Saturday, April 30, 2011

C & D Procedure and More Questions

It has been a couple of days since my last update so I have a lot to get caught up on....so let's get started.

April 28, 8:00 a.m. arrive at dermatologist office for the curettage and destruction (C&D) procedure and am promptly called back to the exam room.  The nurse comes in and ask me to remove my shirt and if I wanted to stay sitting up or lie down...I decide to stay sitting up so I can turn my head and watch....yes I said watch.

8:05 a.m. the PA that is treating me walks in and says that the nurse told her I have some questions about my legs to which I reply, yes, and show her the big round place at the bottom of my calf.  She very casually says, "oh that is more of the same thing we already biopsied...porokeratosis"...to which I replied what is the difference between that and what's on my arm and why are we treating them differently.  At first she looked puzzled and pulled up my chart on the computer..."We did treat your arms...that is simple actinic keratosis and we froze those off."  I must have had quite the perplexed look on my face because she continued, "freezing is not recommended for your legs...it typically doesn't work and since you had the allergic reaction to the Solaraze I haven't had a chance to confer with Dr. (name withheld as to not identify the practice) yet....he left for a conference and vacation and I have been out sick.  But, I will call him and get a recommendation and call you today".  I asked if we should biopsy the spot on my calf because to me it looked much different than the other spot that came back "almost cancer" according to the pathology report" to which I was told there was no need because she was 100% sure it was the same thing.  I then asked about a full body mapping....to which she replies..."we did that on the 11th didn't we?"  I reminded her that we had missed the spots on the back of my leg and that she did not look at my scalp and hairline as was recommended by my LiveSTRONG nurse.  The PA looked at me and said, "you've got too much hair to worry about your scalp" and very quickly ran her fingers through my hair and replied, "yeah your good...we will just have to watch your part as it has exposed skin".   I can't tell you just how frustrating that was and maybe, just maybe, I am blowing this way out of proportion but it just seemed a little too casual.  Then again, basal cell carcinoma is the most common form of skin cancer. 

8:18 a.m. the nurse comes back in to numb up the spot for the C&D...and after two complete little vials of whatever it was they were using I could finally answer, "can you feel this..." with a definitive no.  The nurse was very concerned that I not be able to feel even the slightest little needle prick, which I was very grateful for once the PA started the procedure.

8:20 a.m. the PA comes in and asks if I am ready as she rolls the tray around to my right side..."of course" was my reply. As she picked up the little electrical device I turned to look which caught her quite by surprise and said you will probably smell this...and started carving a circle around the original biopsy scar with the electrical device....and yes I did smell it.  She then picked up what I can only describe as something similar to a melon baller (for those of you that do not know your way around a kitchen that is the little device that chefs use to make fancy little fruit balls out of melons, fruits, etc) and began scraping over the entire area inside the circle she just burnt.  "We are going to do this 3 or 4 times....the procedure states 3 but I like adding that extra one to ensure that I get all of the cancerous cells".  So, we did this same procedure 3 more times and it was over.  She places a active flex type band aid over the area and says she is going to pull up some information on my legs because, "while I've seen it a few times before it is rare and can progress to skin cancer but I don't know much more than that...."  The nurse comes in with the wound care instructions, the check out sheet, and a photocopied page  for DISSEMINATED SUPERFICIAL ACTINIC POROKERATOSIS (DSAP) which is what she says is on my legs.  The nurse reiterates the PA's comment that she is going to confer with the Dr and call me with treatment options later that day.

8:50 a.m. arrive back home, take some ibuprofen, and just guide of doze on the couch the remainder of the day since I didn't sleep well the night before.

At one point, I decide to come in and do my own research on DSAP and start doing internet searches and will save all of that for subsequent post.  Needless to say, I am driving myself crazy so I don't know if this whole having tons of information, commentary, and people's personal thoughts readily available on the web is a good thing. But then again, here I am posting about it...just a little irony in that statement....you think!

