A Long Time Coming

Well, here we are almost two months later and I have yet to update the blog. I knew that this would happen!

The last week of July I returned to work at SXC; except now it’s called Catamaran and is double the size it was when I left on maternity leave back in May. While I was gone they acquired a company named Catalyst; another similar sized PBM.  Since my return things have been incredibly busy.  On one hand it is great because it makes the days go by fast, but on the other hand I am worn out by the time I get home and get to see the girls.

I can’t believe how quickly those 12 weeks flew by!  And returning to work was extremely difficult for me; more so this time than it was when I came back after Ryleigh.  Don’t get me wrong there were definitely those moments while I was at home that I longed for some adult interaction or to run screaming in the other direction at the thought of another one of Ryleigh’s tantrums.  But all in all I loved being home with both of the girls.  It’s just amazing to me to watch them learn and grow before your eyes.  Can you believe that Emily is already 4 months old?!

Let me catch you up on some things that have happened in the last few months.  Over the 4^th of July weekend RG, Emily and I flew to Dallas, TX for the Nevus Outreach Conference. This is a conference that the Nevus Outreach Organization holds every two years for nevus owners and nevus families to come together to meet and to learn more about the condition.  RG and I went back and forth for about a month before committing to going.  Once we got there we were really happy that we made the decision to go.  We met so many great families; most of which had young children that were also born with CMN.  A lot of the kids that we met were closer in age to Ryleigh than they were to Emily but that didn't matter; no one can resist a baby!  She was a hit!

The organizers made sure to bring in some experts in the field.  There was a dermatologist, a neurologist and a sugeon. We took advantage of this and scheduled some time to meet with Dr. Bruce Bauer. He is well known doctor in the field of pediatric plastic & reconstructive surgery. Lucky for us he is right here in Chicago!  A lot of the families that choose to have their child's nevus removed travel from around the country to come to Dr. Bauer. The method of removal that Dr. Bauer uses is tissue expansion.  This is done by placing tissue expanders, think durable water balloons, under the skin near the nevus. Each week the balloons are exanded a little bit more by filling them with saline.  At the end of the expansion, 10 - 12 weeks later, the expanders are removed and the new, expanded skin is sewn together to replace the area where the nevus was. There are a few other options for removal as well. There is the option of laser removal and dermabrasion. Both of these options are used to remove layers of skin, lightening the nevus as they go. Since neither of these procedures are actually removing the nevus skin there is always a chance for the nevus to return and both would require multiple sessions. This would happen if any melanocytes that were missed during the procedures started to darken.  A third option is skin grafting. This option takes skin from another area on the body to replace the skin that is removed at the location of the nevus.  The downside to this is that the color and texture of the skin may not match, and the graft may not 'take' or may not be accepted by the new location. The location and size of the nevus will determine which procedure is best.

When we met with Dr. Bauer he took a look at Emily's large nevus and said that she was definitely a candidate for the expansion surgery.  He said that for the size and location of her nevus he hoped that they could remove the entire thing with one round.  A round includes two surgerys; the first to insert the tissue expanders under the skin and the second 10 to 12 weeks later to remove the nevus and bring the new skin together.  After meeting with Dr. Bauer and talking with all of the families at the conference we decided that this is the route that we wanted to go.

This wasn't a hard decision for me.  I just tried to put myself in her shoes as she gets older and thought that if it were me I would prefer a scar over the giant nevus. Some people may say that we are changing her by removing her nevus, but RG and I think that we are doing the best thing for her.

About a month after the conference I called Dr. Bauer's office to make the appointments for her surgeries.  The first will be Thursday, November 1st. I wanted to schedule the appointment as early as we could so that we could get it over with.  They won't do the surgery until she is 6 months old; the biggest concern being the anesthesia.  Dr. Bauer prefers to do these sugeries when they are younger for a couple of reasons, they are less likely to remember any of it and their skin is much more elastic at this age.  Her second surgery will be January 18th. 

Up until this point I hadn't thought twice about having her nevus removed, but once I scheduled the surgeries it all became very real.  I instantly started second guessing myself.  Are we really doing the right thing? Could I put her through this?  Would she make the same decision if it were up to her?  For now I'm trying not to think too much about it.  But I fear that these next six weeks are going to go by entirely to fast!  In the mean time we are taking full advantage of our weekends and spending lots of time with family and friends.

Happy Fall!!