It was so odd how within the space of a week we went from snow and cold to warmth and spring. There was some damage to early flowers and buds on trees but so much is blooming again that it's hard to even notice the damage. We may still return to the cold and more damage but at the moment, I'm enjoying spring in full force.
The wildlife are certainly enjoying the warmer weather and becoming increasingly abundant. I enjoy listening to the bird calls and wish I was better at recognizing the individual voices.
It was a huge relief to get past my March doctor's appointments and four year PET/CT scan. The fact that I've gone four years now without a melanoma recurrence is making me increasingly optimistic. 
I remember after my three year scan, I decided that I was done with melanoma. I felt like I had to reach a point where I put it behind me. To a large extent that worked. I have worried less, talked about it less, in general moved on with the rest of my life.
The problem is I am still followed by oncologists, a dermatologist, a pain specialist, blah, blah, blah, and I still get annual full body scans. Sometimes I think to put it behind me I need to drop all of the doctors, although that's not possible in terms of pain management. 
That has been the hardest part, dealing with the physical "issues" I've had following my lymph node dissection. The issues have made it hard for me to listen to my body. As a matter of fact I've had to learn to stop listening to my body. I've blogged enough about all of that in past years and at this point I like to focus on relief. The relief of being one of the lucky ones who are diagnosed with a deep melanoma primary and a positive node but don't have a recurrence.
It's even possible that some of my physical problems are part of why I've done so well with the cancer. My body may have mounted its own autoimmune response which have resulted in irritating pain but are part of why the cancer hasn't recurred. The fact that my C reactive protein has been high every time my rheumatologist tested it is at least one indication that my body has had an autoimmune response of some kind.
I didn't intend for this post to start veering into the whine territory so I'm going to end with relief. The birds are singing, the flowers are blooming, and my four years tests and appointments are done with and turned out well.
The photographs in this post will be a continuation of shots I took in downtown Raleigh on Saturday. I focused on the capitol for my weekend snapshot post so for this post I'll use some shots I took from the rest of downtown. The content will begin with good news regarding my melanoma follow up and is a continuation of the good news I posted after my 3 year PET/CT scan was clear.
I had my surgical oncology check up today (Monday). I am three years out from my stage III melanoma diagnosis and all is going well. After my PET/CT scan in February, I went ahead and posted that I was three years out from my diagnosis and no evidence of recurrent or metastatic disease. Today was the physical exam and everything looked fine so I don't go back for six months which is when I see the surgical oncologist. Today's appointment was with the nurse practitioner. As long as there aren't any problems they alternate appointments (surgical oncologist and the nurse practitioner who works at the same university). A note on the photographs. The first group of photographs in this post were taken at Moore Square. The green space of Moore Square is one of two parks which were part of Raleigh's original plan in 1792.
The Moore Square part of downtown went through a decline after World War II but local government initiatives in the 1980s have attempted to revitalize the area. There is a city market , restaurants, pubs, galleries, an artspace where artists work, and a Farmer's Market. I'm going to go back for a moment to oncology. Sorry, I can't figure out natural segues so this may be a wee bit disjointed. As I've mentioned before, I am currently followed by two oncologists. The surgical oncologist who works at UNC in Chapel Hill and the medical oncologist who is at a cancer center in Raleigh where I live. 
Neither of the two oncologists are that far from me but UNC is around an hour drive depending on traffic and the Rex Cancer Center is 15 minutes away. Therefore, when I started seeing a medical oncologist in Raleigh, and I was given the option of getting my scans done at his hospital, I went with that option. I was a little thrown off when I saw the Raleigh doc in December and he said that it might be better if I stop getting scans. I know there are two schools of thought on that. On the plus side asymptomatic scans can sometimes catch a recurrence faster but on the down side there is the tension that can result from false positives (I've been through that one).
My Raleigh doc set up the scan for me after I told him my UNC doc had asked if I was going to get the scan in Raleigh, or if I wanted him to schedule it at UNC. However, the Raleigh doc said assuming the PET scan was clear, that I probably wouldn't need to keep getting them after that. I brought the scan issue up with the NP today at my check up and she said that the UNC protocol for my stage was for me to keep getting an annual PET scan forever. Of course forever is a long time and I know that UNC could change their protocol between now and forever but I'll admit that at one level I was relieved. 
