Category Archives: Skin Cancer

Skin Cancer Update 

  

It has been awhile since I have made an update related to skin cancer. I have been focused on enjoying life since my most recent treatment ended and have placed all those not so pleasant months in the back of my mind. That strategy was working quite well for me until I went to the Dentist for my regular checkup a few weeks ago. She noticed a lesion on the left lateral portion of my tongue. Her immediate thought was something as benign as Migratory Glossitis but due to my history with skin cancer, she felt I should be seen by someone for an evaluation of the lesion. I had already set up my yearly physical with my general practitioner for the following week so when I went to see her she referred me to an ENT surgeon for evaluation the next day.

 

When most of us think about skin cancer we think of lesions that pop up on parts of the skin that have been exposed to UV rays. Cancerous lesions on the tongue or inside the mouth caused by UV exposure is not something we usually hear about. Alas, the ugly beast can spring up inside your mouth in the form of Squamous Cell Carcinoma or Melanoma and According to the American Cancer Society, it can indeed be caused by too much sun exposure over time. This does not mean you need to run around in the sunshine with your tongue sticking out of your mouth in order to get it. 

There are of course other risk factors that can be the cause of oral cancers such as smoking and excessive alcohol use, but in my case the risk factor would appear to be excessive UV exposure and the fact that I have a history of Basal Cell Carcinoma. Thus the concern and need for evaluation. 

 

Now I don’t know your particular level of pain tolerance but mine is pretty high. When I had both the biopsy and then Mohs surgery on my face I barely felt the needles that injected the local anesthetic right on the side of the bridge of my nose. Things were very different when it came to my tongue. Think for a second about the times you have bitten your tongue, your lip, or the inside of your cheeks and how much that hurt and continued to hurt for some time. Now multiply that pain by one hundred. The needle stick was not fun. Fortunately my tongue went instantly numb. 

I have this little anxiety thing about being unable to swallow. Going to the Dentist is difficult enough for me especially when there are suction tubes and a pair of hands and instruments all up inside the small space that leads to my airway. There I was sitting in a sterile room with drool spilling down the corner of my lip, a pair of gloved hands pulling on my tongue and holding it taught while poking and cutting and digging at the mystery spot. I could feel my intense need to swallow begin to rise and I could do nothing about it. 

Add to that most uncomfortable mix the warm rush of blood and a wad of gauze stuffed in my mouth to stop the bleeding and well, you can probably imagine how I felt. Then There was the tug and pull of the suture needle that went around the wound and up through the center of my tongue. Not once, but four times. Yes, I felt a bit squeamish.

  

The anesthetic wore off two hours after the surgery. That is when I was reminded how much we rely on this funky looking mass of muscle for a variety of things. It was extremely painful to swallow, to talk, to eat, to drink, to sneeze, to cough, to blow my nose. My tongue was swollen and angry and it let me know.

For the first three days I could only handle a liquid diet. Protein shakes and water became my friend. The dissolving stitches worked their way loose within a few hours and I became brave enough to cut the long loose ends off by myself before they made their way down my throat. Did I mention how ugly my tongue looked? Ghastly ugly indeed. I have photos but I will spare you.

The biopsy results came back within 24 hours and fortunately it is a benign epitheleal tumor in the squamous layer. Yay! We now keep an eye on it over time just to make sure it doesn’t grow back into something malignant.

Beyond this little inconvenient interim reminder that I will most likely face additional skin cancers in my lifetime, my full body skin recheck appointment is not until mid-August with my Dermatologist. So after this painful biopsy spot decides to heal completely (it has been one week now and it still hurts to eat, to talk, to swallow) I will be back to living and enjoying life mindfully. 

Did I mention that in the midst of all this fun I came down with a Streptococcus infection and am now on a regiment of antibiotics? The challenges never cease, but there is still a whole lot of beauty in this world to balance out the little patches of ugly :).

**A photo of a Sunflower because it is prettier than the thought of my tongue :).**

  

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Zen in the Garden: Finding Peace and Healing Through Nature

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So I wrote and published a short little Kindle e-book called “Zen in the Garden: Finding Peace and Healing Through Nature.” I wrote it after my recent journey with skin cancer, surgeries, and chemotherapy. It is meant to provide inspiration and motivation through a combination of written words and my photographs. It also contains some gardening tips and nature challenges.

It was published on Valentine’s Day and has already reached the top 100 Amazon Best Sellers Rank in the category of “Spiritual Healing.” All I can say is “wow!” I am humbled and happy and hope this little book can touch the lives of those who are open to its message.

Here is where it ranked last night. It was at #43 in Spiritual Healing:

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If you would like to read a copy it is currently only $2.99 and can be purchased here on Amazon: Zen in the Garden. If you do purchase it I would love it if you will take a moment to give it a review. Even better, if you can think of someone in your life who might benefit from its message please gift it forward. You can do this by choosing “Give as a Gift” on the Amazon book page. Or simply share this post with your friends if you feel moved to do so :).

You can also view my Amazon author page here: Tracy J Thomas.

Here is an example of one of my photos that appear in this book combined with a snippet of my writing.

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Skin Cancer Treatment – Fluorouracil Day 39 to 46

I took a much needed break from all things related to skin cancer following my last post on day 38. My skin has still been in the process of healing over these last eight days and I am just now beginning to look closer to my “normal” self. My forehead has continued to peel and itch and still, after eight weeks, has feint red lines criss-crossing like little pathways on a roadmap. The rest of my face from the nose down looks pretty good but it is still a slight pink and turns a deeper red most evenings. Fortunately my eyebrow hairs and the hair on my head stopped falling out as soon as I stopped treatment.

**Almost back to normal.**

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My energy level has improved although I still have occasional bouts of nausea that I believe is due to my body’s efforts to rid itself of the last remaining traces of Fluorouracil.

Over Christmas I had my first real trip away from the house in seven weeks and it was heavenly. After being inside for so long everything seemed so fresh and new and fabulous. We even had a white Christmas with a dusting of snow that was the perfect ending to this whole stressful and painful ordeal.

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When I look back on the past four months from the date of my first surgery, I realize everything I have been through has changed me. I feel the need to embrace the beautiful things in life more and let go of all the crap. I desire to live more fully now instead of putting everything off until later in life when I am too old and tired (or sick) to enjoy it. Although my skin cancer experience so far has not been as harrowing and life threatening as what some individuals have faced, it has definitely rattled my psyche to the point of affecting change. I truly do see things differently now and I appreciate what I have much more than I did before.

I plan to continue to make occasional skin cancer posts moving forward as I have my follow up scans and appointments or should anything new arise. I will also post a timelapse of my face over the course of Fluorouracil treatment as soon as it is clear again. For now I will get back to my regular posting about photography, writing and art.

Thank you all for following along on this journey. Your kind words and support helped to make the pain and tedium so much easier to deal with. You are each appreciated more than I can ever put into words.


Skin Cancer Treatment – Fluorouracil Day 35 to 38

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I love the comparison of these two “mug” shots. The first is from when I was in the middle of Fluorouracil Hell and the second is from yesterday, my second day post Fluorouracil. Although I am not smiling in either I see a look of desperation and pain in my eyes and expression in the first image. In the second image my eyes seem clearer and expression softer. That’s part of the beauty of black and white photography as you are not overwhelmed by color and can more easily get to the emotion of the photograph.

Monday night, day 35, was my last night of Fluorouracil treatment. I was so happy to put the tube of poison away in the cabinet and out of my sight. It was a long and very difficult five weeks. As much as I would love to say everything is done and I am back to normal now, that is not the case. Days 36 through 38 have been a combination of festering blisters, itching, burning and peeling. Last night was another sleepless night due to a lot of discomfort on my forehead. Today there is a bit less inflammation however it still hurts a lot to wash my forehead especially around my temples where the most intense rows of crusty blisters reside. So if you have Fluorouracil treatment in your future don’t expect everything to go back to “normal” too quickly because as in my experience it won’t.

**My face this morning, three days post Fluorouracil on my forehead and
eighteen days post Fluorouracil from my nose down**

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For the past few days I have been playing with metal clay. If you are not familiar with metal clay, it is just like traditional wet clay that can be kneaded, formed, molded, and shaped into whatever you want it to be. It was invented by the Japanese and contains tiny bits of metal, water and a binder. Once fired, the water and binder burns away and the bits of metal form into one solid piece.

The process of working with metal clay is the perfect analogy for the Fluorouracil Hell that I have just experienced. So it is fitting that I have intuitively turned to this medium during the healing phase. The clay has to go through the process of firing at a very high temperature for a specific amount of time in order to lose the impurities of the binder. Once fired, the piece is quenched in cool water and is then soaked in a pickling solution to remove any scale from the firing. After pickling it is burnished to create a beautiful shine.

If firing was incomplete, you can end up with hairline fractures that will cause the piece to break under pressure. If firing was complete, you end up with a strong piece of metal that shimmers and shines with a unique beauty.

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At this point in my journey with Fluorouracil I feel as if I have come through the fire and am now in the pickling phase where the last remaining bits of scale are being removed from my face. Soon I will be like that piece of shimmery metal. Only time will tell whether my firing was complete or if there are any hidden fracture lines waiting to reveal themselves at a later date.


Skin Cancer Treatment – Fluorouracil Day 32 to 34

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Finally, I see light at the end of the tunnel. Tomorrow night will be my last application of Fluorouracil to my forehead. The past few days have seen an increase in inflammation, burning, itching, blistering, oozing and peeling with the larger spots finally reaching erosion phase.

The remainder of my face from the nose down is still healing well however there have been a few days when it has become red and a bit irritated again (instead of pink) and the itching returned. However I am now able to go places by pulling one of my winter hats down over my forehead since the rest of my face looks closer to normal now.

