Posted by: cg00n | October 31, 2010

Halloween Special: The Leg of Doom

Well, you asked for it.  The following is intended to shock, offend and horrify.  A little bit.  And there are pictures too.

It all started so innocently as a little birthmark, a small patch of slightly raised brown skin on the right side of the heel.  For decades it was just there, a slight blemish on an otherwise spotless right foot, perhaps growing a bit darker as the years went by.  Almost overnight things changed.  As spring sprung it began to look irritated as though the strap of a sandal had rubbed it raw.  After a few weeks of this a doctor’s visit seemed called for and a few weeks after that Dr. B hacked the thing out and sent it off for analysis.  Two weeks later the other shoe dropped.

It had only been eight weeks or so since the first doctor had started the referral chain moving.  How bad could a problem possibly get in that length of time?  The answer:  not much worse than it had over the last twenty years.  Melanoma is a nasty cancer.  There is little the doctors can do except cut it out when they can and move on to the next case when they can cut no more.

right foot prior to wide excision

Now that the cancer had burrowed deeply into the heel all that could be done was to take out all the flesh that may have been infected.  This would leave a pretty big hole.  Dr. M proposed to rearrange the foot in order to fill the void.  A flap of skin would be detached from behind the toes and slid subcutaneously around to its new home while a skin graft obtained from the left thigh would seal the flap’s fate.

Weeks went by.  The sheath of bandages was eventually removed and the flap and patch gradually settled into their ghastly new roles but life would never be the same again.

While the foot was recovering the third shoe dropped making a tripod of problems.  The cancer had infiltrated the lymph system and was found as far north as the popliteal lymph nodes behind the right knee.  They would have to go; all of them.  Dr. H was consulted and surgery arranged for the late summer.  Perhaps this time the last of the cancer would be excised.  It was not to be.

Once the ooze from the new wound had been stopped  by forcing about 30 metres of bandage into the hole, new and more suspicious signs of activity began to appear.

leaking leg

An itchy spot just above the site of the excised tumour began to emerge like a sort of large insect bite.  Tests on a sample of fluid agonizingly extracted from the eruption using a long needle revealed nothing of concern but the bites kept on coming.

Insect bites or something more sinister?

A rapidly-growing lump on the calf muscle finally provoked some further cutting and that turned out to be more disease.  It was becoming apparent that the creeping cancer was still very much alive and seeking to avenge the destruction of its mother tumour.  The doctors decided to deploy their chemical weapons.

Wielding their knives and surrounded by mysterious machines, Dr. G and his surgeons made a 20cm gash at the top of the leg, in the right groin.

Former location of inguinal lymph nodes

Through this they removed all the lymph nodes remaining in the leg and, piercing the femoral artery, pumped their ghastly cocktail of diabolical poisons through the leg.  Doubtless cackling as they worked, they also removed all the itchy lumps leaving some areas so devoid of skin that they would never heal without further skin grafts.

Patch and rampant graft

The left thigh was also feeling the effects by this time having donated about 200 square centimetres of skin.

Sore skin on the port thigh

More than a year later the scars have faded somewhat.

Fading scars

For now the cancer has been beaten back but it bides its time, lurking in the leg.  Every so often a little, innocent lump can be felt, barely discernible among the scars.  At least, it may look innocent but who knows what horrors it might portend?  The leg will meet its doom, slowly but surely.  Even now a new lump is growing….

Happy halloween, everyone!

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Responses

  1. Didn’t squick me in the slightest, but then leprosy, the bubonic plaque, and St. Vitus dance have been interesting to me since childhood.

    I have a friend who’s interested in hemorrhagic fevers & illnesses. She’s no longer allowed to talk about it over meals. She’s the one whose floater resembled the Ebola virus, which really bothered her until the eye doctor pronounced it a benign floater.

    My sqished-gnat floater is also plain benign.

  2. Great (i know that sounds weird-hah) but most of us have some of the same scars-Happy Halloween!!randi

  3. A patchwork leg of battle scars. One thought might be to sell the photos to CSI? Or if you decided to put pen to paper you could use it as a jump off point to a tear jerker, horror or inspirational story. More seriously I’m glad that we have doctors expert at doing this sort of thing because you are precious and worth keeping around as long as possible.

  4. Caught me. I am a secret lurker on your blog pages!!! Usually I don’t say much, just keep an eye on your current state and think of you – but this did provoke a vocal reaction. Contrary to the other posters (is that really a word in this context) I found it strangely disturbing to contemplate your disassociated and somewhat truncated parts. Good to see that your rather peculiar sense of humour and wry manner of looking at the world survive happily.

  5. I’m glad I found this blog. It’s very well written and informative. My mother had a spot of melanoma removed from the bottom of her foot in July and more surgery was discussed, but has since been deemed impossible. My mom is stage IV metastatic, with a slew of nodes affected in her torso. Ironically, her foot and leg (aside from her groin) are disease free. She is only 66. The good news is, her organs are clean; for now.

    We are waiting for a referral to Princess Margaret in Toronto, because treatment options here are limited to Dacarbazine or Interleukin. Radiation won’t help much. We’re hoping for the BRAf mutation so my mom can qualify for the PLX4302 trial. She has to be treatment naive though. So we wait.

    She’s ok for now. Some discomfort and nausea, but it’s better than “living” with side effects of treatment I guess? We’re being cautiously optimistic in light of her grim prognosis.

    Sorry for the LONG comment. If interested, I’ve written much about this on my own blog. You and I have a similarity too… I’ve had a severe anxiety disorder for years. I write about that too.