I meant it when I said that I had decided that I was done with being a melanoma patient when my three year scan was clear. I can't spend the rest of my life waiting for the other shoe to drop. However, I am also aware that people do have late recurrences and that the health problems I've had since my lymph node dissection make it hard for me to know if I'm symptomatic. Therefore, I was somewhat comforted that my surgical oncologist would order an annual scans, even if that means I need to go back to getting them at UNC. It's not that bad driving to Chapel Hill for a scan but I'll admit that driving there without coffee for a PET scan isn't at the top of my list. That's the main reason it was nice having a shorter drive when I have scans done in Raleigh.
Back to the photographs, the shot I used in this post where you can see buses turning around was taken a few blocks from Moore Square, at Fayetteville St. The idea was to commission a large piece of art for the end of the street in the small portion of the surface which was left from the pedestrian mall years (my WS post covered the Fayetteville St. fiasco). One idea was to have a plaza of lights and falling water. However, when the city council couldn't agree on whether to approve the design by Spanish sculptor Jaume Plensa, the benefactor who had committed 2.5 million dollars to help with the project, withdrew his gift. He said that the City Council lost its vision and he was done with the patron business.
The shot after the one with the buses turning around shows part of the Federal Building, which is also on Fayetteville St. That building was built between 1874 and 1878 to house all local offices of federal agencies and continues to house the downtown post office. The next shot is of the NC Governor's Mansion which is on Blount St. another downtown Raleigh street. The current Governor's mansion was completed in 1890 and it's just as well that it's largely hidden behind the tree because it's not everyone's cup of tea (certainly not mine). The last shot is of the children's museum which has had an identity crisis and name change in the 17 years since it was originally built. However, considering that the original capitol was burned down trying to fire proof the roof, as I discussed in the WS post, and the main downtown street was ripped up for a pedestrian mall, and then the mall was ripped up to put the street back in; I would expect no less from something worthwhile in my city. I think I'll stop here and save more of my downtown Raleigh tour for another part. Perhaps mix up more shots while I whine about my rheumatology or dermatology or pain doc appointments which are stacked up the rest of this month. Oh Joy.
As I mentioned in my last post, now that I have my three year scan behind me and the news was great (no evidence of metastatic disease), the challenge is to begin to put the cancer behind me. As a step in that direction, I took melanoma off my blogs title where it used to be in the description line. I wanted to keep some kind of description under Carver's Sight or is that Site and for now I've settled on Photography and Rambling Prose from my Secret Garden and Beyond its Borders, to replace the old description. It's one tangible way I have to draw a line in the sand. On the other side of the line was me, a melanoma patient. On this side of the line is me, three years out without a recurrence, deciding that I'm done with it. It's a little bit of bravado but hopefully in time it will be a new reality replacing the one I've had for the past three years.
In my blog profile, I kept the fact that my blog was inspired by the blogs of other melanoma patients who I got to know through the MPIP. I don't want to change that part of my profile because it explains why I started this blog in the first place. I have a page with links to some of the blogs by melanoma patients or their caregivers. I haven't updated it recently but it includes some of the first blogs I visited, as well as ones I found later. I never would have started this blog and I certainly would never have participated on a bulletin board if I hadn't been diagnosed with a life threatening cancer. If I hadn't had severe nerve damage, an extended time with a surgical drain (9 weeks), peripheral neuropathy, balance issues, and ongoing pain, I never would have stumbled on the MPIP while doing research. I arrived on the MPIP and decided to ask a quick questions to see if others had experience with, or information about, some issues I questioned.
I was amazed at how quickly several people responded to me and what a welcoming, kind, and often fun as well as supportive group of people I found. All of us fighting the same cancer. I'll never forget when I was frustrated with being passed from one specialist to another and someone said, what's the matter with those idiots. Although the doctors in question were doing their best within the system they worked in, to have someone respond in such a definitive way to my frustration made me feel better. 
I remember when BarbaraGA, Kim from Iowa, and Jackie Doss mentioned their blogs and laughed about how hip they were to have a blog at their age (all were around my age). I went to their blogs and thought I'd give blogging a chance, much to my surprise. Before then, I'd never understood the idea of a blog. Keeping this blog and participating on the MPIP has been a great outlet through some of my most difficult times. It has not been without heartbreak. I have been privileged to be inspired by some of the most courageous people I've ever known who have shared their last months with honesty and humor. I am also inspired by people who are facing, each in their own way, living with cancer and side effects from treatments they've done. I am grateful for the people who have become my friends, many of whom I haven't met except through reading their posts on the MPIP, in some cases blogs, and email. I've been lucky to get to meet a few of my MPIP friends in person, and I hope to make it to one of the big bashes in the future.
