Wednesday, December 29, 2010

CAUTION: Sores that won't heal may be skin cancer!!!

I've had several family members with skin cancer and can share several stories to drive home the need for regular skin cancer screening but a recent event does a much better job.  I hope that the following story will prod anyone to get a check up ASAP for themselves or their loved ones.  The short story:  a friend's mom had a Moh's procedure to remove all the skin on the side of her nose.  For 2 years, she asked her doctor about a sore spot  and he told her it was due to sensitive skin.  He was clueless and it cost her a lot in medical procedures, pain and suffering - especially the pain and suffering. 

The long version: A friend called in a panic just before Christmas - her Mom had skin cancer on the side of her nose and they had to operate immediately.   She was especially upset because she'd asked her mother's doctor about the sore for more than 2 years.   She finally moved her mom to another state and took her for a check up.  Before her Mother sat down in the doctors office, he asked about the sore on her nose and sent her down the hall to a dermotologist.  She was in surgery within a couple of days.  It was a severe basil cell melanoma and had nearly spread to the skin around her eye.  

The surgery and subsequent reconstruction were gruesome and hard on her 84 year old body.  After all the the skin was removed from the side of her nose, ( Did you HEAR ME???!!!ALL THE SKIN!! from the side of her nose *OH MY GAWD!!)) she had to have a flap of skin grafted from her forehead to her nose.  The bad part is that the flap had to remain partially attached to the forehead AND stitched to the nose. It remained this way - an open bloody wound -  for 3 weeks.  The flap permits blood to flow to the tissue to keep it alive while the graft grows into the skin surrounding the surgical wound.  Eventually the grafted skin will get enough blood supply from the skin around the nose so the flap can be removed.   

This was hard on her Mom, it was hard to make her understand why it was necessary and what happened to her.  She's a sweet kind woman and has become quite forgetful so it was hard for her to process it all.   The really sad part is that it could have been avoided, literally, years before if her doctor had taken it seriously.  All the doctor had to do was refer her to a dermotologist. Why he didn't is a mystery but he deserves to be charged with malpractice.   My friend is in the process of filing complaints in 2 states where he sees patients - Washington and Idaho.  

This sort of skin cancer is NOT reserved for the elderly and years of sun exposure.  My own nephew, age 27, had the same surgery two years ago.  He had a recurring pimple on the side of his nose and he let it go a long time before seeing a dermotologist.  Because it was "just a pimple", he thought he'd get a prescription for a topical antibiotic or a chemical peel, he had no idea it was skin cancer.   The sore would erupt like a pimple then get red, bleed a bit and heal up.  This sort of cancer was new to all of us in the family.  We knew to look for dark spots that were not symmetrical.  We new to suspect anything that grew in size or had various colors - we didn't know to look for a wound like a cold sore.  Since his original Moh's procedure - removal of a whole nostril, a skin flap and reconstructive adjustments to the skin - he's had two smaller spots removed.  These were caught in time but he'll have to be vigilant - and watch the skin all over his body - for the rest of his life.

So - the bottom line is simple - CATCH IT WHEN IT'S SMALL  - the treatment is simple and relatively painless.  Wait, and you'll have to suffer a gruesome surgery and reconstruction - or it might cost your life.  

Here's a link that should scare you into a visit to the doctor early on:  CAUTION:  This site contains VERY GRAPHIC IMAGES that may disturb you.  It shows patients after surgery for skin cancer and before reconstructive surgery.    Some of these are really, really, gruesome and nearly made me sick but if it gets you to the doctor - then I did my job:

I have a cold sore that won't heal, what is it?  Grandma has a sore that won't heal. Grandpa has a sore that won't heal.  Do I have cancer sore soar that won't heal.

Tuesday, December 28, 2010

Finding Mom in the dark makes me SEE RED!!!!

My good mood over having Mom home on Christmas Eve disappeared quickly when I went to see her Christmas Day.   I found her sitting in her room in the DARK!  She was trapped, sitting in her wheel chair with nothing to do and no way to get out of the room.  Her call button was no where to be found - I found it wedged under her pillow and completely out of her reach. Her roommate was asleep and her wheelchair was between Mom and the door, Mom's TV (which is on a swinging arm) was above her head, off and out of her reach.  The lights were off - switches also out of her reach - and there was a table wedged between her and her dresser which holds her reading materials and pens.   She was just sitting there in the dark like some blanket they laid down on a table top. 

I was so mad - and so hurt for her.   There is no excuse for this - I told the aides who were circled around the nurses station how I found her and they said "she can call for help".  They didn't want to believe where I found the call button and that it was out of her reach.  They are so freaking clueless!!!! They all looked young and I'd never seen any of them before - a new crew, probably the newest hires since they were working Christmas Day.  It should not matter.  I expect an experienced nurse or aid on duty to prevent this kind of crap.   They might have thought she was asleep but they should have put her in bed or her easy chair NOT left her sitting in the wheel chair.

So - before leaving town I wrote a letter to the administrator and left it in her office.   She's had 2 days to read it and I've not heard a thing.   (She dislikes me already because I - justifiably - complained about the size of Mom's wheelchair and a worn out pad that meant she slipped forward and fell out of it. )  Tomorrow I'll call the social services office and see what they have to say.    If it happens again, I'm called a friend who works for the state department of medicaide and ask for an inspection.  If they're slipping up on basic things, then larger more severe problems are probably hidding in there too!!

Oh how I wish I could win the lottery so I could hire some help and take her home!!!  If I could, I'd buy a big house and invite a couple of her friends to live with her.  They could all have such a good quality of life with the right care givers and the right layout in a home.  They could sleep in or stay up late if they wished.  They could be active - they could do things they enjoy and only do as much as they could with help and continue to feel like they have something to offer.   UGH!! These nursing homes are just too large, they are run by huge for-profit companies that don't care about their residents.   It's immoral.  it's down right immoral!!