**The photo on the left is from the middle of my treatment and the one on the right is from today.**

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It’s really interesting to look back on all the photos I have taken the past five weeks to compare the stages. As soon as I am completely healed I am going to put together a little stop motion video to show the progression of the treatment (because those are the silly things that photographers do).

There are still a few spots on my cheeks that I have concern about and plan to go back to my Dermatologist after the new year to have them checked along with a new growth that has appeared on my back. But I just want to enjoy the rest of the holiday season without thinking of the possibility of further treatment.

Almost there. Finally…


Skin Cancer Treatment – Fluorouracil Day 29 through 31

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Days 29 through 31 have brought much of the same. My face continues to heal from the nose down and the itching and peeling have diminished greatly. My forehead is now on day 31 of Fluorouracil and has become increasingly inflamed and continues to burn intensely and itch. The past few evenings it felt like some little gremlin was running back and forth across my forehead with a pair of spiked golf shoes. Not a pleasant sensation.

I continue to lose eyebrow hairs and have most recently begun to lose handfuls of hair from my head. Fortunately I have a thick head of hair and I know this is only temporary.

**The transition in my face over the last three days.**

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One positive thing I have noticed this week is increased spurts of energy during my days mixed in with bouts of nausea and feeling super tired. It’s kind of like a roller coaster ride. Fortunately these past few days I have actually been able to get a few things accomplished which is a good thing.

After going through this past four plus weeks of Hell I have been asked by several people if I think it has been worth it. When I consider the amount of sun damage on my face and the alternative of ignoring the growths and running the risk of the basal cells invading bone and surrounding tissue or of actinic keratoses mutating into squamous cell carcinomas, then yes, it has definitely been worth it. Although I often wonder if this treatment is going to knock out all the little nasties that are lurking on my face. I realize it is only killing those bad cells that live on the top few layers of the skin and does nothing to eradicate any cancer cells that may be multiplying in the sub dermal layers. Here is the National Cancer Institute’s take on topical chemo treatment: “Given the superficial nature of its effects, nonvisible dermal involvement may persist, giving a false impression of treatment success.”

Of course the most intelligent course of action would have been prevention. But hindsight is just that. Education along with a little dose of reality can make a big difference now that the damage has been done. As I have said before, I am a realist and I know I will more than likely be dealing with skin cancer for many years to come. But now I am very aware and know what to look for in order to remain on top of it.

The statistics speak for themselves:

Approximately 36% of all patients find a new basal cell or squamous cell carcinoma within the next five years following treatment. Having a basal cell carcinoma before the age of 60 may also increase the chance of developing other cancers in internal organs.

As many as three thousand deaths from advanced basal cell carcinoma occur annually in the US. (Skin Cancer Foundation)

Approximately 65 percent of all squamous cell carcinomas and 36 percent of all basal cell carcinomas arise in lesions that previously were diagnosed as actinic keratoses. (Skin Cancer Foundation)

Men and women with a history of nonmelanoma skin cancer [basal cell and squamous cell carcinoma] are at a higher risk of developing melanoma than people without a nonmelanoma skin cancer history. (American Academy of Dermatology)

Women with a history of nonmelanoma skin cancer are at a higher risk of developing leukemia, breast, kidney, and lung cancers and men with a history of nonmelanoma skin cancer are at a higher risk of developing prostate cancer. (American Academy of Dermatology)

From a recent Harvard Medical School study:
Results showed that people with nonmelanoma skin cancer were at an increased risk of developing the deadly skin cancer melanoma, and that women with nonmelanoma skin cancer were at increased risk of lung cancer and breast cancer, according to the study.

So the answer is a definite yes. This treatment is, has been, and will continue to be worth the extreme pain and discomfort that it delivers. At times I look at it as penance paid for all those hours of foolishly subjecting my skin to UV rays for the sake of vanity.


Skin Cancer Treatment – Fluorouracil Day 25 through 28

The last four days have shown steady improvement and healing from my nose down. The Aquaphor has definitely been the savior for the severely dry skin after ending the Fluorouracil. My face from the nose down has continued to blister, peel, burn and itch since stopping the Fluorouracil on Tuesday and today is the first day with a significant decrease in inflammation.

My forehead is a different story. Today marks four weeks of treatment with Fluorouracil on my forehead and I still have one more week to go. It is finally beginning to reach the major inflammation stage and is beginning to burn like a mutha’. At least I know what to expect after living through Hell with the rest of my face.

**Here is a grid with photos from days 25-28 that shows the inflammation diminishing from the nose down. Ah, progress!**

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Today, day 28, has been a mixture of feeling happy that my entire face is no longer in pain 24 hours a day, super tired from the wear and tear of this whole ordeal, hopeful with the knowledge I only have one more week on the Fluorouracil (which I am now calling “my poison”), and bored after being holed up inside this house for way too long (I want so badly to go outside and run down the street like a crazy lady in the rain).

The last few days I noticed another side effect from the chemo. I have begun to lose my eyebrow hairs. I now wake up every morning with new eyebrow hairs stuck to the Aquaphor on my cheeks. Oh goody I say. Just one more thing to make me prettier than I am at the moment.

This afternoon I had a window of time where I actually felt good enough to play with clay again. The majority of the past four weeks I have not been able to do much at all except to sit and read and write. Whenever I attempted to do any other projects they were short lived because of the pain and discomfort and general feeling of exhaustion due to lack of sleep. So, if you will be going through this treatment for your whole face I strongly advise you to get all important projects completed before you begin.

**Something pretty to look at besides my face :). They will be up on my Etsy shop soon. (Another shameless plug. But a girl has to make money somehow when she is incapacitated :).**

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So, there is light at the end of the tunnel but it just takes a long time to reach it. I will let you know when I finally get there…


Skin Cancer Treatment – Fluorouracil Day 23 & 24

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I have a strong tolerance for pain. I truly do. When I gave birth to my son, I made it through 23 hours of intense labor without any drugs and he weighed in at a whopping 9 pounds, 13 ounces. After I broke my foot playing basketball I rode my bicycle 60 miles with a cast up to my knee (crazy young college student). After rupturing my achilles tendon while playing softball, I waited in the stands one hour until the game was over before catching a ride to the ER. That injury required full repair surgery. So when I say Fluorouracil treatment has been painful I truly mean it.

The above photo is of one of my clay tools for creating texture. It consists of dozens of very sharp steel barbs. The pain related to Fluorouracil treatment at times feels as if someone is using this tool to impale my face. So when your doctor smiles while he writes out the prescription and tells all you first timers that it will probably be “a bit uncomfortable,” brace yourselves, especially if you have to treat your entire face.

Yesterday was day 23 and it was the first day off of Fluorouracil from my nose down. As I said in my last post, my doctor wants me to continue treatment on my forehead for two more weeks because it is not reacting as fast as the rest of my face did.

As much as I would love to say yesterday was all roses and furry kittens after stopping application on the majority of my face, it was not. In fact it was more painful and annoying in many ways. My face developed an increased amount of blisters and throughout the day they would pop and ooze down my cheeks. It would sting a lot at the blister sites and then itch like crazy. I also had increased burning over my whole face for the majority of the day.

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The one thing that helps to provide some comfort is Aquaphor. I am now supposed to apply it and nothing else from the nose down for one week. Aquaphor is made of lanolin, glycerin, petrolatum, pro- vitamin B5, and bisabolol (derived from the Chamomile plant, it has anti-inflammatory, anti-pruritic and healing effects). It is a lovely, soothing ointment but it has a similar feel to Aloe Vera gel but doesn’t soak into the skin or dry out and it is very, very messy. It gets on everything.

This is how it works:

“Unlike Vaseline (100% petrolatum), which is occlusive, Aquaphor (41% petrolatum) forms a semi-occlusive barrier on the skin. This enables the transmission of water and oxygen, important in wound healing, and the formation of a protective moist healing environment.[8] Its other key ingredients absorb the skin’s natural wound exudates, keeping the wound moist to help promote healing.[9]”

This morning, day 24, I have developed even more blisters, Yesterday’s blisters are still oozing, I have a headache, and my skin is beginning to slough off especially on my cheeks. Yes it still burns and itches like crazy even with the Aquaphor but it doesn’t feel as dry as it did before. My face is still inflamed but a little less than yesterday. My forehead, where I am still applying Fluorouracil, is beginning to burn more as it catches up with the rest of my face.

**A comparison photo between day 23 (left) and day 24 (right). You can see a tad less inflammation (yippee for progress)**

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Skin Cancer Treatment – Fluorouracil Day 21 & 22

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**My most recent mug shot.**

As much as I would love to say that yesterday, day 21, was my last day on topical chemo, it was not. My doctor has extended treatment on my entire face by one day and on my forehead for another two weeks. My forehead has taken a lot longer to react to the drug. I have quite a few spots on my forehead but they are far from erosion phase.

Last night was another sleepless night with only two hours total. My face was burning really badly so I sat in the living room and read until pure exhaustion allowed me to sleep for a short spell. This morning I have an increased amount of blisters on my cheeks and jawline and they have begun to ooze a bit which adds to the itching.

I managed to shoot another video this morning.

So, I am still at it. Trying to keep my chin up and focus on getting a few things accomplished while the fun continues.

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Now for the shameless but humble pitch to help me pay off my medical co-pay for both surgeries and treatments:

For all of you who are still doing your holiday shopping, I have a Black Friday/Cyber Monday special in my Etsy shop today through Tuesday at noon. You will get 40% off all handmade jewelry, prices as marked.

If you like fine art photography enter code PLMVBU at checkout to receive 30% off all of my photography offered on my Fine Art America gallery.

There is also a GoFundMe page that has been set up to help with my medical expenses.

Onward and upward!


