POST-OP POST

(WARNING: Graphic surgical wound images ahead.)

Night before surgery

Last Monday's surgery went better than I worried it might, even though the cancer was more extensive than my doctor thought it was initially.  She kept asking me when I first noticed the cancer, which I thought meant the red spot on the end of my nose.  That was last summer.  Then I told her about the change in my nose contour, very slight, that I noticed the year before.  On the roundest part of my nose tip, the skin seemed to go flat - ever so slightly - and didn't reflect light like the rest of my nose did.

"Ah, yes.  Of course," she said.  "That is likeliest when it began."  Dr. B is from Russia, by way of West Germany, then to Pennsylvania, where she has lived and practiced medicine for the last 30 years.  She speaks English beautifully (better than I do) with the most charming accent.  (I thought she was from Ukraine.)

She had to cut slices from my nose three times before pathology gave her the all clear to proceed with the graft.  I will post some photos my daughter and I took.  I wasn't allowed to have Karie in the room with me, so some of these were after I had been bandaged between slices, and the next day.

The final cut before graft.

Daughter, whose sense of humor about such things is as twisted as mine, said the wound above reminded her of a slice of Italian sausage on pizza.  My face was swollen from the several injections of anesthetic, and from being tugged this-way-and-that by tissue forceps.  Took almost four days for it to return to normal.  My upper lip looked as if it had been cosmetically enhanced.

 My behind-the-ear lift, graft skin source.  Used 4-0 braided something - nylon?  Feels like a toothbrush back there.  

When Dr. B pulled one suture through, it sounded like a guitar string.  Did you know that most of the ear parts are located behind your ears, inside your skull?  Had a hearing test at Lebanon VA hospital last Saturday and the audiologist tested back there.  (I have perfect hearing, turns out.  Went there because of tinnitus - sounds like my head is full of crickets, tree-frogs and cicadas, all singing at once and at full volume.  Turns out the culprit is amlodipine - Norvasc.)

Headed home, with first nose cone.  Puffy-faced, hard to smile because mid-face was still numb

.

Call me Cyrano.  

Tuesday, we went out for coffee, mostly so I could get used to being out in public with my nose cone.  Karie suggested I put orange and white strips of duct tape on the dressing like a safety cone.  I get no respect.

After second bandage.  Swelling down quite a bit.  

Still not allowed to take photos at doc's office.  I said to heck with that and took it off last night to see what was underneath.  That yellow thing on top of the graft is called a bolster.  It is stitched down onto my nose, through the graft, to help hold everything in place.  It's loaded with some sort of petroleum-jelly-like stuff, which melted and soaked through the first dressing, loosening the tape holding the dressing in place.  I figured I could replace it myself.  Well, of course I can!

ARE YOU KIDDING ME?!

 Okay, maybe not.  I didn't have the proper materials on hand.  The paper tape doesn't stick to my skin and I kept adding more on top of the other, which also didn't stick.  I called Karie.  She said my nose looked like those baby vultures in some Disney movie she watched.  Or maybe a baby eagle's beak.

I get no respect.  Did I say that already?  Well, let me say it again...NO RESPECT!

New bandage, with Karie's help.

It helps to have an extra pair of hands to replace the bandages.  Grandson said it looks like strips of Silly Putty...just like his mother.  I give up.  

This will do until I can have my nurse redress the wound on Tuesday.  I just hope I didn't introduce any bacteria which will cause the graft to rot off.  I was very careful.

I had a great team who took the best of care.  I especially liked my nurse, who did a good bit of the work and answered my questions.  Her name is Katie.  She's about half my age and a no-nonsense professional, very patient-oriented in her care.  All in all, everything went well.  

But then I knew it probably would because I went in wearing a cloak of kind thoughts and good wishes, plus I had on my magical, lucky socks!

(PS: Please wear sunscreen with as high a SPF-value you can find, and limit your exposure to only a few minutes at a time during early morning or late afternoon hours.  Have your doctor check your skin at least once a year and learn what to look for when you check yourself.  My cancer likely started 50 years ago when I fell asleep on the beach in Gulfport, Mississippi.  I was face down for almost two hours during the worst time of day.  Had sheets of blisters on everything that wasn't covered by bathing suit.  Had sun-poisoning (radiation?), had to stay in bed for almost a week, was sick as a dog.

But it doesn't take something like that to cause skin cancers, so please be careful.)

If I Only Had...

http://www.darkrealmfox.com/film_reviews/wp-content/images/wizard_oz_pics/wizard_oz_11.jpg

Tomorrow I will have the tip of my nose (or a large portion thereof) cut off.  Not to spite my face (yes, I've heard that so many times in the last month!) but because of skin cancer; basal cell carcinoma, thank goodness.

