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This is Brave: Coolibar’s Chad Novak Learns to Prioritize Doctor Check-ins
By: Chad Novak, Director of Studio Photography at Coolibar

On January 1st, I moved from a high-deductible pay-full-price-out-of-pocket-for-everything insurance plan to a low-copay and no-referral-needed plan. It was exciting for me. I felt like Andy in that episode of Parks and Recreation where Andy and April realize they have medical insurance and go to the doctor for literally everything. I felt that free.

My first doctor visit with my new insurance was to a dermatologist. This was my first visit to a dermatologist in more than a decade. I had no prior visits to this doctor and I was unfamiliar with this doctors process. I remember feeling a little surprised at how many medical professionals were in the room with me (5 to be exact). They stepped out for a minute to allow me to change into a gown, and then they all returned a moment later (all 5 of them). I was overcome by modesty in the presence of all these strangers, but the doctor put me at ease and began her full-body check.

From head-to-toe, armpit to fingertip, she examined all of my moles. “Nothing strange”, about any of them she said, except one. She asked me about a mole on my back, and I said, “What mole?” I had no idea there was an odd-shaped multi-color mole on my back. And how would I, I don’t have a way to look at my back regularly and certainly not something smaller than a pencil eraser. She asked if she could biopsy the mole and send it to a lab for testing. Of course, I agreed. And I was on my way.

A few days later I received a call from my dermatologist. I learned that I results from the lab test revealed the mole was melanoma. I was shocked. She explained that it was Stage 1A and asked for me to schedule an appointment to have it removed right away. I asked if I could just “let it go”, to which she replied, “That is not an option”. I couldn’t help but feel scared in that moment. That went from zero to serious fast. My mind raced with fears about the cancerous cells spreading, and I felt unsettled about the fact that if I had not chosen to go to the dermatologist when I did, I could be facing a life-threatening situation.

Here is an alarming fact: It’s possible for melanoma cancer to spread to your entire body in as little as 4-6 weeks. 45 Days – and you might be terminal. I had no idea things could go so bad so quickly and I would not feel a thing in my body. It’s hard to wrap my head around that. But it’s real. And it opened my eyes to the dangers of letting things go. Or just acting like I’m fine.

My diagnosis opened a pandoras box. I have full body exams scheduled every 90 days for the next 5 years, I have had multiple treatments on my incision area to reduce scarring, and I just learned that my life insurance was dropped. It feels like a lot. It became a bigger deal than I wanted. But had it gone differently, I may not be writing this story.

Here’s what I know. The decision I made saved my life. I think about that once and while to remind myself that I’m not invincible like I think I am. This experience taught me an important life lesson: It is not a sign of weakness (as a man) to go to a doctor.

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Together We Will

Dr. Patel: The Power of Observation

As physicians we have a unique ability to provide care, comfort and our expertise to patients on an individual basis. However, being able to partner with organizations dedicated to a particular disease or diseases is a way to make an impact for a larger group of people beyond our immediate patient population. It’s an important way to make sure our care extends as far as we can stretch it.

Since my days in high school, volunteering gave me an important understanding of the impact a medical provider can have beyond the classroom and exam room. Early on I got involved in a volunteer program at a brain tumor center. The program paired pediatric patients with medical students who acted as big brothers or sisters to observe how they were handling their care. Eventually, we were able to purchase disposable cameras that the patients used to document their emotions, thoughts, and lives outside the clinic and hospital as they underwent treatment. The scrapbooks acted as a form of therapeutic expression for them and allow others to observe what these pediatric patients were experiencing. That experience and value it added to patient care and education really taught me the importance of getting involved in volunteer programs.

Something I’ve carried with me from that opportunity is the power of observation. By pairing with these children and reviewing their scrapbooks, we were able to observe their experience, learn from it, and make more informed medical decisions. As I left medical school and started my career as a Dermatologist, the importance of observation became very apparent.

When detecting and treating skin cancer, it starts with what we see or observe. But dermatologists can only observe what is near them. We need help from friends, family members, and other individuals in observing and identifying potential trouble spots.

A great example of this is hair stylists. Just in the past few years, two separate hair stylists observed ‘funny moles’ on their clients. After sending those clients to our clinic we diagnosed and treated melanoma. For these patients, the early detection of their “funny moles” led to a simple removal with a complete recovery. But, had those stylists not observed their scalps and sent them our way, their diagnosis could have progressed into something more dangerous. Not all hairstylists are aware of the role they can play in early detection. It’s thanks – in part – to the awareness built by foundations like the Polka Dot Mama. Their community outreach helps educate more people about how to detect skin cancer and understand warning signs. 

When I first met Tracy Callahan (founder of Polka Dot Mama Melanoma Foundation), what caught my attention was her energy. She has always been very passionate about getting the word out about melanoma prevention and early detection. For medical professionals like myself, she’s able to raise funding for research, and create incredible events where we can get out of our clinic and observe and screen thousands of new patients.  

