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.

The saga of another mystery spot

Spot under here

The spot on the inside of my right ankle has been there for months and months. It is a circle the size of a nickel. I have seen blogs where people post gross photos of their skin, but I'm not going to do that. I covered it with a fun bandaid.

A while back, I asked Ellen, the physicians' assistant at the Kraft Family Blood Donor Center, about it, and she said that due to my graft vs. host of the skin, things like this just take longer to heal. She said it didn't look too bad.

One night shortly after that I was looking at it and decided that I should look up ringworm because it looked like a ring. The photos looked similar. I emailed the shots to Melissa and Jenn (Dr. Lin, my primary dermatologist) and asked if they thought it was ringworm. Jenn said it did not look like a fungus. She said someone should look at it.

Cristina Powell and her artwork

So I went to Brigham Dermatology in Boston and saw her colleague, Dr. Yang. She said she could biopsy it but she could also give me an antibiotic ointment that might heal it. She gave me the ointment. I went back in a few weeks and she said it looked better and I could stop using the ointment.

But when I stopped using the ointment, it got red and painful again. Ellen said she has seen people at ECP, aka the light therapy, with spots like this that just don't go away.

When I saw Dr. Alyea recently he said he wasn't happy with a spot that doesn't go away. He said I should get the biopsy. He took a photo and sent it to Dr. Lin. She wrote, "It actually doesn’t look that bad (meaning does not look malignant), but things look different on patients who have had BMT."

I liked the first part of the sentence. I spent some time trying to parse the second part, wondering, does that mean although it doesn't look bad, it is bad? The first opening wasn't until January. I guess if someone thought it was bad they wouldn't delay the biopsy. So...

On Thursday I got a call about a cancellation the next day. It was too late to arrange for transportation. I played tennis in the morning and then got in the car in my tennis clothes and drove to Boston for a 1 p.m. biopsy. 

I spent a little time in the lobby at the medical building and looked at the beautiful artwork done by Cristina Powell, a young woman with cerebral palsy. Through her non-profit, A Brighter Way, she and her mother donate the colorful, cheerful paintings to hospitals, cancer centers and pain clinics. She makes cards, bookmarks, miniature prints and T-shirts. I usually pass by, but I had the time so I talked to both of them. And I shopped. A little something for some people I thought would like it and a little something for me.

When I got home, the stupid spot hurt like hell after the novocaine wore off, as these things do. I took something for the pain and unwrapped the packages and thought about which one to keep. Although I do not really think this is major, it is part of the drip, drip, drip, and the uncertainty that comes along with it, that can get me down. Looking at the cheerful images helped.

The ride not taken, the biopsies done

Since you might be tired of hearing me complain about my rides, I'll try this one in reverse for a change of pace.

This morning I call MART,  which arranges the in-state rides for patients, and get quickly to the complaint line. This is already a relief because it is hard to get through on the other line when booking rides.

Call Taker: When did the problem happen, on the way there or on the way back?

Me: Neither. I had to drive myself.

I explain, I waited so long for the driver that I had to leave.

My cell phone record comes in handy. He was supposed to pick me up at 9:30 for an 11:15 appointment at Brigham Dermatology Associates in Chestnut Hill, not all the way into Boston so that was enough time.

He calls at 9:25 a.m. to say he is in Springfield in traffic and is going to be late. I say you people need to leave earlier, that's five minutes from now, but I will wait.

9:44 a.m.: I call him and leave a message, where are you, but he doesn't call back.

9:53: a.m.: I call again.

9:54.  Call again. No answer. I get in car and head out to Boston.

10:10: He calls and I can't understand him but I am already on my way.

Call Taker: How did you get home?

Me: (Pause, full of meaning, as in a Harold Pinter play)

Me: Well I drove myself there so I had to drive myself back. I was bleeding and the three places that I had biopsied hurt, which is why I set it up to not drive myself.

Call Taker: Thank you. Your complaint has been filed. Have a nice day.

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Ok, so I had been bleeding not at that moment, but not too long before. I would have considered spending the night but Jane and Jim are away and I had to get home to Maddie.

On my way home from 850 Boylston Street, where the Brigham and Women's dermatology office is located, I made my usual stop at the Waban Starbucks and got a cappuccino. Around Framingham I realized it wasn't enough so I got off and went west on Route 9 and got another shot in Southborough.

Yes I really did that. It was either spend the time making the detour or spend the time pulling over to take a nap.

It had gotten late, and the reason was:

I have been known to be spacey but not this time. I had immediately written the time and date on my calendar when I made the appointment a couple of months ago. It was not a convenient week because I did not have the light therapy, but I knew I needed at least two spots looked at.

But when I got there, it was not in the books. Luckily they were able to fit me in at 2:30. Luckily I had a newspaper and a book. I leaned my head against the wall, took a little nap, read a little and ate lunch and it was time for the appointment.

