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Journal of the Dermatology Nurses' Association:
doi: 10.1097/JDN.0000000000000035
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From Sun Addicted to Sun Savvy: Melanoma From a Patient’s Perspective

Riccardi Morris, Dawn

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Author Information

Dawn Riccardi Morris, CPA, MA, HC, Long Island, NY.

The author declares no conflicts of interest.

Correspondence concerning this article should be addressed to Dawn Riccardi Morris, CPA, MA, HC. http://transformedbyfood.com/contact/

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Abstract

Diagnosed with melanoma at the age of 19 years, I’ve learned the importance of finding healthcare professionals who make you feel at ease and who take time out to answer your many questions. I now see a diagnosis as a wake-up call to action, as diet and lifestyle factors play an important role in the prevention and development of disease. This is my story, which I am sharing to allow others, including nurses and nurse practitioners, to see this diagnosis and its management from the perspective of a patient.

Iblacked out, while sitting down. I heard what the dermatologist was saying, but could not see him. He had just told me that he suspected the black pencil-eraser-sized mole on my thigh could very well be a melanoma. Having just taken medical science in high school, I immediately knew that any diagnosis ending in “oma” was not a good thing.

Just half an hour earlier, my mother and I were sitting in the waiting area. She told me it was probably nothing and that she doubted we needed to come at all. I did not think it could be skin cancer either. I was only a teenager, after all. We were both wrong.

The truth is, I’d had an uneasy gut feeling ever since I’d spotted the mole. It was bigger than most of my freckles (I do not have many, either), and pitch black. It did not look like my friendly looking, chocolate-brownish freckles. Not only that, but I’d done so much sunbathing that my skin was many shades darker than it should have been as well (July through December, at least).

The only time I could remember burning was when we took a family trip to Hawaii. The sun is so much stronger there. At home on Long Island, I’d soak up a nice, dark tan without much effort. How could I possibly think of the sun as my enemy, when it had been like a close friend all of those years?

Thoughts went through my head, but the hustle and bustle of college life enabled me to brush them aside. So, despite my concern, I waited 6 months to visit the dermatologist. What college student wanted to worry about doctors?

I guess I was in denial. I’d already been through a lot that year. Within weeks of starting college, my half-sister died. She was 10 years older than me and had been sick on and off the whole second half of her life. I always thought she’d be there, as she was like a second mom to me, in a way. We’d spent a lot of time together over the years.

That time was both sad and stressful. Death had come knocking at my front door, not once but twice, and I felt like I’d had the wind knocked out of me. Was stress a contributing factor? It makes sense that it was, but I’ll never know for sure.

Luckily, I’d caught the melanoma in time. The dermatologist removed it right in his office. He cut a pretty wide area, just to be sure he got it all. The laboratory tests showed that he probably had but did not confirm that it truly was 100% gone. Outta there.

So, I went on with my summer, spending a lot less time in the sun than usual. I kept the wound clean and had to bandage it up when I went to work. There was a wound in my leg, and a hole in my heart at the same time.

After a few weeks, the incision was not healing the way it should have been. Consequently, the dermatologist referred me to a surgeon at the local hospital. The dermatologist thought maybe he had not removed all of the cancer cells.

I had to have the procedure done again, and this time, they might have to do a skin graft that would leave me with what they referred to as a “pom pom.” I imagined myself having a scar with a ball of skin on top. Fortunately, when the surgeon did his thing, he said it looked a lot better than he thought it would and that the dermatologist did, in fact, appear to have gotten all of the cancer cells. The incision probably just was not getting the air it needed to heal properly. I walked away with staples and a big dent in my leg, but it did not matter. I knew the situation could have been a lot worse. By trusting my gut instincts, I had saved my own life!

Of course, any cancer diagnosis leaves-life forever changed. I could no longer feel invincible. For 10 years, every time I went to the doctor, I lived in fear of another diagnosis. A few false alarms caused me much anxiety, but each time, everything turned out okay.

Getting past the 10-year mark was a huge relief for me, especially because I was a new parent at the time. For my own closure, the dermatologist (not the same one, because I lived in a different area at the time) suggested I have a chest x-ray just to confirm that the skin cancer had not spread. It was a routine test, so I was not worried.

A few days later, I got a call that put me in panic mode. The nurse from my primary care physician’s office called me at work to ask for a copy of my last chest x-ray. She said they needed to compare the two. The radiologist thought he or she had seen a vascular shadow. I had no idea what that meant, and the nurse did not explain. She just said they needed the old x-ray.

Back then, I could not just Google something to figure out what it meant. I assumed the worst. My heart was racing. All I could think to do was to call the primary care doctor. He was not available when I first called, so I had to wait until the end of the day to speak with him. In the meantime, I found out that my previous doctor’s office had recently discarded my old x-ray because they were not obligated to keep them longer than 10 years. So now, the radiologist had nothing to compare with.

