Wrapping UP

Here it is the last day of January already and I've neglected my blog again. It's kind of been my pattern for about a year now and I know someday I'll regret it. I'll look back and wonder why I didn't write down some of what's going on in my life - even if it's not much. So I'll resolve to change all that from now on.

And I'll start by reviewing January. We had a lot of birthdays and I did manage to observe those at least but I didn't do well with You Capture having only participated once. Starting right now though I resolve not to miss another one.

I think I might have a mild case of that depression you can get when the days are short and the weather prospects offer nothing but snow and cold. This month, though, we've been pleasantly surprised. We had a snow or two but they didn't last. And since the last one it's been amazingly warm. In fact, right now it's 54 degrees outside.

When it it did snow a couple of weeks ago, I rather eagerly got out my bird feeder and filled it with the most expensive seeds - guaranteed to attract the most colorful birds. But unfortunately it attracted more pesky squirrels than colorful birds.

(I wrote about this same problem and how we handled it with a Hav-a-Hart trap last year here and here. We went on to catch quite a few of them and it really seemed to make a difference but last Fall I started to see more of them around again.)

So I watched the squirrels chase away any birds that happened on their private habitat and I watched all their friends and relatives join them. I watched them swing on the bird feeder and generally make a mess of everything. They even knocked down some of the little statues we have out there in their efforts to push off them and leap to the bird feeder.

I pretty much became a bird feeder nazi. When I saw those dang things out there, I would open the door and shout at them and sometimes even walk toward them in an effort to startle the brazen little rodents. Mostly they ignored me so a couple of times I even threw stones at them. I thought if just once I hit one, I'd feel better.

(Years ago I'd thrown a sizable rock at a squirrel in a tree in front of the house and I hit the limb he was standing on. The impact knocked the squirrel out of the tree and he landed on the ground and starting flipping and flopping all over the place. Finally he flopped onto the front steps and died. At least it looked like he did. We wouldn't even walk near him so we had to come into the house through the back door and watched in wonder through the window as he came back to life, stretched, and scampered off. Squirrels are very durable little creatures.)

Anyway, this shows you that my aim isn't very good but my intentions were pure evil toward those nasty little buggers. This winter then, we hadn't set out the trap but we were having an increasingly serious problem with the squirrels. One day I was happy to see five cardinals all around the feeder. Then they disappeared to be replaced by a squirrel. I stepped quietly out the door, picked up a rock, took careful aim, and I nailed it!!! Not the squirrel - my bird feeder. It broke and scattered all the seeds all over the ground and the squirrel and his friends AND relatives had a party while they laughed at the crazy woman who'd served the fabulous snacks.

Mr. Right patiently bought me another feeder and I pondered what to do about those stinking squirrels. I considered setting food out just for them so they wouldn't hang on the feeder but I was pretty sure the population explosion we were experiencing would be small potatoes compared to the one we'd have if we deliberately fed them. And I looked at squirrel deterrents but none seemed like they'd work with our pole and the one that was most interesting and looked the most effective cost $89. In retrospect, I probably should have gotten that but we had just gotten this brand new feeder.

Yesterday I was on the treadmill for 45 minutes and for each and every one of those minutes a squirrel dangled from the bird feeder. That did it. I set the trap and within an hour I'd caught the first one. Twenty four hours later, I've trapped five of them. And I've driven them to a wildlife refuge and a state park both of which are over ten miles away. That's why I should have just spent $89 for a squirrel resistant feeder except that they'd still hang around on the ground and scare the birds away. So that's that for the squirrels - for now. But I'm pretty sure there are only about three more to capture. We'll see.

Also this month I did another course of chemo cream on my basal cell skin cancer. I finished the course, saw the plastic surgeon, and was told to come back on the 15th of March for another assessment. I'm a little unnerved because as the days go by post-treatment, my nose looks redder and more blistered than it did right after I finished. I'm also experiencing a lot of weird sensations and irritations. I'm not sure what all that indicates but I guess I'll find out in March.

I also remembered that I haven't finished my Christmas Story series. I'll do that very shortly just as soon as I get a letter that is an integral part of the story. Which leads to another life changer for the past month. This is the month that I got completely addicted to Words With Friends. I blame that completely on Alec Baldwin and the news breaking trouble he caused because he wouldn't quit playing on an airline tarmac one day. I can totally see that happening to me. It's that addicting and just the fact that I don't understand why they'll only let you play twenty games at a time proves it.

The Good The Bad and The Ugly

My first granddaughter, Amber, and mother to our three great grandchildren had her stitches removed Monday that were put in when the worrisome tumor was removed from the back of her head. When the doctor went in, he thought he was removing a pilar cyst and that was good news for everybody but when he removed it, he knew it was something else and sent it off to be biopsied.

