Yet Another Basal Cell

June 10th was my usual six month checkup with my dermatologist. As usual she found several spots that are precancerous that she zapped with liquid nitrogen. Unfortunately she also found a spot on my left shoulder that she felt warranted a biopsy. Even worse, she told me that she is leaving the dermatology practice where I have been going since my move to Charlotte nearly seven years ago. She will still be practicing in Charlotte, but her new location is further away for me, and also does not have a Moh's specialist on its staff. With my history, I am guaranteed to need that again in the future. So I'll have to decide if I want to leave with her or not. My current practice will not have any female dermatologists at the location I go to once Dr. Seminar leaves. So that might influence my decision as well.

To no one's surprise, my biopsy came back positive for a basal cell carcinoma. I wanted Dr. Seminara to do the ED&C I knew would be required, so I quickly called to see if I could get in before her last day. For the first time, my call was handled by AI. The voice was so good it sounded like a human. It was only when the AI butchered saying Dr. Seminara's name that I realized it was not a real person on the phone. The AI said I couldn't see Seminara since she was leaving soon, and then told me I was being transferred to the Moh's surgery desk to schedule surgery. Fortunately I know enough with my history to understand I did not require Moh's, only an ED&C. But what if I didn't know that? Anyway, I insisted on talking to a real person, and I was able to get my appointment with Dr. Seminar, albeit at a different location than I normally go.

The ED&C went well, and I have now healed from the procedure. I just need to decide which direction I want to go so that I can get a six month appointment scheduled.

basal cell

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.

More Biopsies

more skin cancer

Last week I had my six month checkup with my dermatologist, and as expected needed a couple more biopsies. At my last visit she was going to biopsy the spot at my left temple, but because I was going somewhere tropical where I would be snorkeling, she said I could wait until this visit for the procedure to be done. I also had another spot on the back of my right arm that I wanted her to look at as well. It is very near the location of my last basal cell removal.

She did both of the biopsies, and also used liquid nitrogen on a few spots both on my face and my right neck. At this visit, she brought up the option of using blue light therapy on my face in the future. Apparently at the office they apply a photosensitizing agent to your face, and then you wait an hour before placing your face in a light box. Supposedly the blue light only has an effect on sun damaged areas of the face, such as precancerous cells. The reaction is like a sunburn, and you must stay totally out of the sun for a couple of days. Healing can take 1-2 weeks, and my doctor suggested a series of three sessions spaced at a month or so apart. 

This is definitely something I will need to think about. First of all, I need to see if my insurance will cover the procedure. I suspect with my skin cancer history they will likely approve the procedure, especially if it will prevent some future skin cancer removals. But also, when would be a good time to start this process? We have a lot of activities coming up, so this may be something I put off until 2026.

Another thing that I have going on is a lump on the palm of my right hand. I have had it for quite a while, and believed that it was just a callous from my pickleball paddle. But it has been changing, and now has some lines coming off the top of the lump. So I asked the dermatologist to take a look as I wanted to make sure it was not a tumor. She immediately said, "You need to see a hand surgeon." I know I looked at her in surprise, and she added that I have trigger finger. She gave me a referral for a hand surgeon.

Dupuytren Contracture?

Monday I will call for an appointment, but I have shown my palm to multiple nurses in my community. They all said the same thing - that's Dupuytren Contracture. In looking at photos of this condition online, I have to think that my ladies are correct. We'll see what the expert has to say about it. Hopefully this will not require surgery.

In the meantime I have to wait on my biopsy results. It has taken as long as two weeks for this lab work to come back. My dermatologist has been very accurate in predicting which things on my skin are cancerous. I have no doubt she was correct on these two as well.

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!

More Lip Service

My dermatologist was able to squeeze me in to have my lip zapped on Wednesday. Even though that is my favorite pickleball day, I just wanted to get on with trying to get my lower lip healed. Even if that meant making it worse to get better.

I'm no stranger to the torment of liquid nitrogen (cryotherapy), having had many spots frozen on my skin over the past 30 plus years. But I have never had my lip treated with it, and was warned that it would hurt and look bad for at least a week. I figured that was one way to help me along with my class reunion diet - less likely to eat if your mouth hurts, right?

It did, indeed, hurt like a son of a gun when she froze the two spots on my lip. It brought tears to my eyes for sure. Maybe that's why it's call cryotherapy? But once that settled down, the pain has not been bad at all. It is difficult to eat without bumping the sores, and my lip looks horrible. It looks so bad that when I had to do some errands yesterday, I wore a mask. There was no reason for the people in the bank or stores to have to see that mess. I'm hoping it looks better over the next few days, and I'm really praying the zapping does the trick. The doctor did warn me that sometimes it takes two tries! 