I think what I'm laboriously working around to is that although I am not going to forget what prompted me to start this blog, and I don't ever want to lose touch with the friends I've made because of cancer, I am also ready to stop thinking of myself as a melanoma patient. This started as a melanoma blog or a way of dealing with my diagnosis and lingering health issues which began after surgery. It was where I vented about the endless doctor appointments, scares, worrisome scans, physical therapy, and pain management. Over time, I've found myself writing posts that have nothing to do with cancer or health issues and that feels good to me. I doubt I could have written much in this blog at all without the calming effect of writing around my photography.
At first I posted mostly old flower shots I took when I was making garden cards (garden glimpses was a line of cards I did mostly for fun roughly five years ago). Then I started taking more and more pictures because I was running out of old shots to use and I found it easier to write if I posted my photography. At this point, my blog is more and more a home for my photography, and less and less a place where I deal with the frustrations about my health issues. I've also enjoyed discovering many different kinds of blogs and getting to know people from all over the world. Most of us won't ever meet beyond our online sites, but that doesn't mean that we don't connect in meaningful ways.
I want to end this babbling brook of a post with a thank you to the people I've gotten to know through the online community. Some through the MPIP, some through blogs, some through photohunters and weekend snapshot. This is starting to sound like a goodbye which isn't what I'm saying. I'll be around. I'm sure I'll continue to have posts from time to time about melanoma, cancer in general and related issues. However, I'm more and more finding myself wanting to close the door on thinking that I'm at a high risk for recurrence or even thinking of myself as a stage III melanoma patient. I want to move towards thinking of myself as a slightly cantankerous curmudgeon standing in the middle of the road to get the sun setting on the trees at the bottom of the court. Daring the car that's approaching to honk when it's obvious that all I need is 15 more seconds to get the shot.
When I saw that the photohunt theme this week was narrow, I knew exactly what I was going to feature. I had a PET scan today (routine part of my stage III melanoma follow-up and hopefully I'll get good news early next week). I had to lie on a very narrow bed while I went through the scanner. I was scanned from head to toe. The problem with using that for photohunters was I needed to take a photograph of the scanner. When it came down to it, I didn't ask the technician if I could snap some pictures of the scanner. Apparently someone else wasn't as shy as me because the narrow scanner is on someone's flickr site. So if you go there, you will see just how narrow that bed is, especially for someone like me who is getting wider. I had a fusion PET/CT scan but it looks a lot like the PET scan on flickr. Since I didn't take my own photographs when I got my scan this morning, I'll go with another choice for the narrow theme. Through the years I have hiked on many narrow paths in the mountains. 
The ones that seem the to be particularly narrow go straight up, and have a drop down into the valley if you stumble off the path. The one above isn't so bad because there are trees to catch hold of, if you do slip off the narrow path. Looking back over my photos, I realize that I don't have the best examples of scary narrow paths because I'm too nervous to take a picture when it requires focus to climb.
The scariest climbs I've done were in the past before I started doing much photography. However, these fairly recent shots at least give a taste of some narrow mountain paths. The shot below is a narrow dirt road which isn't wide enough for meeting another car, and it's never a car. Whenever we meet someone on a road where you need to back up, it's always a truck.
The road above on the left hand side isn't a road we drove on. We were on the paved road above it but I've been in a car on similar roads many times.
Saturday is the photohunt day. I post early but Saturday is when you can find the photohunters at PhotoHunt. You can also find some photohunters on technorati - 
photohunt however, in spite of including the tag and pinging, technorati doesn't seem to be getting my new posts anymore. Not sure what's up with that. I hope everyone has a great weekend.
I only have to wait two more days until my annual full body PET/CT scan which is part of my routine follow up for stage III melanoma. The photograph above is from the CD images of a prior scan. That's as close to naked pictures as I'm likely to come on my blog unless I take photographs in a museum. Bright and early Friday morning I will be scanned from head to toe and after that I hope that I will be able to officially proclaim myself 3 years clear of cancer. I will probably leave the hospital with the CDs from the scan because I need them for my March appointment at another hospital. I started getting scans last year at a cancer center close to home which is much better than driving an hour in rush hour traffic to the cancer center where my melanoma specialist (surgical oncologist) is. After I started being followed by a medical oncologist in my home town, I was given the option of getting the scans done here.
