Biopsies of biopsies: The results beget more results...

Well folks, it was quite an interesting dermatological day. First thing this morning I had an appointment to get the results from the 3 biopsies I had two weeks ago. Apparently, the cells and their structure were atypical enough to be of concern, so the lab wanted a larger and deeper sample from the two sites on my back. They need those tissues to determine exactly what is going on and how severe it is. We know it's not basal cell carcinoma, so the dermatologist told me they're looking for melanoma. Good to know.

Anyway, getting larger and deeper tissue samples means.... surprise! More stitches! Wow, in the past 6 weeks I've had 4 incisions in October, 3 in November and now 2 more (so far!) in December. Fun! The dermatologist used the punch method and removed 8mm deep of tissue to be sent off to the lab. So now I have 6 more stitches on two sites, and they were both bleeders too! It was pretty funny to have the bleeding issue again. He actually used a cauterizing tool to help stop it along with a pressure bandage. Thank God for local anesthesia, you know what I'm sayin'?

So the other thing Derma #5 laid on me today was the fact that he's moving to a practice in Mississauga. Man! I'm going through dermatologists like dirty shirts. So now he's handed me off to his colleague for my results and stitches removal in two weeks (Dec. 22nd - merry Christmas!).

Next up today was my appointment that was set waaaaay back in October with the dermatologist at the private clinic who took the lacklustre pictures of my skin (see here for a refresher on that episode). Today's appointment was supposed to be the review of those photos.

First of all, it took almost two months to get this appointment at the private clinic - and I paid to have those photos taken and for the meeting with the dermatologist today. So much for private health care, it sucks as much as the public kind in Canada! Second of all, he HAD NOT EVEN LOOKED at the photos. Great - so what did I pay you for? Third, when he saw that I had recent scars and bandages from this morning, he pretty much brushed me off. Wait a second buddy! I'm paying for your time! I managed to get him to look my skin over, and he only mentioned the lesion on my foot as something to keep an eye on. All in all, he spent at most 10 minutes with me - didn't ask me any health-related questions, hadn't reviewed my photos and pretty much rushed out the door. So much for Derma #6. Forget me going to see him again!

So, here I am with two fresh wounds, more biopsy results to wait for, and two more weeks of chemo to go over Christmas (starting Dec. 15th). I'm having to get to know a new dermatologist - again - and I don't even know if she's going to be any good. Oh well, I guess we're starting from scratch (no pun intended!)

Anyway, I'm not quite bummed but a wee bit frustrated. A bit of retail therapy after work did help, and now I'm off to eat popcorn and watch guilty TV. Tomorrow will be a better day!

12 Days After Latest Biopsies

Hello everyone!

It's been 12 days since my latest biopsies, and I've also completed my first round of chemo special cream. I'm to take two weeks off the treatment, then on Dec. 15 I'll start my last two weeks. This coming Wednesday I'll get the results from the biopsies, and have the doctor look at how I'm healing. The poor stitches on my inner thigh keep opening up and bleeding, and I think it's when I cross my legs as I get a tearing kind of pain when I do that and don't realise I'm doing it. The ones on my back are taking their time to heal, and are sore. So, since there's nothing interesting to report, I thought I would post some more  recent pictures! These I just took tonight; which was hard because I'm home alone. Try taking a picture of a certain part of your back all by yourself!!!

Remember, the two on my back were removed by a method they call "scraping", but it was more like meat carving. The one on my thigh was removed using a "punch" (which created a deep circle hole) and the circle was closed with stitches. Here they are today:



Thigh, 12 days after punch removal



Two on back, 12 days after scraping removal

So you can see that the bruise on my thigh is gone, and it was pretty cool to watch as it changed colours: purple, yellow, blue, green... bruises are very fascinating things. Why yellow? Why blue? Is my blood a rainbow of colours??? The stitches are holding up, but I'm not sure they're going to be ready to be removed on Wednesday. We'd better be ready for a repeat session of the bleeding if the doctor decides to take the stitches out! You can also see that the two on my back are healing, but they're kinda sore.

So, I'll post back again on Wednesday with the results of the biopsies, and the plan for ongoing assessment. Thanks for reading, and talk soon!

Very Cool - The Day After

I finally took off the pressure bandage from the biopsy site on my inner thigh, and COOL! Check out what was underneath. I don't know why it looks this way - obviously it had to do with the excessive bleeding - but it sure looks unusual:


Neat-o: my thigh incision the day after!