Yesterday we found out it was a neurofibroma, a benign nerve sheath tumor in the peripheral nervous system. The key word for us here is benign. Thank you, God.

That's the good.

I had my follow up appointment with my plastic surgeon last week. He feels sure there are at least precancerous cells left. He explained that if he removed a cancerous cyst from my back, he would cut fairly generously taking a little more than he needed to just to be sure to get it all. This is made possible by the fact that there's plenty of stretchy skin there making it easy to close the wound. However, when he's removing a cyst from the tip of a nose, he needs to remove as little as possible because there's no extra skin to stretch in order to close the wound.

So....in January we'll do another round of chemo cream. And possibly another surgery.

That's the bad.

Right now I'm continuing with the 'Scar Away Silicone Pads and massage to try to minimize the scarring. Unfortunately my nose is still somewhat lumpy and bumpy. And the chemo cream will make it lump, bumpy, and fire red.

That's the ugly.

But again. It could be worse. I'm going into the holidays with a feeling of relief. The two special prayers I've prayed lately are that Amber's tumor would be benign and that Dave would get home safely from Afghanistan. And a couple of days ago, Dave wrote that he could be home as early as January 3rd instead of February 6th as we originally thought which could be very conducive to an answer to my second special prayer.

So that's more good.

Last Sunday I started the dreaded cold symptoms that I knew were coming when Mr. Right got sick. But I started taking Zicam and so far I really believe it's helped. So that's more bad.... but it could be worse.

And I don't have more ugly except for the weight I keep gaining.

There! Now I'm updated. And the good news is that there's a lot more good than bad or ugly.

Does It All Start With A Common Cold?

Last year, right after Thanksgiving, I got a really bad cold. I didn't suffer long before I visited my doctor who prescribed an antibiotic. Then I got worse. And a new antibiotic. Then Christmas arrived and I wasn't any better. In fact I was even worse. During Christmas week when I'd normally be in seventh heaven because our family was together, I was sick. And went to the doctor again. I think my kidneys were failing or something because the doctor said that the antibiotic that I was on could affect the kidneys.

I don't remember getting completely well after Christmas but in the very early Spring I went ahead with the shoulder surgery that seemed necessary at the time. And oh my, what did I do? It was so much worse than I thought it would be and I thought I'd never regain the mobility that I'd enjoyed or the small pain that I thought needed correcting. After months of physical therapy and then home physical therapy, I've seen steady but slow improvement.

Then I was diagnosed with skin cancer on my nose - not the deadly kind but any kind on the tip of your nose is a challenge. We started with a chemo cream the effects of which are terrible, then a biopsy, more chemo cream, excision of the tumor, a lingering unattractive bump, more chemo cream this coming January and then possibly another surgery to address the bump.

Healthwise it's been a difficult and challenging year. I've exacerbated the problem by gaining 30 pounds and feeling completely unmotivated to do anything about it.

And it all started with a cold after Thanksgiving last year.

Now things are looking up for me. I'm walking about a mile and a third a few times a week - it's not much but I really believe that staying active is the key and I'm increasing the time and effort I expend by just a little every week.

I'm hopeful that I've completed a year-long bad health cycle of some kind and that the coming year and hopefully all those to follow will be better.

But after Thanksgiving this year....... Mr. Right got a cold and a cough that seems to go on and on. He thinks it's a little better and he's somewhat reassured because he got a pneumonia shot last Fall so that's good.

But now he's got a really bad toothache.

Oh no. Does it all start with a common cold?

Another Update

Yesterday I had my post-op appointment with my plastic surgeon. I wasn't sure what to expect so I had lots of scenarios in my mind but none panned out. Before this is over, I'm almost sure I'll learn to quit guessing what's going to happen and just wait and see.

Yesterday the doctor looked at the incision and the flap repair and said, "We're very very lucky". I asked if he meant because he was able to do the flap as opposed to one of the skin graft options and he said, "yes, the graft from behind my ear probably wouldn't have worked". And I interrupted to say that I'd looked at some forehead to nose skin graft pictures on the internet and they were pretty horrible. Of course he wasn't too pleased that I was checking things out on the internet but he agreed, they were difficult to see.

So I was lucky - really lucky and I'm feeling pretty euphoric about it right now. Of course my cautious personality still reserves the chance that the flap repair could fail but I think that's just to be prepared - you know worst case scenario.

Right now it looks like it's supposed to. And that's awesome.