So, at this point I have to go back every 6 months, the PA "thinks" she got all of the bcc cells, and I am left with more questions than answers about DSAP.  Oh yeah, the original reason I went to the dermatologist to begin with...the place on my hand, the mole on my back (that still itches like crazy), and all of the bothersome skin tags....all still there. 

Tuesday, April 26, 2011

Random thoughts from the day....

It is absolutely amazing going through one's daily routine and realize there are so many people that either have cancer, have a family member with cancer, or have a close friend who is dealing with cancer.  I say this because we had 24 Hours of Booty out at my job today to educate and solicit volunteers for the July 29th - 30th event this year.  Several of the people who stopped by, once they got passed the name, relayed stories of family, friends, or themselves dealing with cancer.  We only got one volunteer to sign up today...but the event is still 3 months out and folks just don't plan that far in advance any more.

As Thursday approaches, I am getting a bit more trepidation about the day.  While I know that all they will be doing is, in the words of the nurse who called and scheduled it, "cutting, burning, and scooping" until they feel confident that they have removed all of the cancerous cells.  I was told to expect a scar from the procedure...duh...they are cutting on me so what else would I expect?  My real concern is the place that I found on the back of my right leg last week.  I am going to insist on that spot being biopsied as well....stay tuned.

On an separate note, have I mentioned that I am doing a bike ride to fight cancer.....?  If not, let me tell you again so you can go out and make a donation to my ride.  You will be providing a tax deductible donation to the official 24 hour cycling event of the Lance Armstrong Foundation with 50% of the funds raised staying in the local community.  Please make a small donation.

I know I promised information on how to do a self exam for today's post....but....you know what...there is ample information out there and I am just too tired right now to do it justice.  I have now worked out and/or rode my bike three days in a row so I am a bit tired.  So, until we meet again here on my blog....good night and farewell!!!

Monday, April 25, 2011

Protecting yourself from skin cancer

When I was a kid growing up on a small family farm in Tennessee; skin care and protecting myself from skin cancer was the farthest thing on my mind.  I was more concerned about having that deep, dark, bronze tan and usually spent most of the summer in shorts and sneakers without a shirt whenever I was outside.  I would spend hours cutting, raking, and baling hay for the small herd of cattle that we kept to sell and use for beef and if I didn't think I was getting a dark enough tan would use tanning oils or baby oil to enhance the effect.  I was never told about these risk factors for skin cancer: my comments in parentheses

  • Having fair skin, red or blond hair (not me)
  • Having light-colored eyes (green eyes)
  • Sunburning easily (didn't burn easily as a child....literally tanned in the sun but did have some bad burns)
  • Having many moles, freckles or birthmarks (covered in freckles as a little boy)
  • Working or playing outside (duh....working on a farm, marching in high school and college band)
  • Being in the sun a lot as a child (again grew up on a farm...hay, vegetable gardens, yada, yada, yada)
  • Having had a serious sunburn (one or two bad burns over the course of my life)
  • Having had skin cancer, or having family members who have had skin cancer (not until recently)
  • Tanning in the sun or with a sunlamp (did that a lot in the past 10 years....)
What is that old adage, "hindsight is 20/20". Well in my case it certainly is just that 20/20.  Would I have done anything differently?  Probably not, but who knows at this point.  All I do know is that I have been diagnosed with basal cell carcinoma and will be having two more spots biopsied Thursday of this week after the doctor digs around in my shoulder for a few minutes until she is comfortable that she has removed all of the bad cells at that location.

Can you prevent or minimize your chances of getting skin cancer?  ABSOLUTELY!!!  Here are some of the best known ways to reduce your risk:

  • Stay our of the sun if you can, especially from 11 a.m. to 3 p.m., when the sun's rays are the strongest.
  • STOP using tanning booths or sunlamps...while they make you feel good they are destroying your skin!
  • Put on protective clothing and a hat whenever you go outside. Keep those hands and arms protected while driving!  Keep some sunscreen in your car for those long trips or wear long sleeves.
  • Wear sunglasses that wrap and are rated to block at least 99% of UVA sunlight.
  • Do a complete body map and check your skin every month for signs of skin cancer. Check back tomorrow for a guide to self exams.
  • Do not be afraid to ask your doctor if something looks different or a new place appears! 
  • USE SUN SCREEN OF 15 SPF OR  HIGHER ALL OF THE TIME!
So, even though it is fun to get a deep dark tan and it gives us all a great sense of self worth it can potentially be bad for you.  In my case, I guess it really was bad for me.  If you have one or more of the risk factors listed above then please consider taking some of the precautions listed.