This thing started last summer as a crusty spot on the end of my nose, very tiny, like an errant dandruff flake that fell from my head.  I brushed it off and thought no more about it.  Until the next one, which was more difficult to brush away.  When it grew slightly larger and turned bright pink, I thought it was perhaps a mosquito bite.  When I finally realized this just might be cancer, the pink bump had become a slight depression surrounded by a raised rim.  This was in September.  

My PCP (primary care provider) at the VA clinic confirmed my suspicion and began the process of getting a referral to a civilian dermatologist.  This was in late September.  The earliest appointment I could find in two counties was for February.  A biopsy ruled out squamous cell carcinoma (thank you, Universe!) and surgery was scheduled for a month later.

I was doing well, emotionally, with this idea of having my nose lopped off and the Mohs procedure which will cause my face to be sliced in a wonky zig-zag fashion to cut a circle of skin to cover the hole at the end of my nose, then stitch all that back together again...like Humpty Dumpty, maybe.

But as the hour draws nearer, I feel more like the Cowardly Lion than Pollyanna.  Oh, I'll be okay when morning comes, and I'm a big girl now and won't cry and all that, but somewhere inside me there is a little girl who feared getting injections so much that she screamed all the way to the doctor's office - even when she was just going in for a check-up.  (Mama, I am so very sorry about that.)

I do wish I had a wizard who would give me a medal for courage to make it all better, though.

(Hope this isn't too gross-looking for the Internet.)

Whiskey Tango Foxtrot Dreams

We've all had them, those weird, unsettling dreams that wake you from deep sleep, putting you in a state of confusion and dismay.  Those dreams that when you first waken you think your real world is the dream and nothing seems right, that you need to go back to sleep - quick! - so your life will be okay again?  I call them whiskey-tango-foxtrot dreams.

I woke at 0315 today from such a dream about attending a veterans' reunion supposedly in the desert somewhere in the Middle East.  I was a corpsman assigned to a prison camp for American and European civilian "traitors", a good many of whom were Quakers doing field service work with refugees in the area.  Mixed in with the Quakers were, though, an equal number of people who had switched teams, so to speak; they'd joined the enemy.  (I'm tapdancing around what to call these political prisoners because it is difficult to see them as enemies.)

The reunion was for those of us who had served, gone home and presumably reclaimed our civilian, pre-war lives.  We were meeting in a huge mess tent that looked like a seafood restaurant I once went to somewhere along the South Carolina coast.  Above the entrance was a sign like the one above.  The civilians I was with, including my long deceased mother, couldn't understand the sign.  I told Mom it said "Welcome home."

"Why is it backwards?" my mother asked.

"So you can read it in the rearview mirrors as you are leaving camp,"  I said, "except the ones when we left to go home read Farewell."

"That makes no sense," she said.  "No sense at all.  Why would anyone look back when leaving such hell?"

Maybe to make sure it wasn't gaining on us, my brother, Mac (Viet Nam vet), told her.

None of this makes any sense.

When I was awake enough to understand that my stumbling around in the dark of my house to find the latrine was not real, old feelings of sadness and grief and anger swept in and took my down.  Will this stuff never end, I whimpered to myself, then felt really chicken---t for feeling sorry for myself.  I mean, for crying out loud, I wasn't there!  I didn't go through any of the stuff in the dream, ever.  What is wrong with me?!

Maybe I'm going november-uniform-tango-sierra.

Weathering the Storm

(Yes, those are my eyes, the only thing you could see were I to walk outdoors right now.)

Greetings, Bloglandia, from Outer Slobovia, Pennsylvania, formerly known as Hanover!  We're being visited by Winter Storm Jonas who is bringing snow by the ship-load...so far 26 inches of the white stuff, though it is piled higher in some spots because of the near-20-mph winds.  With forecasts of up to 3-inches more per hour until around midnight (another twelve hours as I type this), it's easy to see why the town is shut down except for emergency and protective services.

I've spent the morning chinking drafts around windows and doors.  Had no idea just how drafty the house normally is, nor how easily the drafts can be reduced by a bit of cloth over the sills and at the tops of windows and doors - amazing!

My attire would make a fashionista pale in shock or disgust, but do I care?  I have two pairs of socks on my feet, which are inside fake-fur lined slippers.  Beneath my slightly-too-large jeans, I am wearing long-johns and flannel pajama bottoms.  My torso is encased in a cotton-wool tank top, an oversized T-shirt (short sleeved), a heavy-weight long-sleeved T-shirt and a heavy-duty sweatshirt.  I can't move worth crap, but - by god! - I am warm and cozy.  If it gets colder by bedtime, I might add a sweater and a watch cap, maybe throw another blankie on the bed.

(Bison in Yellowstone National Park)

I receive photos from a national park site and the one above is today's picture.  Bison have very strong neck muscles and put their faces in the snow to plow a path through it.  According to the info accompanying the picture, they even take turns, which explains the turn-outs from the main path.  We could use a couple of them on my street today!

Had an e-mail from a local friend, Ann, who said she was snuggled in with books, chocolate bars and brownies, ending with, "What more could I ask for?"