Ultimately I realize that skin cancer doesn't deserve the press and fear that other cancers warrant even if it's potentially disfiguring but it's still been a source of stress for me. One that I haven't given vent to because I'd feel guilty giving it so much more attention than it deserves.

And, it's not over yet. I have an appointment in two weeks and he already told me that we'll have to do another course of chemo cream.

Now, though, the stitches have been removed to minimize scarring and there are no steri strips because with the flap repair, that wasn't an option, so I have to be really careful. My nose is red and there are little scabs so it's hard to visualize what it will look like. I know that it will look different - at least to me. I can see that the shape has changed some which is okay with me - I wasn't in love with the way it was.

But the biggest change is in how I feel right now. I'm so grateful and so relieved and so ready to have all this behind me.

Skin cancer. If it's basal cell, it's not life threatening but the other skin cancers aren't quite as innocuous. And they all threaten the way you live your life and how you feel about yourself. It's nothing to mess around with.

So I have to reiterate again and again. Keep exercising and eating right but take care of your skin too. Remember your sunscreen has to have zinc oxide and/or titanium dioxide and, when you can, stay out of the sun.

Updates

Here I am - two days post surgery and I'm feeling pretty good. The first day, once the effects of the general anesthesia (which made me a little loopy) wore off, I felt a little rocky. And a little dreamy, sleepy, and at peace because the surgery was behind me. I took a peek when the dressing came lose and I pretty much saw what I expected.

There's an incision a little over an inch long with neat black stitches from one end to the other. The stitches seem to be more bunched up near where the main tumor was and there's an area that appears to be open - however, I think I see a thin layer of skin over it. It's possible, of course, that that's just what I expected to see. The cut starts just above my right nostril and curves over and down to just left of and below the tip on the left side. It's longer than I thought it would be but when I remember the large open areas I saw on other nasal carcinoma patients on the internet, it seems quite narrow.

Somehow, the most complicated part of the treatment is following doctor's orders. Keep it covered the first day, expect some bleeding and oozing, shower the second day, no stooping, bending, lifting or grimacing that might affect that area. The thought of showering was quite daunting to me. I just couldn't imagine getting it wet much less gently washing it and patting it dry. But I did.

Another thing that's challenging and doesn't seem like it should be is keeping my head elevated when I sleep. I just can't seem to get comfortable and even when I feel fairly comfortable, my back hurts in the morning. But that's minor - just interesting to me.

Of course, I have done some bending, modified stooping, and grimacing - at least until it hurts - then I remember. Yawning is one of those mindless activities that has taken on some significance - along with unconsciously reaching up to touch a tickle or itch. And yes, there's lots of tingling and itching and and a hard-to-describe achy feeling.

Tomorrow I see the doctor again and I'm not sure what to expect. The Monday after I got the biopsy the stitches were removed and replaced with steri strips. I think some of these stitches could be removed but Harry just pointed out that there's an open area that probably won't get steri strips so I'm not sure what will happen.

Speaking of Harry, evidently he and the doctor had some pretty in-depth conversation, complete with drawings of my nose, while I was moving to recovery. I just found out today that the doctor said he's confident that he got all of the cancer. Although there may be some precancerous cells left, they can be treated. (Does that mean more chemo cream? Probably. UGH!)

I've taken pictures and eventually maybe I'll show 'before and after' shots but not yet. Right now I'm a little worried about grossing anyone out that happens to read this.

In other concerns, Beth has a clogged duct or mastitis complete with fever and pain. Of all times. I wish more than anything that I could be there to help but no stooping, bending, or lifting equates to no help. I'm kind of railing at the timing but it is what it is.

Fortunately, Lori will be there tomorrow to help her - but deep down, it'll still be painful to be so far away from Babytown.

Tomorrow I'll talk about measurements. Yawn right? We'll see.

I Have Skin Cancer - Part 2

On July 18th, I finally saw the plastic surgeon. I left feeling pretty relieved - almost exhilarated.

Here's an excerpt from an email I sent to the kids after that appointment:

I have a carcinoma in probably the worst possible place cosmetically. If he (the surgeon) did surgery now, I would be very unhappy with the outcome because it would leave a divot about the size of his thumbnail.

Therefore, he prescribed a chemo cream to try to shrink it. I will use it for ten days starting on the 24th and see him again on the 4th of August. At that time he will see if it's working. If it is working and he thinks it could do more good, he'll have me continue it for up to two weeks. The best possible scenario is that it would shrink the tumor enough that when he does the surgery, I would have a small scar. If it doesn't, he'll do the surgery but as I said earlier the results would be challenging. He would attempt to fix it by doing a skin graft but the logistics of that are so unpleasant that I won't share it with you unless it comes to that.

