Tuesday, August 30, 2016

Well *that* was fun. Basal-squamous carcinoma excision, graft, and repair.

You know how you hear about those people who notice something odd on their skin and ignore it, waiting months – or even years – to have it looked at by a dermatologist? Well, that wasn’t me.

Until now.

Knowing that I have something called Dysplatic Nevi, I am at my beloved dermatologist at least every six months for a full body mole check. I’ve had lots of resulting biopsies, but never a cancer diagnosis.

Until now.

My last mole check was in May and was I given a happy “all clear, thumbs-up.” A few days after my appointment we went camping and took a few photos.


Do you see anything on my nose?

May 13-A

I don’t. And neither did my dermatologist. Thus the all-clear.

We had quite a few out of town guests this summer, and we went on vacation, so I have a steady stream of photos. Let me know when you notice anything on my nose.

June 6-A

June 6th. Nada.

June 7-A

June 7th. Nope.

June 12-A

June 12th. Hmmmm, maybe a tiny bit of dimpling? Maybe?

June 13-A

June 13th. I don’t see anything. Do you?

June 25-B

June 25th. All I see are freckles.

July 9-A

July 9th. I think I see something. But certainly not enough to concern me. I didn’t give it a second thought – especially because we were on vacation (in the sun, along the Oregon Coast).

July 10-B

July 10th. Yeah, there’s a little nothing of a bump.

July 12-A

July 12th. Yup, there’s a little something there. It didn’t even occur to me for a second that it could be something – and keep in mind that I’m hyper-vigilant!

July 13-A

July 13th. Even with the sun shining right on it, it’s barely noticeable!

July 23-A

July 23rd. AHA!! In those 10 days, the little “pock” started to bleed just a little.

I called the doctor on the morning of July 25th and was seen that morning, due to a fortunate cancellation. I told Dr. Voss that I called it “my little Molakai” because it was sort of a small rolled half circle under my skin. The minute Dr. Voss saw it, she said, “Yeah, this could be something.” And it was!

She took a little cone sample. No big deal at all.

July27-Post biopsy

At that point, I fully expected that it was cancer and wasn’t surprised at all when I got a call a few days later to confirm that it was a basal-squamous cell carcinoma. An appointment was made right then to have it excised. Dr. Voss is a cosmetic dermatologist, known for her great surgical and repair abilities.

But I had to go all Dr. Google and decided to opt for a Moh’s procedure followed by plastic surgery instead. Dr. Voss is trained in Moh’s (I learned later) but chooses not to do this method. Although both Moh’s and excision have cure rates in the mid-to-high ninety percent, Moh’s rates are very slightly higher, so I figured I go that route. Due to the nature of the procedure (removing a layer, testing it, removing another layer, testing it, until margins are “clean”), Moh’s potentially takes quite a few hours. Then I’d be put under general anesthesia that afternoon for the repair, done by a partner plastic surgeon.

The consult call with the surgeon was a nightmare! He began the call with “Wouldn't it have been nice if we’d met at Whole Foods, you looking for peanut butter and I looking for jelly…” The he called me “hon” and “babe” repeatedly. I was looking for a good surgeon, not a date! To make things worse, every time I asked a question he was belittling and condescending and treated me like I was some bimbo. (Ya know, every great once in a while I just want to throw the whole “I have a graduate degree, summa cum laude, from Stanford University; you can talk to me as if I understand” thing in people’s faces!) I hung up the phone and dissolved into tears. I did not want that surgeon near me! But I resigned myself to it because by then all the plans were in place.

Two days later I found another suspicious mole and headed back to Dr. Voss, who asked why I’d cancelled the original appointment for the excision. I told her the whole convoluted story – at which point all four eyes were rolling!

Long story short (because the anesthesia is wearing off and I want to lie down), I cancelled the Moh’s and plastic surgery and Julie Voss did the excision today. It was a relatively quick procedure, in which she dug out the cancer (and then some, to be safe) and grafted some skin from near my ear to repair the resulting crater wound. No general anesthesia (but lots and lots of local anesthesia because, you know, I’m a redhead!), Queen and the Stones playing on the radio, and conversation as if we were all having coffee together! It was a perfectly pleasant experience! (Keep in mind, I’m still numb as I write this, so….)

Wanna see photos? OK, take a breath!


Dr. Voss and me, pre-op. She had hoped to do some “flap” procedure, but when she saw the actual size of the cancer – mostly subcutaneous, thus the lack of external signs till very recently -- she decided she’d have to graft instead.