In real life this area is about 4 inches by 2.5 inches. I'll let you know how the healing process continues.

Oh, and as for "Does it hurt?" Not really; it's just sore, and when there's pressure on it it's like a sensitive bruise, but otherwise it's no big whoop. I just think it's neat to look at!

: )

Buh-bye Numbers 1, 2 and 3!

There! Just a week after I saw the new Dermatologist in Toronto, and based on the recommendations of the clinic in Detroit, I had the three lesions removed today. Here's a reminder of how they looked a few weeks ago:

And now how they look:

These were removed using the "scraping technique" which was basically using a scalpel and cutting them, like carving a slice of meat!

This one, on my inner thing, was removed using a "punch", it was a tool that looks like a pen. The doctor said that the tool is also useful if you need to make an additional hole in a belt!!!

Poor Number 3, which is on my inner right thigh, was a bleeder! It took four stitches and lots of pressure bandaging to get it to stop bleeding. The dermatologist even asked me if I took blood thinners it was bleeding so much! It added excitement to the visit and gave me an excuse to buy myself popcorn (I was such a good patient!!!) My next appointment is in two weeks when he'll take out the stitches (hopefully he'll remember to take ALL of them, not like Derma #3), and to get the biopsy results.

The other thing he did today, was to look at the BCC site which is currently getting the "special cream" - so named to make my BFF more comfortable with the idea of it being chemotherapy! On the surface (hahaha) it doesn't look like anything is happening, but the doctor said that's OK. So I am just finishing week one of the first two weeks, then I'm off the treatment for two weeks, and then back on for another two weeks. I should be done right around Christmas. Here is the latest picture of Mr. BCC: after 5 days of treatment:

So that's it for now! Remember: check your skin - that includes your lips and the tips of your ears!

Getting some action!

Woo, I"m getting some action! Some dermatological action that is.

You know the expression "when the cat's away the mice will play"? Well, this mouse knew that her regular GP was on vacation this week, so I went to his temporary replacement (a doctor I've seen before and like) and asked her to refer me to another dermatologist. Remember that my GP discouraged me to get a second opinion? That was why I went to the clinic in Detroit. But now I need a dermatologist here who can carry out the instructions from the visit to the clinic (further care to the original BCC lesion, and 3 more lesions removed for biopsy). So temp GP referred me to a dermatologist she said was fantastic, but it could be quite a wait to see him. I agreed because I was hoping he was well worth the wait. Before I left the doctor's office I cancelled my Dec. 3rd surgery appointment with the clinic's dermatologist, having decided that I would now wait for the new dermatologist. It was a risky decision, but I didn't want Derma #3 to cut me up anymore!

Well my friends, I got lucky, because I saw the GP on Monday, she faxed the referral that day, and I got a call yesterday from the Dermatologist's clinic (we'll call him Derma #4) saying they had a cancellation and I could come in today. So I jumped at the opportunity!

So, today I was eager for my appointment, and was trying to not expect too much from Derma #4. I could walk to the clinic as it was near work, and although I had to wait a half hour to see Derma #4 once I got there, I was patient (ha ha ha) since at least this appointment was so much sooner than I expected. [I heard the receptionist today on the phone saying that new referrals were booking into February]. Anyway, here's the outcome of my appointment: Derma #4 was pretty good, he actually had a dermatoscope (and used it!) and now I have an appointment NEXT WEEK for the removal and biopsy of the 3 lesions as recommended by the Detroit clinic. Woohoo! Glad I cancelled that December 3rd appointment now.

So, here's the weird part that I don't want you to get all upset about. So, before we go on, please promise me in your head that you're not going to freak out. OK. Thanks. So, he also recommended that instead of doing further surgery on the original BCC site, he wants to kill the remaining cancerous cells in that area with chemotherapy. OK, so I know how that word sounds - scary right? - but it's really OK. Really! Its just a topical chemotherapy (a cream) that we do at home, put on and left on for exactly 8 hours once a day for two weeks, then off for two weeks, then on again for two weeks. It's a really new treatment for BCC and I'm interested in trying it. So I have the meds and tonight will be day #1 of week #1. [Despite my appreciation for the care I got in the US, I am grateful for my company's benefit plan which covered 100% of the cost of this expensive treatment, and I'm assuming that would probably not be the case in the US.]

