Hi everyone. I need your advice.

I've had a mole on my lower back "scooped" twice to check for melanoma. Though both results were negative, I'm now told I should get an "excisional biopsy" done on it because it keeps growing back, which could be a sign of melanoma. The excisional biopsy is a deep, elliptical cut that should remove the entire mole and all risk of melanoma. The down-side to all of this? It's not the scar; it's no weight lifting for 12 to 16 weeks.

This is what my doctor told me at the consultation. Supposedly, any stretching of the skin would tear the scar and/or the "internal stitching" of the cut. "You could still do lower body," he tried to assure me. Yeah, right. This is unacceptable to me. I can't watch my ~2 years of hard work dwindle in a few months. It's also particularly difficult for me to accept because I just started a much-needed bulking phase which I've been planning for a long time. I'm too skinny and I'm finally gaining weight, but now I'm told that I can't weight-lift --- a necessary component of bulking.

So... I need advice about what to do. Has anyone had this done before? Did you stay away from the gym? If so, how long? The target site is on the small of my back. Do you think I could work out if I paid meticulous attention to form and kept my back perfectly straight? Or should I just man up and stay away from the gym for three to four months? If so, what do I eat? Maintenence? Will I lose much muscle?

Thanks everyone,
Rymanes

12-16 weeks?!?!?

Personally I've never heard of a simple excisional biopsy taking that long to heal unless...

How much skin are they taking? Will they need to graft new skin or just pull together the skin edges?

I suspect that at your age, the healing process will not take anywhere near that long. You will be able to figure out how to do exercises that do not stretch the skin. I would give it a good 3 weeks though before risking anything.

I would get a second opinion. I would also speak to a dermatologist who specializes in vanity treatments and/or a plastic surgeon. They will have a better idea what is in store.

Does your doctor workout? The odds are no. Doctors tend to be full of doom and gloom about working out. Their idea of how much stress and strain is put on is way out of proportion to what is really going.

I remember my dentist telling me that he thought I was lifting too heavy weights and stressing through clenching my teeth. I was dead-lifting 40 lbs at the time...:lol: coming back from a hiatus and building up slow.

I do hear your resentment about the medical stuff costing you your work-out. It is extremely frustrating. I am recovering from a hysterectomy, which I also did not want to have for similar reasons, and I finally relented because there was some chance of cancer.(It proved that there was not.) You can check out my thread to see all the hi-jinks I have gone through to get back into shape and to minimize fitness loss here (http://forums.johnstonefitness.com/showthread.php?t=29474).

But it is the risk of cancer you are facing. As horrible as it is that your whole hard work that is finally achieving some results is being scuttled for 3-4 months, it is no where near as horrible as dying from cancer. And particularly when you are so young.

SO as long as 4 months seems to you, it really isn't in a whole lifetime.... SO check out some of your sources... but I would go ahead and do it. But I would be sure it was being done by an oncologist, not a primary care physician or a dermatologist. You want a cancer specialist... for absolutely certain. :nod:

But it is the risk of cancer you are facing. As horrible as it is that your whole hard work that is finally achieving some results is being scuttled for 3-4 months, it is no where near as horrible as dying from cancer. And particularly when you are so young.Most definitely. I exercise fanatically but if a doc told me no working out at all for 3-4 months to remove something that had a good chance of giving me cancer, I'd go couch shopping! Hopefully the recovery won't be that long in this case, though.

Also, 3-4 months will not remove all gains made in two years. There will be a loss, but not a massive one. It will be significant but I bet it could be recovered in a few months.

Most definitely. I exercise fanatically but if a doc told me no working out at all for 3-4 months to remove something that had a good chance of giving me cancer, I'd go couch shopping!


Hell yeah! But you will know after a few weeks how the healing process is going. And do some damn lower body lifting. You may need it. Everyone needs it.

Hell yeah! But you will know after a few weeks how the healing process is going. And do some damn lower body lifting. You may need it. Everyone needs it.I guess the doc wasn't thinking of squats when he said lower body, eh? ;) If anything'll bust stitches in the lower back, it's them!

no weight lifting for 12 to 16 weeks.

You're 20. It will feel like forever, but your doctor is probably right. And it's not going to wreck you. At 20, you will probably pick up your progress after less than a month.

