“Am I Going to Have to Get Totally Naked?”

Each year when I write about my skin checks (and subsequent “fuck I’m pre-cancerous again and going back in to get hacked up”) I get quite a few comments and emails from people with questions about the process. I love-love-love this because it makes me feel helpful and for a disease best combatted by prevention and early detection, I feel each person I convince to go in for a check is a little battle won.

So I figured today I’d walk you through my latest appointment to give you a better idea what to expect, and/or convince you it’s not as intimidating as it may seem. And this is coming from a girl who really hates going to any doctor for anything.

(reminds me I should probably hit the dentist… for the first time in three years)

This is by no means a “here’s this post so you’ll stop asking me all these questions” – please PLEASE if you need or want to someone to talk to about skin cancer prevention, detection, treatment, etc get ahold of me! onceuponalime at gmail.com. I’m way happy to help however I can.

Well let’s get to it.

Pre-Appointment

I had visited an insurance in-network dermatologist for acne a few years back and learned they did skin checks, which is how I chose to go there. I believe some family physicians will also perform the exam, but you’ll need to ask. Derms are a pretty surefire bet.

My insurance covers preventative exams, so I pay a small co-pay and the visit is covered. This seems to be pretty standard (think of routine annual physicals, teeth cleaning, pap smear, etc) but do check your coverage before believing my fat mouth.

Annual Skin Check Appointment

After signing in like any other doctor’s appointment, I busied myself browsing all the age-reversing, cold-sculpting, latisse-this, collagen-that flyers and frequent botox’er loyalty programs before getting taken back to an exam room. Ahh, life in the OC. I was given a paper sheet and told to strip down to bra and undies, and lie on the table with the sheet over top of me like a blanket.

A very thin blanket, with a slight draft blowing right on me, made for a slightly uncomfortable 5 minute (?) wait.

2011 at the plastic surgeon for post-op (spoiler alert) – paper gown >> paper sheet

The doctor looked over each square inch – hands, arms, chest, neck, behind the ears – then uncovered ‘blanketed’ quadrants at a time to check breasts, stomach, and pelvis – moved down to legs and feet, then after a flip finished the back side. The whole process took less than two minutes.

Anything a little larger, darker, or misshapen than normal she measured and noted on my chart to keep an eye on in the future. Anything alarming – like the suddenly appeared mole on the sole of my foot and a stomach freckle that had grown since last appointment – gets removed for biopsy to check if the cells are cancerous. Otherwise you’re good to go.

– cue last post’s mention of nickname “Abby Normal”. I go in now just assuming something needs taken off. #extremewhitegirlproblems –

Skin Check Bonus Round! Biopsy Time!

After a few injections of local anesthetic which stings a teeny bit, she used a flat little square tool with a hole cut out of it (lined I assume with a sharp edge but I did not inspect that closely because, kinda creepygross) to “shave” the area off and send off to a lab for testing. A regular bandage handles the bleeding and a faint scar might be left, otherwise it’s easy peasy. I’ve been told not to workout for 3-5 days, but it’s just a tiny scrape so I say go sweat on just clean it up after (but I’m not a doctor, listen to them not me!)

This bitch on my foot might keep me out of my Brooks a few extra days though. Sad face.

Post-Appointment : In Case of Abnormal Results

After a week the office calls to share the results of the biopsy. I’ve heard:

“cells were normal, nothing to worry about,” and …

“cells were pre-cancerous but margins of the shaved area were clear so it looks like we got it all out – we’ll keep an eye on the area,” and…

“cells are pre-cancerous (blah blah nevus atypia), margins were not clear so we have to hack off a bigger area to get all the bad stuff out – when can you come in?” and my least favorite…

“cells are cancerous, but the mostly non-life-threatening kind (basal cell carcinoma), so you’re probably not dying but we need to cut that shit out like, yesterday.”

I’ve been lucky to not get option 5: MELANOMA and hopefully with regular check ups I’ll never land there, but do keep in mind that is an unfortunately common diagnosis and can be very very serious. Scare tactics – check.

Follow Up : Cut That Shit Out

For my two procedures (four separate removals) I’ve gone two routes:

1) plastic surgeon, full-anesthesia, hospital stay and huge medical bills way my derm suggested and I didn’t know other options existed,

and 2) the “can’t you just do it here in your office? I don’t care if I have a gnarly scar or you haven’t thrown a stitch since medical school, I’m cheap and don’t want to take the time off for full-on surgery” sorta sketchy back alley (but equally effective) way.

(for the record, both left scars, IMO the more faded ones were definitely not worth $xxx. If it had been on my face, maybe it’d be a different story…)

Depending on your level of atypia, size of the area, and doctor the removal process can vary greatly so I’m not going to weigh in much. Plus the whole not-a-doctor thing. My last two were taken care of with a simple punch biopsy (a circle tool cuts out the bad spot) and sewn together with 3-5 stitches in the derm’s office. That did take a few weeks to heal and get the stitches removed, so don’t plan on any peak training or races post-op.

(since mine were non-metastasizing, I was able to push the procedure back a few weeks until after racing season was over. non-runner doc shook her head but said it was fine.)

*

And that’s it. I don’t mean to scare or gross you out with the details, but I believe it’s easier going into something like this not completely blind. The initial skin check is easy, painless, and only like, 15% embarrassing, so do yourself and my worried soul a favor and make an appointment. And if shit happens at least you know I’ve probably got a matching scar we can bond over.

or half-taped ankles to hold bottom-of-foot bandages on? so fetch.

Again feel free to contact me with any questions or concerns. I’m no expert of medical professional but I’ve spent enough time in that exam room to shed some light on the process.

And “What Celebrity is a Fan of Cool Sculpting?”

Sarah OUaL, the human biopsy doll

*disclosure – this is my personal experience. Obviously people’s experiences will vary based on situation and doctor. If you are concerned about the process you can always call and ask what type of exam the doctor performs and their typical course of action for any abnormal results. Don’t be afraid to ask ‘stupid’ questions!