Photos As Health History

Health, Sun, Skin
It was a recent rainy Thursday, late in the afternoon. I was on a train, returning to NYC from a meeting with colleagues when the call came in.
“Hi Marci, this is Dee from the doctor’s office. I have some bad news”.
I took a deep breath and braced myself.
“Your biopsy results are in. You have stage 2 skin cancer. I’m sorry”.
My first thoughts were probably the same as anyone else in this situation. It’s a mistake. It’s actually a dysplastic nevi like last time. This is a bad dream from which I will awaken, groggy yet surprised I’d fallen asleep.
Instead, I asked about next steps. Like this was happening to someone else, and I was a suddenly a calm and hyper-focused patient advocate.
My colleagues knew there was something wrong. But I was fortunate to be traveling with an incredibly supportive group of women. One shared that she was also a visitor to Cancer Land. We discussed her (harrowing) experience and yet it helped me. After all, she’s still here, alive and well, and working, just like me. We also laughed, talked about our meeting and tried not to dwell on my current state. I needed the distractions.
Once home, I told my husband the news. He poured us a stiff drink and immediately went online and looked up the Mohs surgery that was recommended. I’d never heard of it, but Mohs has an excellent success rate and relatively quick recovery time, depending on the stage and depth of the cancer cells. The following day I made an appointment with my doctor in Manhattan. The surgery would be performed that Monday, in-office, under local anethesia and could take several hours. I had a whole weekend to ruminate and research, to keep calm and carry on. As if.
The few well-meaning souls I shared my situation with told me not to stress about it. I’m sorry, but if there’s anything that actually requires stressing out about, it’s a cancer diagnosis. Others told me to “think positive! you’ll be fine!” Those who know me can tell you that that mental state is not exactly my forte. I’m an introvert, prone to dwelling and overthinking. But I decided to try to be as upbeat as possible – which meant plenty of gallows humor over the weekend. I watched videos of comedian Tig Nagaro discuss losing her breasts on Conan (somehow she made her reaction to the illness funny). I read excerpts from people who have gone through this – young and old, both survivors and those who eventually succumbed. I thought of those I know who have been lost to this disease, like my father who died of melanoma at the age of 64. I reminded myself his fate is not necessarily mine, and that I know far more survivors than not.
Monday arrived. As I left for my appointment, the rainy weather that was predicted had dissipated, the air warmed and the sun came out.  Was this a good sign or nature’s way of mocking me? While I waited for the train, a porcelin-skinned young woman walked by. She was in full UV ray-combat gear: a wide-brimmed hat, wrap-around sunglasses, a scarf over her neck, in a long-sleeve jumpsuit and high-top sneakers. Got it, I thought. Message received!
The Mohs surgery itself was not much different from the biopsies I’d had (and there have been many). This time the stakes were higher, but I was fortunate. The doctor got all of the rogue cells in the first go-round (there can be multiple sessions while you wait for the tissue to be examined; if there’s still cancer, more layers of tissue are removed until no trace remains). I was sent home without sutures (hooray!) an antibiotic ointment, a fat bandage and a follow-up appointment two weeks later. I’m also lucky the cancer was on the side of my big toe. The other patients in the waiting room all had bandages on their heads, necks, hands and faces, and were called in multiple times.
I am of Northern European descent, with pale skin, hundreds of freckles and moles and prone to sunburn. The cancer was a result of skin damage from decades ago. In the 1970s sunscreen wasn’t easily available or popular. Monthly skin exams for me are a must now. I will collaborate with my dermatologist, marking the potential problem areas and taking photos of them for comparison. Keeping the photos in an organized folder, and reviewing them monthly may well save my life. It can also save yours. This is a great example of the sorts of images you do not want to delete!
I urge anyone reading this to do the following:
• Get your skin checked annually
• Be smart about your sun exposure. There are plenty of excellent blogs + websites to follow, such as www.skincancer.org
• Use photos as a way of documenting your overall health history. Take photos, noting any changes, especially on your skin (both good and areas of concern).
Using photos as a way to document and manage your health is empowering. If you don’t have a health history photo file, please consider starting one today. It’s a powerful tool.