Wednesday, September 10, 2008

Consultation With Dr. Economou

Today I met with Dr. Economou regarding my wide excision/sentinel node biopsy. I think he first explained some of the previous stuff that he'd gotten from Dr. Korteum, some of which was reassuring. The most salient tidbit was this: the depth of 5.2 mm is normally quite bad, but as with real estate, location is everything.

Since it was on my back, the skin is thicker there than, say, on the hand. This helped make the difference between being a class 5 something (through the skin) and a class 4 something (not through the skin). He was also happy to hear that the PET/CT scan was already done and was negative (which to me means positive/happy results).

He proceeded to describe the surgical procedure I will be undertaking next week on Tuesday. It starts out with by making a series of injections with some radioactive stuff in the area surrounding the initial spot that was removed. Then I go wait for a couple hours. When the waiting is done, there's another round of injections of some kind of dye, but I'll probably be under general anesthesia as the main bit begins.

The incision and such was something I was curious about, and he described it well enough for me to find a picture of how I imagine it. It would be about at a 45 degree angle on my back, starting on the lower left and angling toward the neck. But it's only taking the skin, not getting into the underlying tissue (I think because it was the class 4). So he's going to remove that football of skin and send it off to the lab and stitch me up.

Then he'll start poking around with a Geiger counter to find the sentinel node -- which I understand to be the lymph node most likely to which the melanoma drained to. Then they'll remove the sentinel node and send that off for biopsy. I may have the order wrong, but I trust he knows how to do it.


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