After I've used it for a few days, I'll post back on how it feels, and also post a picture of the lesion as it gets barraged with chemicals. Wish me luck!

The Visit to the Clinic

Hello everyone!

So it's now November 9th, which means that yesterday I went to the Karmanos Cancer Clinic in Detroit. I went there primarily for a second opinion and a full skin evaluation from a skin cancer specialist (as opposed to a regular dermatologist).

Karmanos Cancer Centre, Detroit MI

The visit was exactly what I expected and what I had hoped for from dermatologists here in Canada. Here's a summary of the visit:

1. The doctor reviewed all my previous dermatological files BEFORE my appointment.
2. She explained BCC to me and also explained Dysplastic Nevi Syndrome, and the risks of associated with both disorders.
3. She gave me informative pamphlets on these skin issues - and I know that must sound pretty trivial, but to have something in hand when you're being told about a health concern, it's great to have something tangible to look at, sanctioned by your doctor, instead of searching for information for yourself on the internet.
4. She took more than a half hour to look at every inch of my skin - after a resident doctor did an initial review.
5. For those moles and lesions that she thought were unusual with the naked eye, she used what she called a "dermatoscope" to look at them up close. The dermatoscope was a handheld microscope like thing that she put right against the skin to see a lesion up really close. She could also measure the size of each lesion with the same tool.
6. She told me that she would like to see three more lesions removed, and circled them for me, took pictures of them, and will send me a detailed report of all of her recommendations for me to bring to a dermatologist here. I could go to her clinic there, but the 4 hour drive to Detroit is BO-RING!
7. She is going to have the Karmanos Cancer Centre pathology unit review the pathology slides from the biopsies I've already had done, to make sure that they didn't miss anything.

So, all in all, you'd have to say "wow, now there's a thorough doctor's visit"! Despite the new lesions that need to be removed, I'm very positive about the outlook and I know that I did the right thing in getting a second opinion. For your entertainment, here are the photos of the lesions she wants me to have removed and biopsied. These are #1 and #2:

Numbers 1 and 2 on my back waiting for removal.

This is number #3 on the inside of my thigh, which all three dermatologists to date have disregarded:

Number 3 on my inner thigh (sexy!)

So these three will be removed hopefully within the next month and biopsied, and then all the other suspicious ones will be monitored; like this one on my foot:

This one looks to me like a freckle "in real life", but this is the second time a dermatologist wants to "keep an eye on it".

So, to sum everything up, I'm looking forward to having the three suspicious lesions removed and biopsied, and I'm thinking of trying to find a new dermatologist here in Toronto who has experience and expertise in skin cancers. This means if I see "wrinkles, botox and age spots treated here" on signs all over the doctor's office,  I'm in the wrong place. If I see gross pictures of gnarly looking skin lesions, I'm in the right place!!!!

I hope this experience has been educational for you as well as for me! Please be sure to look over your skin, no matter how old or young you are. We don't always fit into the "statistical norm". So if a doctor tells you, "you're too young to have XXX", get a second opinion!!! I'll keep you posted on the next biopsies, so stay tuned!



The Wait

Ok, so it's only Tuesday, so I still have 6 days to wait for the clinic visit in Detroit. The waiting is driving me nuts, but there have been distractions... Picking up medical records, pathology slides, planning the travel to Detroit: drive? Train? Fly? Where to stay - this is apparently an important decision when traveling to Detroit! My husband worked there for a few months last year, so luckily has first hand experience of where to avoid.

All in all, my experience so far with Karmanos Cancer Centre has been great. They are so thorough; from reviewing the biopsy pathology reports AND slides to make sure the diagnosis was correct, to reviewing my ENTIRE medical file for the past 10 years. I also had a few tests done this week here in Toronto and will bring those results with me too. So far it sounds worth my $400!

As for how i'm feeling health-wise, I'm just tired and itchy! The tiredness has been a problem since about June and I can't recall when the itchiness began. Lately I've been late to work, and even taking sick days or working from home because I'm so pooped. But otherwise I'm normal; had a great night out with my BFF last week and laughed our heads off and enjoyed some great pub grub and long island iced teas! That was great. Then Halloween with my nephew and nieces was great too; there's nothing like girl-time and playing with (good) kids to distract you!

So friends, remember to check your skin. Have you checked the bottoms of your feet? What about your scalp? You can check most of your scalp when you're blow drying your hair. Do it!