Surgery Number One Done

Wednesday I saw my dermatologist for an ED&C, the procedure she uses for removal of small basal cell carcinomas. She's done a few on me in the past, including one in March on a basal cell that was near the one she removed this week on my right arm.

The procedure itself is not too bad, once you get over the sting of the lidocaine shot. The whole thing only took about 10 minutes. For me the issue is my allergic reaction to anything with adhesive. They want me to keep this covered for two weeks, and that will definitely be a challenge. I have tried every type of bandage out there, including the so-called sensitive skin ones. They all make me itch and break out. 

Last night I put on a gauze pad and wrapped an elastic bandage around my arm to hold it in place. It held up pretty well, but even the elastic bandage irritated my skin a bit. I'm going to try a different brand tonight and see if that works better.

My Mohs surgery for the basal cell on my left temple is scheduled for September 25th. That one will take several hours as they remove tissue, wait for it to be read by a pathologist, and then take more as needed. I'm definitely not looking forward to that, and pray that the doctor will get it all in one or two tries. It was really unnerving when it took five attempts to get all the cancer on my nose in 2019.

Also on Wednesday I had my annual mammogram. I had to go to a different radiology center as my insurance changed January 1. The office was very efficient, and I was in and out in no time. Now I just have to wait for the pathology report.

Biopsy Results

basal cell

The dermatology office called yesterday with my biopsy results. To no one's surprise, both of them came back positive for basal cell carcinoma. My dermatologist is quite accurate in determining which of my spots requires a biopsy. She only missed once, resulting in a biopsy that was negative. I'd rather her err on the side of caution rather than overlook something bad.

With the latest two biopsies, I have now had 22 basal and/or squamous cell carcinomas. Ugh! For the one on my arm, she can do an ED&C as she has for the last four basal cells. However, the spot on my left temple is too large for that procedure. The two options I was given for removal are Mohs surgery and radiation therapy. This is the first time I have been offered radiation. It is not done in the office closest to me, which makes this option inconvenient. It would require me to come in three times a week for seven weeks. Wow! I just don't see making that work with my schedule. I told the gal on the phone that I would opt for the Mohs procedure. Unfortunately the doctor who did my previous Mohs is no longer with the practice, so I'm not sure who will do the surgery. I will ask that of the scheduler when she calls me back to set my appointments.

Not Immune to Infection

today's sunrise

Well, unfortunately my ED&C surgery resulted in an infection. By Saturday the area around the excision site got red, warm and hard. Sunday the red area had increased in size and my arm began to hurt. First thing Monday I called the doctor's office and explained what was going on. They had me take a photograph of it and text it to them.

As the doctor was confidant that it was indeed infected, she ordered an oral antibiotic for me. I have to take it twice a day for 10 days. I'm now on the fifth day of using them, and the area definitely looks better than it did originally. I guess I was expecting it to be almost healed by now. The redness, warmth and hardness are gone, but the wound itself still has some oozing going on. That's probably normal, but with my allergy to adhesives, keeping a bandage on it has been very difficult so I really need it to dry up. I've been keeping it open to the air during the day, wearing only sleeveless shirts. So I have been pretty housebound for a week since I can't put a jacket over the open sore.

I did cover it up Wednesday evening as we had registered for a floral watercolor class that was being offered here in the neighborhood. It was nice to get out for a bit, and the class was pretty good. I need to work on some of the techniques we learned for sure. Some of my flowers definitely do not look like what they are supposed to be!

floral watercolor class

ED&C Number 4

basal cell removal

On Wednesday I had my fourth Electrodesiccation and Curettage (ED&C) performed to remove the basal cell carcinoma from my right arm - my 20th skin cancer surgery to date. As I have posted in the past, the dermatologist scrapes off the top layer of cells with a curette until healthy cells are revealed. Then an electrocautery device is used to apply small amounts of electricity to the treated surface to burn away any remaining cancer cells. This is performed as a less invasive cancer removal option.