The best news I got at the doctor's office is that my biopsy from July 29th came back negative. So at least I don't have to schedule an ED&C for the spot on my right shoulder. Now if the lip behaves, I won't have to go back there until my 6-month appointment in January.

lip cryotherapy

What's Up, Doc?

biopsy

Yesterday was my regular six-month checkup with the dermatologist. She froze one spot on my right cheek that has been continually peeling. Unfortunately, she also saw a spot on my right shoulder that she felt should be biopsied. That wouldn't have been too bad except it is right where my bra strap sits. I am highly sensitive to any adhesives, and I've yet to find any bandage that does not make my skin break out in an itchy rash. While the wound doesn't necessitate a bandage, the fact that I have to keep it smeared with vaseline and its location make it impossible not to keep it covered for a few days.

But I was most interested in hearing what the doctor thought about my lip situation. I showed her a photograph from when it looked its worst, and she does not think it is due to cold sores. She believes it is severe lip damage. I don't know what caused it to react so extreme as I wear a big-brimmed hat if I am going to be outside, as well as Z-Block on my lips. 

She wanted to use the liquid nitrogen on my lip, which she said would hurt and look bad for about a week. As we have company coming today, I did not have her do it. She said just schedule it when it's convenient for me. When would that be? When is it convenient to have your lip look awful for a week, and have issues eating and drinking??? In the meantime she called in a prescription for an ointment that should at least make the lip feel better until I can get that done.

Our community brought in a gal from the Carolina Raptor Center yesterday afternoon to talk about their organization as well as raptors we might see in our area. She was great and very enthusiastic about her job. What I wasn't expecting is that she would bring three birds with her. She also had talons, a small skull and bird wings to show us. It was a wonderful presentation, and well worth missing our normal Wednesday pickleball session.

Carolina Raptor Center

Read My Lips

It's now five weeks that I have been dealing with lip issues. My bottom lip is much improved, no question. But it is still sore and sensitive. I have my six month skin check with my dermatologist on Tuesday, so I decided to wait it out to see what she has to say. Hopefully there is just some prescription cream I can put on to finally heal it up. I'll also be hoping that she doesn't see anything that needs to be burned off or biopsied. We have guests arriving on Thursday and I don't want to have to deal with any of that while they are here. Fingers crossed...

The dog days of summer have certainly been here. We had excessively high heat here, like a lot of the country. We were in a drought, but this week brought us some much-needed rain. It was great to get a break from the daily watering of our outdoor plants. The temperature has also been a bit cooler the past few days.

We so enjoy having the lake out our back door. The other day we watched an eagle fishing. He caught such a big catfish with his talons that he could not lift up out of the water. Instead he channeled his inner Michael Phelps and did the breast stroke across the lake. When he got to the shore, he rested and had himself a feast. My camera lens isn't long enough to capture an image that far away, but it was certainly something to see. Fortunately I can always get a nice sky picture from my backyard.

Mountain Island Lake

Another ED&C

squamous cell carcinoma

Yesterday I had another Electrodesiccation and Curettage (ED&C) performed to remove the squamous cell carcinoma from my left arm. Basically 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. I believe this also helps to stop the bleeding.

ED&Cs are used instead of Mohs surgery when the basal or squamous cells are smaller, newer growths. The procedure has a 96% success rate. It only took my doctor about fifteen minutes, and because no stitches are needed I don't have to go back until my next regular checkup, which is in four months. The downside of having no stitches, though, is that it will not heal as quickly. 

While I do not have to keep a bandage on it, obviously I don't want to get the vaseline and/or any drainage on my clothes or sheets. However, I am allergic to every bandage out there, and they make me itch and break out in red dots. The paper tape does the same thing, so I can't even cover it with gauze and use tape. I am compromising by keeping a bandage off while I am in the house and wearing a short-sleeved top. Hopefully this one will heal quicker than the ones on my neck did so I can forgo the bandages. 

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

Dissolvable Stitches?

Who would have thought that the term dissolvable stitches is actually an oxymoron? Before the plastic surgeon stapled my head wounds closed following Mohs surgery for basal cell carcinoma, he stitched them with "dissolvable" thread. Supposedly your body gradually absorbs the sutures so you don't have to return to the doctor to have them removed.

When I went in two weeks post surgery to have the staples removed, I was told that the other sutures should dissolve on their own. If not, I am supposed to go back in and have them removed in the office. I wasn't too concerned about it, but now that all the scabs have come off, the other sutures are poking through my scalp. They feel like fishing line. While no one can see them due to my hair, I know that they are there and I pick at them.

