20/20: the year I had a baby and cancer in the midst of global chaos

June 2017 — thin dark line noticeable on index finger nail

June 2020 — 3 years after line first became noticeable; it’s grown darker and thicker

This past year I had a non-hospital birth in the early throes of the pandemic shutdowns. My second son Hayden was born on May 12th, 2020, weighing a full 8 pounds and 12 ounces that did not treat the lower half of my body well. Sigh. If you’ve ever had a baby, you know that postpartum healing is not linear. 

When I was three months postpartum, I had a biopsy done on the index finger nail bed of my right (dominant) hand. Since 2017, I had had a thin dark line called a melanonychia running from the bottom of my nail bed (where the cuticle is) and continuing to the top of my nail. This can be a sign of melanoma within the nail matrix. It was monitored by a dermatologist every six months, and we noticed that it continued to grow (ever so slightly) darker and thicker over time, warranting a biopsy. 

Nail matrix biopsies require a hole being ‘punched’ through the bottom of your nail bed. I had nightmares leading up to this initial procedure for weeks. I also wasn’t looking forward to losing the use of my dominant hand as I navigated early postpartum with a newborn to hold and care for.

The results came back quickly, showing melanoma in situ or Stage 0. This meant it was thankfully still in place, but it was in fact cancer, so it would need to be removed immediately via surgery. The original recommendation was amputation from the DIP joint on up. I left that first surgeon consultation in tears.

I am forever grateful for the care of an expert hand surgeon local to me who chose to do more research, interview colleagues in his field, and look into other options for me. We decided on a 2-surgery approach, where the nail, nail bed and nail matrix would be excised with a wide enough margin to remove each and every melanoma cell. This would leave a gaping hole in the top portion of my finger. Therefore, surgery #2 would fall three weeks later with a skin graft from my inner wrist to cover the top of my finger. It would be a long process, but I would maintain the full length of my finger without actual amputation.

Post-op surgery #1, finally at home with baby Hayden; September 4, 2020.

Everything went as hoped. In the month of September, the cancer was successfully removed with healthy margins. My graft held and healed slowly. And I was eventually able to hold my baby, breastfeed, and shower without the help of my incredibly faithful husband.

But in the midst of all of it, there was so much pain, fear and waiting. 

At one follow-up appointment with my hand surgeon, I had to have my entire hand numbed just so they could remove the bandage without me screaming. I remember feeling sweaty and faint with pain, trying to explain to the Physician’s Assistant that I had just had a drug-free childbirth, and that this was truly SO. MUCH. WORSE. Fingertip nerves are not a joke!

Speaking of that follow-up appointment…my husband cam with me to one because he was supposed to watch and learn how to change the dressing on the wound nightly. I was actually holding it together, when we looked over and realized David was turning pale and sweaty at the sight of my gaping wound. So the PA had him switch spots with me so he could lie down and they could bring him a washcloth for his head.

Post-op surgery #2 — September 25, 2020

Several months post-surgery, I started noticing a bump on the edge of the healed skin graft. It looked like a cyst, and sure enough, it was diagnosed as an inclusion cyst — harmless for the most part. Until a few weeks later, when what I thought was a scab began covering a tiny sliver, only to have a doctor confirm that it was actually a tiny shard of nail re-growing. Apparently a few nail matrix cells (nail-producing cells) had been left behind during surgery, and had begun to do work again. I was assured that this shouldn’t become a huge problem unless it started to snag or bother me. In this case, I could opt for another surgery (no thanks!) to fully remove the nail area, yet again. TBD, but for now I’m sitting tight and praying it will take care of itself and possibly even “cease and desist.”

Throughout the entire ordeal I clung to Jesus as best I could, and still am daily. I love the reminder in 1 Kings 20:28 that he truly is a God of both the hills and the valleys. I also had my favorite poem by Rainer Rilke on repeat in my head. Here’s a snippet for you below, and the rest can be found here.

“Let everything happen to you: beauty and terror.
Just keep going. No feeling is final.”

In summary: FIND A DERMATOLOGIST AND MAKE AN APPOINTMENT TODAY!

Post skin graft from wrist — looks like a nail almost…but it’s just skin!

Three months after the initial surgery.