I am of the theory "work around and injury." Because I know how crazy you get just sitting there.

Last summer I fractured my rib in a sparring session. I was supposed to lay off of doing anything for 4-6 weeks per Dr.'s instruction, but I didn't. I just stayed away as best I could from aggravating it - like pull ups, or push ups, or abdominal exercises. Basically anything that would really stretch the intercostal muscles.

Most recently, I finally went and had an x-ray of my hand as I have had and on again/off again hand injury since February 2005. It heals up for awhile, then gets reinjured. After having it x-rayed, I apparently at some point fractured my index metacarpal, but luckily it healed up well on its own, so they won't need to go in an fix it. I however did not give it enough time in between to heal fully, so I continued to sprain it and have swelling.

So, in the meantime - no hitting. :lol: But I work around it. I work the other hand, shadow box, run, weights etc. There is a lot I can do. Dr. always tells me to take it easy and rest for awhile. But I won't. LOL It is a fighter's mentality - suck it up anyway..

Basically, what I am saying is find something that you can do to keep up your level of fitness. Maybe focus on swimming or other cardiovascular stuff that won't stretch the skin too much. Just an idea.

Sorry to hear about the setback, but there is a bigger issue here. Cancer. This is an insidious disease process that I promise you do not want to deal with. The really good news is that your previous test results have come back negative, so far. The “so far” part is what has your physician taking this precautionary move of excising the mole.

Once the mole, or any excised tissue for that matter, has been removed it will be set to pathology for analysis. In your case they will look for abnormal cell growth. When we excise tissue in the O.R. it is under a scope within minutes to be absolutely certain that the margins of the tissue look normal. This ensures that we removed the “bad stuff” entirely. We won’t close until we get that call from pathology.
For lack of a better analogy it’s much like removing rust from a car. If you do not sand or grind all of the rust out you have a significantly higher recurrence rate.

Your concern is with exercise post operatively. Here are some things to think about. First, take a banana and stitch the peel back together with regular thread. Now pull the peel back apart and take note as to just how easy that is. You have just simulated what the stitches where the mole was. Obviously they cannot take much tension before they tear free. On the other hand, each passing day allows the tissues to grow back together and become stronger. However, keep in mind that a scar is only about 80% as strong as the original skin so that area will most likely never be as tough as it once was. On a persons back this is not a problem, but we keep this in mind when doing hand and knee procedures.

Not knowing you healing ability I suspect he was giving you the old standby answer of 12-16 weeks. That leaves plenty of leeway for the MD to wiggle. Often if we tell our patients a specific date they take that as gospel.

“How long before my knee is better?”
“Give it three weeks and you should be just fine”

Fast-forward 22 days. Patient comes back into the office for follow up.

“You said in three weeks I would be better! It’s been three weeks and the scab still hurts!” Never mind that they didn’t keep the incision clean and had a mild infection for the first week.

The best thing I could possibly recommend is that you not do ANYTHING strenuous for the first couple of weeks. That will give your skin a chance to produce the initial fibrin layer and toughen up and the stitches should mostly be removed. Also up your protein intake as that is what your body will use to “fill in the hole.” After that, VERY GRADUALLY begin your physical activities. If you tear the tissue (most tears will be too small to see with the naked eye) the body will need to re-repair that area taking longer time to finish. Plus you have now degraded the scar again. Pain is natures way of saying “slow down and take a break.”

Will it take 12-16 weeks? Maybe. At your age I really suspect it will not pending no setbacks like colds, trauma or infection.

Look at the bigger picture. It’s a potential source of cancer that is being removed early. I have several patients who would trade places in a second. This should be a wake up call as well to watch any other moles you may have. You doctor will be able to thoroughly educate you as to what to look for.

Also, if the scar is an issue, pick up something called Mederma. It is over the counter and great stuff. The plastic surgeon I work with turned me onto this stuff and it works. However, after about a year and a half of healing, what you see is what you get as far as scar formation and reduction.

:cool:

www.mederma.com

Thanks everyone for your comments and advice, with an especially big thankyou to SatDive 1 -- awesome post! I'm having the surgery in a couple of weeks once school gets underway, and I plan to listen to what seems to be the majority opinion: complete hiatus for at least 3-4 weeks followed by a gradual return to the weight room.

Thanks again,
Rymanes