happen.  still a little shell shocked.

m

Chemo report day 2

It is wednesday at 1pm.  I leave for my third chemo treatment in an hour.  I feel like total shit.

Yesterday seemed like it was going well.  I woke up feeling okay.  Not 100%, but kind of like I had a hangover.  I felt pretty okay going in to chemo.

While I was there I met a man named Bob who had finished the full Interferon sequence two months previous.  He was in just to get IV fluids.  He was still experiencing fatigue.  He offered to answer questions. I asked him if it got better or worse, and he said that after the four weeks of high dose it pretty much stays the same.  The first week is the worst. The fever and chills get better, but the fatigue builds through week four and doesn’t go away.  I asked him if he had been able to go to work, and he paused for a bit, and said kinda: 3 to 4 days a week, for 5 hours a day.  He said that by 2pm you are just done.  Not physically tired, just done.

He remarked at how young I was.  He was the next youngest, and he was mbe 50.  Everyone else was in their 70s and above. The place was full, and loud.  I was happy that I could meditate through it the way I did.

He also asked if I had a history of clinical depression.  I told him that I didn’t, but that I had been put on prophylactic antidepressants by my Psychiatrist.  He asked which, and I told him Lexapro.  He noded, and said that is what he was on, and that it helped.  Everyone asks about the depression factor.  It must be serious.

Other than Bob, chemo was uneventful.  We left and got home on time.  I ate earlier than the day before.  That helped a lot.  I started to get a headache, as expected, but it wasn’t as bad as the day before.  The headache built, but never peaked like it did the first day.  My friend C came over, and we had a nice time hanging out.  I haven’t seen him since Thanksgiving.

I felt so much better.  I started to think this whole thing would be a piece of cake.  right…

I curled up in bed and didn’t fall asleep.  All night.  I was restless, and nervous. I was afraid to take an Ambien on top of the Klonopin, so I didn’t.  And so I didn’t sleep.  As the night grew on and on, I tried music.  I got up and then tried to go back to bed a second time.  I even tried masturbating, b/c sometimes that release lets me sleep: I couldn’t even come b/c my left hand has the IV in it and it hurt too much to hold myself.

And plus, by that time I was getting cold.  I didn’t really realize it happening, but I got cold.  Really cold.  By the time I realized it, I had the chills.  I put on an extra blanket.  But was still shivering. My dad came in at 630 to get me to take my next set of tylenol, but i was already wide awake.  He seemed hurt that i hadn’t wakened him to put more blankets on me, but I didn’t even realize how cold I was.  He went back to bed, and I put two more blankets on my bed.   Six total, I think.  Mbe seven.  Still cold, though slowly warming.

When my mom came in around 8pm with the dogs I finally was warm.  I held one of the dogs for a moment, before she ran downstairs to go out for the morning pee.  Then I finally fell asleep for two hrs.

I woke with a start at 10.  Confused about where I was and what time it was.  I knew I had to be somewhere, but couldn’t remember where and when.  After jumping out of bed, I remembered I had physical therapy at 11.

Today I really am scared of the chemo.  I was full of energy the last two days.  Today I need to get my energy up.  I feel like hell.  Like the worst kind of hangover.  No sleep.

Time to rest for the remaining 40 minutes before I have to go.

ADENDUM:

I leave in 5 minutes.  I took a shower, changed my clothes, and pretended I was getting dressed for a sporting competition.  A soccer match.  Or a ski race.  It worked.  I’m amped up.  I know I’m weak underneath, but I’m pumped on the surface.  Ready for this.  Ready right now.  Tired, but ready.

Time to go.