Spot is gone; pain and itching are on

Post-surgical fashion statement

Today I am focusing my investigative journalism efforts on what to do if your stitches are itchy.

The fact that the itchiness is a sign of healing does not make it easier to stand. On Wednesday and Thursday after my Mohs surgery, pain was my biggest problem. Now I have less pain although still some at the area on my ankle where the surgeon removed the squamous cell cancer and put on a skin graft to fill the hole in. But the area on my stomach where they took the skin for the graft is itching like CRAZY. Now I understand why they put an ice pack in with the materials needed to change the dressing. The ice pack helps somewhat. I took some Benadryl last night and might take some more.

The ice pack fit into my sweatshirt pocket. I wore it in there for a while because it is right over the spot. Then it lost its cold and I put it in the freezer to see if it would reactivate, but I'm not sure it will work. Meanwhile I have taken a larger freezer pack and tied it around my waist with my scarf. It is hard to concentrate on anything else.

The fashion statement might equal the one I made when wearing one of David's Teva sandals home because my boot didn't fit over the bandage on my ankle. Diane lent me a pair of socks because my feet were cold in the ones I had brought and also because it was hard to fit mine over the bandage. Joe came home to have pizza with me last night, make dinner tonight and help take care of Maddie. It takes a village.

When the nurse at the Mohs center at Faulkner Hospital took my blood pressure on Wednesday, it was 170-something over 90-something. She said it might be a good idea for me to take something. I agreed it was as good a time as any for me to take one of the Ativan I had brought. So while they were getting the room ready, that is what I did.

I have had at least 10 of these surgeries and never got so anxious. It was the thing about the larger size and the graft.

It took a while for them to draw their shapes on me: one on the ankle, one on my stomach, and one on my left hand. Dr. Schmults, who is director of the Mohs Center and who is really nice, said the one on my left hand is too small to treat. She recommended that I treat that and the backs of both of my hands with Effudex, a chemotherapy cream, saying the only way for it to work is to wrap my hands in Saran wrap after I put the cream on, every night for three weeks.

Since I have mentioned this frequently lately, I probably should repeat what Mohs surgery is all about. According to the definition on the Faulkner Hospital website: Mohs surgery, a form of skin cancer removal in which the borders are examined by the surgeon microscopically while the patient waits, boasts a remarkable 99% cure rate for most basal and squamous cell skin cancers as well as a high cure rate for other rare forms of skin cancer.  

A doctor, Frederick Mohs, developed it in the 1930s. If the margins are not clear upon first examination, they take a little more, examine again, and so on until it is all gone. I asked once and learned that sometimes it can take quite a few times to get it all. Only once did I need a second pass. This one came off, as did all but one, on the first try.

During the prep work, I talked to one of the residents. He was impressed by my four bone marrow transplants. They always ask, four? We talked about it some more while he was outlining the spot for the graft. Dr. Schmults suggested a little change in the shape. I had an odd feeling of being the material for a coloring project. I asked if he could still concentrate while I talked, and he said yes, he could. Classical music filtered in while they worked. My appointment was at 1 and I was done at about 5. Some of this was waiting, some was drawing on me, some was getting numbed up with a lot of needles, and some was the actual procedure.

Diane picked me up. I had a nice dinner with her and David and enjoyed what Diane knew would be the best medicine for me, a rich piece of chocolate cake.

On my drive in, I had posted on Facebook about feeling anxious. I appreciated the support that people gave me. As we all know, FB has its downsides, but it is great when you need a virtual helping hand. It was also helpful when, at 1:38 a.m., I wrote that the Tylenol and codeine that Dr. Schmults had prescribed wasn't working. The pain was bringing tears to my eyes. I needed to take an oxycodone, but I didn't want to wake my sister to get something for me to eat and I didn't know if the clementine and potato chips I had in my room were adequate. Somebody is always up. My friend Nan Imbesi replied that my snack should be substantial enough. So I had my snack and my medicine and drifted back to sleep.

I haven't complained about my drivers recently. That's because I have had some good luck lately. I had the same nice driver in and back. When I mentioned to him, as I have to some others, that many of the other drivers have been, um, less than polite, he said he had heard a lot of complaints. We agreed that it doesn't make too much sense because it doesn't take much to be nice, especially when you are driving people to medical appointments.

I go back Wednesday to get the stitches removed. That will be a relief.

