Stitched

With Trent's gracious consent, I am going to fill you in on his skin cancer surgery. As you know, anyone can experience skin cancer. When many of us were younger, sunscreen wasn't really much of a thing. I remember tv commercials for suntan lotions to help achieve a bronze glow. I also remember people slathering themselves with baby oil trying to develop a nutty brown skin. What I don't remember as a child is hearing about sun protection. Nowadays we hear about the aging and cancer and other problems associated with the benign neglect, or even outright abuse, experienced by our skin. I shudder at the memory of the many blistering sunburns of my childhood and youth. 

Trent has a double whammy as far as his risk for skin cancers. He was a lifeguard and aquatics director for many years, and had plenty of sun exposure. Another factor is being a transplant patient. Because the immune system is suppressed post-transplant to prevent organ rejection, a transplant recipient has less ability to fight off all sorts of diseases. We often joke that Trent could catch a cold from across the street, but it's sort of true. Unfortunately, one of the disease types that can often occur in transplant recipients is cancers.

In the hospital transplant program of which Trent is a patient, patients routinely have skin cancer assessments once or twice a year. When we go, Doctor Theresa usually finds several pre-cancerous spots that she freezes off with liquid nitrogen. There are also often spots that need to be biopsied. Trent's right ear has had a recurring issue, and the biopsy in late November showed skin cancer. A surgical procedure was scheduled for Monday, December 18th. He's had this procedure two other times on different areas of his face, so we felt like we knew what to expect.

The procedure is named Mohs, after Frederic E. Mohs, the surgeon who created the technique in 1938. In my opinion, it's a brilliantly simple but effective technique. The cure rate is generally above 95%. The procedure goes like this: the patient is given a local anesthetic, along with Valium if desired. A thin layer of affected skin, and underlying tissue, if necessary, is removed. The surrounding margin is very small so that no more skin is removed than absolutely necessary. While the patient is in a waiting area with family and/or friends, the excised skin is marked for its orientation on the skin - top, bottom, right, left - and sent to the lab. If there are cancer cells on any of the edges, the process is repeated. In Trent's previous Mohs surgeries, one time he was called back once, and another time he was called back twice. This time around, they cut five times before they got it all. 

When Trent's ear was finally stitched up, they let me in the room so that I could see it before it was bandaged. I must say that I was totally unprepared. At first glance, it looked like Trent was laying there with a major chunk of his ear gone. Do this for me, please, so you'll know what I'm talking about. If you hold your finger parallel to the floor with the fingertip touching the entrance to the tunnel that directs sounds, your finger will be covering the area on the outside edge of the ear where Trent's cancer was removed. 

Since a goodish amount of skin was removed, something had to be done to protect the ear and keep blood flow going to the edge of his outer ear. Now take that finger and feel the crease behind your ear where the cup of your ear meets up with your noggin. The doctors cut down that line and pulled the skin over the outer curve of his ear, so his ear was sort of tucked under a flap of skin from the head/neck. There were quite a few stitches, and he was bandaged up and sent home with instructions to do nothing to the ear except come back in a couple of days.

Needless to say, Trent started having pain and discomfort fairly soon, and we were relieved not to have to irritate the ear by re-bandaging the area. When we went back for wound care, I had to get a lesson in how to do the special dressing of the area. Not only did it need to be cleaned and kept moist with petroleum jelly, there was a tunnel of sorts behind his ear where the skin had been lifted and moved. This had to be treated as well so that the skin didn't grow shut, making the reversal difficult. The treatment included threading a strip of cloth pre-treated with a petroleum jelly based ointment through this tunnel.

I've done post-surgery wound care for more than 20 surgeries for Trent. I've dealt with back surgeries and transplants and all kinds of stuff. In other words, it wasn't my first rodeo, but that threading the strip through the tunnel step was something that filled me with dread. The time came for me to change the dressing for the first time. I removed the dressing and the cloth strip. I mixed baby shampoo with water for cleansing with cotton swabs. I carefully cleaned the areas around all of the stitches and covered the incision with petroleum jelly. I swabbed extra on the cloth strip per the nurse's advice and wrapped it around the edge of the swab to thread it through the half-skinned tunnel. And hit a roadblock. Yes, the strip went nowhere. I broke out in a hot, burning sweat from the stress. I just couldn't get it in there. To at least do something, I tucked one end in the top and the other in the bottom, but it was pretty pathetic. I made sure that there was plenty of ointment there and we went back to the hospital a few days later.  