Come back tomorrow for quick and easy self exam methods and then later this week for some reviews of popular sun screen products.

Thanks for reading!

Sunday, April 24, 2011

Back on my bike again

Okay, so after an 8th month layoff of not riding and not working out I got back on my bike today.  I refuse to let skin cancer force me to give up one of my favorite things to do.  Yes, I will have to be more careful with my skin care but I will still ride.

I started riding back in 2004 when a co-worker who lost her Dad to brain cancer convinced me to give it a try.  Now, like most of us I had a bike as a kid and rode it quite a lot.  I remember having my first 10 speed and riding the 1.5 miles to the base of the mountain we lived near in Tennessee and always turning around.  Back then, Breaking Away was a hit movie and Greg LeMond was becoming a household name by being the first American to win the Tour de France.  I always thought someday I would tackle climbing the 4.5 miles up to the top but never did.....life got in the way.  After college and a stint in the Army we moved back to Tennessee and I looked at bikes but never bought one....then I started moving with my career.  In 1999, I became interested in cycling again, as did a great many Americans, watching Lance Armstrong reclaim his life and his stature as a truly competitive cyclist by winning the first of 7 consecutive Tours de France.  I bought a hybrid bike and rode a little but still didn't put a lot into riding.

As mentioned in an earlier post, I wasn't around to help Mom through her cancer and that is why I took the challenge from my co-worker to get a bike and ride in the 24 Hours of Booty. I bought a bike off of the community bulletin board at work which was 4 cm too small, even with the seat post elevated as far as it would go, and I only managed to ride 30 miles.  What was embarrassing was having to get off and walk the bike up the little incline on the back side of the course after 10 miles. I missed the 2005 and 2006 rides.  In 2005, I chose to focus on training for and riding in the MS 150 and decided to go back to Tennessee the weekend of the ride.  In 2006, I just didn't ride.

By 2007, I had found the miracle that is Facebook and had reconnected with many of my old high school band mates.  Unfortunately, reconnecting with these friends brought me closer to cancer, again.  Two of my good friends passed away from pancreas cancer between 2007 and 2008 so I was determined at that point to never again miss another opportunity to rasie money for cancer research and support by riding in the 24 Hours of Booty. 

Fast forward to now.....I am on my 2nd year volunteering my time for the Booty Organizing committee, helping ensure that this event is truly world class and riding!  As long as I can swing a leg over a bike and keep my balance I will ride a bike.

Friday, April 22, 2011

Strike Out Cancer Night

Last night was the third annual Wildcats Strike Out Cancer night at Lake Norman High School in Mooresville, NC. The event raises money for 24 Hours of Booty, a 24 hour cycling event in Charlotte, NC that raises money for cancer research and support activities and is the official 24 hour cycling event of the Lane Armstrong Foundation.

The head coach is a cancer survivor and we have special jerseys representing different cancer support colors that the team wears during the game. The jerseys are then auctioned off during the game with all proceeds going to 24 Hours of Booty.
It is a great event for the players because afterwards they are asked to autograph their jersey for the winning bidder.

I have ridden in this event for 6 of the 10 years. If you would like to donate to the ride and help me fight cancer, both my own and everyone else fighting, check out my fundraising page link. You can also get more information about 24 Hours of Booty through my fundraising page. Thanks for reading and helping strike out cancer!

Wednesday, April 20, 2011

Cancer Statistics - Skin Cancer is on the rise!!