We’ll operate right… here.


I have no idea why it’s covered up!


Maybe to keep it moist while they harvested some skin from near my ear?


Malakai is now a crater!



Ta da! I have a honkin’ bandage on my swollen face, and will for a few weeks, but I’m glad to put all this behind me.


Yes, there is a miniscule chance that she didn’t get all the cancer, in which case she’d need to go back in, but she said she’s confident she got it all. The pathology report should confirm that.

The lesson for you? I’ve been yelling it from the rooftop for years: never ignore anything suspicious on your skin! If in doubt, get it checked! Please. Mine was an “iceberg, not an ice cream cone” -- in other words, mostly under the surface, not above the surface. Can you imagine if I’d ignored it?!

If you’ve been meaning to get that mole checked, please promise me that you’ll make an appointment right…



ADDENDUM (September 14, 2016, 15 days since surgery):

Best things first: The cancer is GONE!  The lab result from the surgery indicates “no residual basosquamous cell carcinoma identified.”


Here are a few photos of the healing process. Faces sure heal quickly!

1 day post-surgery: Nice stitch job. Dead-looking graft.


2 days post-surgery: Still no blood supply to the graft.


3 days post-surgery: Look – a blood supply has begun to establish itself!


4 days post-surgery: I puffed up! So swollen!


5 days post-surgery: Less swelling, a bit smoother.


1 week post-surgery: Swelling is gone. Suddenly the wound isn’t so blatantly obvious.


9 days post-surgery. Looking pink… and scabby. No more Band-Aid!


12 days post-surgery. A bit smoother.


13 days post surgery. The scab came off!


15 days post-surgery. A bit scabby again, but I went to a workshop today and no one even mentioned it!


I have an appointment to have a CO2 laser treatment next month, but I’m thinking that I might not even need it – especially since it costs $500 and insurance doesn’t cover it.

I’ll try to remember to post an add-addendum at some point down the road. If I forget and you’re curious, let me know!

