basal cell

Full Circle


Entertainingly enough, I have come full circle.

Nearly two years ago, I came to this hospital for a group appointment to discuss options for laser hair removal. I really can't stand shaving, even though I've been doing it nearly every day for over last two decades, and wanted another option. I went to check out laser hair removal as it promised quick (sweet!) and painless (awesome!). The reality is far from the idealized version of such promises, but that's the subject of another post.

Today, I'm sitting here again. This time, as an after patient. I'm here with three old women with names like Gertrude, Arvilla and Palmina. Fifty years from now, will some punk kid look at me sitting across the room and think my name is odd?

The other people are here to listen to the presentation about the Mohs procedure: what it means, what to expect. I have never seen this video before. I'd like to see it, but I'll be heading into the back room while the rest of the crew watches the full video.

Once again, I feel like I'm in the wrong place. What am I doing here with these old people? I'm reminded of when Mom's second husband's mother told us about why she stopped going to her high school reunions: it was full of old people. She'd look at all these white haired people that she used to know and think, "Where did all these old people come from?" They reminded her of her own age, and who wants to be reminded of that?

Note to self: send an email to Scott. Before the email address I have doesn't work any more.

Holy crap.

A woman my age just walked in!

With her mother!

Okay, the older woman is her cousin. But her cousin looks old enough to be her mother. And she doesn't look old enough to have skin cancer.

Which may be the point.

It happens. It happens to a lot of people. Ask around. Just about everyone you know will know someone who has had some form of skin cancer or growth that needed to be removed. The only time it's a worry is when it's located close to something important (can you say, "eye?").

Time to get the stitches out

Yeargh! It itches!


Gah! This thing itches like mad. I get the stitches out tomorrow, but have another 24 hours left before that happens. If I think about it, it drives me nuts. If I don't think about it, then, well, it's bearable. What is it about the healing process that makes it so annoyingly painful (itching being a low-grade, localized pain).



6:39 Bella stirs, and wakes me up. She does this every morning, without fail. She'll realize that, oh no! Annie is in the bed! Shock! Horror! She'll jump out of the bed, so that she can bark and huff and puff at Annie from the floor, then whine to get back into bed. What she has Here and now isn't good enough, not quite realizing that what she strives for isn't any better than what she has now.

I head into the bathroom. As I leave I hear mom stir. I try to go back to sleep.

7:30 I must have succeeded in sleeping, because I awake to Kris poking me. poke-poke-poke. I open my eyes. Kris is standing there smiling, dog leashes in hand, making sure I'm up before he leaves.


Poke poke.

7:47 I've avoided waking up as long as I can, yet still need to be ready by 8, I need to get up now. I need to get up now. I walk into the bathroom and realize I stink. If I can smell myself, it must be bad. I'm worried. I jump in the shower thinking, well, at least I won't have to shave for a couple of days.

8:00 Mom and Kris come back. I am standing in the living room naked, looking for new clothes to wear today. I need clothes I can bleed on and not worry about. I hear them walking up, and run from the living room to the bedroom.

8:15 We leave the house for the Starbucks, Kris in another car.

8:20 We arrive at Starbucks, to discover a line out the door. Kris comments he never sees the line this long. I reply, sure, but you never arrive before 9:40 am.

8:30 We leave to drive to Palo Alto. We catch each. and. every. single. red. light on Central until we arrive in Palo Alto. The world is trying to tell me to turn around and go home.


8:58 We arrive in Palo Alto, but I consider the original lot to be the wrong parking lot. We drive to the other lot, I pay my $1.50, and we head over to the medical office.

9:14 We check in at the reception. I have time to sit down, arrange all my crap around me, and open my orange juice before my name is called by the nurse. I drop my orange juice bottle lid.

9:20 We go back to the procedure room. I have to pee.

9:27 The doctor begins the procedure by numbing my face next to my right eye. My face goes numb. It feels like a migraine starting. I start quietly crying as I lie there.

9:30 Crying doesn't help, and is making things worse.

I stop crying.

9:49 I'm done. Mom and I head into the recovery room to sit for a couple hours. We're told to expect to head in for either another round, or repair surgery around 11:45.

I'm given an ice packe to put on my face: 15 minutes on, fifteen minutes off for the next few hours, to keep the swelling down. By this time, I have to pee, and pee really badly. I head into the bathroom, and go. As I'm finishing up, I note, once again, that my poop smells like my maternal grandparents'.

Gah. My period just started.

9:52 I put the pice pack on my face after my mom takes a few picures of my face. She says I look like a a beatup drunk. I laugh, and ask for more pictures. She compilies.

10:07 I take the ice pack off my face, and mom and I talk about sewing machines, quilting and needle point. I make it fifteen minutes before I need to pee again.

We talk about the new sewing machine, how it's $600 more expensive than Mom realized, but how she's really interested in getting it.

I am saddened by the fact that I can't afford to just buy it for her. I feel I should have been successful at this point in my life. I feel as if I have let her down.

I have let myself down.

There are two other patients in here with me: both of them in their sixties, near my mother's age.

I feel so young.

I feel so out of place.

I shouldn't be here.

I wonder what I could have done differently. The other patients are male. One has a spot on his ear, the other on his nose. Both agree he is glad he doesn't have his where mine is. I smile, and wish I didn't, too.