If you need some light reading before you go to bed tonight you can check out the link with this post.  It is the complete breakdown of the most recent full cancer statistics published through The American Cancer Society. 

The study is through 2010 and while basal cell and squamous cell carcinomas are not required to be reported to cancer registries more than 2 million people were treated for these two cancers in 2006.  They are the most easily treated cancers (basal cell more so than squamous cell) but the incidents are on the rise. If you love the sun as much as I did/still do then you are at risk for developing skin cancer.  I didn't listen to my parnets when they told me to put on sun screen...quite the contrary. I would use tanning oils to accelerate my tan.  I can't count the number of times that I got seriously burned working on the farm, laying out by a pool, or at high school/college band camps.  When you couple this with the fact that I also have a fair complexion and green eyes puts me very much at risk.

Basal cell carcinomas typically does not spread and are typically treated by excising them completely. I have my next appointment on April 28th to finish excising my shoulder. I will have two other spots on my leg examined as well.

My purpose for blogging about my skin cancer is to educate.  I hope this is a good first start!

Tuesday, April 19, 2011

Solaraze and aspirin allergies

I promised in an earlier post that I would discuss my experience with Solaraze, so presented now for your reading pleasure...

As my dermatologist was casually looking over my arms and legs and dropping subtle little hints that I probably have, at a minimum basal cell carcinoma, she talked about using a medicated gel to treat the precancerous places on my legs.  Of course I was immediately perplexed because she said that we would only use it on my legs but would just monitor my arms???  Go figure. So after all the numbing, scraping, and shave biopsy action she handed me a sample bag, discount card, and a prescription for Solaraze 5% topical solution.  She asked, in passing if I could take/use NSAIDs to which I replied "yes" because I have taken them before.  Even though her nurse had documented my allergies (note I am allergic to aspirin) she didn't notice or ask about said allergies.

Well, I show up at my local CVS for my prescription and nearly fall out from the price tag for this 100 ml tube of 5% Solaraze....even with my insurance benefit it was going to be north of $150. Luckily, the handy little discount card from the pharmaceutical company allowed me to pay a whopping $20 for this same tube.....was I a happy camper or what? 

Wednesday of last week I start using the gel  twice a day as prescribed choosing first to use the samples I had been provided.  One day down...no issues with the gel. Thursday comes and goes with 2 more applications of this gel with no issues.  Friday morning I begin to notice that I was not feeling like my self....mild headache, a bit nauseated, and a bit of a rash on my legs.  Not to be slowed down, I pressed on through the day because I was doing volunteer work for 24 Hours of Booty, learn more HERE, and for my son's high school band. By the time I got home Friday afternoon I was really out of sorts and just sat on the couch all night.  I got little to no sleep Friday night because of severe stomach cramps.  Saturday was another morning spent fighting off a severe headache so I could go to Columbia, SC and visit my sophomore at USC.  When it came time to leave, I handed my wonderful wife the keys and she knew at that point that I wasn't feeling well.  You see, I don't like giving up the wheel when we travel...I am not a very good passenger.  About 5 minutes in to our drive and I started getting motion sickness.  I am an avid roller coaster enthusiast so I never get motion sick!!  Something wasn't quite right.  Saturday night was a 2nd straight night with severe cramps and many trips to the toilet....

Fast forward to Sunday morning, a little Google research on side effects of Solaraze, and some conversation with my wife and I decide to stop using this stuff and leave a message with my dermatologist's office.  As Sunday progressed I noticed the dizziness, the cramping, and headache started to subside and my appetite slowly came back. Monday morning, I spent a fantastic hour on the phone with a Navigate Cancer Foundation oncology nurse practitioner during which I relayed my experiences from the past week.  Her first question was, "by any chance you would not be allergic to aspirin are you".....  DING, DING, DING, DING we have a potential winner!!! She concurred with my decision to discontinue use and consult with my dermatologist again.  I had already called the office a 2nd time and was waiting on a call back at this point.

So, how does this little novella end you ask? My dermatologist said stop using Solaraze and that we would discuss other options on my next appointment on April 28th. 