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Saturday, July 02, 2016

Emma’s visit

Let’s begin with a bit of ancestry and history.
In 1969, my mother’s nephew, Dieter, visited us in Berkeley. My mother had been fairly close to Dieter, her sister’s child, as he grew up. Now he was all grown up with a wife, Elke and young daughter, Annette. Nine months after their trip the US, they had a second daughter, and asked me to be her godmother. Dieter and Elke named her Sonja Carolin.
I visited Sonja and her family every time I went to Germany in my youth, so had a chance to watch her grow up.
Sonja and Carol circa 1980
In 1990, I was a young mother with four kids under the age of six and Sonja was 20. We invited her to live with us and be our au pair.
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Fast-forward 15 years and Sonja has three children of her own, Elisabeth is wanting a break from the intensity of Cal, and the idea of au pairing for Sonja’s family looks intriguing. So when Elisabeth is the age Sonja was when au pairing for us, Elisabeth goes to Germany to be an au pair for a few months for all-grown-up Sonja and her three kids, Justus, 8, Emma, 6, and Marleen, 2. (Simon came along a year later, giving Sonja two boys and two girls, just like us!)
Europe Trip, Spring 2005 242
Europe Trip, Spring 2005 474Europe Trip, Spring 2005 293Europe Trip, Spring 2005 483
Fast-forward another 10 years or so and Emma is all grown up!
A redhead! Yes, Emma is the redheaded daughter I never got.
Are you wondering how Emma and I are related? We did – so we looked it up on Ancestry. Although the relationship feels much closer, Emma is my grand niece twice removed.
Last January, Sonja asked whether Emma might come visit us in the US this summer. Of course she can! So for the past month, Emma has been living with us, practicing her English, babysitting for some local families, and being our youngest, red-headedest daughter… twice-removed, of course.
Emma arrived on June 6th – coincidentally her mother’s birthday. Yes, for her mother’s birthday, I got her daughter! Emma said good-bye to her parents at the Frankfurt airport…
Emma and parents
and winged her way across the ocean, just as her mom had done 25 years earlier.
Sonja and I texted madly over WhatsApp as I stood in the Seattle-Tacoma airport, awaiting Emma’s arrival. There we were, two mother hens, pecking away at technology, wondering where our chicklet was. Did she get lost? Ah, THERE she is!
We took a quick photo and told Sonja to finally go to bed. I have it from here! Smile
For the first few days, Emma spoke very little. Not only is she much more shy than her mother, she also hadn’t travelled to Canada, having a chance to practice her English for months before coming to the US, as her mother had.
But Emma settled in quickly, making friends with those in our home who understood the most important language of all – the language of “pet me, I’m yours, I love you!”
Before Emma had even had a chance to recover from jetlag, I took her to Snoqualmie Falls. It was a short trip, giving her a quick flavor of the Pacific Northwest.
We grabbed lunch at The Attic, looking straight down onto the falls.
(Disclaimer: From Google Images, to show our view.)
We haven’t had kids living at home for quite a few years and I was worried that Emma would be bored stiff with just us ol’ foggies, so we were able to line up a few local babysitting jobs for her and during the following week I came to realize that Emma is as good with kids as her mom was. Er, IS!
On her first weekend in Seattle, Emma finally got to actually see Seattle – and meet three of its residents, Peter, Alex, and Kat. (Elisabeth, Emma’s former au pair,  had taken – and passed! -- her oral anesthesia boards  the same day Emma arrived, and would fly home to see her next weekend.)
Emma Carol marketEmma SNEmma wheel 1Emma Kat Alex Peter Carol
During Emma’s stay Tom, who simply can’t not build stuff, started a landscaping project that includes a small deck outside Emma’s room, earning the deck its own name, “Emma’s deck,” which Tom actually burned into the wood!
Now Emma’s presence will always be felt at our home, even after she heads back to Germany . And when she comes back with her own children someday, she can remind them, as they jump off the towering (not) platform that it is rightly her deck!
Two weeks after Emma arrived in Seattle, we picked Elisabeth up from the airport for a three day stay to visit Emma – who was six the last time they had been together – and to spend Father’s Day with her family. The two of them picked up right where they left off – well, except that this time they’re both adults! Emma reminded Elisabeth that tradition holds that Emma should now be Elisabeth’s au pair, representing generation number three of our families’ au pair-ish connections, but it’ll be a few years still before Elisabeth has kids – and you better believe that Emma is ready to come back to Seattle and step in when that happens!
Our first order of business was ceramic painting!
They actually turned out pretty nicely. Elisabeth made a soup bowl for Danny, I made a ladybug mug (of course), and Emma made a gorgeous vase!
The next day, Emma and Elisabeth joined Kat and Ian for the Solstice Festival in Seattle. They had a blast – as you can see.
The weather wasn’t warm at all, but they sure didn’t care and swimming in Lake Washington did happen. Brrrrr!
Father’s Day began with a hike to Annette Lake in the Cascades, including everyone except Shasta and me, old redheaded bitches ladies that we are!
IMG_9749 (2)
IMG_9787 (7)IMG_9804
Peter and Alex didn’t hike either, but they did come home to celebrate Father’s Day. How nice for Tom to have all his kids home!
The next week was fairly quiet. A card game with Kat…
…and more babysitting.
Madelyn kitty
We couldn’t very well have Emma visit from Germany and not go camping, right?! So we packed up the trailer and headed to Ohanapecosh at Mt. Rainier, where I had reservations for the BEST campsite, directly next to the river. (I had made the reservation exactly six months before, on the first day one could reserve a site, which was Christmas Eve! I checked the system a few hours later and all river sites had been scooped up! We were lucky!)
Emma had her own tent, giving her a true feeling of Northwest camping.
I’ll be reserving this site again first thing in the morning next Christmas Eve!
I reminded Emma that she could say that she climbed Mt. Rainier. She might not have climbed to the top, but she was there and some climbing was involved.
In the evening, Emma discovered S’MORES! It was a happy discovery.
Tonight we’ll have a “Verabschied’s Abendessen” (farewell dinner) with Kat and tomorrow morning I’ll bring Emma back to SeaTac for her flight to Santa Barbara (where Tom and I met forty years ago, coincidentally), where she’ll attend EF English Language School for two weeks before flying home to her family in Germany.
We’ll miss her! But she’ll be back; she promised!

Addendum: I’ve been lightheartedly hounding Emma to drink some coffee while she’s in Seattle. Not a coffee drinker at home, she resisted for four entire weeks – UNTL…! Just before she disappeared into the security line at SeaTac we stopped at Starbucks and, miracle of miracles, THIS happened!
Who doesn’t love a caramel macchiato? NOT Emma, that’s who! Smile (Re-visit this sentence after two weeks at English language school, Emma.  We’ll just call this your lesson on double negatives.)

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