Bumping My Head Was The Best Thing That Happened To Me This Year

The garage door at our old house didn’t leave enough clearance to fully open the hatch on our Ioniq 5, so we programmed it to stop partway up. That put the pointy part of the latch right at my forehead height. Sometime in late March, I leaned in to get something from the back, and when I stood up, I wound up bumping my head on that pointy thing.

It hurt, and I went about my day. A couple of days later, a small bump showed up. I didn’t think much of that either. I’ve bumped my head harder than that plenty of times in my life. Hematomas happen. They also just go away with time.

I also didn’t think much about where this little bump was. The previous September, Kaiser in Panorama City removed what’s called an “atypical fibroxanthoma” (AFX). The bump was actually right on the scar. An AFX is a skin cancer that isn’t considered particularly aggressive. So the Mohs surgery was simple. They gave me a local anesthetic, cut it out, closed it up, and I went back to work that same day. In my mind, that was finished.

But my new bump didn’t go down. After a couple of weeks, it had turned hard to the touch, so I went to urgent care. The urgent care doctor noticed that it was sitting right on the scar. He told me the odds of the two being connected were close to zero. In his opinion, it looked and felt like a calcified hematoma, and those can take four to six weeks to resolve. I’m not a doctor, and that seemed reasonable, so I went home.

However, three weeks later, it was bigger, and it seemed to be growing fast. My business partner, Phil Kells, began calling it “my third eye.” It was his way of saying, “you really should go get that checked again, mate.” But I didn’t. And I hit it a few more times, and it was painful, and I still thought it was just a hematoma.

Bumping My Head Again

By the end of May, we had sold the house, moved most of our stuff into our apartment in Vancouver, Washington, and were just a few days away from driving north with the rest of our things. The house was empty, except for a few boxes. While picking one of them up, I hit the exact same spot on an exposed chandelier, and the pain literally dropped me to my knees. It was agonizing. That was my body’s signal that something else was going on.

I went back to urgent care that moment, and this time I didn’t ask for an opinion. My Kaiser coverage in Southern California was going to end before my Pacific Northwest coverage started. I learned that the two Kaisers share a name, but they are separate systems. So I told the urgent care doctor he could examine it as much as he wanted, but I needed an urgent referral to a dermatologist that day. He heard me and got me in that same afternoon.

The dermatologist, Dr. Nandan Kamath, had never seen me before. I liked him immediately. When he examined the bump, he said, almost instantly, that it felt like something worse. He suspected it was a pleomorphic dermal sarcoma (PDS). It sounded both fancy and scary.

He explained that it was fairly rare and aggressive, and that unlike most skin cancers, it could spread beyond the skin into the rest of the body. Dr. Kamath also said that if I were staying in Southern California, he’d want to get me in front of a surgeon as fast as possible. Since I wasn’t, he practically begged me to call Kaiser in the Northwest the next day so I could see a dermatologist for a surgical referral the day I arrived in Vancouver.

I Didn’t Make The Call

I had meetings the entire next day, and I didn’t make the call.

At 8:30 pm that night, my phone rang. It was Dr. Klamath. Racquel was sitting next to me, so I put it on speaker. It was the dermatologist, checking whether I had called. I said I hadn’t. He said he wanted to be as clear as he could be: this was a matter of life and death.

My wife, Racquel, heard every word.

I scheduled a virtual appointment for June 1 with a primary care doctor, Dr. Miguel Sotelo, so I could do it from the road. He immediately referred me to a dermatologist in Vancouver, Dr. Craig Hersh. On June 3, he took a punch biopsy. And on June 11, the pathology confirmed it was a pleomorphic dermal sarcoma.

On June 15, the next person I saw was Dr. Andrew Kroeker, who was then head of Surgical Oncology at Kaiser Pacific Northwest. I got really lucky. He was amazing. He explained that AFX and PDS sit on a spectrum, and the difference is how the tumor behaves. This wasn’t a new cancer. It was the old one, but returning, deeper, and more aggressive. The urgent care doctor had told me there was “almost no chance” the two were related. Almost no chance, it turned out, is not the same as “no chance.”

Dr. Kroeker, like Dr. Kamath, didn’t want to wait. He ordered a whole-body PET scan to check whether the PDS had spread and an MRI to see what it was doing to my skull. The PET scan was the next day, on June 16. The MRI was on June 17. That confirmed the tumor was several centimeters across and sat right against the bone of my forehead.

The best news I received was that the PET scan came back clean. There was no sign it had spread. I cried when I got the news. They had been trying to scare me into moving fast, and it worked.

On June 19, just 18 days after my first call in Vancouver, I went under general anesthesia. Dr. Kroeker removed far more than just the tumor, cutting all the way down to my skull. The MRI hadn’t shown the tumor in the bone, but he burred down the surface anyway as an extra margin of safety. I have a photo where you can actually see the grooves in my skull. At its widest, the opening was about three inches wide and almost 6 inches long, and he was still able to close it without a skin graft. And the margins came back clean.

Because this was a recurrence, the tumor board recommended radiation to decrease the chance of it coming back again. Once the wound had healed enough, I started daily treatments Monday through Friday for six weeks. My Radiation Oncologist, Dr. Eric Chang, explained that they could deliver the entire dose in a single session, but it “might” burn a hole through my skull. That’s not a very good outcome, so they divide the radiation doses into amounts the body can handle.

My head right now just looks like I have a major sunburn. I still can’t quite wrap my head around the fact that solar radiation gave me cancer, and a different kind of radiation capable of burning a hole in my head is what keeps it away.

Yesterday I finished treatment number thirty and rang that bell. And the radiology and oncology staff sang to me.

And I cried for the second time.

I’m still a bit fatigued, and I’m told I’ll stay that way for a couple of weeks. In due course, I’ll likely get another scan, but this is the first time in months that I’m not actively treating cancer. The worst is now in the rearview mirror.

Why I’m Writing About Bumping My Head

I wasn’t going to write about any of this. Only a handful of friends outside of my family knew about this. I didn’t really want to be a cancer poster child. But I’ll be at NAR’s annual conference in a month with a noticeable scar on my head, and I suppose I’d rather tell the story once than explain it to everyone I meet.

Today I told my friend Peter Brewer the full story. And I shared that I wasn’t planning to write about it. “We blokes have a tendency to think we’re bullet proof,” he said. “Many of us are entering that dangerous decade where lumps, bumps and little niggles are sending us important signals that shouldn’t be ignored. It’s time to obey the body. Write the story. It just might be the difference between your mates wishing you happy birthday or wishing your family their sincere condolences.”

Peter is right, of course. He’ll be chuffed to read that.

When I tell this story, I like to say the bump saved me. It’s a good story, and I do believe that. But I also know that for two months, the bump kept me from worrying. Bumping my head gave a returning cancer a harmless name, and almost everyone, me included, accepted it. But bumping my head on that latch also showed me something was there, hiding. And that only got its real name when I went back to urgent care and said, “today!”

And that prompted a caring doctor to go the extra mile, call me at 8:30 at night, and scare me straight.

Four to six weeks for a calcified hematoma to heal is a reasonable thing for a doctor to tell you. I spent most of that time just waiting. But I won’t be doing that again. When something shows up on my body and doesn’t go away, I’m going in immediately and asking for urgency.

I won’t be ignoring any more bumps. I’m hoping you won’t either.

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