The Sun will Come up (Part 2 of Erin’s journey)

Many of you have been asking me privately, “How is Erin doing? Is she finished with her surgery for her skin cancer?” You might recall that I wrote about it in my column titled, “Ray of Light” and about how she had been documenting her skin cancer journey on the Instagram page: bccnosejourney.

After posting her photos and her updates on social media she has received many private messages from other’s that are having the same type of MOH surgery and subsequent reconstruction using the Paramedian Forehead Flap technique.

This is how I described the Paramedian flap in my first column: “The reconstructive surgical procedure is called a Paramedian Forehead Flap or PMFF for short. The surgeon harvests a piece of cartilage from the ear and uses it to recreate the stability of the nose. The forehead flap is a fancy-pants surgical technique that means, ‘take some tissue from the forehead and use it for the nose’.” That tissue is then left attached to the eyebrow for 6 weeks to encourage and support the new cartilage to grow.

Erin had that surgery and then another surgery to begin finessing the look of her new and improved nose. She still has the tissue from the forehead flap in place (called a pedicle), which is one of the reasons why this surgery can be so traumatic. Can you imagine being a young woman with this pedicle thing on your face for 2 months? You can’t really cover it up, and it extends from your eyebrow to the tip of your nose so you can’t drive because it obscures your vision; therefore you become very reclusive.

Which is why I felt the need to write about this once again. I wanted to provide an update on her progress and I needed to write about how insensitive and clueless people can be when someone looks “different” than they do.

After 5 weeks of not going anywhere but back and forth to Edmonton for appointments or spending time at her grandparent’s home, Erin decided to join a bunch of us at the movie to see the Melissa McCarthy movie, “The Boss”. She placed a bandage on her face and joined us for a night of fun and laughter. The first time she had been ANYWHERE public.

Standing in line at the movie theatre, waiting for the obligatory popcorn and small beverage from the concession, Erin overhears the people immediately behind her talking about her….and they aren’t whispering. They weren’t children, the were grown adults and the man and woman were speaking in normal voices RIGHT BESIDE HER. You know…the “oh my gawd, what is wrong with her face?” conversation.

Up to that point Erin has not really left the house. She understands getting stares because her reconstruction progress can look alarming, but a grown man and woman discussing her condition as they stood beside her?

FYI people…..she had cartilage taken from her ear for her nose….it didn’t effect her hearing. Much like the boy in the movie, The Sixth Sense, she still can hear “ignorant people”

Now before some of you say that I am being too harsh and that these types of things can be difficult for others and that it is acceptable to point and stare and talk well….. I say NO. I am not being too harsh and the Webster definition of “Ignorance” is: destitute of knowledge or education, lacking knowledge of comprehension of the thing specified and resulting from or showing lack of knowledge or intelligence.

On Monday, she is heading back to Edmonton for a big surgery. I am calling it a “big surgery” because it is during that surgery that the surgeon is going to clip the pedicle and it will no longer be attached from eyebrow to nose. She will be able to see clearly for the first time in weeks and will finally begin looking like her old (well…young) self again.

She will be able to play with her baby without worry, she will be able to drive and she will be able to leave her home without stares and whispers.

I write this today as a reminder that being and looking different is not a bad thing. It is not something that we should be afraid of or intimidated by. Acceptance is a virtue that we all can embody.

A Ray of Light (Part 1 of Erin’s Journey)

erin57_nShe got her first tattoo at sixteen. Typical teenage rebellion, the decision to get a tattoo came from a moment in time that many teenagers wrestle with. Most stop at one tattoo: the powerful need to defy or assert personal identity and power satisfied with a tiny heart on the ankle or butterfly on the wrist.

Not this girl, nope! Erin loves the individuality of beautiful ink: artwork as individual as a fingerprint. Parts of her shoulders, arms and legs are adorned with colourful pigments of her imagination.

Perhaps this is why she didn’t notice the imperceptible mark on the side of her nose: this Trojan Horse disguised as a freckle. “When did it appear Erin?” I asked her before I wrote this column. She couldn’t really say. She cannot remember when it wasn’t there, but she can’t recall when it appeared. It just “was”.

It wasn’t until her recent pregnancy that she noticed it begin to grow. Hormonal surges seem to do that to women: the same magical hormone elixir that grows and feeds a fetus also grows our hair, our nails and our skin cells. The freckled blemish began to change; the edges became ragged and red, a stubborn sore that would not heal. A topical over the counter antibiotic cream was applied, but to no avail. It simply would not heal.

A doctors appointment indicated that indeed it was a very suspicious sore and quite possibly cancerous. A surgeon was contacted and the journey for my young niece began: The journey that many, many take when diagnosed with basal cell carcinoma – one of the most common forms of skin cancer.

The first surgery was completed, the cancerous lesion removed and the lesion and margins of the area sent to a clinic for biopsy. The biopsy would determine the type of cancer and the margins would be inspected to see if any cancer remained.

Erin waited. Meanwhile, the scar faded quickly and you would hardly notice that anything had been removed.

Weeks passed and the results came in….they were both good and bad news. The good news was that the cancer was indeed basal cell carcinoma (one of the easiest to treat and rarely life threatening), the bad news was the margins were not clear and that she needed to be referred to another surgeon, one that specializes in removal of this type of cancer.

This was the first time I had heard of MOH Surgery. MOH surgery (MOH because it was developed by Dr. Frederick Moh) is now one of the most effective techniques for removing basal cell carcinoma. A very precise technique, the doctor removes very thin pieces of tissue, examining each section for cancer cells until the microscope can identify no cancerous cells in the tissue. The goal is to keep as much healthy tissue as possible, while removing the cancerous tissue.

Erin would also be referred to another surgeon, one that specializes in reconstruction of a MOH surgical site on the nose. This doctor would reconstruct Erin’s beautiful nose following the cancer surgery.

As I write this column, I have just left the hospital where Erin is recovering following her reconstructive surgery. The MOH surgery that happened last week successfully removed a circular section of tissue and Erin is now cancer free. Unfortunately, the surgery comes with a cost and that cost is now undergoing another procedure that came with a lot of trepidation.

The reconstructive surgical procedure is called a Paramedian Forehead Flap or PMFF for short. The surgeon harvests a piece of cartilage from the ear and uses it to recreate the stability of the nose. The forehead flap is a fancy-pants surgical technique that means, “take some tissue from the forehead and use it for the nose”. As Erin said with a sarcastic laugh, “thank goodness I have a big forehead’’.

The doctor says that she will have at least two more surgeries before she can put this experience behind her. When she was first diagnosed we said, “No way! Not Erin – she HATES the sun” and that is true now, but wasn’t the case when she was 20 years old. Those days were spent in the tanning bed, trying to get a bronze tint to her skin that refused to change colour. She is not saying that a tanning bed did the damage, but the type of cancer she is battling is generally caused by repeated unprotected sun exposure including tanning beds.

Of course I asked Erin’s permission to use her story this week in my column and she said this: “if it encourages people to take a good look at their skin and go to the doctor if they notice anything suspicious, then that is a good thing”. She also wishes she had never used a tanning bed but knows that you can’t go back in time and change it, you can make the choice to do better and move forward.

My beautiful niece decided to face this scary medical experience head on and document her surgeries and reconstruction progression on Instagram. If you are interested in finding out a little more about her story or perhaps dealing with this type of surgery yourself and want to learn more, you can follow her on Instagram at BCCNOSEJOURNEY.