As with every time, they bandaged the spot before I left. And as with every time, the skin in the area broke out in a rash due to my adhesive allergy. You technically don't need a bandage for the wound, but since I have to keep vaseline on it for two weeks, the bandage protects my clothes and sheets.

Today my arm is feeling sore and a little warm in the area of the excision. I have it totally uncovered except for the vaseline. I am a little concerned that it is getting infected. I'll keep an eye on it and call the doctor if necessary. Only once before has a skin cancer surgery resulted in an infection, so I guess I have been pretty lucky. I pray that my luck will hold in this case as well.

feeling lucky

While at the office I had the doctor treat two sun damaged spots on my lower lip with liquid nitrogen. She had done this once before in July of last year, but the spots came back. Does that ever hurt when she zaps them! So far they have not turned into large blisters like they did last time, but instead have gone directly to the draining stage. Hopefully this time will do the trick. 

Skin Cancer Number 20

skin cancer biopsy

Tuesday was my six month checkup with the dermatologist. Since I have had so many skin cancers, she has me come in every six months for a full body review. There was a pre-cancerous spot on my left arm that she zapped with liquid nitrogen, but also a spot on my right arm near the shoulder that she was concerned about. It looked suspiciously like the squamous cell she removed from my left arm last March. She removed a small piece for biopsy.

Surprisingly I received the path report this morning. That came back fast! It was indeed cancer, only this time an early basal cell. The doctor cannot fit me in until March 5th for removal of it. Because it is so small and a basal cell, she will again do an ED&C procedure to take it off and I won't require Moh's surgery. This makes skin cancer number 20, of which 4 were squamous cell and 16 basal cell. Early detection is the key here, but holy moly that is a lot of skin cancer!

The Dark Side of the Sun

sun damage

When I was growing up we played outside all the time. After all, there was no air conditioning in the house, so at least being outdoors with friends made us forget the heat. There was also no sunblock available, at least at my house. Through the years my skin has had a lot of exposure to the sun, and I have been paying for it since I got my first skin cancer diagnosis in 1992. 

Last week I went in for my six month checkup. One of the spots the doctor had frozen at my last visit has disappeared, which was great news. I pointed out some trouble spots to her, and she froze four on my right hand and one on my left temple. The temple one will bear watching. But she took a biopsy of a spot on my left arm above my elbow. 

I should have gotten the results by now, but I guess the lab is backed up. I'd like to think no news is good news, but she has been spot on (pardon the pun) when it comes to calling what she thinks is a skin cancer. But I can still hope she is wrong, I guess.

Though I am diligent now with applying sunscreen and wearing a big hat, I can't undo the damage that was done in the past. I just have to accept these continuing skin cancers as a part of my life. And hope that this one isn't number 19 for me.

More Basal Cell Surgery

basal cell surgery

Yesterday the dermatologist performed an ED&C to remove the two basal cell carcinomas they found on my neck last month. Basically this involved them numbing the two spots, and then using a tool to scrape off the skin cells. She performed this procedure three times on each spot, using a cautery machine between each scraping to stem the bleeding. It really didn't take her too long, and the worst parts were the shots to numb the areas and the smell of something burning when she used the cautery machine.

The two spots were bandaged when she was done, and I reminded them that I have an allergy to the adhesive on bandages. This time they used gauze and some non-latex tape. I'm supposed to keep Vaseline and bandages on for two weeks, but I doubt I'll be able to tolerate that even with the new tape. She said as long as I keep the spots moist with Vaseline, the bandage really doesn't matter. I suspect they are really to protect my clothes from the ointment, as well as the sores from being rubbed by my clothes.

I haven't removed the bandages yet as I am going out to dinner and to a play with a few of my female pickleball players from the neighborhood. I wasn't sure I would be able to secure the gauze as well as the nurse did. I'll definitely do it when I get home tonight though. It will be interesting to see what the wounds look like since I haven't had this procedure done before.