I probably won't hear the results until next week and at that point I'll pick up the radiologist report to take with me to my appointment in early March. Let me just say that if they do give me the CDs when I leave on Friday, I will try not to look at them on my computer. They are less than meaningless to me. I see all sorts of thing because we have all sorts of organs. That's a good thing. I wouldn't know the difference between a prayer cap and a brain. I think the top of my head, in the image I began this post with, looks like the prayer caps children used to wear to chapel at the Episcopal elementary school I attended as a child. That prayer cap is my brain, I think.
There is much debate amongst melanoma clinics as to the best follow up and they all do it a little differently. Some centers don't have any asymptomatic scans thinking that the tension from scans and false positives, out weight the benefits of catching a recurrence before it becomes symptomatic. My main melanoma doctor has an annual scan as part of his protocol, although this is the first time I've gone a year before getting a scan. The issues I've had since my lymph node dissection make it hard for me to know if I'm symptomatic. I have a new name for my issues. I was looking at my last sheet from my pain doc and noticed the diagnosis was unspecified hereditary and idiopathic peripheral neuropathy and unspecified myalgia and myositis. Odd that hereditary would be used for something that started after my LND and for something that no one in my family has. I'm sure there is something I'm missing. It could be as simple as coding for insurance companies. 
Since some people have the problems I have after the surgery I had, I'm not sure why they can't just say the issues are following surgery. I've read that some doctors think the percentage of patients who have ongoing side effects following the groin LND are higher than previously reported. I wonder how many others, like me, with ongoing side effects aren't included in the stats for future reports. I signed the forms to be included in a data base of patients my surgical ONC is following but I have no way of knowing if my issues get chalked up to chance or to the surgery. My surgical ONC acknowledged that a percentage of patients do end up with chronic pain after that surgery. However, during appointments with NP in his group, she has been quick to say my problems aren't related to the surgery. Never have figured out what's up with that.
Back to the scanning issue, I went through a cycle of three month repeats on scans because I had an imaged mass which eventually went away. The assumption is that mass was connected with my dissection and was a benign thingie, for want of a better word. The scan I had a year ago was the first one which was clear and therefore, I didn't need a repeat for a year. Because this is the longest I've gone without a scan, that may account for my increasing nervousness. The problem for me is that I have had to stop listening to my body. While a cancer patient should be alert to changes and let their doctor know of new symptoms, I have had too many symptoms and they change. I have to tune out pain and I have to have pain management. Much of the past year, I have been telling myself to get on with my life and ignore the issues I have to learn to live with. When something new happens I try to ignore it. I tell myself, you had a clear scan in March of 2007 and everything is fine. I did ask to go ahead and get my 2008 scan sooner rather than later which is why it's scheduled for February 1. Hopefully this scan will be clear and I can start trying to put this all behind me.
I thought it might be fun to pick out a photograph from each month last year and make a 2007 photo collage. If anyone wants to see them better you can click on the collage for an enlargement. I didn't spend very much time on it and I didn't try to pick a representative shot, I just quickly flipped through the photographs and picked one. The top row, left to right, is January 2007 through April 2007; middle row is May 2007 through August 2007, bottom row is September 2007 through December 2007. The bottom right photo in my 2007 collage showed the bird bath water dumped out because it was a solid block of ice. The good part is that while we had some cold nights in December, the salad boxes were doing fine because I covered them during the heat of the day.
Looking at my 2007 collage this morning made me think about checking the weather. It was supposed to be above freezing so I didn't cover my boxes but instead it was 10 degrees below freezing this morning. When I checked my boxes today, I did have some losses but some of the lettuce was hanging in there. I wondered who dug up the radish above. I have an easter egg blend of radishes, so called because the colors vary from red, to pink, to purple, to white.
A few minutes ago I took some photographs of a likely candidate for digging in my boxes. The neighborhood cat above is one I've bonded with and mentioned in my blog before. He's on my un-planted boxes which are reserved for peas which don't get planted until later but I suspect he may be who was digging up the radishes. I was kind of glad to see him with his collar and lean body because earlier this month I spotted a cat that has similar coloring on my deck. However, the fat cat didn't have a collar and was about double the size of the lean one. I thought something was seriously wrong for a cat to gain that much weight so good to confirm they are two different cats.
