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.

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 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.

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.

More Mohs Surgery

two grinches

Last Thursday I went to the plastic surgeon's office. I wore my grinch face mask as it mirrored my mood at having more skin cancer. It was ironic that the grinch greeted me in the waiting room. I was scheduled for Mohs surgery to remove the two basal cell carcinomas they found on my scalp. I had a tiny one in my hair on the left-hand side towards my forehead, and a larger one further back in my hair on the right-hand side. 

Dr. Mu was my surgeon again - she removed the squamous cell and the basal cell hiding below it from my nose in December of 2019. While she was unable to get clear margins on either of these after the first excisions, at least she was able to get all of them in the second cut. The one on my nose took five tries!

After she was done Dr. Freeman came in to do the closings. He discussed the pros and cons of stitches versus staples, and we decided to do the staples this time. I have not had them before, and it sounds just like you think it would. Imagine someone holding a staple gun up to your head and firing away. It took 8 staples to close the one on the left and 14 to close the one on the right. 

Mohs followed by staples

hair loss

I was able to manage the pain with Tylenol, which is good as stronger drugs make me sick. The larger wound did bleed a bit that night, so I covered it with Neosporin and a gauze pad. Though I was advised I could wash my hair after 24 hours, I chose to wait an extra day to do so. A large chunk of my hair came out, I'm guessing from the area of the large incision. I'm not sure why they didn't just go ahead and cut the hair in that spot. While the dried blood came out with the double shampooing, the solution Dr. Freeman used to clean my head before closing up the incisions did not all come out. I can still feel it caked on my scalp. I guess I'll need to pick on it a bit before the next shampoo.

Next week I go back in to have the staples removed. Hopefully that won't be too bad.

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

The dermatology office called to say that both of the biopsies taken last week are basal cell carcinomas. These are my 15th and 16th skin cancers. Ugh! We do not have a family history of basal or squamous cell carcinomas, and I was not out in the sun more than any other kids growing up in the 60s and 70s. I always say I wear my Irish heritage proudly with the red cast in my hair and my freckles, but it stinks that my skin has to suffer for it.

Now I have to wait for the scheduling office to call and see when they can get me in. With our granddaughter making her big debut next week, it will take some planning to coordinate when I want to have the surgeries done. Since these are very slow growing cancers, it won't be a huge rush. Celebrating my first time as a grandma is going to take precedence for sure!