More Skin Cancer

Because of the two basal cell carcinomas found in my scalp last November, the dermatologist wanted to see me three months following the Mohs surgery. I went in the end of February, where she did an all body scan. She asked about a spot on my left neck, and I reminded her that she had put liquid nitrogen on it the last time I was in. She decided to biopsy the spot, along with one a few inches behind it. They put bandages on both before I left due to bleeding. I left those on overnight as I didn't want to get blood on my pillowcase.

Unfortunately, I have an allergy to latex - specifically bandages, oddly enough. By the next morning the spots on my neck had angry red welts, and they itched like crazy. I put an antibiotic ointment on them, and recovered them with bandages that have paper tape on them. That was also a mistake, as the welts and itching got worse. So I had to leave them uncovered, and used Benadryl cream on the welts.

Both the biopsies came back positive for basal cells, but apparently they are in the very early stages. So instead of having the plastic surgeon in the office do Mohs surgery, she is going to do an ED&C on them. I wasn't sure what that meant, so I had to ask Dr. Google. It stands for electrodesiccation and curettage, and is a procedure where they basically scrape off the cancerous cells. I have not had this done before, despite being on cancer spots number 17 & 18. I'm not sure exactly how they will know if they have gotten all the cells. With Mohs they examine each removal in the lab to make sure that they have gotten clean margins in the piece. If not, they go back and take more. Apparently with the ED&C, they will make three passes over each of the basal cells to try to remove all the cancerous tissue. The procedure has a 95% success rate, so hopefully I will fall into that category. I'm not scheduled until next month, so I'll report back on how it goes.

I'm not sure I followed up here regarding the infection in my scalp. Two weeks after they took a scraping to check for infection, it ended up that my one wound had a MRSA infection. This was definitely a surprise to me, as the most common way you get this type of infection is from a hospital or other health care setting. My guess is I got it when they removed my staples back in December. I opted to continue with the topical antibiotic rather than taking an oral antibiotic. Fortunately after another week of use the infection went away, and was cleared up before we went to Africa. I'm praying the next surgeries will not have any surprises coming out of them. 

Monday morning I got up early and walked down to a nearby point on the lake. It was cold, and fog was rising off the water. I'm reminded that beauty is all around us if we only look for it.

Mountain Island Lake

Medical Staple Removal

Thursday I went in to the plastic surgeon's office to have the Mohs surgery staples removed. I just assumed my plastic surgeon would be the one doing the removal, and I came prepared with a joke to play one him. I bought along my staple removal to suggest he use it to remove the staples. The joke was on me as a physicians assistant came in to take the staples out.

surgical staple remover

The bottom jaw of the surgical staple remover is placed under the staple, and when the handles are pressed they bend the staple and pull it out of the skin. Theoretically, anyway. They do not give you any anesthesia for this procedure. 

The first couple staples came out with little effort on her part or pain on mine. Then she got to the tougher ones, and those hurt! I knew she had a total of 22 to take out, so it was not a fun time. There ended up to be 4 that she couldn't remove, and she had to get my surgeon after all. He did a little clean up on the crusted areas around the wounds, which seemed to help him get the last of them out. It was no picnic, and the larger wound ended up bleeding again. I'm not sure the staples are a better option than dissolvable stitches for wounds in the hair after all.

Granddaughter is here!

Our granddaughter was born Monday evening! She is little, but mighty. As I'm not sure how much the kids want me to share, I'll just say that we are thrilled that everyone is healthy. We can't wait to get our hands on that baby!

My Mohs surgery to remove my latest two basal cells has been scheduled for December 1st. I pray that Dr. Mu will be able to get clear margins after the first cuts. When she did my nose three years ago, it took five tries before she finally got it all. Hopefully that will not be the case this time.

The Mount Holly Lantern Parade took place last month, and our community won First Place in the Group Category for the second year in a row. We are two for two now, and that puts a lot of pressure on us for next year's entry. The theme was Written in the Stars, so we decided to up-cycle our minions from last year. We added space helmets, rockets and stars, and created a girl minion. We weren't sure if the judges would approve of us reusing lanterns, but I think we made enough changes that they could tell the amount of work we put into them.