Skin Cancer Treatment – Fluorouracil Day 20

Day 20 is finally here. I have still been having a difficult time sleeping. I wake up about every half an hour now with severe itching on my face. Today I have developed several small blisters on both cheeks which confirms for me I am reaching the erosion stage. At least on the bottom half of my face. My forehead is still far behind the rest of my face however and I may need to continue another week just on my forehead.

The itching and burning have still been here for the majority of today although it finally feels a bit more bearable. This third week has been the most intense week out of all in terms of pain but now (fingers crissed) things seem to be slowing down a bit.

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During the entire course of this treatment I have had a difficult time doing the work I normally do. The one thing I found I could do every day regardless of my pain and discomfort was to sit and write. I mentioned it in an earlier post that I had decided to undertake the NaNoWriMo (National Novel Writing Month) challenge where you vow to write every day during the month of November in order to reach 50,000 words towards a novel in just 30 days. If you finish by November 30th then you are declared a “Winner.”

Today I am proud to say I am a winner of NaNoWriMo 2014. So now I have a first draft of my new novel and can begin edits and re-writes during the month of December. In the near future I will begin sharing excerpts on this blog for fun.

Here is the great video you receive from the NaNoWriMo team following validation of your word count. It was the highlight of my day. Correction. The highlight of my year :).

It appears I have been slaying lots of dragons this year (note winner’s graphic above) 👍.


Skin Cancer Treatment – Fluorouracil Day 18 & 19

For those of you who live in the U.S., I hope you all had a wonderful Thanksgiving! Thanksgiving day was day 18 for me on the Fluorouracil. Needless to say we did not travel or have a house full of people this year. We stayed home and had a nice, quiet, relaxing day.

In regards to my face, yesterday was more of the same. Intense burning for the majority of the day with another headache and insomnia to boot. However, the lesions that have darkened have begun to scab over, dry out, and some of my skin has started to peel. I think I am finally reaching the erosion stage.

**Day 19 gorgeous selfie**

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**Some of the lesions have begun to scab and erode.**

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Today is day 19. My face is alternating between burning and itching and I feel super tired. Lack of sleep is finally catching up with me. I tried to work with clay today and managed to make a couple of cuff bracelets but had to stop after an hour because my face started to burn again. I can normally crank out a dozen pieces in that same amount of time. Needless to say this treatment has definitely cut into my ability to be productive.

**Polymer clay cuff bracelets ready for the oven. Visit: www.etsy.com/shop/zeninthegarden for 40% OFF everything right now.**

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For the past three days my face has felt super dry, almost as if someone had wrapped it in cellophane and pulled it really hard towards the back of my head. When I open my mouth to take a bite of food the skin on my cheeks feels tight and hurts. Several people have used Aquaphor over the Fluorouracil to help with the dryness but it already hurts too much when I wash my face between applications. I can’t imagine also trying to scrub off all the Aquaphor before applying more cream. At this point my skin is so sensitive just rubbing the cream on sends me through the roof.

Technically I have just five more applications of the chemo although I am waiting to hear from my doctor after he reviews my most recent photos. If Sunday is really my last day then I get to look forward to a very painful two to three days off Fluorouracil before the face calms down then from four to eight weeks of healing before I will look and feel “normal” again.

To those of you who have been so gracious to donate to the GoFundMe page that was set up for me to help with my medical bills, I humbly thank you from the bottom of my soul. I also appreciate each and every one of you for continuing to follow along on my journey and for all your kind words and support. It’s truly great to know there are so many people in our world with such kind hearts.


Skin Cancer Treatment – Fluorouracil Day 17

As I sit here in pain, yes real live my face is burning intensely and I want to rip it off type of pain, I keep thinking about my past and all the UV exposure my skin has had. I am an intelligent person who has made some poor decisions in life, the “I am human” factor. But one of the decisions I regret the most as an adult is exposing my fair skin to that bright yellow disk in the sky.

The decisions I made as an adult were often motivated by how and when I was raised. I was born in the late 50’s, a decade when there was no such thing as sunscreen. A blend of baby oil and mercurochrome were the recipe of the day to rub all over your body for that “healthy” tan. My mother was a true sun goddess and like all new moms of that time, she taught me early how to lay out by the pool for that sexy tan.

**My mom the sexy sun goddess in her teens**

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**Me, her first born absolutely LOVING the fact my little fair-skinned body was working on a tan.**

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**What do you do when a baby gets all fussy in the hot sun? Why you roll them over onto their belly so they can get an even tan.**

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I am not blaming my mother for my bout with skin cancer, however the fact I now have it is due to my early years of severe exposure without protection that has damaged my DNA and triggered the “little nasties” to grow right about now. Several other factors worked against me. I grew up at a high altitude where UV rays were more intense. We spent most of our early years in the outdoors hiking, climbing, swimming, skiing, etc. without any sunscreen.

**Spending summers in my grandparent’s pool without sunscreen was probably not a bright idea either. But there wasn’t any back then.**

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I was also born of that fair-skinned, green-eyed, freckled-faced Irish ancestry that simply doesn’t handle the sun too well.

**My mom, little bro and myself in all our fair-skinned glory.**

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As I grew older I definitely had a hand in helping to add to my skin damage. In my college years I hit the tanning booths, floated on big inner tubes down rivers all day long in the hot summer sun drinking beer with my friends, lay out on rooftops slathered in baby oil so I could keep up that “sexy” tan (you know, the one I never had), and continued to ignore the dangers they were finally beginning to whisper about in the papers because that would NEVER happen to me.

Then what did I do? Why I turned right around after giving birth to my own fair-skinned son and exposed him to the same harmful UV rays with little protection. Fortunately they had invented sunscreen by then and I did use it on him when I remembered.

**Me and my son kayaking in the Sea of Cortez, Baja, Mexico (both hatless) where the sun was so intense I would break out in hives from too much exposure.**

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I guess my point here with this post is that skin cancer is preventable if you take the proper precautions to protect yourselves. For some of us who grew up with that intense exposure during times when protection wasn’t encouraged, we will and are unfortunately suffering the consequences in our later years.

For those of you who have been blessed with parents who kept you out of both the sun and tanning beds, consider yourselves lucky and please continue to do the same for your loved ones.

For those of you who still choose to deny and ignore the warnings, I wish you the best of luck. Skin cancer is real. It is not pleasant. It is not as simple as just cutting it away and moving on with your life. You will always be waiting for that next one to appear. And in some cases it will spread and kill you.

Trust me, soaking up those rays to get that “healthy” tan truly isn’t worth the suffering of trying to reverse the damage.


Skin Cancer Treatment – Fluorouracil Days 15 &16

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**My little friend Lily helping me to feel better.**

Yesterday, day 15, my face continued to burn and itch throughout the day. I noticed some deepening in color of some of the lesions and some slight shedding of the skin near my mouth.

Today there are more spots showing up on my forehead all of a sudden and the lesions on my cheeks are getting even darker and some of them look like little scabs. My forehead seems to be the last part on my face to react to the drug. Hopefully that does not mean I will have to continue for another week. I will know more when I check in with my doctor again at the end of this week.

Yesterday I had a consistent combination of itching and burning throughout the day with a couple periods of calm where I could actually focus and get some work done.

**Lovely photo of the day – lesions are getting darker, more inflamed and burning a lot.**

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Today is a different story. My face has been on fire for the majority of the day, I have a headache, and am extremely tired. This three weeks straight stuff of discomfort, pain, itching, and less sleep has definitely taken a toll on me in many ways. Physically, mentally, emotionally, and in my ability to be productive.

To ease some of my stress, my wonderful partner created a GoFundMe page to help me with the costs of my co-pay for my surgeries and treatments. I am personally very shy about those types of things and don’t normally ask for help. But this was definitely not an expected expense on my radar for this year. Such is the life of the working artist. So, if you feel so moved here is the link to the GoFundMe page: http://www.gofundme.com/hgdvmk.

I am one who likes to give in exchange for giving. So, if you would prefer to help out by purchasing some of my artwork instead of just a blanket donation, here are two places you can do that along with discount coupons for each:

My Etsy Shop (handmade polymer clay jewelry): http://www.etsy.com/shop/zeninthegarden – Enter coupon code: WPSKIN1 at checkout and receive 30% off your total purchase. A portion of the proceeds for this shop will be donated to the Skin Cancer Foundation.

My Fine Art America gallery (fine art photographs): http://tracy-thomas.artistwebsites.com – Enter coupon code: PLMVBU at checkout and receive 30% off your total purchase.

And if none of these appeal to you please feel free to share this post or those links along with coupon codes. You are all, each one of you, appreciated for your kind and encouraging words and especially for continuing to travel along on this journey.


Skin Cancer Treatment – Fluorouracil Day 13 & 14

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Yesterday morning, day 13, I woke up to increased inflammation and a very dry feeling around my mouth to the point it was hard to talk or eat. Just to move my mouth caused pain.

It is also more difficult now to wash my face and apply the cream. It hurts a LOT when doing either. It feels like every nerve in my face is on fire. Once I apply the cream I experience a window of about an hour where everything calms down a bit. Then as the day progresses it alternates between intense burning and extreme itching. Not a fun way to spend one’s day for sure. At this point it takes a ton of resolve to keep my hands from scratching at my face when it itches or burying my face in an ice bucket when it burns. Neither of which I am supposed to do.

**I bravely decided to do a little video**

Again, I am a realist, so if you will be facing 5% Fluorouracil treatment for your whole face in the future just prepare yourself for some pretty heavy-duty pain and discomfort.

Last night was another sleepless night. I slipped into the living room and read until around 3:00am and had some fun with a couple of creepy selfie night shots using just my iPhone and the light from my iPad to illuminate my face.

