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. 

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

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!

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.

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!