Read Bob's Story

Chapter 6:

Moving Forward With Life

I had the surgery in the month of June and resumed golfing a few weeks later. Per my physicians, there was now a much higher risk of getting a repeat occurrence of melanoma.  Because of this, I was advised to completely protect myself from the sun.  My boss even used the phrase “You can never get sunburnt again”.  Since I was a walker on the golf course using a three-wheeled push cart, I purchased a wide-brimmed farmer type hat to protect my face. Walking for golf exposes you to the sun much more than riding in a covered motorized cart.  I even tried wearing pants a time or two in the beginning. Coming back to play in this manner was just weird and uncomfortable.

Along this whole journey I’ve seen and experienced so many fascinating and odd events with my body.  For example, walking along a golf path on the edge of a dense tree line I noticed my longtime buddy was staring at me.  He stopped me to take a closer look and said to me: “your forehead isn’t sweating above your scar”.  The rest of my face was soaked with sweat as it was a hot July day.   My incision was in the dead middle of my forehead; about 1 inch above the bridge of my nose.  The doctor closed the open chunk of missing skin by pulling the skin above the cut line down and inward like a “V”.  So, you could see a “V” outline almost like how the fabric of fitted sheets pucker on the four corners of your bed.  He was accurate.  There was no sweat in this “V”.  I was only perspiring on each side of the tightly pulled skin and below.  For a few years the whole area was also numb.  This skin texture is no longer visible today, as the skin has stretched out naturally over the years.  I say laughingly that this was like a mini facelift for me.  My receding hairline was helped an inch by this surgery.  The hair on the top of my forehead was about an inch lower than before surgery.  In the beginning I even would get sprouts of hair growing near my incision in the dead middle of my forehead.  It was comical if nothing else.

The remainder of that summer was uneventful.  I recovered fully, and all of my energy returned.  I even started a major house remodeling project that fall, under the guidance of my friend.  My basement was being converted from concrete block walls to a living/game room and small fully equipped kitchen.  A lot of very physical work was completed.  Most of it was being done on weekends.  At some point around late October or early November I noticed something odd.  I don’t even recall what made me notice this.  I found a lump in the right side of my neck. It was under the hinge of my jaw (below my ear lobe). My face is very chubby, so it certainly wasn’t anything easily noticed.  From the outside it appeared to be the diameter of a golf ball.  It was hard to notice it without me craning my neck by raising my chin upward and back.  Whatever this thing might be, it was causing no noticeable pain in the area.  I rationalized it as a swelled lymph node from fighting a cold or flu bug.  Something we can all surely identify with.

A few weeks passed, and I hadn’t thought very much about my neck.  Although I do recall that I never developed any substantial flu, and the lump was still present.  I figured that this couldn’t be anything alarming or uncommon, and that if I asked my boss she would know what it was immediately.  She examined me very well.  By palpitating the whole area.  It was a bit perplexing to her.  Not what I had expected.  She was suspicious of a “reactive lymph node”.   This meant that the node was swelled because of an infection near the wound, or because it was actively healing the wound.  The odd part of this scenario was that surgery was months ago.  It was fully healed, and there were no signs of infection.  So why a lymph node would still be reacting now was the question?  But, there really was no other explanation.  A few more weeks pass by, and now it’s the winter months.  Nothing had changed regarding the lump in my neck.  It did not get larger.  It did not get smaller.   There was still no pain.  Unsure about it, my boss advised me to call my surgeon.  It should have passed by now if it was anything acutely minor.

I got an appointment to see my surgeon in late January 2011.  He too was very unsure what was happening.  I remember his first comment after he examined me, and as we were discussing the reactive lymph node scenario.  “No…..That’s not from me.  I wasn’t in there” was his reaction.   His cutting was an inch or two behind the location of the current growth. He was effectively ruling out the lymph node possibility.  Because of his lack for an answer,  my doctor ordered a radiologic testing procedure called a PET Scan (Positron Emission Tomography).  A PET Scan is based on a very complex yet ingeniously simple scientific theory.   I was told it was originally used as a way of tracking either the progression of malignant conditions, or to monitor treatment therapy for results.  It wasn’t necessarily used as a diagnostic radiological procedure.  The basis of the test revolves around the cellular use of sugar for energy.  Malignant cancer cells have a higher metabolic rate than normal cells, and therefore use much more sugar to function.  You are given a fruit flavored drink which contains sugar that has radioactive isotopes attached to it.  In addition, there is a contrast material injected into your body. These two substances are what allow for the detection of malignant cells.  The malignant cells and areas of higher metabolic activity will absorb the radioactive sugar isotopes.  You can have three areas light up on the subsequent scan.  Your brain, your heart, and your bladder should be seen.  The brain and heart show up because they are areas of high activity using more energy, and your bladder for obvious reasons.  Anything else that shows up needs further diagnostic work. After you’re given the drink and the contrast material, there is a half hour or so wait until you lie on the CT Scan table.  It may be a faster scan with today’s technology, but for me it was about a 3.5 hours on the CT table.  Remember that this is a full body scan.

My results came a few days later via a call from my doctor’s nurse.  They were pretty good for the most part.  The phrase used to indicate spots of concern are called “areas of uptake”.  Adjectives are used to describe it such as “area of intense uptake”.  I had a few mesenteric lymph nodes show up weakly.  Those are in your abdomen.  Mesentery refers to a layer of “fabric” that holds your organs to the inside wall of your abdomen.  These weren’t a concern to doctors, but they were to be a foreshadowing of looming events.  The most important thing was that my neck had no areas of uptake, although there was one spot that did.  That area was my butt.  Yep, that’s right, my butt.  I told the nurse that it must have been because of a pilonidal cyst I had on my tailbone.  It still had to be checked out visually.  I thought to myself.  Are you kidding me?  So embarrassing.  I went back to see my surgeon for a review of the results.  I told him the cyst had been infected in the past so that must have been the source or reason for the uptake.  He examined me and couldn’t find any infection or area where an abscess had manifested.  It was decided that the cyst must be the source of the uptake, but since there was no serious infection it did not need treated.  Subsequently, I was referred to an ear, nose, and throat doctor for further evaluation regarding the oddity in my neck.

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