Chapter 4: Mohs Surgery

Today was filled with mostly good news and good things with only minor downsides.

The short version: They cut it out and I'm mostly in the clear now.  Thanks to everyone who has given me support and helped me out.


The longer version:
It turns out that it was Basal Cell Carcinoma, the bad side was that it was "Infiltrative Basal  Cell Carcinoma."  What that ended up meaning was a few things:

1. It was a lot bigger than they originally thought.
2. There  is "only" a 96% cure rate rather than a 99.7% for standard Basal Cell.
3. If it does recur, it will most likely be another case of cutting it out of the skin.

So I was in the clinic for more than six hours getting cut and waiting while they analyzed the cuttings.
By the time they were done, it was a pretty sizable hole on the side of my face and neck.
They stitched it up pretty well, but it will be a noticeable scar.

They said the analysis indicated that it didn't go deeper than the dermis (thick parts of the skin), just that it went wide.

Thanks to everyone for their support and well-wishes.
Apologies to everyone with "Real Cancer" that had to deal with me freaking out over this.

Here are some pictures:
Warning: Some of these are graphic

At this point my major life change is that I'll need to see the dermatologist regularly to check for other skin cancer sites or recurrence of this one.
I'll take it!

Episode 3: Some phone calls

I got a little figety and started making some phone calls.

I called my doctor's office to see if he would chat with me about the diagnosis.  The receptionist wouldn't let me do that without making an appointment. What a pain.  Make an appointment 3 weeks out for a 5 minute conversation? Pass.  My questions will be moot by then.

So I called the specialist clinic to find out if the appointment my doctor made was for treatment or for further diagnosis.  They basically said "could be both." I took that as good news.
They plan to look at it and see if:

• They can treat it the same day or
• They can treat it, but need a longer appointment or set of appointments or
• They can't treat it and I need to go elsewhere.

That gives me some hope.

Then I called a friend of mine who is a general practitioner MD and imposed on him to give me some insight.

He didn't want to make any promises, but that it sounded like "Basal Cell Carcinoma."
He said if that is the case and if it hasn't gone too deep, the cure rate is high.

So: fingers crossed.

Episode 2: Specialist visit delayed

To be frank, I'm not sure if I got rescheduled or if I was not listening properly when my specialist visit was scheduled (totally possible, I was not thinking clearly) but when I called with some questions I found out that my appointment is not this coming Wednesday as I originally thought. It is on the 27th.

On the bright side: I found out that if, at this consultation, it looks "minor enough" they will try to remove it that day.  Otherwise we will have to make other arrangements.

Episode 1.5: Coping with bad news at Gen-Con

As it turns out, Gen Con may be one of the best places to be when you get bad news.  There was plenty of activity going on to distract me long enough to get my head straight before I needed to go home and talk to my kids about this.
(This entire post is just anecdotes of me coping at the con.  I you are reading for more detail on the cancer, you will not find it in this post.)

I go to meet Jake, Kurt, and Drew for dinner and drop this on them like a bomb...  and start drinking.
I have not drank any alcohol for over 2 years, and for more than 15 years before that, nothing more than a Champaign toast at a wedding or new year's, but this felt like a good time to break that trend.  One of the things I find out right away is that a side effect of my Gastric Bypass from 2 years ago is that alcohol hits me hard and quickly.  I go from 0 to a strong buzz about 2 minutes after the first shot.

That night I do a lot of behaving irresponsibly, but since it is me, even my irresponsibility is pretty tame and well contained.
To put it in perspective, here is me "behaving badly" and blowing off steam:

• Drinking, but not to the point where I "get drunk" or even to the point where my walking becomes shaky. (I actually discovered that the Gastric bypass side effect i mentioned earlier helped my very accurately control how tipsy I was. )
• Going to a Strip club but taking special care to make sure that I wasn't "getting all handsy."
• Crossing the street against the light with a smirk on my face (after looking both ways)

I think my biggest offense of the night was my loquaciousness. I was basically telling everyone I talked to for more than five minutes about my new news.  Including an exotic dancer at the Red Garter by the Stage Name of Destiny, who then made it her goal to distract me for the evening, even if it meant that she didn't make her nightly goal/quota.  Who but me goes to a strip club, befriends one of the girls and spends most of the night chatting about comics and movies and music?  Thanks for being an instant friend when I needed one, Destiny.