Monday, April 18, 2011

Why I hate cancer....

If you are like most Americans, you either know someone who has cancer or you are fighting this horrible disease yourself.  The other reality for most Americans is that you have lost someone special to you to cancer.  I now fall in to both categories:  fighting skin cancer, my Dad has fought skin cancer, and I lost my Mom to breast cancer in October 2003. 

When my Mom was first diagnosed I was already living in North Carolina and was not with her in Tennessee as she battled breast cancer and shortly after her diagnosis I transferred to Washington state.  I missed most of her first fight and the little victory of being declared cancer free.  I transferred back to NC in 2001 and over the course of 2 years went home too few times.  In the summer of 2003 she started feeling bad again...but her doctors told her she just had a summer cold. Well the summer cold turned into a full blown relapse of cancer...this time not only breast but in her lungs....only no one knew it until it was too late.  The last time I saw her alive was labor day weekend when we had gone camping at a state park near my childhood home and stopped by the house for 30 minutes or so on our way back to NC.  By the end of September she had been rushed to Nashville, TN and had several test that revealed the return of cancer I wrote of earlier.  On October 13, 2003 while on my way to my son's baseball practice my phone rang...it was my Aunt (Mom's youngest sister) informing me that Mom had left us.

Mom was 61 at the time...way to young to have lost a battle with cancer.  There is not a day that goes by that I don't miss her!!

So, why do I hate cancer....cancer took my Mom way to young, it has inflicted its curse on my Dad, and now I am dealing with it.....Enough said!

Sunday, April 17, 2011

My world has changed....

So, I have had little annoying places on my arms and legs for about 2 years.  I never gave them much thought until I went in for my VA annual physical this year.  The VA doctor recommended that I see a dermatologist, which I must say startled me just a little.  Since we still have good private insurance I called my dermatologist and scheduled an appointment.

So, on Monday April 11, 2011 I went to my dermatologist.  I showed her the spot my VA doctor told me to have looked at and she immediately said that it was harmless and called it, for lack of a better term, an old age spot....me 44, old age spot???  Then she started looking at the annoying places on my arms and asked if I had spent a lot of time in the sun as a kid.  Of course, having grown up on a farm having to work outside throughout the day most of the summer I got burnt and tanned every year.  She told me the places on my are were actinic keratosis, which are pre cancerous cells.  As she checked both arms she came to a spot on my right shoulder and immediately asked if I knew about that particular spot.  I had seen it in the mirror and thought it was a pimple....she took out her marker, circled it, and said "we are going to test that one".... in a very calm, matter of fact tone. She then moved to my legs and found another spot that she circled.... Now, I am getting worried!  The other spots on my legs were deemed to be pre cancerous as well but she was going to treat them with a medicated gel.  The worst spots on my arm were frozen off before the biopsy procedure.

The two spots were subjected to a "shave biopsy" and she gave me a prescription for a Solaraze for the spots on my legs, 16 weeks worth of treatments.  I was told that the biopsy results would take about a week but she (my dermatologist) was 99.9% certain the spot on my shoulder was cancer.  So I went back to work.

The next afternoon, at around 4:15 pm my phone rang and it was the doctor's office....I answered the phone and was told that I had skin cancer!!!  That had to be the hardest thing to hear since I got the call that I had lost my Mom to cancer (we'll save that story for later as I have never really recovered from that day). The only positive to take from this phone call was that the skin cancer I have is basal cell carcinoma

This is the most common and easiest to treat of the skin cancers.  The doctor scheduled me for a "d and c" which is dilation and curettage for the place on my shoulder...basically cut and scrape the location until all of the cancer cells are believed to be removed. I picked up the prescription for the Solaraze and started using it on Thursday....that will have to be a separate post as well. 

So, this blog will now chronicle my journey with skin cancer. I have subsequently found two more places on my right leg that look just like the place on my right shoulder. I will have them examined next Thursday when I am scheduled for the d&c procedure.