Preparing for Cancer Surgery as a Healthy Person

For the 4th time, I have a couple of patches of malignant melanoma, Stage 2, that need to be removed. I will have surgery March 3. One patch is where I would put my right hand when I do the Pledge of Allegiance. The other is on my upper right thigh.

I’ve had three patches removed on my back and one on the outer upper right arm. The one on my arm started out not a big deal, but during surgery, the surgeon found it had “roots” and I ended up with a 10 in. by 5 in. incision that is now a pretty scar. I have a half-sleeve tattoo (that I do not like and want fixed/covered up) that the incision went into. The doctor, expertly, put the tattoo back together. I love this surgeon lots.

Short Tutorial on How to NOT Get Skin Cancer

(Add “without sunscreen” to all of these Do Nots.)

• Do not lie out in the sun every day while living in Florida starting at age 12.
• Don’t slather your freckled white skin with Crisco.
• Don’t put Baby Oil on your body when you have blue eyes and light-colored hair.
• Don’t show off your red face and burnt skin as a sign of pride to your friends.
• Don’t think 1000 more freckles two days after sunning is a fantastic sign of success.
• Don’t be a lifeguard for 3 years starting at age 16.
• Don’t swim every day for decades in an outdoor pool.
• Don’t teach swim classes to kids in outdoor pools.
• Don’t teach swim classes to adult non-swimmers in outdoor pools.
• Don’t lie on balconies to get tanned if you can’t get to the pool.
• Don’t be in the sun, but especially to suntan, between 10:00am and 2:00pm (which were my focused time slots… I made sure those were the hours I was outside).

And a few DOs:

• Wear sunscreen. ALL THE TIME. All over any skin that’s seeing the sun.
• Keep your skin pale and soft.
• Wear wide brimmed hats.
• Make sure the back of your neck is covered from the sun.
• Swim in long sleeves and pants that are above 50 SPF.
• Make sure your makeup has sunscreen in it.

You don’t want to have cancer melon-balled out of your skin when you’re 50+ years old. Surgery, and healing from surgery, sucks.

Prehabilitation

I learned a new word that others might know already: Prehabilitation (Prehab). This means preparing one’s body and mind for surgery.  

Prehabilitation is defined as a process of improving the functional capability of a patient prior to a surgical procedure so the patient can withstand any postoperative inactivity and associated decline. In other words, to get you to a better place physically before an operation.

There are four pillars to what prehab entails.

• High-intensity endurance and strength training
• High-protein nutrition and supplements
• Smoking cessation
• Psychological support

I probably never heard this word before because I was so big, the idea of my changing anything was absurd. I could not have physically done the recommendations anyway. Blessedly, I don’t smoke, so that one was already done.

However now I am on GLP-1s and my life has changed completely from what it was before.

380 Lbs. for Last Surgery; Almost Falling Off the OR Table

When I had the last surgery, the cancer was on my back. I was given anesthesia while I was on my back, so that meant I had to be rolled over for the surgery. Apparently, as several people were trying to turn me over, they nearly dropped me. I didn’t know this until I woke up the next morning and saw finger bruises on me as well as my under-breast being “sliced” open.

I called the surgeon and asked what happened. He was very kind and explained that I was almost dropped because it was “challenging” to turn me over. He apologized and said he would make sure there were more people next time. I accepted his apology and the episode was dropped.

Interestingly, at that time, I didn’t feel bad about being so fat I was almost dropped. But now, 275 lbs. lighter than I was then, I’m horrified I was that big and that difficult to turn over. It’s humiliating now. It wasn’t then because I was always strongly pro-fat activism. I’ve fought since the late 80’s for fat rights (long before the “Body Positivity” movement). I am embarrassed for me. My shame is my own. Plenty of others who have had similar experiences would be disturbed at my shame, but blame the experience on others.. But, I claim it.

So, now that I am heading to that same operating room with the same doctor, I cannot express my relief at being 260+ pounds less than they last saw me in that hospital. While there is always a possibility of accidents during surgery, I have two important factors now on my side: my cancer being on the front of my body so I don’t need to be turned over, and being infinitely healthier than I was when my last surgery occurred in 2019.

My Prehab Began with GLP-1s in 2022

While I could not walk without a walker or wheelchair for decades, when I started on Trulicity in early 2022 and then Mounjaro in late 2023, I didn’t know it, but that’s when I started my prehab.

High Intensity Endurance

Today, in February 2025, I have a phenomenal amount of high intensity endurance. I can walk for seven miles (on a flat surface) without even breaking a sweat. My daughter Meghann encouraged me to start walking on the treadmill at the gym, creating “hills” with elevating the thing. I now walk on it and raise and lower the “hills” while walking faster and faster. I sweat now!

Strength Training

I’ve done strength training for about two years, but just started at the gym in November 2024. This is me on the thigh strength machine. (That might not be the name, but I’m a novice.) I kick ass on the machines!

 

High Protein & Supplements

I’ve been eating a fantastic amount of protein for over two years so I have that taken care of, too. Yay, me! Yay GLP-1s!

Psychological Support

A couple of things. I’ve been in therapy for almost 5 decades. I have Bipolar Disorder 1 that was diagnosed in 1995. I’ve been on psych meds since the diagnosis.

Since I was 18 years old, I’ve been in therapy and now have psych meds and go to therapy. I saw my psychiatrist today and she was very supportive and offered help if I needed it around the surgery. I told her I was doing pretty good.

An adjunct to psychological support is my using meditation for pain relief. I was addicted to opiates for eight years, so do not use pain meds beyond ibuprofen post surgeries. I tell the docs, “You can ply me with any pain meds you want while I am in the hospital, but do NOT write me a prescription or send me home with pain meds because they will be gone before leaving the parking lot.” Of course, they always comply.

I learned meditation many years ago in two 2-week, Jon Kabat-Zinn Mindfulness-Based Stress Reduction (MBSR) course. I went because I was in so much pain it was hard to cope without pain meds. Now I know the pain was from my having obesity. I could not get down on the floor like the others, so sat in a chair for the exercises. I felt quite out of place, but held my head high and asked for the things I needed to feel comfortable.

MBSR has been my go-to for pain relief for many years now. It’s an amazing process and I do love meditating.

Therefore, I am practicing with a purpose right now, preparing for caring for myself after surgery. I know I can do it.

Interestingly, this magnificen Cracked Light sculpture has dark spots on her left side exactly where my surgery will be.

GLP-1 Protocol Before Surgery

I have been directed to stay off Mounjaro for 7 days pre-op. I will refrain from my shot 10 days before. I also have been asked to have only clear liquids for 2 days before. I shall do 3.

Many might feel this is extreme, but it’s important to me to be as safe as possible during surgery. The last thing I want is to aspirate something that was leftover in my stomach and then throw up while under anesthesia. Aspiration Pneumonia is not good.

Be Here Now

I’m trying to stay in the moment and not ponder too far ahead. I remind myself I’ve done this before. I’ve had many surgeries… too many… and have always been extremely fat. This time, I am older, but also healthier than I have ever been.

I’ll let you know how it goes!