Another skin cancer, another crazy driver

My squamous cell radar regarding my skin, like my parking radar in New York, continues to be accurate.

Before I went to Faulkner Hospital on Monday for the Mohs consult about the spot on my right jawbone, Ellen, the physician's assistant at the Kraft Family Blood Donor Center, said she didn't like a raised flaky spot on my cheek. I had noticed a spot at the top of my nose, right where you might put your pointer finger if you were deep in thought, and felt that the flakiness there might signal a problem.

These are not the kind of signs usually associated with skin cancer. But upon looking into it, I saw that the Mayo clinic described the signs of a squamous cell cancer this way: "a flat lesion with a scaly, crusted surface." The signs of basal cell cancer and melanoma are different.

So when I had my appointment I pointed out the two new spots. The dermatologist wasn't worried about Ellen's spot, which will be taken care of by my upcoming face fry, or photodynamic therapy, but she did biopsy "my" spot. When I got the biopsy report during the week, I learned it was what I suspected. Luckily these have all been in situ – on the skin. I got a message saying that I could either apply the chemotherapy cream I already have or wait to get it frozen when I return for the Mohs. I am applying the cream.

Do you remember Kenny?

The driver who stopped late at night so the other passenger could get her diabetes medicine? Do you remember the kerfuffle that ensued? Well, wouldn't you know it, another problem occurred on my way home, exacerbated by the pain in the biopsied spot as the numbing medicine wore off. When his dispatcher called to tell him to pick up a patient in Worcester and bring her home to Springfield, I heard him say that his passenger (me) wouldn't like it and he was going to have to listen to me yelling all the way home.

I said I wasn't going to yell but since the last time we had driven all the way to East Springfield AND stopped for the medicine would he get off at Exit 7 and take me home first because I was in pain. He said why would he do that because he lives in Chicopee and it was more convenient for him to go to Springfield first and then to South Hadley.

Oh and did I mention that previously he had been talking on his (hand held) phone and telling a friend that he was annoyed that he had to lock his gun in his glove compartment?

He said he was the driver and the order of dropping off was up to him and I had to EARN the right to say when I wanted to get dropped off and so on and so forth in a continuing rant.

You are probably thinking don't get into it with these drivers, but he was taunting me and I got hysterical like the last time I was in the car with him. We took our detour through Worcester. The woman who he picked up at a hospital got in the front seat. When she heard me sniffling, she asked, "You all right, honey"?

Apparently she had had her own problems with MART after waiting for hours and hours to get picked up. When I told her that I really needed to get home, she said she had been waiting so long that she didn't care if she waited a little longer so he should go ahead and drop me off first.

Kenny turned around and said, "See"?

See what?

I got over myself after she started telling me about her own problems. Her hospital visit didn't sound serious – aspiration of what sounded like a non-cancerous cyst – but her health history was.

 She said she was a recovered crack cocaine addict and alcoholic. She said Worcester was a drug haven and she had to get out of there but she still went back for medical care.

It dawned on me that she was the same woman who had demanded we stop for her medicine. I hadn't seen her that well in the dark, but the pieces began to add up. She must have been having a really bad night because on Monday she was a different person.

She said she had neuropathy in her feet (due to diabetes). I said I had it from chemo. We found that we both take gabapentin and that nothing totally makes the pins and needles go away. Hers sounds worse. We showed each other photos of our children. Then, it being the day before Super Tuesday, she brought up the election.

"I'm going to vote for my Hillary," she said. All of her people in Georgia were going to also.

She said that while George Bush was flying over New Orleans after Hurricane Katrina, Bill and Hillary were there taking care of the babies. She doesn't like Hillary as much as she liked Bill, but, she said, "He has her back."

You can find solidarity in the most unlikely places.

People ask why I continue to take these rides. The answer is that some of drivers are fine, and the cost/benefit ratio still weighs in favor of the benefit of not having to do the driving myself.

I am going to call the company and say I will not get in a car again with Kenny.

And I'm going to drive myself the next two times anyway since I have a double-header on both ECP weeks.

This week I'm staying at Margaret's on Wednesday because I have my regular check-up with Dr. Alyea on Thursday. Next week I'll stay at Diane's Tuesday night because I have the Mohs that day and ECP the next day.

I'm lucky to have my sister and my sister/friend so close to Dana-Farber!