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.

Sliding shelf makes storing and sorting canned foods easier

My husband just installed a handy device for my brother - a sliding shelf inside a kitchen cabinet.    My brother is not doing too well, is over weight and suffers from emphysema.   He has a very deep kitchen cupboard where he keeps all kinds of canned goods and miscellaneous stuff.  Visiting last week I noticed that it was chock full of canned goods so I went through it.   I found multiple cans of the same few items - canned spinach, beans, soups - with expiration dates as far back as 2007.  We sorted the food into really expired, recently expired, about to expire and okay.   The first two categories went to the dump and the "about to expire and okay" went back in the cupboard.   Then I tackled the CAUSE of the build up.... My brother is too fat and too weak to dig into the back of the cupboard. Rather than find what's there, he just buys more.

To make his search easier my husband installed a shallow drawer on slides. The drawer sits on the shelf and has a drawer pull so he can it out to see what's there.   This way he doesn't have to bend down low or reach into the back to find canned goods.  We were worried about the weight of the drawer and slider mechanism but they weighed far less than the 40 or so 15-20 ounce cans of food that we tossed away.   I also reorganized the cupboard so that little-used items are on the bottom shelf - trays, a blender, baking pans, electric fry pan, etc....   My brother will never use these things again so they went to the bottom and the food and few items he'll use went on the higher shelf and sliding drawers where it's easier to reach. 

Signs your parent needs "adjustment"

Two main objectives to keeping your Elders at home are enabling them to do as much for themselves as possible and ensuring their safety. Often they will make minor adjustments for themselves to help get things done but we kids and grand kids we also need to OBSERVE and ACT to enable their day to day activities and be safe.

Be patient and prepare to do things like this often or RE-do them often. I see things during every visit that I can change for Mom to help her do things more easily. As she grows weaker, we often address the same problem again and again. When she began to have trouble doing laundry, we got front loading washer & dryer. Six months later stairs were becoming difficult and were impossible with an arm load of clothes, so we did a minor remodel and moved the new machines from basement to the kitchen. Three months after that we had to install a shelf to create storage for the laundry soap and softener at arm height so she didn't have to reach up or bend down to get at it. Within a few more months, she could barely lift wet items from the washer to dryer but she kept at it one garment at a time. She wanted to do it for herself so we enabled that through a lot of work and effort on our part. Remember if you care about your parent, Aunt, uncle or friend, you will help them to help themselves.

Here's a list of things that we did at Mom's that enabled her to do for herself and be safe. Be sure to read later posts with aging in place tags for more ideas:

• Opening cans of food :
  moderate difficulty: get an electric can opener
  more difficultly: buy foods with flip top lids
• Soda cans or bottles: Get Open Sesame - a multi-tool for cans and bottles. It works on flip top soda cans, twist off caps and has a magnet for storage on the fridge.
  
• Opening jars:
  moderate difficulty: use rubber gloves, one to hold the jar and one to grip the top
  more difficulty: use under the counter mounted devices; these grip the lid while the user turns the jar, using rubber gloves to grip the jar is best. I don't have a specific name or source for these; I've found them in catalogs, dollar stores - I saw them in all kinds of places when I didn't mean to buy one and ordered one online when we did need it.
  
• Stairs: often going down is more dangerous than going up - my Mom seemed to have equilibrium problems when looking DOWN and decending at the same time. Ensure that railings are tight and strong enough to hold up under a lot of use and a lot of weight. Can you install railings on BOTH sides of the stairway? Consider a ramp for short rises like from the back door to the yard. The most sure fire safe thing: get your Elder on one level - eating, relaxing, sleeping, bathroom and laundry. There are also more spendy solutions like the lift chairs that ride up and down on a railing; I've seen this only once and it was quite an expensive solution. I'd prefer to sacrifice a formal dining room or living room to get my Mom on one floor.
  
• Medications and pills: This is one of the touchier issues with elderly folks. Often Elders underestimate the importance of keeping up with medications for a variety of reasons. This is another key issue to consider whether an Elder can no longer live alone.
  
  moderate difficulty: make a schedule by time and put it on the fridge, get a pill box labeled by days of the week or even morning, noon and evening. Fill it for them weekly.
  more difficulty: Call them with a reminder or hire an aid to visit regularily and remind them to take their meds. Sometimes aides cannot give meds due to liability but they can check the pill box and the schedule and "help your Elder remember" with gentle words. This person should also report back to the family if the Elder refuses, the pills in the box don't coincide with the schedule or other issues crop up

That's all for now, look for more installments as time permits.