10:22 I hold the ice pack back up to my eye, and try dictating my experiences to Mom. Hearing the words come out my mouth, instead of in my head is hard. I edit myself.

I lose my voice.

I stop.

10:27 I balance the ice pack on my face while typing blind, hoping the editor stays open and the focus stays on the editor. I hope my words aren't lost by a computer glitch that my fingers don't notice.

Mom continues to embroider. We talk about nothing.

We start talking about Mom's mom.

Third of eight children. An athlete, she played baseball. A tomboy. She had a birthmark on her face that was the source of endless teasing. When something wore out, she threw it away. She threw away anything that reminded her of her failures.

My aunt immediately called her dermatologist when she heard my news.

11:15 The nurse comes in to tell me I'm one of the lucky ones. One in four people are clear after the first check. I am one of them. I'll be going in for repair surgery instead of another procedure.

I am glad. I start packing up myself.

6:00 The clock in the repair surgery room is set incorrectly. I no longer know what time it is.

The doctor gives me my options, and her preferences. I can leave the wound alone, allowing it to heal naturally. The healing process will take about three weeks to close, I may have an indent on my face.

I care little about the potential indentation. I care more about the healing time. Stitches means the the wound will heal in a week.

I should not exercise for a week.

A week.

I am allowed to walk.

I am not allowed to use stairs.

I look as if I have been beaten up. My eye is puffy.

I choose the stitches.

I can begin playing ultimate in a week, provided I wear safety goggles. I am not to do any exercise for the next two days. I can take Tylenol for the pain. She offers me a prescription for Vicodin. I say yes, thinking I can use it for the laser hair removal treatment.

After the stitches, I look exotic.

I look like Cleopatra.

I am still beautiful.

I am healthy again.

Bad, good, and bad good


So, apparently there are bad cancers, good cancers and bad good cancers.

Melanoma is considered a bad cancer. It's an aggressive cancer, difficult to treat and has a low cure rate. Other bad cancers include breast, ovarian, and blood cancers.

Basal cell carcinoma is considered a good cancer. It's easy to treat, typically balls into discreet tumours and has a high cure rate.

However, bcc doesn't always form with sharp edges. Sometimes the tumour sends tendrils out, and invades other cell areas. We'll call this the bad good cancers.

Apparently, this is what I have, the bad good. I won't know the extent of the tumour until the surgery on May 11th. The doctor said I can expect stitches from the middle of my eyelid to my temple. They'll be in six days before being removed.

I talked to my mom about the timing of the surgery before I scheduled it. The first available appointment was this coming Thursday, the 28th, but I won't be able to fly until the stitches are out, and absolutely not any exertion for two days (no ultimate for at least a week). So, the 28th would mean no Hawaii. Having it removed the following Thusday would mean no road trip with Paul, so that week is out.

The following weekend is my sister-in-law's college graduation. I'm torn about that weekend, because it's her graduation. But another week. This thing itches like mad. I don't think I can wait another week, especially mentally.

As I was waiting for the doctor today, I looked at my chart. I think most people don't bother actually looking at their charts. I was curious. The initial diagnosis was so casual. "Bumps on back." With quotes. Like I was imagining the bumps on my back and near my eye. Now everything I see has me wondering, is this cancerous, too? Should I have this looked at?

Thank goodness my zits and pimples are few and far between.

BCC means something new!


Last week, I went to the doctor to have the annoying growth along my right eye checked, and, because of my overwhelming vanity, removed. The doctor did a great job removing it, very clean. She sent the "skin tag" in for biopsy, out of routine.

Well, for the last few days, there were missed calls on my cell phone from "No ID." I finally was able to pick up on one today.

It was a call from my doctor. The skin tag is cancerous. It's not the agressive type, but rather basal cell carcinoma.


The Most Common Skin Cancer

Basal cell carcinoma is the most common form of skin cancer, affecting 800,000 Americans each year. In fact, it is the most common of all cancers. One out of every three new cancers is a skin cancer, and the vast majority are basal cell carcinomas, often referred to by the abbreviation, BCC. These cancers arise in the basal cells, which are at the bottom of the epidermis (outer skin layer). Until recently, those most often affected were older people, particularly men who had worked outdoors. Although the number of new cases has increased sharply each year in the last few decades, the average age of onset of the disease has steadily decreased. More women are getting BCCs than in the past; nonetheless, men still outnumber them greatly.

Because the location is right next to something so vital (my eye!), the doctor recommended Mohs Micrographic Surgery to remove all the growth:

The physician removes the visible tumor with a curette or scalpel and then removes very thin layers of the remaining surrounding skin one layer at a time. Each layer is checked under a microscope, and the procedure is repeated until the last layer viewed is cancer-free. This technique has the highest cure rate and can save the greatest amount of healthy tissue. It is often used for tumors that have recurred or are in hard-to-treat places such as the head, neck, hands, and feet.

It's the most time intensive removal, but the best for me because of the location. I'll be heading in next week. The surgery should take all day because of the iterative process.

I'm already really good about sunscreen, but I now need to be even more diligent. I'm a bit surprised at my reaction, which was about 2 minutes of crying, then acceptance. It is what it is. I have work to do, and gardens to plant.