Annoyed

I had almost forgotten about the biopsy that I had on the tiny spot on my forehead, so when my dermatologist, Dr. Lieu,  called today to say it was another squamous cell I was a little surprised.

It's the usual – in situ – or on the skin, but still I need to apply a chemotherapy cream to it for a few weeks.

Our conversation about some swelling and stiffness in my left hand was more disconcerting. I have had trouble flattening out that hand for a while and thought I might be developing arthritis. I am going to bring this up with my internist when I see him Monday. But lately I have noticed swelling also. I brought this up with Dr. Lieu by way of wondering if this is related to the GVHD on other areas of my skin. She said yes it is more likely that and less likely arthritis and that I should probably come in before my next scheduled appointment.

I don't mind not doing the perfect down dog but I would rather that hand not curl up on me since I need it for writing.

I might have to increase my prednisone dose, which of course is not the way I want to go. Another possibility previously mentioned is ECP, or Extracorporeal photopheresis. I found this definition on the website of the National Institutes of Health: ECP is a cell-based immunomodulatory therapy that involves collecting leukocytes from peripheral blood. These cells are exposed to a photosensitizing agent, 8-methoxypsoralen, and are then treated with ultraviolet (uv) radiation, after which they are re-infused. 

This would require twice a week for a ridiculous amount of time. Plus Boston might be the only place it could be done. She will talk to Melissa and they will see if they can arrive at some alternatives.