**Creepy low-light vampire selfie**

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This morning, day 14, I am one cranky ass. Yes, this is another listed side effect of the drug. I feel trapped in the house and trapped inside this face. Sometimes I feel like a vampire. I can’t go outside during the day because the drug causes extreme photosensitivity (yet another irony). They say if you do decide to leave the house to wear lots of sunscreen over the Fluorouracil. Negatory Big Ben. It’s hard enough for me to rub the drug on itself, I can’t imagine rubbing sunscreen on top of that then scrubbing at my face later to get it all off before the next application. So for now I will stick to wandering the streets in the darkness thank you. I also do not want to scare anyone who does not know my story. I have visions of children screaming and running down the street in terror while hoards of torch bearing vigilantes heave rocks in my direction. Yes I can be facetiously dramatic and indeed it wreaks a bit of havoc on one’s self-esteem.

This is the end of week two of application. Seven more days to go of applying the cream, that is if my face reaches the “Erosion” phase during this next seven days. If not, then it’s up to my doctor to decide whether to tack on extra time or not.

Gettin’ there, but definitely not fast enough for my taste…


Skin Cancer Treatment – Fluorouracil Day 12

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This morning I look and feel like a Meth Head between hits. My face feels swollen and it is painful to open my mouth to talk or eat. I have giant, puffy rings under my eyes due to lack of sleep and it feels like a tiny Gremlin is running around on my face poking it with a million little needles.

Yes, this is one of those not so good days in this treatment cycle. I ordinarily have a high tolerance for pain, however this treatment experience delivers a pretty constant level of pain that just gets to you after awhile. I can understand today why a lot of people tell their doctors they can’t continue with the entire regimen. But I intend to keep plugging for my remaining time on the drug because I feel the alternative is not a smart one for me based on the amount of nasty cells it has already uncovered on my face.

**The uber tired me after a sleepless night of discomfort and nausea.**

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I haven’t been able to accomplish much of anything the past three days. But the one thing I have been able to do faithfully is write. I am still hammering away at the NaNoWriMo challenge and am just 10,000 words away from reaching the goal of 50,000 words. At least I will have a rough draft of a novel at the end of all this if nothing more.

**Here is a closeup of the spots on the right side of my face that are the most sensitive.**

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Skin Cancer Treatment – Fluorouracil Day 11

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I reached the halfway point today, at least with the application of the Fluorouracil part. I know there will still be several weeks following the 21 days of treatment where the skin will be super sensitive, scabby, festering and sloughing while the new healthy skin grows back to replace the pre-cancerous and cancerous spots. But at least I’m not back at the beginning all over again.

When I began this treatment I was of course nervous. I had read numerous blogs and had seen all the photos and videos of those who have gone through this treatment and it wasn’t pretty. It turns out my fears were not unfounded. It really does hurt like a Motha’. In fact it hurts way more for a prolonged period of time than either of my surgery sites did.

I don’t ascribe to sugar coating anything. I believe it is far more valuable to present things exactly how you experience them so that others will know what they may or may not have to face when doing the same. Of course we all experience things differently and my level of reaction to and pain caused by Fluorouracil may not be the same as the next person who uses it. But going into it educated with all the possibilities has allowed me to mentally prepare myself for what might be.

**Tired of looking at my flaming red face every day so I am taking a break and posting a black and white instead :).**

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Fluorouracil is sort of an enigma. You are putting it on your skin to help eradicate bad cells and it in turn causes your skin to react at times severely. It is harsh on the skin to say the least. At the same time once you wash it off between applications during the 10 minute wait, your skin starts to feel extremely dry and begins to burn way more than it did when you had the cream on in the first place. Once you rub the next dose on your face the burning and dryness calm down a bit until a few hours later when your face begins to scream at you again and all you want to do is wash it off. I think of it as a wolf in sheep’s clothing. A heavy duty caustic chemo drug dressed up in a nice soothing cream base.

I had a mid-point follow up with my doctor yesterday. I sent him several photos (oh the beauty of the internet and the ability to have virtual appointments). He said my face is right on track with where it should be now but to anticipate some “increased discomfort” over the next few days. Oh goody. I love how they use the word “discomfort” when you know they really want to say “it is going to hurt like a mother f***er.”

He advised me to start applying petroleum jelly right now to the nasolabiol and melolabiol folds (the lines that runs from the edge the nostrils down to the mouth) to serve as a barrier to the Fluorouracil. He told me if I don’t do that now it will become so painful over the next few days it will make it hard to contine. Yikes. Petroleum jelly applied!

Today my face is burning a lot more than yesterday. The volume of spots looks about the same but some of them have turned a darker red. I will post another technicolor photo tomorrow.


Skin Cancer Treatment – Fluorouracil Day 10

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Today is day 10, almost halfway through my prescribed 21 days of treatment. Well, at least I am halfway through applying the cream itself. I know there will be several more weeks following the last dose where my face will still be doing it’s thing. I also realize my face has not yet reached the most uncomfortable phase of treatment based on following other bloggers during their own course of treatment.

**My pretty face at this juncture in my treatment**

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Yesterday was another difficult day. My face still burned quite a bit intermixed with some severe itching. I felt nauseous and had a headache for most of the day. I also had a difficult time sleeping last night and woke up with my face burning again.

**Side view right (the small dark wide line on the side of my nose leading straight into my eye is the scar from my recent Mohs surgery to remove one of the Basal Cell Carcinomas – they did a wonderful job)**

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Right now after washing my face and applying my morning dose, my face has calmed down and is bearable. That seems to be how the course of my days go with Fluorouracil so far. Mornings are the least painful and uncomfortable but as the day goes on it hurts more and is pretty bad by evening.

**Side view left**

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I am still able to tackle some work projects during the day however by early afternoon I am pretty wiped out. I am lucky that I work from home and am my own boss. I have no idea how people who go through this treatment and need to leave their homes for work do it. If any of you are going to go through this treatment and have not yet started, I would highly recommend you use some vacation time or get a note from your doctor and take some sick leave.

Onward and upward!


Skin Cancer Treatment – Fluorouracil Day 9

I decided to write this post earlier in the day today since I tend to feel worse during the evenings for some reason. Yesterday was not a good day as you could probably tell by my post. It was the first day where my face began to turn red in addition to the multiple spots that had shown up on days 6 & 7. My face literally went from feeling uncomfortably itchy in the morning to burning like it was on fire by the afternoon. It was not fun and I know I haven’t even gotten to the “fun” part yet in this cycle.

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So far today my face is not burning as much however I have a pretty constant headache and some nausea this a.m. My face feels extra dry even with the cream base of the Fluorouracil and it is starting to hurt when I open my mouth.

With the exception of yesterday, so far it has been bearable and I know the outcome of subjecting myself to this uncomfortable and at times painful experience will be a positive one. I would much rather eradicate the “Little Nasties” now than have to go through multiple Mohs surgeries on my face in the future. I know this will not be my last time using Fluorouracil as my Dermatologist told me as much due to the amount of UV damage I have on my skin. I was also one of the stupid people, yes I said “stupid,” who chose to tan in a tanning booth when I was in my twenties. Crossing my fingers that something worse like Melanoma does not grow out of that poor decision from my past.

Onward and upward!


Skin Cancer Treatment – Fluorouracil Day 8

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All I want to do today is claw my face off. Fluorouracil burns. That is all…


Skin Cancer Treatment – Fluorouracil Days 6 & 7

Yesterday, day 6 on Fluorouracil, my face burned a lot throughout the day. My skin was a little bit pinker but for the most part looked the same as day 5. But if felt different, as if things were beginning to happen beneath the surface.

This morning, day 7, I woke up to around four dozen deep red spots on both cheeks, my nose, around my mouth and on my forehead. The majority of these spots were not visible prior to application of Fluorouracil so I assume these are the “Little Nasties” that were lurking beneath the surface of my skin all this time just waiting to turn into cancerous lesions. The spots look angry, like they are really pissed off at me for attempting to eradicate them. Meh, let them be pissed. I don’t want to go through surgery again so flame away!

(Photo: pissed off angry spots on my right cheek and side of my face)

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My face was more uncomfortable today with a pretty consistent burning similar to a mild sunburn intermixed with itching. It took a lot to keep myself from touching and scratching my face today. I am also feeling extra tired the last few days. Sleeping pretty well so far but it’s as if my body is working overtime to deal with the reaction happening on my face.

I dislike being so hyper-focused on something like my face. But being a slave to this treatment means I need to plan my days around the timing of the applications and how I am feeling. That means thinking about my face, staring at my face, taking photos of my face, wanting to scratch off my face, trying to hide my face in public, writing about my face, dreaming about my face being pressed against a hot iron… you get the idea.

I realize this is only the beginning and I have not reached the worse part yet. But I keep trying to focus on the rewards – a decrease in the chance of another surgery and as my Dermatologist says, when it’s all over I will have a face as “smooth as a baby’s butt.” Yes he said that. He really did :-).


Skin Cancer Treatment – Fluorouracil Days 4 & 5

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Yesterday on day 4 of Fluorouracil it was pretty much the same as day 3. Still waiting for Christmas to arrive with the same few acne like spots and the blister appearing on my nose.

Today, day 5, is a different story. My face now feels like it is periodically sitting over a low burning flame. And when it’s not burning it begins to itch and I want to scratch it really bad. I also noticed a few more red spots appearing on my cheeks, nose and forehead and when I wash my face prior to application of the next dosage it feels like my face has a sunburn when I pat it dry with a towel.

Even though my face was extra sensitive today I was still able to concentrate and get a lot accomplished. I made several pieces of jewelry and posted them for sale on my Etsy shop (www.etsy.com/shop/zeninthegarden) **SHAMELESS SELF PROMOTION** and I reached 30,028 words written on my novel in the #NaNoWriMo challenge. Go team!

