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

Keeping me in Stitches

This morning I made an unplanned visit to the plastic surgeon. The smaller of the two basal cell surgical spots in my scalp had begun to bleed. As I am 8 weeks post surgery, this is really surprising. The wounds had been healing nicely, and I even colored my hair with no problem a couple weeks ago. The only thing that had been bothering me was the dissolvable stitches that were popping up through my scalp.

I called the office when I noticed the discharge, and they told me to come right in. The technician clipped the stitches, and then took a scraping of the head wound. It will be sent to the lab to check for signs of infection. When the doctor was able to see me, he cleaned the wound up but didn't seem overly concerned. He said that because of my hair, it's likely that one of the hair follicles formed a pustule due to the dissolvable stitches and that it has erupted. He gave me a prescription for a topical antibiotic to put on the wound, but didn't want to start me on an oral antibiotic until the lab results come back. That might not be until next week, so I'm sure that's why he went ahead with a topical in the meantime.

By the time I got home, the wound was bleeding quite a bit. I know that head wounds have a tendency to do that. So I put a cold compress on it until it slowed, and then put an over the counter ointment on it to help stop the bleeding until my prescription is ready. This is the first time in the 15 skin cancers that I've had removed that there has been an issue, so I guess I can't complain. Hopefully the lab result is negative, and the topical ointment does the trick. 

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 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

Mini Facelift for a Cause

March 7

On March 7th, following two weeks of celebrating Jim's big milestone with a cruise and company, I went under the knife to remove the two skin cancers on my head. The plastic surgeon began with the one on my temple as he deemed it the "simpler" of the two. For whatever reason, it takes a lot of local anesthesia to numb anything on me. The shots to deaden the area are no fun, but they beat the alternative. Except that I felt him cutting the first spot. Yelping in pain, he quickly gave me another shot. Yay. The removal went quickly, but the stitching seemed to take forever. Why does it feel as though your skin is being pulled 10 inches away from your face? It doesn't hurt, exactly, but it kind of makes me sick to my stomach.

Moving on to the second one, which was centered on my upper forehead but extending into the hairline, he commented on the amount of nerve endings in that part of your head. "This will be painful," he predicted. I could tell the second cut was larger than the first by the amount of stitches he put in. How does that old song go? "The first cut is the deepest?" Not so, mister songwriter.

Things didn't look or feel too bad when I first got home from the doctor's office. But then the anesthesia began to wear off, and boy howdy! I was allowed to take Extra Strength Tylenol, but not aspirin. And then the cuts began to bleed some. Because they hurt so much, I did not touch them. The post-op instructions say to wash the wounds with soap and water several times a day. No way was I touching them. Needless to say, I did not get too much sleep that night.

March 8

The next day I attempted to wash the wounds despite the pain, and honestly I thought I was going to pass out. I had to lie down between each one. As I mentioned these are my 9th and 10th skin cancers, but I have never had any that hurt me this badly. It may have been a mistake to have both done at the same time as they were competing for the same skin on my forehead, which was stretched super-tight. I think that combined with the swelling added to the discomfort. There was little sleep on night two either.

It took several days before I was no longer taking Tylenol every four hours. The surgeon actually called me on Thursday the 10th to let me know that he had the pathology report. Both of the lesions were basal cell carcinoma, and he had gotten clean margins on them. I was so concerned that he would have to go back in, but this was overall really good news. If you have to get skin cancer, at least basal cell is the least invasive. He asked about the pain level, and I told him it was still pretty bad. He said he wasn't a bit surprised because of all the nerve endings he disturbed.

March 16

I did not even leave the house except for small walks with the dog until Friday, and then only because I needed food. Jim's aunt had died earlier in the week, so he drove up to Iowa to get his dad and sister to take them to the funeral in South Dakota. He wasn't home to help me out, so if I wanted to eat, I had to go to the store. I slapped a bandage over the most offensive looking wound so I wouldn't scare small children, and headed to the grocery store. It was so sweet because the bagger was all concerned about what had happened to me. I suppose I looked like I had been in a car accident or something.

By the end of the weekend I was able to take long walks with the dog again as my face didn't get jarred with every step I took. But it took until the next Saturday before the rest of the dried blood came off and I could use my bangs to cover up the surgical sites.

March 20

At the end of the day, I am grateful that this is only basal cell carcinoma and that I have health insurance and the means to be able to get rid of the cancer. But like Cher says, "If I could turn back time...", I'd erase the time I spent playing outside in the sun as a kid. All these cancer surgeries are a tough way to get a facelift!

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!