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.