Tuesday, August 30, 2016

" here i am, back on the road again. here i am,up on the stage....there i go, turn the page..." lyrics from "turn the page" by bob seger

yesterday was my birthday. i received a lot of birthday wishes on facebook from my family and friends. i feel very, very blessed to be here for another birthday and i am grateful for that. i spent this past weekend with all of my children and grandchildren. we had a great time panning for gem stones, watching the grandchildren frolic around  in the splash pools and doing their favorite thing- throwing rocks in the river. yesterday, i also received a few happy birthday phone calls which was nice. i did however receive a phone call that was not so nice. it was from my dermatologist. it seems that the place on my face  that i had removed about 10 days ago,  was indeed cancer. they scheduled an appointment for me  with the dermatologist in the practice( different doctor than mine )  who sometimes will take care of skin cancers. i am to see him on  september 7th. the nurse said that the second physician  needed to see it to evaluate if he could remove it, or would need to send me to a special dermatologist who is also a plastic surgeon. i  have heard that if i have to be referred to another plastic surgeon dermatologist, it would be one who works at baptist hospital, in winston-salem. i am just praying that the local dermatologist can do it.

the good news is that the cancer type is basal cell, which is the most common skin cancer. i was a little worried that it was squamous cell carcinoma- since i had one of those removed from my leg about four years ago. squamous cell is a more aggressive cancer, and can sometimes require extensive surgery and radiation. basal cell can rarely involve muscles, nerves or bones, but it is not likely to spread. if a person has had one skin cancer, they are likely to have another one. please remember this bit of information! in other words, check out any suspicious places on your skin. i really recommend that everyone  have a skin check, even if you have never had skin cancer, once a year or so.

so what causes skin cancer? exposure to UV light is a biggie. either by the sunlight or tanning beds. most of us did not wear sunscreen when we were younger. that damage can not be un-done. for the past several years, i have worn sunscreen, a hat when outdoors, and i try not to go outside during the hot part of the day ( about 12 to 4pm). another possible cause is a weakened immune system. BINGO! i think that is my problem. there is not very much a person can do about that except be diligent in checking your skin, and going to the dermatologist as early as possible if you notice anything strange.

my basal cell is between my nose and eye. a tender little area, with not much skin to work with. the type of surgery generally used to remove this is called the "Mohs" procedure. the doctor sort of scraps a little, stops and sends you out to the waiting area, checks for clear margins, and scrapes again as needed before stitching you up. this can take a while, as you might imagine, but it is a very effective procedure from what i have read.

i know that basal cell carcinoma is not as serious as squamous cell or especially melanoma. having this type of skin cancer is not nearly as bad as having thyroid cancer or breast cancer. it may be sort of a side effect ( weakened immune system) though, from having had  one or both. everyone is different, but what i noticed about my basal cell was a crusty little patch- sometimes red, sometimes oozing, that would sometimes be worse than other times. it would appear to go away, but then come back. i am not trying to gross anyone out, but i just would like for people to be aware of any skin changes, and to  please take these seriously!

so here i go, back on the road again, so to speak. as i said, basal cell carcinoma  pales compared to thyroid or breast cancer, but it is cancer, and it is troubling and aggravating. i will do what i need to do to take care of this, and i will move on. if i end up with a little scar on my face, i will just use the cliche, " you should have seen the other guy!".

Sunday, August 21, 2016

" yeah, the W A I T I N G is the hardest part". yes i have used this line a time or two in my blogs . thank you, tom petty.

actually, make this the third time. i had a dermatology appointment last week- to have my yearly check up. i knew that i would have to have some places ( actinic keratosis) frozen off. if left untreated, they can turn into squamous cell carcinomas. i had a squamous cell carcinoma removed from my left leg- a year after my thyroid cancer was diagnosed. i was a little nervous going to the dermatologist this time- after all , it has been a year since my breast cancer diagnosis.

call it fate, call it chance, call it darn bad luck, but guess what? i have a squamous cell carcinoma on my face. the dermatologist is pretty sure that it is squamous cell again, but we are waiting on the results from the biopsy. yes, W A I T I N G. my dermatologist removed the" place", but he said that if the biopsy does indeed confirm the squamous cell, i have to go back to see the special plastic surgeon dermatologist in the practice. the plastic surgeon  does a procedure where he cuts a little, sends you in the waiting room, looks for clear margins, maybe cuts a little more, etc. then sews you up.  my doctor said that it would take anywhere from 8 to 10 days to get the initial biopsy results back. i know this is not thyroid cancer. i know this is not breast cancer, but waiting for biopsy results is getting to be something that i am tired of doing !