I called a friendly neighbor, Joan Vohl Hamilton, who was nice enough to go in and take care of Maddie at the time I would have been home.

The practice had a new doctor or else I might have had to wait even longer, with two out on maternity leave. She said I was going to hate her but she had to biopsy three spots. I expected the two on my face (nose and forehead) so I wasn't surprised, but I thought she would just zap off the spots on the top of my right hand. But she didn't like that it is raised and painful. So she dug a little hole and off it went.

Can I still play tennis? I asked.

I thought she would say no, but she said yes.

Usually they give me a packet of new vaseline and bandaids. But the nurse wasn't getting it so I asked.

"Don't you have bandaids at home?" she asked.

Something must have been in the air yesterday.

Blood started to pour out of the spot on my nose. She sat me back down and put pressure on it.

"I just need them so I don't have to go to the store right away."

She gave me some in a bag. And one vaseline.

I was supposed to keep the bandaids on for 24 hours, but when I got home I noticed that the one on my nose had fallen off, exposing the little puncture. The place where you get a pimple before the high school party.

I felt bad for Maddie so I took her for a walk.

When I got home I called some people. The spot on my head started to bleed. After about 15 minutes I paged the doctor. He said to put a big wad of gauze on it and if it didn't stop, go to the emergency room.

I was lucky it stopped because I had already taken a half an Ativan and a half of an oxycodone. (5 mgs. each.) Before you think something about the oxy, I will repeat that I don't take it too often but that I do take it sometimes because it is better for my system than Tylenol (liver) or Advil and the rest (kidney and some other reason.)

Today was my day to volunteer at The Literacy Project but when I woke up I knew it wasn't happening.

In a week or so I will get the biopsy report and assume I will have to go back for at least one Mohs.

This morning I made a strong cup of coffee. But I am not kidding, I lost it in my house somewhere and had to make another.

On the positive side: I didn't cry.

And now I will get new skin over a spot on my hand that a previous dermatologist had over-zapped, causing it to lose pigment.

I'm sure that when people shake my hand, they don't think, that woman has no pigment in a spot on her hand, but it is one of the spots that is particularly bothersome to me.

Also I have a beautiful mug.

A moment of panic, then, just more of the same

What would you think if you looked up the results of a biopsy of a spot on your face and you saw the word "invasion"? Even if it said "superficial blunt-type invasion," wouldn't you be worried? Especially if you had a friend who died after a squamous cell cancer on her tongue spread to the rest of her body?

I was definitely worried when I went to PatientGateway to see why I got an email saying I had a message and then looked up the results from my two biopsies of a couple of weeks ago. Dr. Lin said she would call me with the results; when I didn't hear I figured no news was good news, but then a friend said I should really call, so I was about to but then I saw the test results. It was the first time in all these years that I slipped through the cracks.

Here is what I read:

PATHOLOGIC DIAGNOSIS:

A. SKIN, NASAL DORSUM, PUNCH:

Part of an actinic keratosis, focally at least bordering on squamous cell

carcinoma in situ.

B. SKIN, RIGHT JAWLINE, PUNCH:

Part of a SQUAMOUS CELL CARCINOMA, at least in situ.

It is difficult to exclude very superficial blunt-type invasion.

It was early in the morning. Luckily I had the doctor's home address, so I emailed her at home and at work to see what this meant. The words "very superficial" sounded OK, but not coupled with "invasion."

She responded right away, saying she was so sorry she hadn't called and that although those words that I mentioned sounded scary, it isn't that bad but it will need Mohs.

"The nose is ok. Blunt-type invasion sounds like a scary word, but blunt-type is the least worrisome type of invasion. All in all, it’s a pretty low risk lesion, but to be safe, I will be sending you to Mohs."

Mohs is the surgical removal of skin cancers. I have had it before in many places. This one will be on my cheek. The bright side: It is not the one on the top of my nose. It is a better place than two of my others: One on the top of my lip and the other practically on top of my tear duct, which left a hole necessitating a visit to a plastic surgeon who took a piece from my eyelid to cover the hole. She said I was getting an eye lift. I asked if she could even me out by doing the other side (joke) and she said no. I had one on my neck and one on my wrist, also.

I need to make an appointment for a consult with a Mohs surgeon in Boston. 

Another fun thing: In a couple of months I am going to return for another session of the face fry that burns off the top layer of skin and with it the spots that can turn into cancer or that might be early cancer. I have some on my neck, also, so PDT, or photodynamic therapy, will extend onto my neck. This treatment uses photosynthesizing agents along with light to kill cancer cells. It burns worse than a terrible sunburn. Holding a little fan in your hand and waving it around helps, somewhat.

So the year that came off my life when I saw the word "invasive" will be returned to me when I get my new skin.