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.**

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.

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.

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**

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.

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.

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.**

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…

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.**

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.

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!**

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 :).**

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…

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.

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)**

**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!