Meg Beturne
Stage:Stage I
Survivorship: A Personal Case Study
The year was 2009, the month was June, the day was Thursday and the time was 12:13p.m.I received the dreaded phone call as I was collecting papers off of the PACU printer. My Dermatologist called to report that the mole he had removed on the previous Tuesday was cancerous. I listened with a sense of disbelief as the diagnosis of Malignant Melanoma was communicated from physician to patient. The only problem with this scenario was that I, a nurse of 41 years and a PACU nurse for almost thirty years, was the patient! As I hung up the phone, dizziness overcame me and I was barely able to walk out of the PACU unassisted. I proceeded to my manager’s office where I mouthed the “C” word, still believing that it was in reference to someone else- certainly not me!
In order to fully appreciate the eventual positive outcome, I need to back up and fill in an important part of this case study. As a seasoned nurse and mature person with plenty of common sense, it is my firm belief that an ounce of prevention is worth a pound of cure. In the spring, I visit my GYN doctor on an annual basis and dutifully have a mammogram and Pap Smear. I am at risk because I lost a sister to breast cancer and I had a benign growth removed from my breast 25 years ago. In the fall, I visit my primary care provider who keeps tabs on my blood pressure; sends me for routine colonoscopies and carefully watches laboratory reports and bone density results .In other words, you could call me a diligent overseer of my general health.
Within the context of health prevention, I decided (with the urging of a colleague) to have a mole checked that was located on the anterior surface of my left great toe. I have had it for such a long time and I did not observe any changes or experience any symptoms relative to its presence there. My GYN doctor was also a source of motivation as he shared with me the ultimate death of one of his patients who had a melanoma in the exact location as mine. Still, when I called for an appointment, I was content to wait the obligatory six- week period for an appointment as I felt that many others with critical problems should be seen before me. My Dermatologist is known for his diligence and in my case, there was no exception. After speaking to me twice more on Thursday, he made contact with two physicians (an orthopedic surgeon and an oncology doctor) to enlist their assistance with treatment options. Unfortunately, the location of the melanoma fell outside the expertise of the surgeon but it was his conscientious approach to my problem which resulted in a quick referral to the Melanoma Clinic at Beth Israel Hospital in Boston.
After an eight- hour consultation at the clinic, I received the promising news that my Melanoma was in a T1A class. What this means is that it has grown below the skin surface to a depth of less than 1milimeter. The decision was made for a surgical procedure (wide-excision with thick skin graft) to be performed in July. I had anticipated a toe amputation so I felt grateful that a less invasive procedure was a realistic option. I found all the clinic staff to be kind and compassionate which was key for me during this time of an unexpected role reversal.
On July 16th, I underwent daystay surgery which was uncomplicated and in the words of my surgeon, “a success.” Since that time, I have made three more trips to Boston for follow-up visits to check on the integrity of the skin graft. I was on strict activity limitations for the first two weeks which included slight heel touchdown only to maintain balance while ambulating on crutches. This was perhaps the most difficult part of my recovery as I am an extremely active person who is on the go from sun up to sun down. I was however cognizant of my surgeon’s instructions which I needed to follow precisely in order for proper healing to occur. After three weeks, I was able to return to work on “light duty” and this had its temptations. Banned to my office with my foot elevated left something to be desired, especially during the peak hours at our surgery center. Still, it was great to be at least on the periphery of the hustle and bustle routine that I so enjoy!
At the month recovery mark, I was finally able to place full weight on my left foot and discard the plastic bag that covered my foot for my daily shower. I still have to allow an extra 15 minutes prep time every morning to complete a dressing change to the graft sight.
My next appointment is booked for September 2nd, and I am hopeful that the majority of the graft will be embedded on my toe by that time. I have changed a few habits since surgery. One is to watch that I have plenty of protein in my daily diet as I loss seven pounds during the initial post-operative period. I have also started to use hand weights in order to increase upper body strength and pace my activities, realizing that I cannot take on the world and its problems everyday.
That does not mean however, that I have forgotten to give back. I have directed some of my energies toward the Melanoma Foundation of New England. This is a wonderful source of information, support and assistance. I have volunteered to help with fund raising events as well as becoming a part of their speaker’s group which sends out survivors to educate others regarding this medical condition.
In the final analysis, nothing I can ever do now or in the future will ever be enough to thank God, my family, my profession, my friends and colleagues, my care givers and cheer leaders who made such a difference in my physical, emotional and mental health and recovery. I was never one to take life for granted, but after this life changing event, I have become even more determined than ever to be all that I can be; do all that I can do and most of all, take time to smell the roses!
Mayflower Article, August, 2009. Reprinted with the permisison of the Mayflower, official newsletter of the Massachusetts Society of PeriAnesthesia Nurses (MASPAN) and submitted by Meg Beturne.
