As usual, just when things are going great, we are faced with the reality of our lives as they are today. As I have told you, Lee has been having many eruptions of skin cancer on his face, neck and head. For the past two years it has been a constant battle for his dermatologist to try to stay ahead of this. Unfortunately, one was especially mean and got ahead of all of us in spite of all that has been done.
On Friday this past week, Lee and I spent the day @ the MOH dermatology clinic at Duke. This was to remove a large squamous cell cancer on his upper forehead. Finally after being there from 8:30 a.m. until 6:15 p.m. we were told that all of the cancer had been removed. The bad news was that he had to almost be scalped to get it all, creating the necessary skin graft that will be done on Wednesday of next week. His head is ensconced in multiple layers of bandages (resembling that of Saudi- Arabian Sheik). The bandage is there to cover the 4 x 4" crater left on top of his head. I would send you a picture but don't want everyone to faint!
I must admit that when the doctor asked me if I would be alright looking at his incised area, I told him I would be fine since I was a well-seasoned operating room nurse. Imagine my surprise when all I could see was Lee's eyes looking at me under this huge crater that was bleeding and had bone underneath exposed! I was not alright! I was very upset! I thought the area would be about 1/4 the size I was looking at. I held Lee's hands in front of me as he was sitting in that chair and asked him if he was doing O.K. He assured me he was just fine! With that, I excused myself from the room, went back to the waiting area that was now empty, sat down and began to cry! I got it all out before Lee came out with his new dressing.
The good news is that the doctor said he was 100% sure he got all the cancer that was there. During surgery next week, the lymph nodes will be examined. Lee is a real trooper and takes all this in stride while I, on the other hand can imagine all possible scenarios and/or complications!
We are leaving in the morning for an appointment with the surgeon, to discuss the upcoming surgery on Wednesday. Lee will be in the hospital for several days after the surgery and we have been advised that the surgery will last 4 -7 hours. We have notified the lung-transplant team and will also have consult with them.
So..........there you have it. Busy time. Spent the Easter week at the beach, then to Duke and now back to Duke for at least another week. Will keep you updated.
More Later.................................Brenda
S
Sunday, April 27, 2014
Thursday, April 17, 2014
A Few Updates
From time to time I have shared with you the "bumps in the road" that are a familiar part of the lung-transplant recovery program. Lee has been experiencing those "bumps" in the form of skin cancer for the past year and half. Most of these have been basal cell; however more than three have been squamous cell carcinoma. Unfortunately, the medication he must take to prevent rejection is not kind to his skin, consequently he has had numerous biopsies. Even though he feels good, has lots of energy and has been able to recover independence, those nasty skin cancers have been very annoying and perplexing.
So............this is where we are today. This past November, a biopsy of a small lesion on his forehead was biopsied for basal cell ca. The past two months that has changed and the size has increased from that of a nickel to a silver dollar, and is now squamous cell ca.. His dermatologist has referred him to a Moh's specialist at Duke. He had his first consult there this past Tuesday, and is scheduled for surgery (in the office) on Friday, April 25, to remove all of it.
To explain further: A basal cell carcinoma is the bottom layer of the epidermis, or outer layer of skin. Cancer in this area is slow-growing and takes a longer time to enlarge to surrounding areas. It begins as a papule and enlarges peripherally, developing a central crater that erodes, crusts and bleeds. Usually caused by excessive exposure to the sun.
A squamous cell carcinoma is a thin flattened layer of cell above the basal or bottom layer. these cells present as a nodule and even though are also slow-growing, can spread to adjacent lymph nodes.
This type of skin cancer is also caused by excessive exposure to the sun or ultra-violet rays. I guess all those years of working on his farm with no sunscreen have undermined what is happening today.
The Moh's procedure will take many hours. Lee will be awake because it will be done under local. He will be given a break, and will be given time to eat. Depending on the size, it may take a couple of hours or eight to nine hours.
Prior to that.............we are leaving tomorrow for the beach and will look forward to enjoying some time with some of our children and grandchildren. This is always a great time for Lee. He loves the beach and apparently the beach loves him because he improves with each visit!
Hoping all of you have a wonderful Easter with many blessings of the promised life we have been given.
More Later.....................................Brenda
So............this is where we are today. This past November, a biopsy of a small lesion on his forehead was biopsied for basal cell ca. The past two months that has changed and the size has increased from that of a nickel to a silver dollar, and is now squamous cell ca.. His dermatologist has referred him to a Moh's specialist at Duke. He had his first consult there this past Tuesday, and is scheduled for surgery (in the office) on Friday, April 25, to remove all of it.
To explain further: A basal cell carcinoma is the bottom layer of the epidermis, or outer layer of skin. Cancer in this area is slow-growing and takes a longer time to enlarge to surrounding areas. It begins as a papule and enlarges peripherally, developing a central crater that erodes, crusts and bleeds. Usually caused by excessive exposure to the sun.