i wear sunscreen, i wear hats, but this damage occurred when i was younger, and not as cautious about sun exposure. it is also in that tender place between your eye and nose. i am wondering, since i know two other people who have had a squamous cell removed from the exact same location, if there is something we are doing wrong. i have thought  perhaps , when we apply sunscreen, we do not apply enough ( or any) to this area because we are afraid of getting some in our eye(s)? it does burn if you get it in your eye, by the way.

as luck would also have it, i had to work this past saturday. i had prepared my fellow peeps about my appearance. i have several red areas on my face, as well as the ubiquitous "spot" band aid that dermatologists seem to be so fond of. no way to prepare the customers, though. i wore my biggest frame reading glasses, but even that did not seem to help. as i said in a facebook post last week, i just told my customers that i got into a fight with my dermatologist and he won.

besides wearing sun screen and hats, we should all be diligent about our skin. i think almost everyone should have a skin check once a year. and of course, if you see something that looks different, appears suddenly, has an irregular shape or color , go see the dermatologist right away. if you have had any kind of cancer, your immune system is weakened. this is especially true if you have had to undergo chemotherapy, radiation, or the RAI-131 treatment.

i will of course report back as to what i found out. until then, we will all be waiting.........

Wednesday, August 10, 2016

" oh, Lord, don't keep me up all night, side by side with the moon. with its desolate eyes miles from the sunrise, the darkness inviting a tune, the insomniac's lullaby" from paul simon's Insomniac's Lullaby

i had my second to last, probably, physical therapy session this week. unfortunately my insurance company only allows so many visits per year. i wonder when health care in this country will focus more on what keeps us healthy, instead of mainly just treating our illnesses? physical therapy has been one of the best things that i have done for myself- as far as taking care of myself. my physicians did not suggest it, but i asked for treatment, and i did get an order written for the physical therapy.

this week, my physical therapist  measured my " lympedema arm" as i call it, and compared the measurements to what they were before i had the lymphatic massage. all of the measurements were better than before, and by that i mean my arm is now somewhat smaller. most of the measurements were just a little better, but one was a whole centimeter smaller. and maybe it is just me, but i feel better. the swelling was also in my side, chest and back. the physical therapist did not measure this, but she said that she could tell ( and i can,too) that the swelling has gone down quite a bit from these areas. lymphedema is a chronic condition, and can not be cured. but it can be managed, and a person can feel better when receiving the right care. of course, i have to do my part,too. i have to wear my compression sleeve and do my massage at home. infection ( cellulitis) can be a serious complication, so i have to be careful not to injure myself- that is a little tough because i am on the clumsy side. also, any infections that i get- such as sinus infections,etc. need to be addressed as soon as possible. i used to think that this was due just to the chemotherapy, and what it did to my immune system. this is partly the case, but that old lymphatic highway is congested now, so that is the other part.

this is just an example of being your own best patient advocate. knowing your body, and what is best for you. recently,  i had a conversation with a friend of mine who is also recovering from breast cancer. she said that she is regretting a major decision that she  made  regarding her treatment. it was a tough call- her doctors could not agree on a particular part of her treatment. in the end, she just had to make the call and go with it. after the procedures were over, two other doctors came out and said that she should not have made the decision that she did. it has not been a good outcome for her, so now what? well, sometimes you just have to make a decision, run with it, and not look back. i told her that all we can do is research the problem, get several opinions, and choose what we think would be the best treatment for us.

i will use this as an example. when i got my RAI- 131 treatment for thyroid cancer, i got a monster dose. that was what the radiologist ordered, and because my thyroid cancer had spread to my lymphatic system, and a couple of the tumors had broken open, i went with his recommendation. now, six years later, the effective dose has been proven to be much lower than the dose that i received. there are some people, though there is no firm research on this, who claim that the RAI-131 may have some link with breast cancer.  i do not know exactly what caused my breast cancer, five years after having thyroid cancer. i do know that they are somehow related, but this theory has not yet been proven. do i regret the decision that i made six years ago about having the large dose of the I-131? good question. i used the information that was available to me at the time, made my decision, and ran with it. hind sight is always 20/20.  the radiologist made the call on what he thought was best for me, and at the time, i agreed with that decision.

my friend that i was talking to told me that she has to let her" bad treatment decision " go and move forward. that is all that any of us can do, ultimately. just make our best decision, go with it, and move forward. this is easier said than done, though. as far as my decision about the I-131 goes, i might just give you a different answer about that monster dose- depending on when you ask me about it.