2022 Mount Holly Lantern Parade

The theme for next year's parade is Heroes and Villains. We are already brainstorming on what we might like to do. Due to the large number of children in the audience, it's important to pick something readily recognizable to them, I think. The minions were a huge crowd pleaser, so we need something to generate that kind of enthusiasm from the crowd. We just had a wrap up celebration party with our team of volunteers. I made sure the minions had one last hurrah by bringing minion cupcakes.

minion cupcakes

More Skin Cancer

skin cancer removal

To add to the list of medical procedures I'm having done this week, yesterday I went to my plastic surgeon to have yet another suspicious spot removed from my forehead. It's one we have been watching for a bit, but as it has not responded to liquid nitrogen (it should blister and then peel, but it does nothing), the dermatologist said to was time to have it removed.

In checking my records I realized that I had not been to the plastic surgeon since September of 2016, so that actually is not too bad for me. Unfortunately this is my 14th skin cancer, if indeed the biopsy comes back positive. I have resigned myself to the fact that this is my life from now on, but I have been taking extra precautions with my skin so hopefully I won't have too many more that will need to be surgically removed.

I did not sleep well last night as the doctor told me to keep my head elevated to lesson the risk of bleeding. It hurts today, but not as much as yesterday. It should feel much better by tomorrow, which is good because I am volunteering at the Michelob Ultra Pickleball Tournament in the morning. It was supposed to be outside at Forest Park, but because rain from the hurricane is headed our way, it has been moved indoors. Unfortunately that means a 45 minute drive for me in the morning, and I have to be there by 7:00 a.m. It is the first sanctioned tournament to be held in St. Louis, so I am eager to see the 4.0 and 5.0 players in action once my volunteer work is finished.

On a more fun note, last weekend was Paint Louis 2018. This was an organized event allowing graffiti artists to legally spray paint the flood wall that runs along the Mississippi River in downtown St. Louis. Hundreds of artists came from mostly around the Midwest, with live hip hop music adding to the party atmosphere. By the time we got down there Monday morning, most of the artists had packed up and left. But there were a few remaining, and it was interesting to talk to them about their work and the process they use in creating art to cover such a large space. Sadly, it won't last for long as other graffiti artists will come along and paint over what is already there. It is a constantly evolving work of art.

Paint Louis 2018

Mammas, Don't Let Your Babies Grow Up to Have Skin Cancer

When I was little, we played outside all day. Like many kids, we only had to be home when the street lights came on as the sun set. There was no such thing as sunblock and no one wore hats, so sunburns were a likely, if unwelcome, consequence of playing foursquare, hopscotch, and jump rope under the hot summer rays. I remember one summer when my arms burned so badly that my mom took me to the doctor. My second and third degree burns were coated in ointment and wrapped in plastic wrap. Can you imagine? The heat was trapped inside the plastic, and my skin continued to cook. That was the way burns were treated back then.

When I was a teenager I wanted to look cool like the other girls, so I spent my fair share of time baking in the sun in pursuit of the illusive tan. How silly was that for someone with blue eyes, pale skin, and Irish heritage? Burn, peel, repeat... I never got tan, so you would think I would have learned my lesson.

While I'd had a couple of suspicious moles removed in the mid-80s, it wasn't until 1992 that I received a diagnosis of skin cancer. CANCER - a word that strikes fear into the hearts of anyone who hears it uttered by their physician. I was 37 years old, and the first in my family to get skin cancer. The basal cell on my forehead was surgically removed in August of that year, with a second one (also located on my forehead) removed three months later. That was just the beginning, and through the years I have had six basal cell and two squamous cell carcinomas removed. All but one of those were located somewhere on my face.

