We met with Dr. Polley for our follow up and he had the pathology report in his hand and said that if we did nothing at all, Austin would likely be just fine.  However, because there is a chance of  melanoma, and melanoma is so aggressive, he suggested that we re-excise sooner than later.  He said he would remove the entire previous incision and a 1mm or so on each side.  He thought he might use a stitch that would require removal under anesthesia but he wouldn't know until our surgery.  So we scheduled the second surgery for 8 days later, on the day before Thanksgiving. Austin was WAY more apprehensive this time around.  He clung to us in the waiting room and tried to avoid the hospital bed at all costs.  He did ok getting the hospital jammies on but when the nurse came in to check vitals he broke down.  I put on some funny cat videos and he calmed down a bit.  The nurse contacted the anesthesiologist who recommended we give him some tylenol and versed.  He cooperatively drank that down, but unfortunately it didn't calm him down much.  By the time Dr. Polley came in to talk with us, Austin was hysterical, which of course was upsetting to me.  The anesthesiolgist and nurse anesthesiolgist came in and had to physically carry him down the OR.  We were escorted back to the waiting room and found our good friends John and Amber waiting there for us with a balloon and little stuffed cheetah for Austin.  It was a touching surprise and so nice to have a good friend to hug and cry with for a moment.  We were scheduled to arrive at the hopsital at 9:30 with surgery at 11:30.  Surgery started at 11:57am.  At 12:30pm they were closing and by 12:42 he was in recovery.  Dr. Polley spoke with us and said everything went great and he used all dissolvable stitches (meaning we wouldn't need to come back for removal under anesthesia).  He used a few interrupted stitches and advised us to come back in 8 days for him to take a look at it.  We made our way back to the waiting room and waited and waited to head back to recovery.  We had been taken back so quickly the first time, that I knew things must not have been going as well this time.  We finally got to see him and he was in and out of consciousness.  The anesthesiologist and nurse anesthesiologist were both in the room when we arrived, along with two other nurses.  They said they needed him to take some big breaths and we tried to encourage him to do so and he just responded "I'm too tired".  We held up some oxygen to his face for a little bit and eventually his oxygen levels stayed above 94 for 10 minutes and they discharged us at 2pm.  He threw up on the way home and his balance was off the rest of the evening but thankfully he was back to normal on Thanksgiving.  I thought having surgery just before the holiday would be a nice calm way to recover, but I forgot about the 7 cousins under the age of 9 thing.  There was some bleeding under the tape, but I think for the most part it is doing ok.  We will follow up with Dr. Polley in a few days. 

His first scar, the morning of surgery:

Feeling nervous at the hospital:

Getting ready for round 2:

Austin avoided staying in the bed at all costs:

A rare smile that morning:

Aaron and I, back to stalking the board:

Totally out of it in recovery.  This is after the iv is already out.

The next morning, back to normal:

Last year around this time, I noticed Austin had a little pimple or bug bite that just didn't seem to go away.  In early January he had his annual preventative exam and I mentioned it to his pediatrician who observed it blanching and diagnosed it as a spider angioma and said it was harmless, likely to go away on its own and to call if anything changes.  As a parent who looks at his child's face every day, it was difficult to notice how it was changing but it became obvious it WAS changing when friends and family began asking about it.  I was a little worried the pediatrician might blow me off again and really just wanted a dermatologists opinion anyway so I tried calling and scheduling a dermatologist appointment first, I figured then we can just skip the $20 pediatrician copay.  Unfortunately it was a 16 week wait to get into the dermatologist.  I never did cancel the appointment - it is still a few weeks away.  I consulted with some close friends who said yes, it can take awhile to get into the dermatologist but a pediatrician referral might speed things up.  Being a parent can be hard - you don't want to seem like an alarmist but you also just want to do what is best for your child.  With their encouragement, I scheduled the pediatrician appointment who fit us in within a few days.  The pediatrician agreed the spot had changed but was still feeling like the angioma diagnosis was accurate.  He felt the change in appearance might be due to a blood clot under the skin.  He could tell I was worried about it so he referred us to a dermatologist and advised that angioma's are removed by laser in Ann Arbor.  Two weeks later, on the 2nd day of school, we were seen by Dr. Carroll who said she believes the spot to be one of three things:  pilomatricoma, juvenile xantrhogranuloma or spitz nevis.  She recommended the spot be removed by a plasitc surgeon and biopsied for a definitive diagnosis.  Another two weeks and we were seen by Dr. Polley who scheduled surgery for November 4th. 

We arrived at the hospital and I think Aaron and I were more anxious than Austin.  He did pretty good.  He was very hangry at first and did NOT tolerate the no eating/drinking policy well but as soon as we got a room with some cartoons he forgot all about that.  When the anesthesilogist wheeled him away he said goodbye to dad and then when I went to give him a hug and kiss he said "mom, I'm scared.  I don't want you to go." At which point I lost it.  I tried to kiss him on the head so he wouldn't see my face and then took him away.  His room was across from the nurse's desk and he had them in tears too.  I cried a bit in the waiting room and then pulled myself together.  The doctor met with us and said things went well and we'll try to keep the bandage on for 10 days.  We barely had time to sit down after meeting with the doctor and they took us back to recovery.  We heard him before we saw him and he was VERY upset.  He was in the nurse's arms and I took him and asked him what was wrong - he was freaked out about the iv in his hand.  We got him some graham crackers and juice and he calmed down and the nurse took the iv out.  We got him dressed and were able to leave very quickly!  Austin was 99% himself when we left and requested Olive Garden for lunch.  He stayed home from school the next day and was back on Friday.  His bandage stayed on exactly 10 days and came off while he was sleeping.  The scar was a little longer than we expected but otherwise looked pretty good!  Austin as a great little patient and never once complained about it hurting, pulling, itching or otherwise bothering him and he never messed with the bandage.  I called Munson daily for to see when the pathology report was available and finally was woken up by a call from our pediatrician on the 17th advising us that the margins weren't clear and re-excision was recommended.  Fortunately we had our follow up scheduled with Dr. Polley later that morning...

Here is Austin at Dr. Polley's office:

Keeping tabs on him via the monitors.  We were scheduled to arrive at 10:45, surgery at 12:45.  Dr. Polley was running ahead of schedule and surgery started at 12:01.  By 12:30 Dr. Polley was closing and by 1:12pm we were in the elevator on our way home.

John and Aaron both had to work today so Amber and I decided to get the kids out of the house and head to Empire!  We took off about noon and came back around 6:30.  There was definitely whining involved, but overall the kids were troopers!  It was super windy, but a warm, gorgeous day.  Ready to see more green on the trees and for the water to warm up!  

The most photogenic of the group:

They are all up there on the dune!

Ashlynn:

We ran into Kris and Noelle at the beach in Empire!  They were in town for Anni's gymnastics State Finals where she did awesome!

Jacob seemed a little under the weather there... no fever and a good appetite, so I'm not sure what was up with him... maybe just tired?

Low humidity, warm and dry conditions and strong winds mean a Red Flag warning and wildfires for Aaron.  It's after 10pm and he's still not home yet!