The fat cat stared at me while I photographed him, daring me to open the door. He had a "make my day look" on his face. Or that's what he looks like to me in the photograph above. I mentioned in a post last week that I was having trouble pushing back some thoughts about my health and was pleased that I was able to schedule my annual scan early. I will get a PET/CT scan done in two weeks and hopefully lay my recurrence fears to rest. February 3 will mark 3 years from when my melanoma primary was removed and February 1 is when I'll get the scan. March will be 3 years from when I had the groin lymph node dissection following the sentinel node biopsy which found the node which was positive for melanoma. I'm glad I don't have to wait until March for the scan. I think a clean scan will go along ways towards helping me move onward and forward.
I started this blog a year and a half after my melanoma diagnosis. In less than a month I will have been a stage III melanoma patient for three years. At one level, I can look back on this blog and feel that I've made some progress in moving on with my life. I no longer talk exclusively about my health, even though this blog was started as a means of dealing with the aftermath of my surgery for node positive melanoma. It used to be that every post was about physical issues I've had which started after my initial recovery from the groin LND. Actually, now that I think of it, my first few weeks of blog entries were about trying to move forward. I was still hopeful that I would recover from the aftermath of my cancer and get back to where I was physically prior to the surgery. I lost the first two weeks of posts when I crashed my blog. When I started it again, I began with my melanoma history and was again fearful that I was having a recurrence.
At one level I've moved past the recurrence fears. I know that I can't trust my body to give me any information. That's not strictly true. Obviously late stage severe symptoms would give me cues but I mean subtler hints. I have learned to live with the fact that chronic pain and neurological symptoms have to be managed and that my symptoms change. Beyond good days and bad days, I have new symptoms which I have to learn to ignore rather than go into alarm mode. I know it could be a lot worse. I am one of the lucky ones. I had a poor prognosis going in and that prognosis improves with each year I go without a recurrence. I have several years under my belt and know that each change is not worth panicking about.
I also know that I have to accept that I can't keep trying to get back to some place physically that I perceive as meaning I've recovered. I've stopped keeping logs which mostly make me feel like I'm falling backwards farther and farther. The fresh starts didn't work out. I am losing ground physically, and although it could be a lot worse, it's not something I can track if I want to feel positive. In theory focusing on improvement not cause was a great idea. The problem is I'm not improving. Sure, I'm better in some ways but in terms of walking more or farther, it isn't happening. I thought if I could give up on ever jogging or running again and focus on walking at least every other day that it was a reasonable goal and I would feel better.
The problem is that I have found I actually feel better if I have little or no physical activity. That goes against everything I believed and certainly what the pain specialist and other doctors thought. The guiding wisdom is that people with chronic pain do better if they are as physically active as possible. The problem is that I do better if I'm not trying to be physically active. I'm not talking about overdoing here. I'm talking about moderate walks. When I stopped trying to have daily or even alternate daily walks, I could hold off some of the newer issues I've been having in terms of symptoms. This has been true over the past few months. However, recently, even that isn't working. I don't want to whine about symptoms but sometimes it's hard to hold myself erect. I feel better when I give up and lie down propped up with a book. On the plus side I'm reading more offline with a full length book as opposed to the short pieces I read online.
What I probably hate the most is I'm finding myself looking ahead to the full body scan in March as the end all. I feel like if I can just get past that scan and have nothing new show up then everything will be ok. I know that's not true and it's irrational. Having a scan show that I'm not having a recurrence doesn't mean I'll feel better physically. I need to find a way to get past the idea of a scan being the magic pill. I am aware that I have kept pushing back signals that something may be wrong. I have had in the back of my mind, not too much longer until my scan and that will ease my mind. The problem is what if it doesn't.
I've had scans in the past which actually worried me more and I even had one where I was given the option of exploratory surgery or re-scanning in three months. I chose the re-scan and the mass got smaller and eventually went away so the assumption is that it wasn't cancer. Then there is the issue of, what happens when I'm far enough out from having active cancer that the scans are no longer part of my follow up protocol. At some point I may have to accept that I'm going to lose ground physically without the doctors being able to help beyond the management of symptoms. That may not be a matter of giving up so much as a matter of being realistic. I may have to accept that the whole thing is totally beyond my control. Which brings me to the reason for this slightly depressing post. I have felt like I wanted to write some kind of New Year post with hopes, dreams, goals, or something beyond the same old, same old. I find this year that I can't do that in any way shape or form. Who knows maybe by April Fool's day I can. This post explains how April Fool's day used to be New Year's day.
