Adventures in Dermatology plus the Death of a Cell Phone

Hello all!

It's been a couple of weeks since I've had anything to post, then this week:  BOOM! goes the dynamite.

Following the advice of just about every medical professional whose seen my left ear over the last several months, I went to my dermatologist this past Thursday.  I've had a 1/4" circular 'thing' (I call it a thing to spare you the less savory details that a fuller description would entail) on the pinna (Google it) of my left ear for about four months now.  At first I thought/hoped it was a bug bite,  healing slowly due to poor circulation in the area. In my heart I knew better--I've been expecting this for the past 15 years.  I was pretty sure it was some form of skin cancer (I have to learn to just say 'no').

The following are the risk factors for skin cancer (provided here for your edification):

• Fair skin. Having less pigment (melanin) in your skin provides less protection from damaging UV radiation. If you have blond or red hair and light-colored eyes, and you freckle or sunburn easily, you're much more likely to develop skin cancer than is a person with darker features.
• A history of sunburns. Every time you get sunburned, you damage your skin cells and increase your risk of developing skin cancer. After a sunburn, your body works to repair the damage. Having multiple blistering sunburns as a child or teenager increases your risk of developing skin cancer as an adult. Sunburns in adulthood also are a risk factor.
• Excessive sun exposure. Anyone who spends considerable time in the sun may develop skin cancer, especially if the skin isn't protected by sunscreen or clothing. Tanning, including exposure to tanning lamps and beds, also puts you at risk. A tan is your skin's injury response to excessive UV radiation.
• Sunny or high-altitude climates. People who live in sunny, warm climates are exposed to more sunlight than are people who live in colder climates. Living at higher elevations, where the sunlight is strongest, also exposes you to more radiation.
• Moles. People who have many moles or abnormal moles called dysplastic nevi are at increased risk of skin cancer. These abnormal moles — which look irregular and are generally larger than normal moles — are more likely than others to become cancerous. If you have a history of abnormal moles, watch them regularly for changes.
• Precancerous skin lesions. Having skin lesions known as actinic keratoses can increase your risk of developing skin cancer. These precancerous skin growths typically appear as rough, scaly patches that range in color from brown to dark pink. They're most common on the face, lower arms and hands of fair-skinned people whose skin has been sun damaged.
• A family history of skin cancer. If one of your parents or a sibling has had skin cancer, you may have an increased risk of the disease.
• A personal history of skin cancer. If you developed skin cancer once, you're at risk of developing it again. Even basal cell and squamous cell carcinomas that have been successfully removed can recur.
• A weakened immune system. People with weakened immune systems have a greater risk of developing skin cancer. This includes people living with HIV/AIDS or leukemia and those taking immunosuppressant drugs after an organ transplant.
• Exposure to certain substances. Exposure to certain substances, such as arsenic, may increase your risk of skin cancer.
• Increasing age. The risk of developing skin cancer increases with age, primarily because many skin cancers develop slowly. The damage that occurs during childhood or adolescence may not become apparent until middle age. Still, skin cancer isn't limited to older people and can occur at any age.

Of the eleven, I can check the block on at least eight, if not nine.  So it was not really a surprise when the dermatologist said, upon looking at my ear, "That has to come off."  Not the ear, silly, just the thing.  Good news is it appears to be a 'basal carcinoma' rather than a 'melanoma'.   Melanoma is heap bad.   On the other hand, "Basal Carcinoma" sounds like a British game show host or something you'd order at Olive Garden.

Anyway, she numbed me up, apologizing for any discomfort.  I laughed and said that after five marrow biopsies, it really wasn't so bad.  She took a biopsy sample, scraped out the rest, then cauterized the wound.  Sounded funny, smelled bad, but didn't hurt.  Put a bandage on it and told me that we were almost certainly done with this adventure.  I figured out a carcinoma blog would likely be much shorter than a CLL blog.

Then to make the week even better--and under the heading of cosmic payback--I fell victim to an accident of a nature for which I had previously mocked others with a similar fate:  My cell phone did a Back 2 1/2 Somersaults in the Tuck Position into the toilet this week.  After hanging on valiantly for a few days, and even seeming to have staged a full recovery, it succumbed to its injuries Friday morning.  I went to the AT&T store today and discovered today that, completely to my surprise and totally against my norm, I had taken out insurance on the phone.  New one should be here in a few days.

