Expecting the unexpected, and being right

In the waiting room after Mohs surger

Yesterday when I went to the Mohs Surgery Center at Brigham and Women’s Faulkner Hospital, I had a feeling that the spot that had been in my ear had disappeared, although there could be a trace of something.

Dr. Lin, (Jennifer), had said the spot was too small for her to biopsy, so that is why she sent me to a specialist. She said it could be a skin cancer or a pimple. Jeff drove me, and I said we might be going all the way for a pimple. I imagined a quick visit leaving time to go out for lunch or take a walk in the Boston area afterwards.

I figured the visit wouldn’t be wasted, because I always have other spots to show.

My ear was indeed fine, but a spot at my right temple looked suspicious. A nice Fellow examined me first. Nice fellow, it sounds funny to say. He said the spot might be a basal cell carcinoma. When he called Dr. Schmults in, she agreed. I signed the papers giving permission for a Mohs, and I lay down on the table.

When she started to apply the anesthesia, I said I had written something nice about her, and she better not let me down. She laughed and said something along the lines of it putting a lot of pressure on her.

As usual, she did a good job. She applies the anesthesia in repeated little pin pricks so that you can hardly feel it. At 2:18, while she was operating, I heard my phone vibrate. It was the widely mocked presidential alert.

I had to wait an hour while she looked at what she had taken out. When she returned, she would know if it was a basal cell or squamous cell and also whether she had gotten it all.

My reaction to presidential alert

It gave me a chance to follow #PresidentialAlert on Twitter and see all the fun people were having putting their own words into it or tweeting reactions. I retweeted some of my favorites. 

The nurse called me back after an hour. It was indeed another squamous cell. The doctor had gotten it all, so she wouldn't need to go back for another pass. The Fellow zapped some other spots I pointed out, a few on my hand, one at the top of my head (he cut a little bit of hair out to do it) and one on my nose. The zapping hurt more than anything else.

The nurse said not to exercise or do yoga for four days. That’s a lot for me. At least it’s OK to walk. When the squamous cells have been on my leg, the restrictions have been worse.

Of course there wasn’t time to do anything. When we got home, it was after 6. I had run out of prednisone, so we went to the store to get the prescription. The anesthesia started to wear off, and the area of excision started to sting. I took some pain medication, and we walked down to Food 101 for dinner. It was a balmy night.  I told my chauffeur that he was a mensch. He also turned out to be a good dinner companion.

It had been a long day, so I don’t know why I wasn’t tired. I stayed up to watch Stephen Colbert on the Late Show, followed by James Corden on the Late Late Show. Both were having fun with the Presidential Alert. Corden did his Take A Break bit at one of Los Angeles’ hottest restaurants, going around to give employees a break. I laughed so hard that I forgot about the blisters on my hands and nose and the bandage on my face.

Don't count your chicken's before they're hatched

I think I might have jinxed myself the other day when, after the driver taking me to Boston checked in, I wrote on Facebook, "Encouraged because driver checking in with me about my ride to Boston later today sounded normal and polite. #Settingalowbar."

It wasn't that the driver was rude. It was just that he never came.

He called around 2 p.m., the time when he was supposed to be here to leave for my 4 p.m. appointment, to say that he was sorry but he would be about 15 minutes late because another driver got two flat tires and the boss insisted he drive someone to Holyoke before coming to get me even though it would make him late for me. He told me he hated the late-day shift and hated that the owner of the company made him do this and he hated to be late. He said the owner told him that he would still be able to get me there on time.

I told him not to worry. I have heard this about the car company owners before. They squeeze in more rides than they are able to do without regard for the passengers or, for that matter, for their drivers. Although I could have done without the rant about the shift since I had problems of my own.

In any case, when he didn't show at 2:15 I took my things out to the car in case I ended up driving myself as happened not too long ago. Around 2:25 I called MART, the agency which arranges the rides, and got through to the complaint line. (A miracle.) The operator put me on hold and said she had gotten through to the driver, who said he would be here in about five minutes. She filed a complaint for me and said to follow up if I never took the ride because then the company wouldn't be paid.

Tears of frustration welled up in my eyes. It wasn't just about the drive there at a time when I was tired. It was also about the ride home the next day (after an overnight) when my dermatologist would have zapped or biopsied who knew what. And it was about the time spent arranging three rides (including one from Dana-Farber to Diane and David's that night) and the time that I would need to spend undoing them.

Five minutes passed. I called the Kraft Family Blood Donor Center and said I would be late for my bi-weekly blood treatment, aka ECP,  and asked if it still made sense for me to come. The nurse said that I should come even though I would get a shortened treatment. I got in the car and left.

At 2:45, when I was on my way, the driver called and said he was on Woodbridge Street but couldn't find my house.

I figured that if I stopped and got coffee, I would be even later, so I pushed on through. I did pretty well except for, near the end, missing the left turn towards the Prudential Center and instead taking the Copley Square exit, adding an extra 10 or 15 minutes to the trip.

By the time I got there it was close to five. They always take my blood pressure. I suggested maybe they wouldn't want to. Actually it was quite low, 120-something over 70-something. I guess my body had figured out a way to cope with this situation; I had been there before. My nurse said some treatment was better than no treatment. So inserted the needle and hooked me up. It didn't take long for me to fall asleep.

After an overnight in Newton, I got up early and went to yoga with Diane. It moved a little faster  than most of the classes I take, but I kept up. I confess to looking around at the trim Newton bodies but turned my focus onto myself. (Or tried to.) When walking to the car afterwards, we discussed our problem areas – Diane's knees and my hands and wrists. My left hand especially will not flatten, and my hands and wrists will not bend at the usual 90-degree angle. I have been told this is mostly due to my graft vs. host of the skin,

Diane pointed out that what I can do is amazing: yoga, tennis, running, riding my bike. She reminded me that at one point I couldn't even turn over in bed, let alone walk. I said it had crossed my mind when I took a shower at their house that morning and remembered when I had to struggle to get into the tub and sit on a shower chair so Diane could give me a sponge bath.

Sometimes I forget. I thanked her for the reminder.

Then I changed and went to Chestnut Hill for my dermatology appointment with my friend Dr. Lin. I got stuck in Route 9 traffic and was worried about being late. As it turned out, she was running late, which I should have guessed. I was just falling asleep in the waiting room when I got called.

She zapped pre-cancerous areas on my neck, face, lips and hands. Not pleasant but we chat our way through it, with an occasional yelp escaping from my mouth. She did a biopsy on an area on my thumb (possibly squamous) and also one on the inside of my ear. She thought this one might be basal cell. Probably nothing horrible but if it is cancerous, I will need a Mohs surgery on it. This strikes me as not a great spot.

With my stinging and burning skin, I would have appreciated a ride home. But it was not to be. On my way out I did my usual pass through Waban, where there is a conveniently located Starbucks. First I pulled into a shady spot and fell asleep in the car. Then I went to Starbucks and got an iced coffee, followed by a stop across the street at Barry's Village Deli for half a corned beef sandwich to go.

Due to my training in the news biz, I can eat anything in the car.

It kept me busy and alert until I got home. By then the local anesthesia had worn off on my thumb and in my ear, and the zapped spots were burning. I took a little something and called it a night. The next day I made sure to call MART to say I never got the ride. When it comes to those rides, I will no longer count my chickens before they're hatched.

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!