    Good luck to you my friend. Keep kicking cancer’s ass!!!

  6. You of all people in my inner circle must fight this battle so valiantly. I’m all heart as you might know and nearly speechless for once! Having recently lost my dearest brother on my birthday, he who was “home” to my sister and me, I came closer to what it means to live on this planet, to pass our days on a slow race to the end. I don’t struggle like [my sister] to find spiritual meaning. Taking one day at a time in gratitude for the journey is my way, in spite of my declining ability to breath. I think often of your parents who were proud of you and I hope that your parentage is equally joyful. I’m so sorry about your need for vigilance and your battle with the insidious invader along with the anguish it carries. In my mind, you and P are contemporary heroes. If you lived where I am, you would have a political scene to add to your disappointment. Be glad where you are, my love.

  7. thank you so much for posting pics of the before lesion! all your pictures are fantastically helpful! i appreciate your documentation. i send you peace and mindfullness

  8. Hello
    I saw your pictures and thank you for posting. I had surgery last Tuesday on the top of my foot. Where there once was a small mole now is probably a huge scar will be. I had a skin grft taken from my thigh and my groin lyphm nodes removed to check and see if the cancer has spread beyond my foot. This is all so scarey for me I just don’t know how to even voice my feelings but I went on this site so hopefully the look of my own scars don’t make me throw up. I know that sounds so wimpy of me. I’m not good with blood and needles and cuts and stitches and this whole experience has been extremely stressful. Thank you for your pictures now I know what to expect when they take the bandages off tomorrow to change them. If I am doing this blogging wrong I apologize I’m not familiar with how to comment. Thanks again so much. Sincerely and truely roseanne

  9. Hello Roseanne,
    I’m sorry to hear you are the victim of the first skirmish in what may be a long war. The first few months in my experience were awful, but my wife, the doctors, nurses, friends, and others who supported me were wonderful and gave me a new appreciation for the life I live. Treatments have come a long way since I started along this path so there is good reason for you to be optimistic about your future. As you may have gathered from other posts on my blog, I am a big fan of mindfulness meditation as an aid to “living in the present moment”. Spending your life being anxious about what might happen is counter-productive, to say the least!
    Good luck. Please stay in touch.
    – B

    • Thank you I will stay in touch am struggling lately and have a lot of anxiety. You are so right about it being counter productive. Thank you so much. Am trying everyday to be stronger and think positive,

    • Went to dr Korvs today and she took a bunch of the bandages off so I saw what I’m dealing with now. The bandage on my my thigh is stuck on because of bleeding so they told to let it air out and cut it back slowly and eventually as my new skin grows it will also come off. Am surprised at how deep the hole in my foot and what new skin looks like. Fascinating science and technology. Am feeling better now knowing that this is it I have what I have for scars and it’s ok. Am waiting for pathology they told me no news on my lyphm nodes yet. No news is good news I suppose.

  10. Hello
    I have been here before to talk and to leave comments I had another surgery am waiting for another yet on sept 2 nd to remove more lyphm nodes as cancer was found in the one lyphm node. Am in a lot of pain and struggling with trying to stay positive thru this all. I had a pet scan last week and got some good news that the cancer hasn’t spread beyond my leg. That’s good news right? Any feedback would be welcomed am just wanting to hear that this will all be ok I guess. Am told I am stage 3 a which talks about not being ulcerated and mytosis and such. It’s all so much to absorb am not sure if I know what I’m talking about. The surgery on the 2 nd of sept is where they’re gonna remove more lyphm nodes in my groin and I am told tissue on my leg and stomach area am not sure what to expect. I know I’m told I’ll be in hospital a few days and I’ll need rehab for my leg as the surgeon said she’s having to move my muscle to get at nodes. Wow is all I have to say. What do I feel like how do I feel about all this I keep thinking. Am still hurting from the last surgery and I have homecare coming to change bandages. Am just curious will this all be ok and get better. Am sorry if I sound stupid am not sleeping well and I apologize for typing errors also. Just need some feed back please. Thank you ever so much,

    • Hi Roseanne,

      The PET scan result is excellent news! There are a lot of things that can be done for melanoma which has not spread beyond a limb, and the leg is about as good as it gets because it puts the main action as far as possible from vital organs. Taking out the lymph nodes in your groin is still AFAIK standard practice, although opinions are somewhat divided on whether or not that will make any long-term difference. My surgeon moved a muscle sheath around too, and that caused exquisite cramp-like pain for about a month every time I had to move the leg. However, it eventually settled down.

      I’m sorry to hear you are in a lot of pain. Is that due to the surgery? Home care, bandages, trouble getting around and taking showers are all part of the miserable package, I’m afraid.

      I *so* understand your desire for comforting news: this is a very anxiety-provoking situation. If you haven’t already, ask your doctor(s) about anti-anxiety meds. I use clonazepam, which takes care of the symptoms for me although I get rather drowsy (which improves my sleep, too). In the early days I needed a couple of pills a day, but now I just take it as needed – which is quite seldom. However, I strongly recommend that you do your best to see this whole experience as an opportunity to face your fears and to develop better coping strategies.

      We are all going to die of something, someday. If not this, then what? If you can gain mental strength from your current experience you will be much better off in the future. In my case I found mindfulness meditation very valuable, because it helps me see into my own mind which, in turn, allows me to deal with my fears more effectively. It gives me better control over my feelings. In a very real sense, *what* is happening is not nearly so important as how you feel about it.

      Do the best you can to stay calm, look into better pain killers and some good tranqs, and use all that anxious energy to become a stronger person.

      Good luck! Drop me another update sometime soon.


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