Beyond that, DC had an earthquake, BP plugged the leaking well (maybe),  and we finally got some rain.  As I said, an eventful week.

New summer haircut

Meeting with Dr. Cheson: Latest Status

You may be asking (as my mom did), "Why is there a picture of the Iwo Jima Memorial of the flag raising on Mount Suribachi on your blog?"  Excellent question!  When I leave Georgetown, I go home over the Francis Key Bridge, through the city of Arlington, and down the George Washington Parkway to get home.  Everytime I take the onramp to get on the GWP, I pass this statue.  I've probably passed it 30 times or more over the last year and a half, and I've never stopped to see the memorial.  Wednesday was a beautiful day, I was out of my appointment before eleven, my lunch "date" with my friend Elena had been overcome by events, and I found myself with time on my hands.  So I stopped.  It is a beautiful memorial with several informative plaques around.  I learned that of the six men depicted (five Marines and one Navy corpsman), three subsequently died on Iwo Jima.  Anyway, it was a neat place I've been meaning to visit, and now I have.  It seemed like an appropriate pre-Independence Day picture

On the the biopsy read:

This is where we are.  I am not yet in remission, but we've beaten the living crap out of the CLL.  The marrow biospy yielded no visible structures associated with the CLL, and the flow cytometry--which measures things at the microscopic cellular/chromosomal level--show a less than 1% involvement of the CLL still in the marrow.  Consider that when this all started, my marrow was over 50% involved.  Consider also that for some patients, merely stopping the advancement of the disease is considered a win.  This is pretty good news, and we're not sure that the Revlimid has finished doing it's thing.  I still have enlarged lymph nodes, but these are significantly down from where we started.  I'm hoping for a comment from Nurse Louise to put this in some perspective for me.

Bottom line:  we are now in "observation" mode.  My next appointment is in three months.

Anyway, I'll soon be hitting you all up to sponsor me in Dr. Cheson's 50-mile Lymphoma Research Bike Ride this October.  Help me stay on this guy's good side.

Have a happy 4th.

Father's Day Picnic

Exercise in Frustration, Georgetown-style

Quick and dirty (and my fault (kinda)):  Had a 12:30 appt. with Dr. Cheson to go over the results of last week's biopsy.  Got there early and figured I'd have about an hour wait because of the time of day.  As a result, I had not arranged a backup pickup for Robbie.   By 1:00 I had discovered that the lady on the bench next to mine had an 11:30 appt and the three other folks around us shared my 12:30 slot.  At 1:35, the lady with the 11:30 was taken in the back and I had learned that I was in last place of the 12:30 folks.  By 2:15, I knew there was no way I was going to see Cheson and pick up Robbie on time.  Me?  Pissed?  I knew that Peggy or Kath or Mindy would have picked Robbie up, but I hadn't prepped Robbie, and I remembered how freaked Elena's son David had been when we once picked him up unannounced.  Besides, I wanted to register my displeasure the only way I could--by leaving. 

Fortunately, I did run into Jenny, the Trials Coordinator, as I was about to leave and got the unofficial word:  still showing progress, bad cell counts down in marrow and bone sample, but still present along with continued presence in some nodes.  So I'm better, but not in remission yet.

Jenny is setting me up with another appointment in a couple of weeks, so hopefully then I'll get the answer to "What next?"  You'll know shortly after I know.

[And to put things in proper perspective, a year ago today I was basically in an induced coma and on a respirator.  Comparatively, this isn't so bad.]

Robbie did Good in Church Today

Someone at church suggested I blog this, so I will.  Today was the annual final performance of the church choir until September.  We performed our traditional final piece called "River in Judea", a gospel song we do only because Alan E. insists.  We did the piece as a post-communion offering, and against my better judgement, I brought Robbie over from the nursery before we performed.  After threatening Robbie with dire outcomes should he make noise during our performance, I brought him over. I told him he would not be allowed to play his new favorite Iphone game "Pocket God" if he made noise.  He agreed.   He took communion with the choir, then returned to our pew.  We sang (making only a few mistakes) and he was great.  After we finished, he said, in a voice loud enough for the entire congregation to hear, "Daddy, I love how you sing!".  When I joined him in the pew, he followed with the question, "Do I get to play Pocket God now?".

As we speak, he is playing Pocket God.  What can I say?