Wednesday, January 05, 2011

The Slippery Slope of Fingernail Discoloration

Slopes can be slippery.  The more that's at stake, the steeper the decline, and the easier it is to get going.  I tend to not do well with hills like these.  When I was 12, I broke my wrist skateboarding by going up a street that was too high for my balance.  My mom encouraged me to "go just a little higher."  I wasn't comfortable and the speed caught me.

Today's skateboarding street is my fingernail to be biopsied for melanoma tomorrow.  A few months ago I noticed a brownish-reddish streak on my left ring fingernail and thought it was a bruise that would grow out as the nail did; however, the bruise didn't grow out. 

Being redhaired and fair skinned, the sun has never been my friend; I've always thought it held too much power over our lives.  I slather on sunscreen, wear a sunhat better suited for a trek in the Mojave, and find shade whenever possible.  Thanks to my skin type and my skateboard coach's early stage melanoma that was removed recently, the dermatologist suggested I see a hand surgeon for a biopsy.  The hand surgeon quickly reached the same conclusion...a nail bed biopsy was needed just to be safe.

A nail bed biopsy involves removing the fingernail as deep as the nail bed.  I think of myself as a reformed nailbiter so as much as I used to have a fondness for chomping down, neither me nor any nailbiter would ever want to go as far as this surgery calls for.  The nail should grow to the fingertip in four months, but it will take about a year for it to look healthy again.

The surgeon said it was difficult to place a percentage on a diagnosis, but if pressed he said there was a 10% or less chance that the streak is the result of cancerous cells.  He said it could simply be from trauma to the nail for example.  Let's hope I somehow forgot that I smashed my fingernail in a doorjamb some time ago.  I'm not concerned about the procedure or care afterward, I'm concerned about the diagnosis.

I don't know why I have this streak and I don't t like waiting to find out.  Can I just skip ahead like I'm watching something on TiVo?  Waiting gives me time to overthink the worst case scenario.  As such, waiting also gives me time to underthink the greater likelihood that this won't be a significant concern.

I'm always quick to remind friends and family to not research medical concerns online, but nobody was faster to Google "subungal melanoma" than me.  From medical sites to message forums, I read horror stories of people passing away from ignoring their nails that were far more hideously discolored than mine to uplifting stories of people getting checked out and being just fine.  I know the information is misleading and only populates my head with unnecessary fears, but I need some control; however unattainable it may be.

Nail bed melanoma is very rare in whites, making up less than 3% of all melanoma cases, and is commonly found on a big toe or thumb.  So I have that in my favor, but my skin type and family history make it an easy call to be safe than sorry.  The common treatment for a toe with this is amputation and for a finger is amputation at the nearest joint to the lesion.  Damn the information online!  My mind gets to race between an inconsequential, benign issue in my nail bed to not getting to see the tip of my finger again.

I know that thinking through any scenario does me little good.  It won't change what is occurring with my finger.  I try to stop myself from thinking the worst, but it's hard not to.  I think all of us naturally jump to the extreme result to feel prepared and feign having control, but really we don't know how we'll feel when we hear for sure.

Whatever the doctor tells me is the next step for treatment, I'll welcome it worth open arms (errrr, fingers) because as my mind races ahead, the alternative would be worse.  I see no reason why I shouldn't use the slippery slope's momentum to boost me up the ensuing uphill climb.

So I bid adieu to the fingernail on Thursday and wait for what's sure to be an agonizing five days to hear the diagnosis on Tuesday.  I hope that my hill levels off and coasts to a stop.


For the diagnosis, see the next entry here.


Whit said...

I'm about to go thru this too and would love to hear about your experience of the actual nail removal and what the doc said. Hoping that all went well for you.

How sore was your finger afterward?

B and T Crowd said...

Sorry to hear about your situation. My nail bed turned out fine ( We'll chat over email.

elise said...

My six year old is having to have this done next week. Any words of wisdom? How long did it hurt? What things were difficult to do while it healed? Did you take prescription pain medication afterwards?

Thanks - Worried Mom

B and T Crowd said...


I'm sorry for the very long delay in my reply. How did the surgery go for your child? I really wish I had seen this comment in time to offer help and advice.