When the worst part is the healing

Not a pretty profile

Ellen, the physician assistant at ECP (the light therapy), said that my Mohs surgery for invasive squamous cell carcinoma was on a small area and would be no big deal. All things considered, it is definitely no big deal, but for the week in which it is healing, it is.

For a small spot that was barely visible (the resident called the BF into the exam room to make sure they had the right spot), it must have gone relatively deep. It only needed one "pass," but it required internal stitches and a running stitch with maybe eight loops. 

Though my blood pressure was a little high, I wasn't worried about the procedure itself. Dr. Schmultz, at the Mohs surgery center at Brigham and Women's Faulkner Hospital, in Jamaica Plain, does such a good job of giving the anesthesia that you barely feel it. Also it was quick, and we chatted for most of it about such relevant topics as making sure I was taking niacinamide (same as nicotinamide) which has been shown in studies to cut down on skin cancer risk. I asked about a product, Tru Niagen, which has the same active ingredient and a big anti-aging marketing campaign. She said it was all the same and she wondered how long it would take for someone to make money off of it.

The anesthesia had worn off by the time we got home. It started to ache. As directed, I took 10 mgs. of oxycodone. It helped with the pain but it affects my sleep. You would think it would knock a person out, but it puts me in a strange state. I took a sliver of Ativan. I tried to read but couldn't focus. I doubt that I got much sleep.

Since then it has hurt on and off. I don't remember the other healing processes being as uncomfortable. Maybe I just forgot. Maybe it really is more uncomfortable due to positioning which causes the area to stretch every time I move my head. I haven't played tennis or run and have just been walking. Yesterday and today I went to yoga because I felt like I needed more. My mental state is not great. The other night, when I washed it and applied Vaseline and a new Bandaid, I must have activated something because it itched so much I thought I would never get to sleep unless I took a Benadryl. I took the Benadryl and woke up hung over. I'm looking forward to tomorrow, when I get the stitches out.

Here's a little something I wrote about having four stem cell transplants. I figure I've had more pain in my life than the one I'm having in this healing process. Still, the pain you have at the moment is the one that hurts and it doesn't make it much easier to think about times that were worse. 

Wanted: someone to remove stitch and find watch

The craziest thing that has happened in a while is that a gremlin took my watch a day after I took a photo of it on my way home from ECP. That's extracorporeal photopheresis, the light therapy for graft vs. host disease of the skin, and one of these days I'll have to explain it again because I haven't done it in a while.  I took the photo to show my watchmaker friend Bev how the lavender  complimented my wraps, and that must have been the act that caused the jinx. (The bandaid is from a biopsied spot.)

I have tried to trace my movements and have looked in all the corners but it is nowhere to be found. A friend said it would help to turn a glass upside down on the counter. (No luck.) When I lost a bag of scarves, a friend prayed to Saint Anthony for me. But I never found the scarves, so I don't think it worked. I was really attached to that watch. I thought there was magic in the way it changed colors in different circumstances. That feeling when you just can't remember where something i

Has anybody seen my watch?

s is very disconcerting

If you do a search beginning with "is losing things a sign of," it fills in dementia, Alzheimer's, ADHD and depression. 

"Misplacing things often happens in everyone’s life, but when it is consistent and you cannot formulate a plan to to retrace your steps, it is a problem worth looking into more carefully," according to The Cleveland Clinic. I can't retrace my steps, or else I would find it, but no, I don't actually think I have Alzheimer's.

I'm wearing a green one until Bev makes me a new lavender one. What can I say, the replacement and the old one still cost a fraction of an Apple Watch.

What I really have is a problem with a stitch that I got in the first of two Boston visits last week, when I went on Tuesday for a spot check and Thursday for ECP.  I had called to try to get the two in one day, but the scheduler did not get the message. Well, the stitch is the immediate problem but I also learned that I need another Mohs surgery on another squamous cell cancer, this time a tiny spot on the back of my jaw. A spot on my wrist that concerned me to the point I thought it was melanoma turned out to be a squamous cell on the skin, as did the spot on my face. I need to apply Efudex, the chemotherapy cream, for three weeks. 

The one I didn't even know existed turned out to be the one that goes deeper. 

But back to the stitch. I thought it odd that when I left, the nurse didn't mention it. So I followed past procedure and called my friend, Nurse Jo, who lives down the street and removes stitches if there are not too many. I picked her some flowers. She met me in my driveway and asked where the suture removal kit was. I said I thought SHE had it. She said she used up all the ones she had – on me – and we agreed I would call the doctor about it. At least we got to chat for a few minutes.

Kathleen, one nurse, told me one thing, followed up by Kathy, who told me something else.

Similar-sounding names can lead to confusion. There’s Kathleen, the nurse for Dr. Liu, and Kathy, the nurse for Dr. Lin.

I had been talking to Kathleen about an upcoming appointment with Dr. Liu when she saw an unusual occurrence, and opening with Dr. Lin.  So she gave me the appointment. I was going to drive myself, but I took J up on the offer to drive me, and it's a good thing I did. I didn't expect to have three spots biopsied and get multiple spots frozen. She said I would get fewer skin cancers if I stopped doing my outdoor activities, but she knows they're important for my mental health, so she wouldn't tell me to stop. I protect so much of my skin that the only thing left would seem to be to get a mask for my face and a scarf for my neck.

A few days ago I called Kathleen about the stitch. She said anyone could take it out. I asked about the biopsy results, and she said Dr. Lin went on vacation and would get back to me when she came back but I should feel pretty good because if it was something serious, then she would have called me.

A day later, Kathy called and said the spot on my jaw is invasive and needs surgery. 

I know the difference between invasive on the skin and invasive inside my body, but I ask each time. I like to make sure, and hearing it again is reassuring.

Ann, my blogger friend, died from squamous cell cancer that had spread from her tongue to her organs. It is a different kind of invasive.

Meanwhile, the issue of the stitch is still unresolved.

Yesterday after my session at Amherst Community Acupuncture, my acupuncturist said she could try to snip it out. We sat by the window and she went after it with a scissors. She said she thought she got it all. 

Actually, she didn't. Two little bristly threads are sticking out from my cheek. I don't think stitch removal is in the boyfriend description, and I don't want to go all the way to Springfield for a doctor's appointment. Friends suggested the CVS Minute Clinic. I think that tomorrow, that's the way I'll go.

Yesterday I got a call about scheduling the Mohs, the procedure in which a surgeon removes a skin cancer a layer at a time until all the margins are clear. What I like least about it is that it keeps me off the tennis courts for a few weeks. The needles going in for the anesthesia come in second place in the dislikable department, but the doctor does such a good job that it isn't as bad as I thought it would be when I had my first one.

Odd that a leukemia blog ends up being more about skin cancer.