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Skin Cancer Treatment – Fluorouracil Day 3

This is day 3 of Fluorouracil treatment. I now have what looks like a mild case of acne, especially on my forehead. I also have a small blister forming on the side of my nose right where my glasses sit. My forehead and cheeks are a light pink and my forehead burns a bit, although so far it’s tolerable.

**I am bravely displaying my naked face below for documentation purposes only in the name of science ;-).**

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I feel like a little kid impatiently waiting for Christmas morning to arrive. Although I would much rather receive the pony I’ve always wanted instead of the “gift” I am about to unwrap after applying this chemical to my face two times a day. As I wrote in my first post, I know most people don’t react to the drug until around the sixth day. The waiting is the most difficult part. I don’t like unknowns. I just want the drug to kick in and do its thing so I know what I have to deal with.

The positive part of all this is my sudden sense of urgency to finish up projects before the hard part gets here. Yesterday I hit the halfway point for NaNoWriMo (National Novel Writing Month). I have already written 25,014 words of my novel in 11 days. The goal is to reach 50,000 by the last day in November. At this pace I should reach the goal by November 22nd. This cancer thing has definitely been the impetus for me to keep my nose to the grindstone and write like a Mother_____er (well, you know).

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I am also a bit less irritable today because I made a point to set some time aside for a bit of clay play. I love creating jewelry and other goodies with polymer clay. The act of squashing and rolling and mixing and folding the clay in my hands is very therapeutic. Losing myself in the act of creating a design is a great way to forget about the stressors that have recently consumed me.

Today’s design I called “Superstar” for everyone who has to endure the more difficult things in life.

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In an hour I will don the glove and spread another dose of the cream all over my face. Maybe tomorrow will be the day. Maybe it won’t. Regardless, I think I will buy myself that pony after all of this is over.


Skin Cancer Treatment – Fluorouracil Day 2

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Day two on Fluorouracil has been pretty uneventful. Last night my face tingled a lot and it felt like I had a mild sunburn (oh the irony). I sleep on my side so my pillow case kept sticking to my cheeks every time I went to turn over. I hear it is even more fun when your face begins to bleed and fester. Plastic covers under the pillowcases anyone?

This morning my face was still pink but the day was mostly uneventful with the exception of the fact I felt slightly irritated. More than likely not a side effect of the drug at this early juncture but feeling a little trapped by the thought of being a slave to this chemical for the next three weeks and not certain how intensely my skin is going to react.

There are a few tiny red spots that are already beginning to pop out on my forehead but nothing worth taking a photo of yet. So I decided to post some photos from my last nature walk this past Sunday instead.

It was my last chance to get in a good walk before starting the Fluorouracil. The medication makes you extra sensitive to UV rays. I have seen the photos of people who used the drug and made the mistake of going out in the sun. Even with sunscreen and short exposure times, their faces became terribly inflamed. Thus I have decided to become a vampire and go on walks after the sun goes down. It makes life more exciting that way :-).

So for now, here are a few iPhone photos I shot using the Tintype app by Hipstamatic. They were shot along the Barge Access Canal across from the Port of Sacramento.

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Skin Cancer Treatment – Fluorouracil Day 1

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Today was the first day of my topical chemotherapy treatment for skin cancer with 5% Fluorouacil. For those of you who have not followed my blog up to this point, I have been through two different surgeries to remove Basal Cell Carcinomas in the past few months. The first was a more advanced lesion on my back. It was removed by way of Curettage and Electrodessication. The second one was on my face near my eye on the Medial Canthus and was removed with Mohs surgery. I have also had close to two-dozen Actinic Karatoses removed from my face, hands, legs, arms and chest through Cryosurgery.

My Dermatologist was a bit concerned by the amount of pre-cancerous lesions that were apparent on my sun damaged face. He prescribed 5% Fluorouracil to stop the growth of cells in both the pre-cancerous lesions and any Basal Cell Carcinomas that may be lurking under the surface.

Fluouracil is an Antimetabolite originally used as an internal chemotherapy to treat a variety of cancers. On the cellular level, Antimetabolites interfere with both DNA and RNA synthesis thus the cancerous cells die off because they can no longer replicate.

If you do a Google search of Fluorouracil, or more specifically “Efudex” treatment, you will find a lot of scary looking photos and some videos from different stages of treatment. Not everyone reacts the same way to this drug. Some individual experiences are more dramatic than others. It all depends on how many lesions you have on or beneath the surface on the skin being treated. Some people are only prescribed treatment for specific or small areas on their bodies so the overall dosage is minimal. However, some people like myself have been prescribed treatment at maximum dosage to cover a larger area, in my case the whole face.

I have decided to document my treatment with photos and updates on my blog and will file these types of posts under the “Skin Cancer” category for those who are interested in following along. I also feel it is important for others who may have to go through this same treatment in the future to know the reality of a variety of people who have used it. I know it helped me immensely to research and read other skin cancer patient’s blogs prior to my treatment.

So here is day one photo of my lovely face sans makeup (just for you) immediately prior to applying my first dose this morning. Note the smile on my face (we shall see how long that lasts).

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I will be applying Fluorouracil to my face twice daily for three weeks straight. There are many possible side effects including: Skin irritation, burning, redness, dryness, pain, swelling, tenderness, changes in skin color, eye irritation (e.g., stinging, watering), trouble sleeping, irritability, temporary hair loss, or abnormal taste in the mouth.

These are the more uncommon but serious side effects: stomach/abdominal pain, bloody diarrhea, vomiting, signs of infection (e.g., fever, chills, persistent sore throat), easy bruising/bleeding, mouth sores, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Yes I know this now sounds like one of those television commercials that I hate so much and question why anyone would use one of those drugs with the risk of all those side effects.

But the benefits definitely outweigh the risks when it comes to skin cancer. Fortunately, the more serious side effects happen to a small percentage of users.

I will be applying the second dosage in about half an hour. Most people do not experience much reaction until after seven days of use. I happen to be blessed (or cursed) with very sensitive skin and my face is already beginning to turn pink and it feels as if I have a slight sunburn. I get the feeling I am going to end up being one of the “prettier” Efudex patients before too long.

And away we go!


Of Fluttering Eyelids, Insomnia, and a Dose of Reality

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Most people despise insomnia. I rather like it. Yes, I said “I like it.” There never seem to be enough hours in the day for me to do all the things I want and need to do. For most of my life I have been the most productive during the still and quiet times of the night. It’s as if my creative switch jumps into turbo mode and I find the need to heed its call. When my body says “hell no” my mind persists until I fling my legs over the side of the bed and shuffle off to my office in the dark. Sometimes I am rewarded with a moment of brilliance. At others I simply stare and curse at my inability to lasso all the free-ranging thoughts and ideas that inflict bruise marks upon my brain.

This past few weeks I have had many of those sleepless episodes. When I view it with logic I attribute it to the need for a bit of overtime to make up for all those unproductive post-op days. I know my body needs the rest and I will still grab several hours even at my worse, but I have photos to edit, code to write, blogging to catch up on, and jewelry to design.

When I allow myself to ease into my emotions I realize it’s all just smoke and mirrors. Time is short. We don’t have forever to make a contribution to this world. My insomnia is my mind’s way of reminding me that all our days are numbered. The dark, vacuous expanse of the night forces me to hear my own thoughts after the noise pollution from my day has finally been silenced. It’s like viewing a full-frontal image of a life not yet fully well-lived. Parts of it are crumbling, parts of it have already died. All the promise of youth; the dreams, the aspirations, the convictions. Some of them accomplished, a few of them long forgotten. Some of them never to be revisited again. They now stare blank faced and wrinkled before me. Energy expended. Searching for the reserves. Is that really all it is? A constant struggle to remake oneself and whittle the vision down into tiny little achievable pieces until the very end?

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A little more than five weeks have passed since the Curettage and Electrodessication surgery to remove the skin cancer on my back and it has been four weeks since the Mohs surgery removed the cancer on my face. My body is healing well with a few exceptions. My energy level has not been the same but I attribute that to my body’s need to call on all reserves in order to heal itself. I suffered nausea and headaches for the first week and a half following my Mohs surgery but that has thankfully subsided to a day here and there. My back is still a bit tender as the new skin grows in to cover the hole left by the removal and I suffered a large rash around the area during the time I had to use bandages to cover the hole. Thankfully the rash is drying up. But I now have another curious growth below the scar that seems to be yet another Basal Cell (sigh). But the bruising and swelling around my eye that left me looking like a prize fighter or one badass hockey player is now only a dime-sized black and blue mark near my cheekbone.

The newest post-op symptom to arise is one that is driving me completely crazy. My upper eyelid has decided to flutter uncontrollably for the better part of every day, especially when I am attempting to get work done in front of my computer. It makes everything look like one of those flip book movies It doesn’t surprise me in that the surgeries (both the Mohs removal and reconstruction) took place on the Medial Canthus of the same eyelid. There are a number of nerves, muscles and vessels that pass through that area and my eye is working overtime to adjust to the trauma of the surgery itself. Fortunately the surgeon who did my reconstruction is an Opthalmologist and I have another follow-up appointment with him in three weeks. If the fluttering is still there at that time, he will be the best one to inquire about it.

Although I am not one to regularly kneel at the alter of vanity, my Oculoplastics surgeon did an amazing job of sealing the site. It looks like I will have a barely visible scar that gets covered for the most part by my eyeglasses. The scarring on my back is another story but the only time that area is shown in public is if I don a bathing suit and go lap swimming. And these days that is a very rare occasion indeed due to my need to stay out of the sun.