Our practice – North Carolina Dermatology Associates – continues to support Polka Dot Mama Melanoma Foundation at free monthly melanoma screenings. We also joined other medical providers in the area to support the world’s largest skin cancer screening, which broke the Guinness Book of World Records in 2019. Through these events, we have been able to detect melanoma earlier and improve patient outcomes. It’s all about connecting with people outside of our clinic to check their skin and teach them to observe and monitor any changes.

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Experts Say

More Men are Diagnosed with and Die from Skin Cancer than Women

Dr. Arthur Ide is the owner of Dermatology, P.A. in Minneapolis, Minn. He is board certified by the American Board of Dermatology and is an Adjunct Associate Professor of Dermatology at the University of Minnesota. He currently has four children and lives in Minneapolis.

 

More men than women are diagnosed with AND die from skin cancer. As dermatologists, we ask ourselves why. Is this a societal issue or does it have to do with biology? What is going on here? It’s a little bit of everything, to be honest. Men are the underdogs when it comes to health and wellness.

Our best approach is to look at five key issues behind this statistic and find solutions.

 

1: Men contract skin cancer differently than women

In general, men and women have different relationships with the sun. Many women seek out UV rays in an aesthetic way. Roughly 8,000,000 women tan indoors when they’re younger compared to 2,000,000 men. Men are more likely to contract skin cancer following a lifetime of sun exposure while engaging in outdoor activities like swimming, fishing or golfing.

SOLUTION: Teach men young and old to care for their skin. If your internal response to that suggestion was “yeah, but how,” I get it. Teaching men to adopt healthy skin habits can be tough. We almost always recommend skin protective clothing instead of sunscreens or lotions. Arm them with the tools that will protect them even if they forget to protect themselves.

2: Men are diagnosed much later in life than women

In part because of the difference in sun habits between men and women, skin cancer diagnoses are more common for women under the age of 49, and for men over the age of 49. Because skin cancer manifests itself at a younger age in women, they will often catch it before it spreads beyond one or two basal cells. Men who are diagnosed later in life will often have accrued multiple basal cells.

SOLUTION: Don’t let men wait! Getting your skin checked by a dermatologist should become part of everyone’s routine. Parents need to teach young people to care for their bodies inside and out. Adolescents learning to check their skin today stand a much better chance of detecting skin cancer when it counts.

3: When women see something, they say something. Men, not so much

Generally, women are champions when it comes to early detection. When they notice a change in their body, they take care of it. Often when a man comes to see me they’ve been ignoring the warning signs so long they’re a bit of a train wreck. We’ll find multiple cancers. The famous line we get from men is, “It didn’t bother me”, which is often followed by, “my wife made me come”. Well sure. Skin cancer doesn’t bother you until it’s killing you. This is a key reason why men’s mortality rates are higher than women.

SOLUTION: We need more watchdogs and evangelists. One of the troubles with detecting skin cancer in men is that it’s more common on their backs. Everyone needs to enlist the help of family doctors, partners and family to detect abnormalities in men.

4: Changing habits is easier for some (women) than it is for others (men)

When a woman comes to our office and discovers she’s at risk or has basal cells, she’ll act. Men are more resistant to change. I had one patient who discovered he had four basal cells on his back on his first visit. Despite this, I still can’t get him to wear even a standard cotton shirt outside 100% of the time.

SOLUTION: I’ve found that with men it’s helpful to show, not tell them what they need. Seeing is believing. The easiest solution is to arm them with clothing that will protect them even when they forget to. Our biggest hurdle with men AND women is to shift their dependence on sunscreen to sun protective clothing. What a lot of people don’t understand is that they need a protective shield that never fades or wears away. At the very minimum, we do our best to get women to cover their head, neck and shoulders and to get men to ALWAYS have a hat on while outdoors. The upper extremities are beacons for sunlight. Sunscreen alone will NOT protect them from harmful UV rays. They must cover up.

5: Educational information isn’t reaching men and women equally  

Information about skin cancer prevention and detection often falls under the heading of “beauty” or “wellness”. These aren’t categories frequently sought out by men. If I could get a sports reporter to highlight sun protection use in the stands at every game, we’d be in much better shape.  We need to get better at spreading the message to everyone that needs it.

SOLUTION: Support organizations like the Melanoma Research Foundation and The Skin Cancer Foundation. Their key purpose is to educate EVERYONE about the importance of skin cancer prevention and detection. Even smaller, local organizations make a big difference in terms of educating men and women about the threat of skin cancer and how to prevent it.