August is increasingly the month, where I live, when the ozone alerts are flashing. The message my desk top screams at me is ground level ozone concentrations may reach unhealthy levels. Today we were in the orange for ozone and we also had a heat advisory. Same in place for much of the week. I had an aha moment when I took my trash down to the street this afternoon. I could tell that my breathing was affected as I walked up my driveway. I started thinking about how the scans I've had which have me a little nervous about my lungs were both either in August, or the beginning of September which isn't that different from August here.
I wouldn't have thought anything about it if my first PET/CT scan which was done after my melanoma dx had shown junk in my lungs, unless the radiologist had thought it indicated a malignancy. I stopped smoking in 2001 and was diagnosed with melanoma in 2005, but I assumed it would take a while for my lungs to get up to snuff because I smoked a LONG time. However, that first scan in February of 2005 didn't show anything that shouldn't be in my lungs. It wasn't until my PET/CT scan at the end of August 2005 that notations such as "hazy opacification" and tiny lung nodule started cropping up. It bothered me for something new to show up.
I asked my oncologist about those notations regarding my lungs and he said it wasn't anything to worry about. That said, the first thing I looked at when I had a full body scan in March of 2006 was to see if anything was noted about my lungs. I was relieved when the lungs weren't mentioned but then the next scan at the end of that summer once again mentioned a lung nodule and a small thorax node lit up. Again, it wasn't anything that concerned my doctor. It did worry me so I was once again relieved by the fact that the March of 2007 scan didn't note anything in my lungs. It wasn't until I was huffing and puffing my driveway today that it occurred to me that the end of summer scans might show these little lungs buggers because of unhealthy ozone levels irritating my lungs. At this point I'm on an annual scan schedule so I won't have another full body PET/CT scan until March of 2008.
My aha moment added into my being glad that I won't be getting a six month scan this year. The point is that if the ozone issues aggravate my lungs and cause barnacles to show up at the end of summer, a scan at the end of winter is much better. The scanning issue in general is one that I'm not entirely resolved about. It bothers me that there isn't a standard for Stage III melanoma. Many of the large melanoma clinics handle it differently. A few don't do any asymptomatic scans, some every 3 months, some every 6 months and some like mine once a year. I had more frequent scans initially because of my concerns over the chronic pain I've had since my LND. The problem was that my first scan 6 months after surgery showed a mass in the basin where I had the lymphadectomy and that had to be followed up on with another scan in 3 months. Now things have settled down and I shouldn't need any more scans until March 2008. Tonight that suits me. Who knows what will suit me tomorrow.
It was so odd how within the space of a week we went from snow and cold to warmth and spring. There was some damage to early flowers and buds on trees but so much is blooming again that it's hard to even notice the damage. We may still return to the cold and more damage but at the moment, I'm enjoying spring in full force.
The wildlife are certainly enjoying the warmer weather and becoming increasingly abundant. I enjoy listening to the bird calls and wish I was better at recognizing the individual voices.
It was a huge relief to get past my March doctor's appointments and four year PET/CT scan. The fact that I've gone four years now without a melanoma recurrence is making me increasingly optimistic. 
I remember after my three year scan, I decided that I was done with melanoma. I felt like I had to reach a point where I put it behind me. To a large extent that worked. I have worried less, talked about it less, in general moved on with the rest of my life.
The problem is I am still followed by oncologists, a dermatologist, a pain specialist, blah, blah, blah, and I still get annual full body scans. Sometimes I think to put it behind me I need to drop all of the doctors, although that's not possible in terms of pain management. 
That has been the hardest part, dealing with the physical "issues" I've had following my lymph node dissection. The issues have made it hard for me to listen to my body. As a matter of fact I've had to learn to stop listening to my body. I've blogged enough about all of that in past years and at this point I like to focus on relief. The relief of being one of the lucky ones who are diagnosed with a deep melanoma primary and a positive node but don't have a recurrence. 
It's even possible that some of my physical problems are part of why I've done so well with the cancer. My body may have mounted its own autoimmune response which have resulted in irritating pain but are part of why the cancer hasn't recurred. The fact that my C reactive protein has been high every time my rheumatologist tested it is at least one indication that my body has had an autoimmune response of some kind.
I didn't intend for this post to start veering into the whine territory so I'm going to end with relief. The birds are singing, the flowers are blooming, and my four years tests and appointments are done with and turned out well.