I was a nervous wreck. Not only was Trent in pain, pain which increased when I tried to dress his wound, but I wasn't even doing a good job. I didn't even want to go back to the treatment room, telling Trent that I was going to be fired by the nurses. The nurses, angels of mercy that they are, were very kind and said that I had done well enough that they would be glad to hire me to bandage their patients. Then they gave me magical swabs, long ones on wooden sticks and with cotton only on one end. The next time I changed the dressing it took me about five seconds to get the strip in place. What a relief.

About ten days after the surgery, we went for something that the doctors and nurses referred to as a takedown. We had no clue what to expect. In a nutshell, since I've talked so much my fingers are getting tired, the skin was cut at the outer edge of the ear. The stitches in the cup of the ear were removed and more stitches placed where the newest incisions were made. Then the neck/head skin was stretched back to where it originally came from, although there was now less of it than before, and sewn back into the crease behind the ear, along with stitches in an incision about an inch long going into the hair behind the upper part of the ear.

All in all Trent has probably had a good one hundred or more stitches go in and out of his ear and scalp. All of the stitches are gone now, but there's still an area about an inch long and maybe a quarter of an inch wide that needs to grow some skin. It still needs to be treated and bandaged daily, but we're both relieved that the tunnel is gone. So after 40 days, a couple of courses of painkillers, and a few courses of antibiotics, we're hoping for the healing to be complete soon. Trent, who tends to sleep on his left side, is looking forward sleeping on his right side again. His body is aching from always sleeping in the same position. And me? I'll just be glad when it's not hurting any more. His ear might end up looking like he defended my honor in a bar fight (my suggested story if anyone asks what happened to his ear, because it's a bit more polite than saying none of your d--- business), but I won't have to be causing him more pain.

So, now that you know that there are some great procedures related to skin cancer removal, I hope that none of us have to experience them. Sure, it's not the most horrible procedure you might ever experience, but it's not necessarily a picnic with a big bowl of potato salad either. Which brings me back to something I mentioned in my last post. Take care of your skin. This amazing envelope your body is in is the only one you get. Wear sunscreen. Hats and umbrellas are your friends. And don't be scared to have weird things on your skin checked out. Lots of them can easily be frozen in the doctors office, followed by short-term pain like those sunburns from days of summers past. No big deal. Be well, friends!



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Roundup

I know, I can't believe it either. My second post in less than a week! I know I've let my readers down, and I certainly am grateful to have such wonderful people who are willing to put up with me when the blog goes on the back burner. You know the one I mean, the one that you can barely reach, but it doesn't matter much anyway because the heating element doesn't always work. But I'm rooting through my toolbox like The Lunatic that I am, trying to turn up the heat.

Well, everyone, we made it through the holidays. Trent and I really enjoy Thanksgiving (we roasted a turkey and had a quiet and delicious feast) and Christmas. All my life, I've loved any opportunity to give others gifts. Unfortunately ee seem to have something we refer to as a Christmas Curse. I know that some of my friends have this same ailment. Invariably, when the season of gifting rolls around, we find ourselves with a huge desire to spread gifts and goodwill, but without the means to do so. There are worse problems to have, so I'll live and learn from the Christmas Curse.  

This holiday season held a few challenges as well as a few triumphs. Through a combination of luck and ingenuity, we managed to find gifts for those we really hoped to, and did so before Thanksgiving had rolled around. In fact, one of the gifts ended up being such a hit that the recipient almost turned into an excited five year old. I'm being purposely vague because I think I'd like to write about that in another installment of my Ravings.

One of the really difficult things about this holiday season was that it was the first without our friend Thayne, who left us behind so suddenly last September. Our holidays have been intertwined with Thayne and Marie for a number of years, and it felt strange without him. 

To add to the excitement of the season, Trent had to go through two surgical procedures within eight days. After the effects of many years of Prednisone and other anti-rejection medications on Trent's teeth, he had to go through oral surgery on the 11th of December. One week later, he was having skin cancer surgery on his ear. Needless to say, we've had quite a few dentist, surgeon, and nurse appointments. Trent has had to deal with a lot of discomfort - okay, pain, and some has been inflicted by me while doing wound care. We have a visit coming next week which should see the final removal of stitches - well over fifty of them. I'll leave it at that vague description until I get his consent to go into more detail.

Liz, who was in the process of her divorce last Christmas season, spent this Christmas season in the company of a new companion. She probably would have expired from boredom if she'd had to rely solely on us for entertainment this season. To borrow from the old-time Timex commercials, we keep on ticking. We have each other, a home, and plenty to eat. Actually, I've been trying to eat less to better manage my blood sugar, and even managed to continue my weight loss over the holidays. Dr. Mike says that on average, most people gain about 7 pounds over the holiday season. I managed to add about that much to my weight loss over the same time period, so maybe I'm starting to get on the right track.

