It's been a couple weeks since my surgery but the pathology results haven't come back yet. I've finished up applying vaseline to the healed incisions and am moving onto scar cream now.
In talking with my surgeon, despite not having pathology data back, I get the sense (just from how he talks about it) that the most likely result is that they will find melanoma in the lymph nodes and that I will go on to do immunotherapy. I think his expectation is driven by the initial depth of the tumor in the ear lobe. He's talked about what will happen next, which is that the pathology will come back and I'll get setup with an oncologist.
I'll mention some details about surgey below so if that is icky, feel free to stop here.
I've healed up from surgery very well. I learned that during my surgery my surgeon found that when removing the tumor from my ear lobe he found clean dissections (no visible tumor infiltration) earlier than he was expecting and as a result didn't need to take as much of the ear lobe as originally planned. Once the pathology on the ear lobe comes back, either it will support what he saw during surgery and no more ear will need to be removed, or it will show that at a microscopic level the tumor did extend beyond where it could be seen visually in which case they'll need to do a second surgery to remove a bit more.
Another interesting thing about the ear surgery, which I didn't realize initially, is that only the front face of the ear lobe needed to be removed. As a result, the back of the ear lobe was folded forward and sutured to my ear. The result is that the front of what remains of my ear lobe is actually the back folded over. You can see this as the scar from one or two of my old ear piercings are visible on the front now.
I also confirmed that in regards to the lymph node removal, it was all done through the single neck incision (4 inches, oriented horizontally, pretty low on my neck). It was from this sincle incision that the surgeon removed 3 nodes pretty far above the incision (maybe 4 inches higher, as well as a single one down near the incision). I was pretty amazed that this was possible (traversing 4ish inches under the skin to remove something).
My surgeon confirmed that nothing about the lymph node removal was unexpected. The four nodes that he removed looked fine visually and nothing looked wrong in my neck while he was working.
My sensation on the surface of my skin on my neck and ear has changed quite a bit since before the surgery. Most of my neck above the neck incision, and up to my jaw line and slightly into my cheek area, as well as the lower portion of my ear is numb at the surface skin layer. This is similar to what's happened to me in the past when I've been in motorcycle accidents. In those cases I lost feeling at the outermost skin layer. The nerves recovered over the subsequent 1 to 3 years. The surgeon said that the nerves would recover from the surgery as well (not sure how long it will take, hopefully months to a year). I'm also intermittently (once every 3 hours or so) experiencing nerve noise in the form of momentary instantaneous bolts of pain. They're only just slightly irritating in that they are incredibly brief.
There's some tightness in my neck that I'll likely just get used to.
Over the past 2 weeks, healing up from surgery, my pain has been very minimal (2 out of 10 at the most). I took over the counter painkillers for the first week or so and then stopped as I didn't need them.
I've met once with a therapist so far. Our conversation was fairly introductory. We talked about methodologies to control negative thoughts. I have some homework on that topic. She identified that I'm dealing with some minor depression (I hadn't thought that I was but when she asked some screening questions, I realized that I am). I'm hoping to do better in regards to controlling where my thoughts are going and regaining my ability to think long term. At the moment I find myself unable to do any long term thinking, I suspect because doing so requires integrating into my thinking scary things that may be true in the long term.
I've not felt up to participating in the weekly tabletop role playing games. I hope to get to a mental position where I can restart that.
I've gotten so many thoughtful and kind communications from folks. I really appreciate it.
I'll post again when I have an update.