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I am a realist at heart. I love all my friends who live in the world of a glass half full and who tend not to dwell on any possibility that doesn’t fall into the category of positive thinking. I prefer to pause at that half full mark more often than not, but in the case of skin cancer I know it is a chronic condition and I am bound to have more lesions arise over time. The DNA damage was done during my careless and clueless younger years and I am just now reaping the “benefits” of all those poor decisions. It’s not an illusion or a conjuring up of bad things that are now bound to happen because of negative thought processes. This is my reality but I feel prepared. I am definitely more cognizant of what to watch for in order to catch things as quickly as possible should they arise. I have developed a great relationship with a group of wonderful doctors who are looking out for my health and are ready to conquer any new demons when they arise. I feel blessed that I wasn’t handed the diagnosis of Melanoma and happy that my tumors were caught in time before further damage was done.

The next step in my journey will be the Flourouracil treatment (topical chemotherapy) on my face, and later my chest. I am stalling a bit in regards to the start date of this treatment. I know it will be extremely uncomfortable at best and absolutely horrible at its worst. My skin is very sensitive and my Dermatologist says I have a lot of spots on my face that he is concerned about, so I have the feeling my experience with Flourouracil will not be a pleasant gourmet Sunday picnic.

I am taking this time during my healing from the surgeries to catch up on a bunch of projects and basically get everything in order for the four plus weeks I will be dealing with the Flourouracil treatment. I am not expecting it to be a whole lot of fun, but at least it will mark the end of a very long and trying year.


Of Frozen Peas and Prize Fights

Frozen peas are my friend.

Frozen peas are my friend.

Today I look like a prize-fighter. Fortunately my opponent looks far worse than I do at this moment in time. Yesterday’s surgeries went well. After a six-hour day of needles, scalpels, bandages, blood and stitches, I can now say I am cancer free. So this week I am focused on healing. Bags of frozen peas have become my best friend for reducing the swelling and controlling the bruising. Once I am fully healed I will move on to the topical chemo in a few months to eradicate any hidden gremlins that might be lurking in the shadows.

The scene of my Mohs surgery.

The scene of my Mohs surgery.

Thank you all for the kind words, prayers and positive thoughts you’ve sent me while I travel down this inconvenient but hopefully short side road along this occasionally convoluted journey we call “life.”

The reconstruction surgeon, Dr. J., who made me all pretty again.

The reconstruction surgeon, Dr. J., who made me all pretty again.


On the Eve of Mohs

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Tomorrow morning I have the Mohs surgery to remove the rest of the tumor on my eyelid (Medial Canthus). The length of the surgery is dependent on how wide and deep the roots of the cancer have grown. The surgeon will take a slice, bandage me up and send me to a waiting area while he freezes the sample and looks at the cells under a microscope. If the margins are not clear he will take another slice and repeat. This process will continue until he views clear margins. They told me it typically takes from three to five hours with most undergoing three passes of the scalpel, some much more.

Once the margins are clear he will inject a longer-lasting anesthetic, bandage me up again and send me on my way to the Oculoplastics surgeon for reconstruction and closure of the surgery site.

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After the surgeries I will have to ice my eye/face 20 minutes on/off for the first three days followed by warm compresses until the stitches are removed, keep the area clean, and put artificial tears in my eyes four times a day. I will have to sleep in a recliner to keep my head elevated and cannot lift much of anything, am not supposed to bend over nor do any exercise. Basically I am supposed to rest and let it heal.

My biggest concern is of course in which direction he will have to cut to follow the cancer. I am hoping it is away from my eye. My second concern is the amount of time my eye will remain swollen and how soon I will be able to wear my glasses. I am pretty blind without them.

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The surgery site on my back is healing well with minimal pain although I have been experiencing daily headaches. Yesterday I was able to go on an easy hike around Sly Park lake for a bit of pre-surgery nature therapy. It felt good to get out in nature but I was not feeling well by the time I got back to the picnic area.

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Tonight I am understandably a bundle of nerves. I am trying to keep myself grounded and positive but I don’t like the fact there are so many unknowns right now. Of course it will all become clear as the surgeon begins his task and I will walk away at the end of the day knowing without a doubt that all the cancer has been removed.

I will update you all as soon as I get to the other side :-).

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And So It Begins…

Surgical Lights. ©Tracy J Thomas, 2014. All rights reserved.

Surgical Lights. ©Tracy J Thomas, 2014. All rights reserved.

So yesterday was surgery #1 for the cancer on my back. After a long discussion with my doctor I chose one of three removal options. The options were by excision, through Immunotherapy drugs, or by Curettage and Electrodessication.

Since it is a larger basal cell, with an excision he would have had to cut about ten inches in length and go pretty deep for clear margins plus I would have quite a few stitches to contend with and the pain that accompanies it. The second option was Immunotherapy via Imiquimod used to treat advanced basal cell carcinomas. The drug uses your own body’s immune system to kill off the tumor but the regimen would require daily topical application for six straight weeks with pain and discomfort accompanied by flu-like symptoms. The third (which I chose) was the Curettage and Electrodessication method. It would not require a large incision or stitches nor the yucky chemo side effects. He used a sharp curette (a spoon-shaped instrument) to scrape and scoop the tumor out then used a machine with an electric current to burn away any excess cancer cells surrounding the tumor spot. So now I have a semi-deep, open spot on my back that simply requires cleaning, application of ointment and bandaging for the next several weeks. It stung quite a bit after the local wore off but I slept well last night after taking an Extra Strength Tylenol and today I only feel it a tiny bit along with a headache.

The surgery room. ©Tracy J Thomas, 2014. All rights reserved.

The surgery room. ©Tracy J Thomas, 2014. All rights reserved.

Although it does not have as high of a success rate as the Imiquimod, I decided the C&E method would be the best choice since I will have to also deal with the healing process, discomfort, etc. of the upcoming surgeries on my face which will be more involved and require stitches.

My lollipop following surgery.

My lollipop following surgery.

I also had another pre-cancer (Actinic Keratosis #20) frozen off my forehead right before the surgery. We discussed moving my topical chemo regimen forward to the end of October following my Mohs instead of waiting any longer since I have so many “spots” of concern on my face. So I have five weeks of possible Hell to look forward to after all this surgery. The level of that particular Hell will depend on how many sub-dermal spots turn up when I use the Fluorouracil. Common side effects of this topical chemotherapy may include: skin irritation, burning, redness, dryness, pain, swelling, tenderness, or changes in skin color at the site of application. Eye irritation (e.g., stinging, watering), trouble sleeping, irritability, temporary hair loss, or abnormal taste in the mouth may also occur. Oh goody!

Paraphernalia to make the owie all better.

Paraphernalia to make the owie all better.

So the lesson in this is WEAR YOUR SUNSCREEN and those big, sexy hats. It’s not “just skin cancer” that can be cut away and forgotten about. It is real, it costs time and money, and it wreaks havoc on one’s psyche.

That is all for now…


Respite in Yosemite

El Capitan. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

El Capitan. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Last week I was “kidnapped” by my lovely partner and held hostage in a Yurt for three days right outside the entrance to Yosemite National Park. It was a much-needed respite in nature as my surgery dates approach.

The Yurt. ©Tracy J Thomas, 2014. All rights reserved.

The Yurt. ©Tracy J Thomas, 2014. All rights reserved.

I grew up near Yosemite on the Eastern side of the Sierras so I have been there many times. I never get tired of the beauty and majesty that this park bestows. I am always in awe and am often brought to tears by its magnificence.

A very dry Mirror Lake. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

A very dry Mirror Lake. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Our days were spent hiking and taking photos. I felt completely energized and renewed while there and wanted to continue hiking and climbing even when I was at my most depleted state due to the higher elevation and lack of oxygen.

It was a wonderful escape from reality as well as an opportunity to reflect on the beauty in life.

The view of Half Dome and Yosemite Valley from on top of Glacier Point. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

The view of Half Dome and Yosemite Valley from on top of Glacier Point. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

This morning I am feeling tense again so I decided to look through my photos in order to go back to my “happy place” and ground myself a bit. That is a big part of photography for me. The ability to relive those moments captured in perpetuity. When I view them I can feel the wind on my face, the smell of the pines, the warmth of the sun (protected by SPF 50 of course), and am embraced once again by a feeling of reverence and an overwhelming silence.

"The Fallen." - Jeffrey Pine on top of Sentinel Dome with a view of El Capitan and Cathedral Spires in the background. ©Tracy J Thomas, 2014. All rights reserved.

“The Fallen.” – Jeffrey Pine on top of Sentinel Dome with a view of El Capitan and Cathedral Spires in the background. ©Tracy J Thomas, 2014. All rights reserved.

Tomorrow it all begins with my back surgery followed 10 days later with the Mohs surgery on my face. I expect tomorrow to be pretty straight forward with an excision and stitches followed by the waiting game for the pathology report. The Mohs surgery on the 8th is a different story. Too many unknowns for my taste. But I will try to stay focused on the beauty of nature and look forward to more trips to Yosemite in the future.

A Mule Deer in the forest. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

A Mule Deer in the forest. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

The majestic face of El Capitan. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

The majestic face of El Capitan. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Bridge over the Tuolumne River. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Bridge over the Tuolumne River. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Granite and trees near lower Yosemite Falls. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Granite and trees near lower Yosemite Falls. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.


A multitude of rock cairns below Half Dome near Mirror Lake. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

A multitude of rock cairns below Half Dome near Mirror Lake. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Sentinel Dome from below. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Sentinel Dome from below. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Hiking down from the top of Sentinel Dome with Half Dome as the backdrop. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Hiking down from the top of Sentinel Dome with Half Dome as the backdrop. Yosemite National Park. ©Tracy J Thomas, 2014. All rights reserved.

Yep, that's a selfie on top of Sentinel Dome. Yosemite National Park.