Starting about 3 to 4 days after I start using the medication, the tumor will open, possibly bleed, scab, and just look generally terrible. He didn't mince any words about that. During that time will probably be the only time in my life when I might not be excited about seeing any of you. I just called to ask if I can put a band aid over it during that unsightly stage and they said I shouldn't. If I have to for a couple of hours, I can but they'd rather I wouldn't. See? It's going to be very challenging. Can Dad stay with one of you for that time? lol

He did not do a biopsy. He's very sure it's a basal cell or squamous cell and he said I've probably heard pretty dire things about squamous cell carcinomas but it's not that bad. The people in danger of those cells spreading are generally AIDS patients or people taking high levels of steroids so that their immune systems are compromised. He said that in 24 years of practice he's only seen one of these turn out to be a melanoma and that even if it were, melanomas are 90% treatable. I asked, if when I go back, we could still do a biopsy, he said yes. But doing one today would only delay the total treatment by several (or maybe just two) weeks.

I hope I haven't made this seem more scary than it is. I think that it's going to be pretty unpleasant for awhile and I hope you'll all have positive thoughts and stuff that this medication will shrink it, but overall he said my problem is cosmetic not life threatening.

So there you have it.

Stay out of the sun.

Oh, and 90% of all Caucasians will get skin cancer if they live long enough. AND the only effective sunscreens are the ones that thave zinc oxide and/or titanium dioxide in them. They've found that the SPF doesn't mean much at all.

That was the result of my first visit.

I started the chemo cream as directed and I had a pretty good attitude about it but as the end of the treatment time approached, I became more and more stressed. Suddenly the tumor was very evident to me. In the middle of this fire-red blotch covering the whole end of my nose was a bump rising higher and higher every day and there was no doubt in my mind that this was going to be much worse than I'd expected.

The doctor walked in on the 4th of August, took one look at my face, and I think he got mad at me. He asked me to review what I'd told him and I did. Then he bluntly said if I did not trust him or had some doubts about the course of treatment that he'd laid out, he wouldn't be mad or insulted if I wanted to see someone else. This kind of hurt my feelings but I had to acknowledge to myself that there was anxiety all over my face.

I replied that I did trust him but that I needed reassurance that what was happening was as expected. I told him that I wouldn't have been alarmed to see the spot open, ooze, bleed, turn color, or become even more unsightly but that I hadn't expected to see a tumor rise like a phoenix in the middle of everything else that was ugly.

I then asked about doing a biopsy (I didn't say it but I was sure this was something much worse than we'd expected). He said, yes. In fact he INSISTED that I have a biopsy the very next day because he didn't want a patient of his to be as stressed as I obviously was.

Whoa! I didn't expect that, but I was glad. They obviously had to work me into his busy surgical schedule and my instructions to prepare were consistent with a real surgery - nothing to eat or drink after midnight. I was to get to the surgical center at noon but at about 11:30 I got a call saying that the doctor didn't want me there before 2:00. I was pretty annoyed with this at first but by the time we got there, I'd reminded myself that he was a very busy surgeon and that they had worked me into his schedule. When we arrived we were told that he was in the 5th hour of a surgery that was expected to be much shorter and I realized that he'd made some sacrifices just to get me in on his one surgery day a week.

About 4 o'clock he came in and explained that they'd do a small vertical incision and that there would be 2 or 3 stitches. Everyone was extraordinarily nice. The surgery staff was awesome and I woke up to a nurse murmuring in my ear that the incision looked great!

The doctor had ended up doing a horizontal incision and I had 6 stitches instead of 2 or 3, but finally I had full and complete trust in him. He was the best! He told me to come back Monday to have the stitches removed.

When they'd scheduled my appointment back in July, it kind of hinged on his being out of town starting the week of August 6th. When we went in Monday they told me that he would be gone starting Wednesday and that a PA would be removing the stitches. They also told me that the lab report wasn't back yet which would tell us what kind of cancer we were dealing with.

Wednesday, I was on my way to Washington DC to spend a few days with my daughter-in-law and grandchildren while my son is in Afghanistan when my cell phone rang. It was my doctor calling to let me know that I had a basal cell carcinoma. It was so great of him to call and when I said "I thought you would be out of town", he replied that he was actually at the airport but wanted to be sure I knew of the results before he left. Wow!

After about a week, the scab came off and the results looked pretty good. I had some unrealistic hopes that the ordeal was over but my next visit proved me wrong.

The doctor wanted to wait until the wound healed and then start another series of chemo cream. About a month after that, he'd see me again.

