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: 
  http://www.newyorkfacialplasticsurgery.com/FacialReconstructiveSurgery.htm

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.

Decline, like growth, happens in spurts

I find myself talking with the PARENTS of my friends more and more these days; they are dealing with the same parental situations as me. I was born when my parents were in their early 40's, they soon had grand kids near my age. Most of my friends parents are active, healthy and have done a lot for themselves. They are often shocked at things their parents do or can no longer do for themselves. I am not. At an early age, I saw and helped my parents with my very elderly grand parents.

Over the past year one thing has come up again and again from family to family - grandma or grandpa changes a lot during the 3, 6 or 12 months since the last visit. It seems that, like little kids who have growth spurts, elders decline in spurts as well. Within 6 months my Mom went from preparing simple meals like soup and a sandwich to being unable to open a can of soup with a conventional can opener. (We got an electric can opener but after another 6 months she was too weak to lift a 14 ounce can.) Her grip went from knuckle crunching to slight, like that of a six year old. Two years prior this, stairs suddenly became a huge problem. She feared going down stairs and going up she would take one step at a time putting both feet on a stair before tackling the next one. Our solution was to put in a ramp to the yard; we moved all of her living to one level of the house the year before.

My Mom's decline demonstrates the need to OBSERVE and ACT. If you are trying to keep your Elder in their home, look for ways to help them do as much as possible given their limits. Prepare to make adjustments often and make sure they are safe. Here's a minor example but one thta means a lot to Mom: She likes a cold Pepsi every afternoon. When I saw her pry open the top of the aluminum soda can a butcher knife I found some plastic gizmo's that fit over the tab and enable the user to lift it to open the can.

Often as our Elders age eating becomes a problem and is something that family must watch closely. Elders will TELL you they are eating well but often they are not. They compromise and eat what is at waist level - donuts, sandwiches for example. They forget how long left overs sit in the fridge and eat spoiled food. Mom's inability to make a meal for herself was a primary factor in our decision to move her to Assisted Living. I dropped by at lunch time to visit and Mom said, "It would be nice to have some warm soup." Translated this means, she can't prepare it for herself and she'd like me to make some lunch for her. It was rare that I visited Mom on a weekday and I suspected she was growing weaker. I told her we'd make it together so handed her a can and the electric opener while I got a pan and some sandwich fixings. I watched her struggle to get the can in the opener for a few minutes. Soon I blamed the opener as to clunky to help her save face. I fixed lunch and we had a nice visit. I left convinced it was time to move her.