While I do know some people who have removed their own stitches, mine seem pretty attached to my scalp. I'm going to try to leave them alone for now. I see the dermatologist again the end of February, so if they are not gone by then I'll just have her take them out at that point. I may have to at least trim a couple of them in the meantime though. I don't want my comb or brush to catch on them. Dissolvable? I don't think so.

Skin Scan

Tuesday was my annual skin check with my dermatologist. It had been three years since any skin cancer was detected, and I had graduated to only having to come in once a year. Well, my lucky streak has probably come to an end. There were a couple of spots in my hair that I wanted the doctor to take a look at, and she decided that both of them needed to be biopsied. As they gave me the shots to numb the area, I kept feeling it when they would stick me to see if it was numb. After three shots in each location, the technician had the doctor come in to give it a try. I still felt her stick as well.

As it ends up, people who have red hair or highlights (that's me with the red highlights and my mom was a redhead) need more lidocaine when having procedures done. This certainly has always been true for me. The doctor said there is a world-wide shortage of lidocaine right now, and it's been hard to get their hands on the higher dosage shots. She went from room to room in the clinic until she located one for me. And sure enough, the extra dosage worked like a charm and she was able to snip the samples she needed.

Now I just have to wait to see what the lab results say. That may take up to two weeks. With my history, I'm fairly certain that it will not be good news. But at least this time the scars will be hidden by my hair. Red highlights and all.

Burn, Baby, Burn

thermos

Yesterday was my semi-annual visit to the dermatologist for skin cancer screening. Since last year was a banner year with four basal cell carcinomas having to be surgically removed within a six month time frame, I wasn't sure what kind of report I would be getting. My doctor, ever optimistic (not!), always enters the exam room with a red plaid thermos filled with liquid nitrogen in hand. I'm old enough to remember the plaid metal lunchbox that came with this exact thermos. What a way to spoil a childhood memory!

The procedure is known as cryotherapy, because liquid nitrogen is extremely cold - at around negative 328 degrees Fahrenheit. Using an extra-long, cotton-tipped swab, the doctor places the liquid nitrogen for ten seconds or so on each spot on my skin that he deems suspicious. The affected skin is frozen, and forms a blister which eventually dries up and falls off. The hope is that all the pre-cancerous cells are killed, and that the remaining cells underneath are healthy. Yesterday I had 25 spots frozen. Yikes! But the good news is that only six of those were on my face, and the doctor was not alarmed by any of the spots that he saw. I'll take that news.

As someone who grew up before the advent of sunblock and spent long, summer days playing outside with my friends, I've had lots of exposure to the sun. Add in my light skin, blue eyes and the fact that I wear my Irish heritage proudly, and I am the poster child for skin cancer. As my doctor says, "You shouldn't walk from the house to your car without wearing sunblock". I try to be vigilant about this.

Onto a happier topic...This weekend we were blessed with incredible weather, particularly on Saturday. I knew that my husband would go out for a motorcycle ride, so I left the house early and drove to the Audubon Center at Riverlands. Many migratory birds stop here during the winter months, and January is usually a good time to see the trumpeter swans. I wrote about visiting the center last January (you can read the post here), and mentioned that there were way fewer birds on site than in 2015. This year I think there were less birds than in 2016. I'm not sure what that means, but it may have something to do with the fact that the weather has been a little milder. Maybe they just don't have to travel so far south to survive the winter. It was a little disappointing, though the sixty plus degree weather helped me get over it.

Audubon Center at Riverlands

Continuing on my drive, I crossed over into Illinois to travel on the River Road. I was hoping to spy some eagles. I saw one swooping down overhead as I was driving, but none in the trees. Normally drivers are pulling over to the side of the road to take photographs or look through binoculars, but that didn't happen either. Driving through Grafton, I saw several cars turning down a side street. Following them, I finally saw an eagle high in a tree. The other photographers there said the eagle had been in the same spot for at least an hour. I snapped off a few photos of the eagle, and then caught this unusual bird formation in the sky. Doesn't it look like a fish?

eagle

The Loading Dock

As luck would have it, my husband and his friend were also traveling on the River Road, so we were able to meet up at The Loading Dock for lunch. It is located right on the river, and has a wonderful patio area. It was nice enough for us to sit outside while we were eating. Following lunch, they continued north and I headed south for home.

On Sunday, Jim and I took our first walk around the neighborhood together since losing Kirby. It was strange not to have him with us, but as each "first" passes, things get easier and easier. I'm sure he walked with us in spirit.

Kirby

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!