Basal cell carcinomas are the most frequently occurring form of all skin cancers. More than one in three new cancers is a skin cancer, most frequently basal cell. About two million new cases are diagnosed in the United States each year. The second most common form of skin cancer is squamous cell, with about 700,000 cases reported each year. Then there is melanoma, the deadliest form of skin cancer. Around 74,000 new cases are reported each year, along with 10,000 melanoma deaths.

three of the twenty burn spots

Every six months I see the dermatologist, and without exception there are always pre-cancerous spots that he treats with liquid nitrogen. This week there were a total of twenty locations that he burned. While it is not a pleasant experience, it beats the heck out of going to the surgeon to have them excised. Unfortunately, two spots on my forehead have not responded well to this treatment. It did not come as a surprise to me that the dermatologist referred me to a plastic surgeon for removal. I have seen enough of these to know that these are skin cancer. The only surprise is that I have managed to go ten years without having any growths removed.

The earliest the plastic surgeon can see me is the beginning of March, so I am scheduled for the surgery on March 7th. I wanted to get through Jim's big birthday weekend before having it done. I know that I have been phenomenally blessed that so far my skin cancers have only been basal cell or squamous cell. I am pleased that the same surgeon who removed the last three is still practicing. He does such a nice job, and people do not notice my scars unless I point them out. Here are the two bumps he will be removing.

skin cancer on center forehead

skin cancer on right forehead

So while it won't be fun, I hope and pray that these are the more minor forms of skin cancer. And that this is the only type of cancer that I ever have to deal with in my life.

To the parents and other child care providers out there, don't skip the sunblock on your wee ones. I know it takes time to put on and that they really just want to get outside to play or jump in the pool, but it is worth it if in the long run you can prevent them from having to go through what I and many other Americans suffer through with our sun-damaged skin. Don't let your babies grow up to be like me!

Be-Nine

The ocular plastic surgeon's office left a message on my answering machine stating that the pathology report was back and "looked good." What does that mean, exactly? Looked good, as in the sample had clean margins? Or looked good, as in there was no cancer? I called the office back, and indeed what the doctor had removed was not a basal cell, or any other kind of cancer. So I did not have a ninth case of skin cancer. That is great news, and I am really happy about it. But there is a part of me protesting the fact that I now have a new hole in my face (which he did not even stitch up after removing what he was certain was a basal cell.) And I am left to wonder if the lump on my eye is really a chalazion, as this doctor insists it is, or a basal cell as my ophthalmologist predicted. I go back to the ocular plastic surgeon next month for a follow up. It will be interesting to see what he has to say about his misdiagnosis. In the meantime, I'll be keeping my "eye" on the so-called chalazion for any changes.

An Eye for An Eye

Today I saw the ocular plastic surgeon. My sister drove me there "just in case." The doctor's office said I would be able to drive myself even if he did a biopsy, but I know after the last thing I had done there was no way I could have driven. It felt like an ice pick had been jammed through my eye and up into my skull. The surgeon walked in, took one look at my eye and said that is not a basal cell, it's a chalazion. I explained that the ophthalmologist also thought that's what it was, until he tried to drain it and nothing came out. This doctor said that's what it is, but this other thing below your eye on your face is a basal cell. What??? I hadn't even seen anything there that I was worried about, and after 8 skin cancers I worry about a lot. So he injected the chalazion with a steroid to break it down, and excised the basal cell and sent it off to pathology. If he is right about all this, I dodged a bullet with the eye, becasue a basal cell on the eyelid usually involves reconstructive surgery. Here's praying the steroid does its thing!

The Eye of the Storm

Well, I didn't get the news I wanted at the ophthalmologist's office today. They are pretty certain that I have a basal cell carcinoma on my eyelid. How unusual is that? Well, I am nothing if not unusual! I am very familiar with those as I have had six (one on my neck and five on my face) as well as two squamous cell on my face. I know what it was like to have them removed from my face, and I can't even imagine how it will be to have it removed from the eye. Next step is a visit to an ocular plastic surgeon. Who even knew such a specialty existed? The earliest I can get in is September 8th, so I'll just have to sweat this out. As with most things in life, the unknown is scarier than what ultimately ends up to be the case. At least "eye" hope!