The doctor called me back later that evening, saying there was nothing to worry about. The radiologist just wanted to compare the two to make sure there were no significant changes from one x-ray to the next. Because the old x-ray was not available, he said the only thing I could do was to have a computed tomography (CAT) scan done. He said it probably was not necessary, and to do so was my choice.

Well, to ease my mind, I decided to do it, and a few days later, there I was. Having to lie there for so long as the machine went on and off was like torture. All kinds of thoughts went through my mind.

Luckily, in the end, everything was fine. Nothing troublesome showed up on the CAT scan. What a relief! The experience, from the telephone call to getting the CAT scan results, is something I will never forget. It left an internal scar that will never be erased.

To this day, I still worry about the high degree of radiation I exposed myself to having the CAT scan. There’s been a lot of controversy over that very issue in recent years. So, if I’m ever in that position again, I will think twice before subjecting myself to another one.

After that traumatic experience, I was lucky enough to find a dermatologist whom I trust and respect. The other two did nothing wrong, but I needed to find one who had a better bedside manner. I was looking for a doctor who would make me feel at ease, who would not rush through my yearly skin cancer screenings, and who would take time out to educate me and answer my questions. Most of all, I was looking for someone whose ability I had the utmost confidence in. These days, such healthcare professionals are not all that easy to find.

Fortunately, I was impressed right away by the one I’ve had for years now. He was the first doctor to ever check my scalp for cancerous moles. Such thoroughness is so important because melanoma can develop in places that are not exposed to the sun. That one simple action spoke volumes. In that one visit, he had shown me that he’s not your average dermatologist.

Over the years, there have been specific moles I’ve been concerned about, and he’s been very good about explaining what they are and why I should not worry about them. To find a doctor who is so willing to answer any and all questions and who takes time to educate the patient every step of the way is so rare.

I’m happy to say that I’ve been “oma” diagnosis free for about 25 years now! During the last few years, I’ve even made peace with the sun. I do not worship it the way I used to, but I do not fear it, either.

I now know that, to absorb the best form of vitamin D, I need to spend 5–10 minutes in the sunshine without sunscreen every other spring and summer day (Holick, 2004; Webb & Engelsen, 2006; Grant & Holick, 2005). I also take a vitamin D3 supplement and eat as pure a diet as I can to boost my immune system (most of which is in my digestive tract) (Liu, 2003; Kennedy, 2006; Pollan, 2013). And of course, minimizing stress is always a good idea. Looking back, I think it had more to do with my diagnosis than the sun actually did, but as I stated before, I’ll never know for sure.

I still have to limit my sun exposure. When I do spend hours outdoors, I bring my hat, sunglasses, a cover-up, and chemical-free sunscreen (please refer to EWG safe sunscreen guide: http://www.ewg.org/2013sunscreen/). Or, I just sit in the shade or under a tree. I may not bathe in the sun for hours anymore, but I make the most of the time that I do spend outside. I’ve always been a nature girl, so now, I just have to find more creative ways to immerse myself in it all.

The realization that the sun could harm me, even kill me, was a real wake-up call. I was addicted to it like some people are to cigarettes, alcohol, or sugar. Forget the tanning bed! I wanted the real thing. No machine could ever replace the way the warmth of real sunlight made me feel. It feeds my soul in a way that no other experience can; but like anything else, it burns if I get too much. I cannot live without it, but I cannot live with too much of it, either.

As the years have gone by, I’ve come to realize that practicing moderation in all things is the key to a healthy, happy life. My skin has faded from a deep tan to more of a sun-kissed glow, and I seem to have stored up many of those warm, sunny memories. Whenever I need a burst of positive solar energy, if I cannot get outside for a few minutes, then all I have to do is close my eyes.

Looking back now, I see that my diagnosis was actually a gift in disguise. It was a flashlight in the darkness of denial. When I saw that mole, I could have ignored my gut feeling and the wake-up call I’d been given. I could have gone on without changing my ways or learning anything from the experience. I could have died at a very young age, without ever truly seeing the light. Thankfully, I didn’t.

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REFERENCES

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Holick M. F.. (2004);. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease [Abstract]. The American Journal of Clinical Nutrition. , 80:(6), 1678S–1688S. http://www.ncbi.nlm.nih.gov/pubmed/15585788

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Kennedy E. T.. (2006);. Evidence for nutritional benefits in prolonging wellness 1,2,3,4 [Abstract]. The American Journal of Clinical Nutrition. , 83:(2), 410S–414S. http://ajcn.nutrition.org/content/83/2/410S.abstract?sid=c783a8f9-9684-40c9-8d63-ddbc9737e448

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Liu R. H.. (2003);. Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals1,2,3,4 [Abstract]. The American Journal of Clinical Nutrition. , 78:(3), 517S–520S. http://ajcn.nutrition.org/content/78/3/517S.short

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Webb A. R., Engelsen O.. (2006);. Calculated ultraviolet exposure levels for a healthy Vitamin D status [Abstract]. Photochemistry and Photobiology. , 82:(6), 1697–1703.

doi:10.1111/j.1751-1097.2006.tb09833.x


Keywords:

Skin Cancer; Melanoma

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