A squamous cell carcinoma is a thin flattened layer of cell above the basal or bottom layer. these cells present as a nodule and even though are also slow-growing, can spread to adjacent lymph nodes.
This type of skin cancer is also caused by excessive exposure to the sun or ultra-violet rays. I guess all those years of working on his farm with no sunscreen have undermined what is happening today.
The Moh's procedure will take many hours. Lee will be awake because it will be done under local. He will be given a break, and will be given time to eat. Depending on the size, it may take a couple of hours or eight to nine hours.
Prior to that.............we are leaving tomorrow for the beach and will look forward to enjoying some time with some of our children and grandchildren. This is always a great time for Lee. He loves the beach and apparently the beach loves him because he improves with each visit!
Hoping all of you have a wonderful Easter with many blessings of the promised life we have been given.
More Later.....................................Brenda
Monday, April 7, 2014
Spring!
You know it is Spring on the farm when the honey bees begin to swarm! That is when the activity really begins for Lee. On a warm sunny Spring day I have usually been instructed to keep my eyes open for a swarm. To date, Lee has had about four swarms. They began last week, and one swarm
was first noticed by our three-year-old great grandson, Easton, who lives next door. He was visiting his g/granddad and playing around the drive while watching Lee clean and repair bee hives in anticipation for new swarms. I had decided to check on them and was seated in the garage talking to Lee when I heard Easton exclaim, "a bee, a bee!". We both reassured him that a bee would not bother him if he just stood still and did not begin yelling. No, he said, BEES! With that, I looked behind me and there was a huge swarm of honey bees at the edge of the open garage door!
Lee grabbed a pan and a hammer and began making loud noises while he gently walked the swarm away from the garage. I took Easton by the hand and carefully guided him across the drive to his house until the bees settled down. Apparently this swarm could not decide on their new home and swarmed again before the day ended. We do not know where they went, but they did not stay here. Since then Lee has had two more swarms and fortunately was able to find someone to take them to their new home.
Easton is a very special little boy! Sometimes he goes AWOL from his house next door to come and visit us. I have included a picture of him in the swing set we keep in our backyard. We have used it for most of our grandchildren, and thought about removing it, but decided to keep it for those g/grandchildren who are now here. The picture below was taken last year so will have to update for you. So far, we have three! Easton (3), Emily (1 1/2) and Alyssa (1 month).
Lee is hoping that his hives will not leave this year. Last year he experienced hive abandonment. He does not know why they left, but they did. Unfortunately, he did not get any honey for the year 2013. He is hoping to get some honey this year, but then again, it is up to the bees, the queen and the entire hive!
Today it is rainy and a bit cool. I have enjoyed a day to read, to write on my blogs, do a little catch-up on laundry, talk by phone to a couple of good friends and enjoy the quiet relaxation of the day. Lee, on the other hand, has been out and about all morning. He decided to attend Rotary for meeting and lunch and will probably return soon. This coming week-end will be very busy with visits from my two brothers and their family, and from my sister and her family. We will celebrate her new book, and she will get to have a family book-signing! We are all excited about this event.
Easton Lee Spencer, age 2, Spring 2013
More Later.............................Brenda
was first noticed by our three-year-old great grandson, Easton, who lives next door. He was visiting his g/granddad and playing around the drive while watching Lee clean and repair bee hives in anticipation for new swarms. I had decided to check on them and was seated in the garage talking to Lee when I heard Easton exclaim, "a bee, a bee!". We both reassured him that a bee would not bother him if he just stood still and did not begin yelling. No, he said, BEES! With that, I looked behind me and there was a huge swarm of honey bees at the edge of the open garage door!
Lee grabbed a pan and a hammer and began making loud noises while he gently walked the swarm away from the garage. I took Easton by the hand and carefully guided him across the drive to his house until the bees settled down. Apparently this swarm could not decide on their new home and swarmed again before the day ended. We do not know where they went, but they did not stay here. Since then Lee has had two more swarms and fortunately was able to find someone to take them to their new home.
Easton is a very special little boy! Sometimes he goes AWOL from his house next door to come and visit us. I have included a picture of him in the swing set we keep in our backyard. We have used it for most of our grandchildren, and thought about removing it, but decided to keep it for those g/grandchildren who are now here. The picture below was taken last year so will have to update for you. So far, we have three! Easton (3), Emily (1 1/2) and Alyssa (1 month).
Lee is hoping that his hives will not leave this year. Last year he experienced hive abandonment. He does not know why they left, but they did. Unfortunately, he did not get any honey for the year 2013. He is hoping to get some honey this year, but then again, it is up to the bees, the queen and the entire hive!
Today it is rainy and a bit cool. I have enjoyed a day to read, to write on my blogs, do a little catch-up on laundry, talk by phone to a couple of good friends and enjoy the quiet relaxation of the day. Lee, on the other hand, has been out and about all morning. He decided to attend Rotary for meeting and lunch and will probably return soon. This coming week-end will be very busy with visits from my two brothers and their family, and from my sister and her family. We will celebrate her new book, and she will get to have a family book-signing! We are all excited about this event.