Anish and Zeb tracked me down at the club to make sure that I wasn't being too self destructive, paid for a couple of my drinks, generally offered me their support, and made sure that I went back to the hotel at a relatively reasonable hour.  (thanks guys)

By the next day, I was actually in a better head space and was more willing to wait until my follow up with the specialist before I act all panic-y, trying not to borrow trouble until I know more. Also at this point, I was only talking about it with friends who sincerely wanted to know how I'm doing or friends that I feel I owe an explanation or apology to for my uncharacteristic emotional distance. Also: I was actually able to really enjoy the convention.  I made a lot of new friends, won a lot of prizes, and generally had a lot of fun.  It was a very helpful multi-day distraction that helped me get the time I needed to put some things into perspective.

I was even able to make light of it with some of my friends. One morbid but hilarious example: I was asking my friend, Vic, who was running a game, for a not-strictly-in-the-rules-game request. Another friend, Brian, added later that I should phrase all of those requests like, "Don't let my new cancer affect your decision, but can I do this in the game?" I'm surprised how funny I found that.

There were a few other moments that were awkward at the time, but 80s sit-com funny if you were on the outside looking in and are funny to me now.  I'll not post those, because a couple of those folks are embarrassed to be a part of them.

As a result of all this, I was able to go home and talk to my family about this and talk to my kids and convincingly tell them that we need to wait until we see the specialist before we decide that things are really bad or not.

Episode 1: Finding out at Gen-Con that you have Cancer

For those of that don't know what Gen-Con is, I won't go into a lot of detail other than that it is a 4 day convention where 50,000+ gaming enthusiasts, movie lovers, costume players, and many other assorted stripe of nerds get together to let their nerd flags fly proudly in the air, myself included. I go as often as I can and it's a lot of fun.  If you want to know more about the con, hit up the Google or go to their home page.  You will easily find more than you bargained for.

So: it's the afternoon of the first day of the con and I'm happily playing a game with a table of brand new friends/acquaintances when I get the call from my doctor's office.

They tell me that the biopsy tested positive for carcinoma and that the biopsy did not remove it all. They have no idea how deep or widely spread it is, and refer me to a specialist/surgeon who will be calling me shortly at home to set up the appointment. At this point I'm not feeling the shock yet and my main concern is that I call my wife and she hear it from me rather than from the specialist's receptionist. I call her and ask her to get the appointment as soon as possible when she gets the call.

I sit back down at the table and try to pay attention to the game but my mind is racing and wandering.
I'd cemented my role at the table as the fun and funny guy earlier, but now I'm quiet. Nobody notices because one of my new friends (Nicole) has lost her wallet and everybody (but me) is throwing the lounge to find it. So I sit quietly with my thoughts.

During this time my wife has set up the appointment and texts me the details.  I'm standing reading the details when Nicole and her boyfriend, Mike come over to apologize for losing her composure and bringing down the game.  I feel like I'm on autopilot and tell her that she doesn't need to apologize and that I'm also trying to not lose my composure because my doctor just told me that I have cancer.

They both hugged me and gave me condolences.  I didn't realize how much the news was affecting me until then, because my knees buckled and the two of them having their hands on me kept me from losing my balance entirely.

Here's where serendipity come into play.  Nicole tells me that she is a cancer survivor.  She and Mike spend a few minutes talking me down from my sudden panic.  They quickly escalate from "new friends" to two of my favorite people.  They were exactly the right people at exactly the right place at exactly the right time.

Episode 0: The Lead-In

This all got started with some bumps on my skin.  I ended up cutting them while shaving and that cut never would heal up.
After a few months of this, I went to see my doctor (actually his Nurse Practitioner), and they gave me some steroid cream, and said that if it didn't heal up after two weeks I should come in for a biopsy.

It didn't heal.  I went in for the biopsy. (Monday august 11th)
She sliced a piece of skin off of my neck about the size and thickness of a quarter that had about half dozen light colored bumps on it and sent that slice off to the lab and said they'd call me later in the week with the results.

A Forward and a little info

I put this Blog together for concerned friends and family.

Many of you know that I am generally not a "Blog guy" (putting it mildly), but since I have so many friends and family members and other concerned parties, this seems like the most effective way of getting my promised updates to so many people.

So let me open up with some gratitude.  If you are reading this, it's because you've expressed some concern for my new condition and I forwarded you this link. (That, or for some reason you were net stalking me and stumbled across this.) either way: thank you so much for your concern.  I can't quantify how helpful it has been and how much it has meant to me to have so many people supporting me and generally being in my corner.

As I start this Blog, all I know for sure is that I have a Carcinoma, but not what kind.
I know that there is a chance that they can remove it with Mohs Surgery. (Do not google that for images unless you have a strong stomach).