You can start by giving to one of these organizations for #GivingTuesday:

Support Awareness and Education:

Skin Cancer Foundation

Melanoma Action Coalition

 

Support Research:

Melanoma Research Alliance

Vitiligo Research Foundation

 

Support Awareness, Education and Research:

American Academy of Dermatology Association

American Cancer Society

Lupus Foundation of America

Melanoma Research Foundation

Polka Dot Mama Melanoma Foundation

 

Support Youth:

American Academy of Pediatrics

Children’s Melanoma Prevention Foundation

Richard David Kann Foundation

 

External Sources:

American Academy of Dermatology Association “Melanoma Strikes Men Harder”

The Skin Cancer Foundation (August 2, 2016) “Men Fall Short in Skin Cancer Knowledge and Prevention”

The Skin Cancer Foundation (May 30, 2018) “Men on the Hook”

HealthDay News (November 5, 2018) “World Melanoma Deaths Up Among Men, But Not Women”

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Experts Say

Sneaky Ways Ultraviolet Rays Reach Us

Dr. Kathryn Dempsey is a board-certified dermatologist who practices in Mobile, Alabama and spends her weekends at Orange Beach. She enjoys teaching about the importance of daily sun protection. Here she has provided some tips on the sneaky ways ultraviolet rays reach us to ensure you stay educated and protected!

Each visit, I ask each of my patients, “How are you doing with your sun protection?” and nine out of ten times I get the same answer: “I don’t go in the sun.” I always take this opportunity for education on the ways ultraviolet rays reach us outside of just tanning on the beach. Most people don’t realize that the majority of our sun exposure happens on a day to day basis, often when we least expect it.

Here are five ways UV radiation reaches us, even when most people think they are safe.

  1. In the Car. Every time you drive you are exposing yourself to UVA radiation. While the law requires most front windshields to block the majority of UVA and UVB, side and rear windows do not have this same requirement and UVA comes straight through. So during that short (or long) commute to work, you are getting direct UVA exposure, mainly to your left side. UVA contributes to both premature aging and skin cancer. We know that more skin cancers occur on the left than the right and this is because of driving.
  2. At Work. (or Working from Home) Many people are lucky enough to have a workspace with windows and if you are working within several feet of one, UVA is reaching you. Remember, UVA penetrates through glass and windows.
  3. In Shade. We get it when we think we are protected by shade. It reflects off of sand, water, pavement, grass and snow. Studies have shown that sunscreen and protective clothing in addition to seeking shade is significantly more beneficial than seeking shade alone.
  4. At a Nail Salon. That’s right! We get it when we have our nails done. Did you know that the lights they use to speed polish drying emit UVA? And UVA Is also what is used to set gel manicures. Protect your hands!
  5. During Rainy Days. This may be the sneakiest way it reaches us and I always see a surge of sunburns after overcast summer days. While clouds may block sunlight, they do not block ultraviolet radiation and some of them even magnify it. Scary!

Did you know that one year of 2 minutes of casual sun daily adds up to 2 weeks of a beach vacation’s worth? And now that you know the sneaky ways that UV rays are reaching you, think about how much you really get – far more than 2 minutes a day. Therefore, it is so important to protect yourself on a day to day basis and this starts with sun protective clothing. I always recommend clothing with UPF 50+, a wide-brimmed hat and a broad-spectrum SPF of at least 30. If we all did this on a daily basis, I assure you there would be a lot less skin cancer in this world!

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Live Wisely

My 2 Reasons for Covering Up In the Sun: Perspectives of a Muslim Dermatologist-in-Training

As a Muslim-American female, I am no stranger to being covered in the sun. In accordance with my faith, I wear the hijab. Wearing the hijab does not only involve covering my hair. I also cover my skin—except for my hands, feet and face.

As an all-American girl, I was born and raised on American fashion trends. I have always seen the fabric I wrap around my head as just another accessory piece to complete my outfit of the day. My struggle truly began with Michigan summers on the lake. In accordance with my faith, I couldn’t wear a revealing bathing suit into the water. I shied away from participating in water activities because I often felt embarrassed to jump in—fully covered.

Flash-forward to just a few years ago, when my husband and I were planning a vacation to escape the stresses of my medical school training. I was yearning for some warmth and sunshine but felt anxious about finding modest swimwear that wouldn’t make me a spectacle to strangers on the beach. My online search led me to Coolibar. Finally, I discovered fashionable, modest clothing with the primary purpose of UV sun protection in both fabric and design.

Following graduation from medical school, I began my residency training in dermatology and became extremely passionate about sun protection. To this day, the first skin cancer excisional surgery I performed is very fresh in my memory. The surge of excitement from my role in the treatment was shadowed by the heavy burden of making sure I correctly conveyed the importance of sun protection to prevent future skin cancers.

As a dermatology resident, I’ve come across patients of all ages, ethnicities and walks of life who have skin cancer. Regardless of their background, every single patient is regretful about their time spent unprotected in the sun.

Through personal and medical reasons, I’ve taken Coolibar to heart. Not only because styles offer more skin coverage for sun safety, but their UPF 50+ sun protection is guaranteed for life. I never have to worry about my patients or myself when it comes to exposure to harmful UV rays. I love my Coolibar gear because it provides me modest, stylish and, most importantly, SAFE clothing to wear while outdoors!

Dr. Fatima Fahs gives her reasoning behind why she chooses to cover up in the sun. Dr. Fahs is a dermatology resident in Detroit, Michigan. She enjoys blogging about skin care, mom life and residency on her Instagram page, @dermy_doctor

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