Well, I sure have rambled on in this post. Please forgive me. I've also thought of several possible posts I'd like to write while I've been tapping away at the keyboard. Wish me well, please, as I'd like to give you a lot more to read this year than I did during the last. Let's hope for the best, shall we?

I hope that you're all content with what is going on in your corners of the world. My hopes for all of us in this and every year are basically the same. I wish us all peace, health, love, and the good fortune of having enough. What else could we ask for, really? We don't need vast amounts of money to survive, although sometimes it feels that way. What we need more are the things all the riches in the world can't buy. I hope they'll be overflowing for all of us.


A note from The Lunatic: I don't want to be a nag, but I will anyway. For your skin's sake, please consider wearing sunscreen or a hat. Or both. Be well, my friends!


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As always, I am happy and honored to write for you. It brings me great joy, and I hope that it gives you joy and/or food for thought. If you'd like to support the cause, please visit:

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Thank you for reading!

Privilege

I almost never get asked to show my receipt at Walmart. I kept this observation to myself for quite a while, thinking that surely I was mistaken. But time after time, it proved to be true. One day I mentioned it to Trent, and he started noticing it as well. I began to change my habits on leaving the store. Instead of stuffing the receipt into my purse or one of my shopping bags, I began to carry it in my hand until we left the store. Still no takers.

I became obsessed. I progressed from simply carrying the receipt to sort of flashing or waving it at the staff member working as Greeter and/or Checker of Receipts and Bags. Still no takers, in spite of the fact that on more than one occasion I had seen the same individuals diligently checking the receipts and carts of other customers who were leaving as we arrived at the store.

I became more bold, bordering on aggressive. As Trent pushed the cart toward the exit door, I would ask the Greeter if they needed to see my receipt. They assured me that no, it wasn't necessary as long as everything I had was in bags. They only needed to look at my receipt if I had non-bagged merchandise in my cart. 

Every time this happened, my heart broke a little, and my anger simmered a little more. Why? Am I a fan of being asked to prove that I purchased everything in my cart? Isn't it enough to have that happen when I buy things at a membership warehouse? Trent, who is in agreement with my feelings on this subject, knows better. It's because I know why it happens. 

You see, I've carefully watched, at stores of all types, the ways people of all descriptions are treated. As I said to Trent when this really started to bother me, unequal treatment exists. In fact, it thrives. On one of the first days this was driven into my consciousness, we were entering the store as a young Asian woman and her children were leaving the store. She had been stopped and asked to provide her receipt. The receipt and the contents of her bags were scrutinized. And no, to the best of my knowledge, there was nothing in her cart that wasn't bagged.

As we left the store, I told Trent how awful it makes me feel to know the unspoken preferential treatment I am given. As I said in that parking lot, they aren't letting me walk on by because everything we bought has been bagged. And it's not because I'm fat and old mature and probably can't run very fast with or without stolen goods. It's because I'm fat, old, and white. And it sickens me.

As much as I hate to jump on bandwagon-type phrases, I have to use this one. White privilege exists and is thriving in the USA. Don't get me wrong, I'm fully aware of how fortunate I am to not be a target of numerous types of judgement and scrutiny based on things like my age. I was once, in my much younger years, accused of stealing from a music store. It was degrading, frightening, and depressing. But I'll never know the fear that must accompany millions of people of color or of other belief systems, individuals both young and mature, every time they go to a store. 

If you look up the word privilege in a dictionary, as I did while preparing to write this piece, you'll see that it is a special right, advantage, or immunity that is only available to a particular person or group of people. I am being given preferential treatment that I have done absolutely nothing special to earn or deserve.  I was simply born looking a certain way. My Eastern European ancestry gave me my blue eyes and my medium-brown hair and my lightly-pigmented complexion. I haven't cured any diseases or written anything fabulous or created world peace, although I long for it every day. I'm just a person, as is everyone who reads (or doesn't read) these words. 

Like everyone else, I was born with the potential to be a healer, a killer, a writer, a reader, a friend, an enemy, or any number of other things. And I could also be a shoplifter or someone who is pretty darn honest when she shops. I just want to be treated like everyone else. I want everyone to enjoy the same privileges I definitely don't take for granted. The privilege I want to see in abundance is a simple one, one that I try to employ in my interactions with others every day. It's about being mindful of human dignity and worth, something that people of every description deserve.

See others not with your eyes, but with your heart.


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The Tip Jar:

As always, I am happy and honored to write for you. It brings me great joy, and I hope that it gives you joy and/or food for thought. If you'd like to support the cause, please visit:

https://www.paypal.me/TheLunatic