When I returned for that appointment, he told me that the tumor had really not shrunk at all and that there was no point in continuing the cream. It had stopped any spread while I was using it but it hadn't reduced the size. It was time to schedule surgery.

Tomorrow morning at 6:30, I have to be at the surgery center for a 7:30 procedure.

I'm very uneasy about it especially after foolishly doing some internet surfing. The doctor will try to close the wound with a flap of skin from an adjoining area but if he can't, he'll take a skin graft from behind my ear. If that doesn't work, they'll do a forehead to nose skin graft which looks particularly unpleasant but I think that would be a separate procedure.

Ultimately, the results should be okay cosmetically and most importantly, the cancer should be gone - but that's not guaranteed. In an effort to minimize the damage, he'll not dig any deeper than he feels is necessary. This leaves some room for a recurrence which would be dealt with if and when necessary.

Finally, I want to reiterate what I said to my kids in the email I sent them:

1. Stay out of the sun
2. Make sure your sunscreen has zinc oxide and/or titanium dioxide in it.

Sixty-Five years old may seem like light years away right now, but it's not. It's right around the corner.

I Have Skin Cancer

About a year (or more) ago, I noticed a pink area near the tip of my nose. It didn't seem to change much at first and since it was easy to cover with make-up, I didn't worry too much about it. As silly as it sounds, I suspected that it was from using my new DSLR camera and having the camera body touch my nose as I looked through the view finder. (At the time, I was taking pictures constantly.) After about six or eight months, that area kind of opened and formed a little crater - I think because I started washing my face with a slightly abrasive cleanser. Although it readily healed whenever I quit the cleanser, it seemed to come back pretty easily.

When I saw my doctor in January, I mentioned the pink spot and he suggested I use a retinol cream on it. Then, for other reasons (I thought), he told me to come back in a month. I used the cream which only seemed to make the pink angry but I didn't go back in a month because by then I'd had shoulder surgery. It seemed logical to me to finish with the surgeon before I went back to my general practitioner.

Although the pink spot continued to be a concern, I wasn't terribly worried about it. I had my shoulder to concentrate on by then and my thoughts easily evaded the 'blemish' on my nose.

In fact, I was able to avoid thinking about it until one day I opened my computer homepage to an article discussing the five most common skin cancers. I really didn't want to look at it, but I opened the site. It came with no great surprise, but a feeling of dread, that the picture showing a squamous cell carcinoma on the tip of someone's nose looked exactly like what I was dealing with. Ugh!

I didn't do anything that day but the next morning I awoke to the announcers on my clock radio discussing skin cancer and the importance of not ignoring symptoms.

Within that short 12 hour period I'd gotten two giant wake up calls. There was no doubt I was getting a message that I needed to take action.

That day I called my doctor and was shocked when I couldn't get an appointment for well over a month, despite the fact that I told the scheduler that I was certain that I had skin cancer on my nose. She very casually advised me not to worry about it too much because even if it was skin cancer the doctor would probably just cut it off in his office. I told her I'd never liked my nose very much but I didn't want it cut off and she laughed and laughed. Her casual attitude, though, went a long way toward allaying my fears.

When I finally saw my doctor, he took one look at my nose and said "this is a problem". He checked it again and said, "this is going to be a real problem and you'll need to see a plastic surgeon". (So much for just cutting it off in his office.) And I realized that there might have been more than one reason that he had wanted me to come back in a month way back in January. He probably planned to look at my blemish to see if it had healed.

I went home to make an appointment with one of the two plastic surgeons that my doctor recommended and got another wake-up call. There were no appointments available for well over a month and that was 'squeezing me in'. I did manage to get an appointment with a MOHS surgeon (a dermatologist certified to do microscopic surgeries on carcinomas), and he said he could do the surgery but that, since I already had an appointment with a plastic surgeon, I should probably just go ahead with that. He also felt it was either a basal cell or a squamous cell carcinoma.

Because of what a couple of the receptionists said, I also felt an urgency to get a biopsy done. But once again, the wait time was long. I tried calling my doctor to see if he'd just do the biopsy and was told that 'no, he wouldn't because it was in an area that would never heal'. I asked the MOHS Surgeon and he said I should wait and let the plastic surgeon do the biopsy. Ouch! Things were sounding more and more ominous. And there didn't seem to be a shred of doubt in either of the doctors' minds that I had skin cancer. They just didn't know what kind of skin cancer it was.

I wrote this post about running out of gas the day I saw the MOHS surgeon.

It's hard to believe it was so long ago but on July 18th I finally had that dreaded, but long-awaited, appointment with the plastic surgeon.

Tomorrow I'll share my journey with the plastic surgeon from July 18th until today. Yep, it's still ongoing.