Yep, that’s a selfie on top of Sentinel Dome. Yosemite National Park.


The Waiting Game

"Upside Down" - ©Tracy J Thomas, 2014. All rights reserved.

“Upside Down” – ©Tracy J Thomas, 2014. All rights reserved.

The past few weeks have been spent focused on design projects for clients while finding ways to keep my stress levels under control. Burying myself in “busy” is a great way to forget about the cancer but it doesn’t necessarily bode well for subconscious stress management. We have been having quite the heat spell here in California so I have not been spending as much Zen time out in the garden with my camera. Instead I have been starting my days off by making my way to the air-conditioned gym to pedal, lift, and sweat away all those ugly stress bugs.

"Cradling the Moon" - ©Tracy J Thomas, 2014. All rights reserved.

“Cradling the Moon” – ©Tracy J Thomas, 2014. All rights reserved.

The surgery to remove the cancer on my back is now scheduled for August 27th. The back surgery should be relatively straight forward with minimal recovery time. A lot will depend on the pathology report a few days following the excision. If the margins are not clear, then I will need to go back in for more. If they are clear then I will have 10 days to recover before the Mohs surgery on my face.

I am the most nervous about the surgery on my face. Most of that comes from all the unknowns that are tied in with this spot. They won’t know until they begin to cut away, freeze the tissue and look under the microscope how much they will need to remove that day. It could be anywhere from a few passes to an all day affair. It all depends on how far the cancer has spread beneath the surface. Once the surgeon gets clear margins I will then need to have reconstructive surgery with the Oculoplastics surgeon that same day. Again, how much reconstruction I will need is an unknown until the cancer is removed.

Hibiscus flower - ©Tracy J Thomas, 2014. All rights reserved.

Hibiscus flower – ©Tracy J Thomas, 2014. All rights reserved.

On Tuesday of this week the U.S. Surgeon General for the first time ever issued a call to action to prevent this disease. This warning is long overdue. Hopefully it will have a strong impact on how people think about UV exposure and the real threat it has on their health. I know it took my own diagnosis to shake up my world and clarify for me the real dangers of tanning, whether it be from the sun or in a tanning bed.

Please wear your sunscreen and those big, floppy, oh-so-sexy hats. Protect yourselves and the ones you love. Pale is definitely the new sexy.


The Better To See You With…

ophthalmologists Phoropter - ©Tracy J Thomas, 2014. All rights reserved.

Opthalmologists Phoropter – ©Tracy J Thomas, 2014. All rights reserved.

Last week I had my appointment with the Ophthalmologist who will be my Oculoplastics surgeon directly following the Mohs surgery. I wasn’t quite sure what to expect when I came to his office for the pre-op consult and examination. He examined my eyes closely with a numbing yellow dye and a split scope then took a ton of measurements of my face from my eye up to my hairline, from my eyelid to the area of the lesion, and across the bridge of my nose. He then took a lot of photographs of my face, especially of the area where the cancer lives.

Split Scope - ©Tracy J Thomas, 2014. All rights reserved.

Split Scope – ©Tracy J Thomas, 2014. All rights reserved.

Dr. J as I will refer to him explained the difficulty of the surgery based on the proximity to the eye. He told me when cancer is found on the midline of the face it is considered high-risk. The face is made up of different types of skin cells so grafting to the area where my cancer grows with skin from somewhere else on my face (i.e. behind my ear) would not do very well. Instead he will be pulling a skin flap over the open region with adjoining healthy skin. This may mean skin pulled over from my top eyelid, bottom eyelid, or down from the bridge of my nose or forehead to the area of the medial canthus. Part of the difficulty of reconstruction for this area is the fact it is a concave pocket and skin likes to grow in a straight line from point A to B especially when they use a graft from another area of the body. However skin cells used from adjacent areas can more easily conform to the natural concave shape of the area.

Anatomy of the eye - ©Tracy J Thomas, 2014. All rights reserved.

Anatomy of the eye – ©Tracy J Thomas, 2014. All rights reserved.

We discussed the unknowns including the fact they won’t know how much skin will be removed until the actual day of the Mohs surgery. Therefore Dr. J does not know how much reconstruction will be required until I make it to him following the first surgery earlier in the day. Such is the nastiness of skin cancer. It likes to take root and grow just under the radar beneath the surface of the skin. The beauty of Mohs surgery is their ability to remove a layer, freeze it, look at it under a microscope to determine whether or not they got clear margins all in the same day. That way you don’t have to wait two days and come back for more surgery. They just keep cutting away until the margins are clear.

I can’t honestly say my anxiety was relieved by the pre-op appointment. There are still too many unknowns at this juncture. I did receive the date for my Mohs surgery and reconstruction the day after my pre-op so at least I now have a target date for which to mentally prepare. The cancer on my back will be removed first in a few weeks by my Dermatologist, most likely through excision. I will then have a month or so to heal before my face surgery occurs on September 8th. Relieved to have a date, however the intensity of it all gave me one big headache.

Me getting rid of my headache with my Spa Comforts lavender eye pillow.

Me getting rid of my headache with my Spa Comforts lavender eye pillow.

Dr. J gave me a handout with post-op care instructions before I left his office. There will be a period of time I most likely will not be able to wear my glasses due to inflammation, swelling and tenderness. This is not a great thing since I am pretty reliant on my glasses to read and see. They told me to expect redness, bruising, and swelling to not only my eye area but my face plus the possibility of bleeding into the white of my eyes for a period of 4-6 weeks. I will need to sleep with my head elevated (yay for brand new, über comfy La-Z-Boy recliners) and I won’t be able to do any heavy work, bending over, lifting or exercise. In other words I am going to be bored for a bit :-).

However boredom is the perfect trade-off for becoming (fingers crossed real tight) cancer free.


Finding My Center

"Qi" - ©Tracy J Thomas, 2014. All rights reserved.

“Qi” – ©Tracy J Thomas, 2014. All rights reserved.

This past week I have been embroiled in a feeble attempt to find my center. There are moments when I feel like a derailed train that continues to move forward without a clear vision of my destination. There have been a whole lot of unknowns that surround my day-to-day. I float somewhere in this middle ground that follows diagnosis but comes before surgery and treatment.

I don’t do well with unknowns. What I do know is the cancer is still growing while I wait to have it removed from my body.

So, I spend an inordinate amount of time doing research on anything related to skin cancer, Mohs surgery and Efudex treatment. I have always been the curious sort with a need to know, oft-times to my own detriment. But I would much rather be educated than blind to the facts and possibilities before me. I suppose it provides me with some semblance of control in the midst of feeling out of control over the current circumstances during my body’s rebellion against the sun.

"Gazania 2" - ©Tracy J Thomas, 2014. All rights reserved.

“Gazania 2” – ©Tracy J Thomas, 2014. All rights reserved.

When you stop and read the statistics on skin cancer it is a bit astounding. One in five people will have some form of skin cancer in their life time. One in five. Yet we continue to have this sordid love affair with tanning booths and the sun.

Skin cancer is not just a simple trip to the Dermatologist to have a couple of bad cells scraped off or frozen away. It can be that for a few, but it also has the potential to be extremely disfiguring. And it can kill you.

We have been taught to shrug our shoulders and say “at least it’s just skin cancer.” In my mind this is nothing more than a statement of denial since we tend to place bronzed skin and vanity on a pedestal far above common sense. Skin cancer of any type can metastasize and spread to the organs if left untreated. I challenge anyone who thinks that skin cancer is “no big deal” to Google it and read the blogs and stories of people who have or are now going through it. It’s not pretty.

Black Beauty

Although I do feel lucky to so far avoided the diagnosis of the creeping black spider that is Melanoma, this in no way diminishes for me the seriousness of my own diagnosis. The fact I have any type of skin cancer at all increases the probability that I will have more in the future. All those days in my past spent carelessly soaking up the sun for the sake of vanity altered my DNA and have finally culminated in something not so pretty.

"Gazania 3" - ©Tracy J Thomas, 2014. All rights reserved.

“Gazania 3” – ©Tracy J Thomas, 2014. All rights reserved.

On Monday I meet with the Opthamologist/Oculoplastics surgeon for the pre-op appointment prior to the Mohs surgery on my face. Since this lesion is close to my eye and my eyelid it is considered high risk. I will need reconstruction surgery and most likely a skin graft following the removal of the cancer by the Mohs surgeon. I should know shortly after this appointment the date of my first surgery.

So, for now as I continue to ride the roller-coaster of stress and emotion and fumble for my center, I take trips out into the garden and attempt to focus on the beauty I see through my lens. When I do this I feel my whole body exhale. I feel my feet grounded on the soil below me. I begin to find my center. I forget, if only for a moment, about the ugly and garner hope for a future filled with the magnificence of the small things we are often too blind to see in this life.

"Emanating" - ©Tracy J Thomas, 2014. All rights reserved.

“Emanating” – ©Tracy J Thomas, 2014. All rights reserved.

You can now purchase any of the photographs from my “Zen in the Garden” series on my Etsy shop here.


Floating Weightless In-Between

"Winged Beauty" - ©Tracy J Thomas, 2014. All rights reserved.

“Winged Beauty” – ©Tracy J Thomas, 2014. All rights reserved.

I am the strong silent type. An observer from day one, I have always preferred to sit back and watch the world. To the dismay of the people closest to me, I crawl into my cocoon of thought and don’t emerge until I feel ready to talk about the things that have impacted my life.

"The Retreat" - ©Tracy J Thomas, 2014. All rights reserved.

“The Retreat” – ©Tracy J Thomas, 2014. All rights reserved.