More Later.............................Brenda
Wednesday, April 2, 2014
But, then again.........................
At your age! Once again, we were reminded yesterday of the many challenges we face as we age. Seems it just gets worse with each passing year!
For the past two years, Lee has been bothered from time to time with a recurring pain in his right shoulder. A visit to his orthopedic surgeon at that time revealed that his shoulder prosthesis that was done in 2006 was doing alright. It was decided that he probably had some arthritis or a possible rotator cuff problem. He was given a special cocktail injection containing a mixture of a steroid, numbing, and anti-inflammatory medicine that was inserted directly into the shoulder area for pain. Fortunately, his pain subsided for several months during the Winter. As soon as Spring arrived, and Lee began to become more active, the shoulder pain came back with a vengeance.
Over the next year, Lee was able to receive those powerful injections every three or four months until the last one in January, which did not relieve his pain. Yesterday, we traveled to Charlotte once again to learn whether or not the prosthesis had changed or at least get a confirmation regarding his shoulder. On the ride to Charlotte, I mentioned to Lee that since he had only been having this problem following his major lung illness and transplant surgery, it could be that having lost so many of his muscles that maybe those shoulder or rotator cuff muscles had not returned. He seemed a little skeptical of that analysis as we journeyed on.
The appointment moved quickly as he was first interviewed by the nurse, then the orthopedic resident, and then the x-ray person. After waiting another fifteen minutes or so, the main doctor (the one who did the surgery in 2006) came in. Following greetings and salutations by all, Lee was put through many ranges of motion. The doctor concluded that because Lee had very good range of motion, and since there were no changes on the x-ray that perhaps there were some other factors. That is when we heard, BUT, THEN AGAIN AT YOUR AGE! Followed by the dismal report that as we age our bodies literally began to disintegrate without a lot of work!
At this point, I interjected, and pointed out that Lee had only had this problem since he was so ill in 2009, and 2010. Could it be possible, I asked, that since he lost 57 pounds in as many days at that time that he could have lost those shoulder muscles. With that, he looked at me and then at the other doctor and said that he thought I could be right! BINGO! He decided against further injections at that time and wrote a prescription for the rotator cuff exercises that Lee would have to do to strengthen those muscles again. We left, thankful for the good report and encouraged with a solution.
It seems that each time the two of us have any type of health issue, there is always the underlying cause that follows a physical exam and any number of high-tech procedures. We usually depart from those powers-to-be medical persons, who, by the way, are young enough to be our grandchildren, with .............But then again, at your age.....................................................
More Later............................................................Brenda
For the past two years, Lee has been bothered from time to time with a recurring pain in his right shoulder. A visit to his orthopedic surgeon at that time revealed that his shoulder prosthesis that was done in 2006 was doing alright. It was decided that he probably had some arthritis or a possible rotator cuff problem. He was given a special cocktail injection containing a mixture of a steroid, numbing, and anti-inflammatory medicine that was inserted directly into the shoulder area for pain. Fortunately, his pain subsided for several months during the Winter. As soon as Spring arrived, and Lee began to become more active, the shoulder pain came back with a vengeance.
Over the next year, Lee was able to receive those powerful injections every three or four months until the last one in January, which did not relieve his pain. Yesterday, we traveled to Charlotte once again to learn whether or not the prosthesis had changed or at least get a confirmation regarding his shoulder. On the ride to Charlotte, I mentioned to Lee that since he had only been having this problem following his major lung illness and transplant surgery, it could be that having lost so many of his muscles that maybe those shoulder or rotator cuff muscles had not returned. He seemed a little skeptical of that analysis as we journeyed on.
The appointment moved quickly as he was first interviewed by the nurse, then the orthopedic resident, and then the x-ray person. After waiting another fifteen minutes or so, the main doctor (the one who did the surgery in 2006) came in. Following greetings and salutations by all, Lee was put through many ranges of motion. The doctor concluded that because Lee had very good range of motion, and since there were no changes on the x-ray that perhaps there were some other factors. That is when we heard, BUT, THEN AGAIN AT YOUR AGE! Followed by the dismal report that as we age our bodies literally began to disintegrate without a lot of work!
At this point, I interjected, and pointed out that Lee had only had this problem since he was so ill in 2009, and 2010. Could it be possible, I asked, that since he lost 57 pounds in as many days at that time that he could have lost those shoulder muscles. With that, he looked at me and then at the other doctor and said that he thought I could be right! BINGO! He decided against further injections at that time and wrote a prescription for the rotator cuff exercises that Lee would have to do to strengthen those muscles again. We left, thankful for the good report and encouraged with a solution.
It seems that each time the two of us have any type of health issue, there is always the underlying cause that follows a physical exam and any number of high-tech procedures. We usually depart from those powers-to-be medical persons, who, by the way, are young enough to be our grandchildren, with .............But then again, at your age.....................................................
More Later............................................................Brenda
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