Since my last post “A Million Angel Kisses,” I have been doing a whole lot of digesting. At this point I am floating weightless in-between. This is the waiting game before the surgery dates are finalized and the biopsy sites and Cryosurgery areas heal. I have traveled from the warp-speed moment of hearing the news to this point that feels as if I am stuck in some relentless traffic jam. I just want everything to be over so I can move on with my life.

"Hopper" - ©Tracy J Thomas, 2014. All rights reserved.

“Little Hopper” – ©Tracy J Thomas, 2014. All rights reserved.

I am not one who likes to have my body poked and prodded. Who does? I feel grief for the loss of control over what is happening to my body. Pieces of me are being removed and examined under a microscope. I don’t like that kind of attention. This makes me feel angry, then sad. Frustrated, then relieved that the prognosis for the type of cancer I have is very good. But there is still this underlying fear of an increased likelihood that more will pop up over time. And that “more” might just be the “bad” kind.

In the midst of my angst and fear I have blamed myself for all those times I basked too long in the sun for the sake of vanity. I suddenly felt guilt for the times I allowed those I love to do the same.

"Carnivale" - ©Tracy J Thomas, 2014. All rights reserved.

“Carnivale” – ©Tracy J Thomas, 2014. All rights reserved.

I am aware all of this is part of the process of reaching acceptance for the cards I have been dealt. This isn’t the first time I have felt this way. I have been through other struggles in life and was quite happy to morph beyond the ugly and back out into the light. Struggle has definitely made me a much stronger human being.

"Baby Snaps" - ©Tracy J Thomas, 2014. All rights reserved.

“Baby Snaps” – ©Tracy J Thomas, 2014. All rights reserved.

So, I continue to find my way back into the garden to clear my mind and find some semblance of peace. Little did I know when I bought my new macro lens and made my first “Zen in the Garden” post a month ago how healing that simple act would continue to be for me.

"Walking the Line" - ©Tracy J Thomas, 2014. All rights reserved.

“Walking the Line” – ©Tracy J Thomas, 2014. All rights reserved.

This past weekend we made a trip to the Sierra’s where I took a long walk in the woods and found plenty of beautiful things to photograph. I of course was slathered with sunscreen, wore my big sexy hat and spent most of the day in the shade, but it was just what I needed to rid myself of the angst I felt the week before. I still have moments of fear, especially during the quiet times at night.

There is still a bumpy little road that I need to travel over the next several months, but I will try to remain focused on the beauty that resides on the other side.


A Million Angel Kisses

©Tracy J Thomas, 2014. All rights reserved.

©Tracy J Thomas, 2014. All rights reserved.

freck·le (ˈfrekəl)
noun
1. a small patch of light brown color on the skin, often becoming more pronounced through exposure to the sun.
synonyms: speckle, fleck, dot, spot, mole, blotch, macula

When I was a child, my grandmother used to tell me the freckles that appeared all over my face and body were the result of a “million angel kisses.” She assured me every opportunity she had that I was special and the angels had smothered me with kisses before I was even born. As time went on and more freckles began to surface, I was convinced it was simply a sign of their undying affections.

©Tracy J Thomas, 2014. All rights reserved.

©Tracy J Thomas, 2014. All rights reserved.

I know now that my grandmother wasn’t exactly telling the truth about my freckles. Her diatribes about making her way to California from Cleveland, Ohio on a wagon train were also untrue. But that’s what Irish grandmothers do. They spin magical tales that captivate the wee ones who sit wide-eyed at their feet. When I think back on all her tall tales spoken in her dramatic half-cocked Irish brogue, I realize these are the best memories of my childhood.

In reality, freckles are pigmented spots that arise from sun exposure. Anyone can get a freckle, however some individuals (like myself) were born with the presence of the melanocortin-1 receptor MC1R gene variant. This genetic variant is why some of us end up with a ton of freckles as we grow and are exposed to the sun. When we are exposed to UV-B radiation it activates melanocytes which increases melanin production. This can cause freckles to become darker and more visible. So in essence, I am still special, just not angel kissing special…

©Tracy J Thomas, 2014. All rights reserved.

©Tracy J Thomas, 2014. All rights reserved.

Not only am I blessed with the melanocortin-1 receptor MC1R gene variant, I am very fair-skinned and have hazel/green eyes. In other words I burn easily. I grew up at a higher elevation (4,500 feet) in a small community surrounded by mountains. Playing outdoors was all I knew as a kid. We climbed, we hiked, we skied, we swam, we did anything that had to do with outdoor activities. And we did it all without sunscreen and more often than not without a hat. I can’t even count the number of times I received sunburns so bad I blistered and eventually peeled. Those were the days when moms brought out the aerosol can of Solarcaine to soothe the screaming pain of sunburn. Oh if they only knew then what we know now…

Sun exposure, especially to the point of sunburn, can have a dramatic effect on the skin over time. It can actually change the DNA and result in skin cancer. You do not have to have fair skin to end up with skin cancer. Even dark-skinned individuals have been known to experience skin cancer. People who have sunburned at least once increase their chances of getting skin cancer by a whopping 50%. Imagine the odds if you have had multiple burns over time.

©Tracy J Thomas, 2014. All rights reserved.

©Tracy J Thomas, 2014. All rights reserved.

Nowadays more young people are being diagnosed with advanced Melanoma, many of them in their 20’s. Pediatric Melanoma is also on the rise with some cases occurring as young as the age of 2. There is no cure for advanced Melanoma (Stage IV). There are a lot of experimental drugs, but no known cure at this time. The prognosis for Stage IV is usually 6-9 months. Grim indeed.

I have heard people exclaim “well at least it’s only skin cancer.” To me that is a pretty foolish statement. I suppose we like to remain in denial when it comes to the sun and like to think we can just run down to the Dermatologist office and have them scrape these little annoyances off so we can get back to tanning. Cancer is cancer and it can be unpredictable and ugly. Once you get skin cancer, whether it be Basal Cell, Squamous Cell, or Melanoma, the odds become higher that you will have more skin cancer at some point in your life. And if you are one of the unlucky, it will spread to your internal organs and you might die.

©Tracy J Thomas, 2014. All rights reserved.

©Tracy J Thomas, 2014. All rights reserved.

Yesterday I had a follow-up appointment with my Dermatologist so he could check several other spots of concern on my body. This appointment followed my initial visit and biopsy of the first Basal Cell Carcinoma near my eye. I had eighteen Seborrheic Keratoses (pre cancerous growths) frozen with liquid nitrogen (Cryosurgery). Seven of the spots were on my hands, eight on my face, one on my leg, and two on my chest and upper abdomen. I also had one lesion on my back biopsied to check for cancer.

©Tracy J Thomas, 2014. All rights reserved.

©Tracy J Thomas, 2014. All rights reserved.

My Dermatologist is very concerned about my face to the point he is putting me on Efudex (topical Chemotherapy) for 3-4 weeks in the fall/winter to fight off any pre-cancers or cancers lurking underneath the surface of the skin. Efudex is not a very pleasant experience. In his words: “Efudex is a topical chemotherapy, and, like many other types of chemotherapy, it is aimed at selectively destroying abnormal cells (in this case precancerous and cancerous cells). Over the course of the treatment we expect the affected areas to get red, inflamed, swollen, and sore. These areas may ooze straw-colored fluid, may bleed, and may become quite scabby. Some undergoing treatment will experience severe pain in treated areas. The reaction caused by Efudex in the skin can be quite dramatic and even alarming. For some people, 3 weeks of treatment is an impossible goal; for others it can be done relatively easily.” Let’s hope I am one of those “relatively easily” peeps.

Of course I was all over researching Efudex the minute I got home from the doctor last eve. I came across the typical horror stories as well as patients who had very minimal difficulty going through the regimen. Here is a video of one man who went through Efudex treatment. He is a fellow videographer and his production made me laugh and understand better what it is you go through with the treatment.

Today all the spots he froze have lovely raised blisters. They still sting a little bit but the one on my chest which was the largest pretty much burns constantly (see photo below). The biopsy spot on my back is also continuing to protest a bit. The last thing I wanted at this juncture in my life was to look in the mirror and see blisters staring back at me. But I realize the importance of attacking these cells before they have an opportunity to morph into something far worse like Melanoma. Indeed a small percentage of people who have Basal Cell Carcinoma have had their cancer spread to internal organs and die. But it is a very small percentage when compared to the rapid and difficult to control spread of Melanoma.

©Tracy J Thomas, 2014. All rights reserved.

©Tracy J Thomas, 2014. All rights reserved.

Now I await the biopsy results for the lesion on my back. I am also waiting for the Mohs surgeon and Plastic surgeon to coordinate a date and time for my surgery. Plastic surgeon you say? Yes, I will most likely need some reconstruction surgery when they remove the Basal Cell on the bridge of my nose because it is so close to my eye. It will all depend on how much skin they need to remove on the surgery day. They won’t know until they start cutting and looking under the microscope. The thing about Basal Cell is its affinity for rooting out under the surface of the skin. It is not simply removing the exposed tumor on the surface, but more often removing tissue beneath or around the tumor until the margins are clear. They can be sneaky little bastards. The result can be quite disfiguring. Thus the Plastics surgeon…

©Tracy J Thomas, 2014. All rights reserved.

©Tracy J Thomas, 2014. All rights reserved.

[Up on my soapbox now] – Please remember to use sunscreen; one that protects against both UVA and UVB rays. Limit the amount of time you and your loved ones (especially your children) spend in direct sunlight between the hours of 10 and 4. When you go outside, wear a great big sexy hat to protect your beautiful face and scalp. And please, oh please don’t be misled into thinking tanning booths are safe. They are not. They are responsible for a large percentage of the cases of Melanoma today. I don’t want you to have to go through what myself and millions of other Americans are going through on a daily basis. One person dies of Melanoma every hour…

Pale is definitely the new sexy.