Just so happens that when I made a last-minute-before-Jonas dash for some groceries last night, I bought the fixings for homemade hot chocolate mix, plus a few staple items such as milk, butter and eggs.  (Already have toilet paper, which is good because there wasn't much left on the shelves.  Do shoppers really think they're going to use that much of the stuff in a couple of days time?!  I digress.)

As soon as I post this, I'm going to make brownies and hot chocolate.  Then I'll get back to that book I started just after Christmas - "In the Heart of the Sea."  I might not surface for a couple of days, except to make more of my Jonas-survival goodies.

Stay safe and warm, y'all!

For Susan (Phantsythat) and Fresca (l'astronave)

Kareema, on our way to PA from California in 1973, in our VW camper.  She was almost three years old here.

Martha, at about the same age, Durham , NC

The Field

Today is the second anniversary of the start of my adventures with PTSD and I had to go to the regional VA hospital abut 75 minutes from my home.  There are a couple of ways that I know of to get there: using the Pennsylvania Turnpike; or, taking US Route 30 by-pass around York over to Lancaster; then up through a handful of small towns and farming communities; past a few large convenience-store-gas-megaplexes; driving within drooling distance of an outstanding BBQ joint;

then left onto Lincoln Avenue in Lebanon, where you turn to the right down a long, tree-lined lane, past a phalanx of American flags (made in China - I kid you not!) snapping to attention in the breeze; finally, left into the parking lot in front of the building where the decked-out lobby pictured above awaits visitors and patients.

Guess which way I went.  (Hint: I didn't have coins for the turnpike toll.)

The Field.  New Year's Eve, 2013, I had an appointment to have labs done at the VA Outreach clinic in York.  That was my second visit to the clinic for the same thing because they couldn't get blood out of me the first time.  I think I've written before about how it felt like old home week sitting in the waiting room with all the other veterans, that I felt like I was where I belonged.  (Don't have a clue why that was.  It is what it is.)

Chatting with the nurse trying to draw blood again, we talked about my time in service, which branch, where I was stationed, what I did - just chit-chat.  I began to feel sad, began remembering things I hadn't thought about in 45 years.  Felt like crying, sick to my stomach.  I wanted to get out of that room, out of the clinic as fast as I could.

I managed to hold it together until she helped me with my coat, patted me on my back and thanked me for my service.  No one had ever said that to me before.  Tears welled up and I had trouble breathing.  By the time I reached the waiting room door, those tears were running down my face.  By the time I was outside, I was sobbing uncontrollably and couldn't see clearly.

Halfway home, I pulled off the highway next to a field.  I couldn't see well, couldn't focus mentally on driving, was crossing into the opposing lane, driving erratically.  I was terrified, had no idea what was happening to me.  Nothing made any sense.  Between sobs, these animal sounds came out of my mouth - howling, moaning, shrieking - which added to the terror.

There was movement at the passenger side of my car: a woman was walking toward the field, her head turned toward a house on the far side.  I was surprised into silence, watched her step across a shallow ditch and onto the field.  She walked about halfway across, fell to her knees, pulled a gun from her jacket pocket and blew her brains out.  I screamed.

My brain started saying, over and over, "This isn't happening, it isn't real, you aren't seeing this!"

My eyes did not transmit that image to my brain, but I saw it.  I heard the report of the shot, saw the side of her face blow away from her head, saw her fall forward to the ground, her butt in the air.  I screamed again and looked away for a split second.  When I looked back, she was gone.  I understood that I was that woman.  My mind was answering my unspoken plea for someone to stop the grief and confusion, the fear and pain I had been feeling for the last half hour.

"That wasn't you.  That didn't happen, it was not real!"

For two years, every time I had to go to York or Lebanon for treatment and tests, I dreaded passing The Field.  Anxiety began setting in as far as two miles before I got to the field.  My daughter went to Lebanon a couple of times with me and I pointed out the field to her as we went by.  The third time, she said I needed to tell my therapist about the field because it obviously was a trigger and I needed to manage it.  (They don't talk about curing or controlling triggers, just about managing them.  How about teaching me how to eradicate the little SOBs, wipe them off the face of the earth?!)

For two years, I drove past The Field as fast as I could, as fast as traffic would allow.  Sometimes I'd close my field-side eye until I either had passed the airport going east, or could see the Labott Road sign ahead going west.  That way I knew The Field was no longer in my line of sight.

I didn't do that today.  Today, I bearded the lion.  I pulled off the highway at the same place I had two years ago.  I sat quietly until the pain in my chest stopped and the knot in my stomach let go.  After a few more minutes, I grabbed my camera, got out and walked along the side of the road to the spot where that woman had stepped across the ditch.


Facing the Labott Road sign, I studied it until the negative image started shimmering around the edge.  I photographed it.  It became an ordinary road sign, had no effect on me.

I turned to The Field and photographed it, too, focusing on the spot where the woman had dropped to her knees.  This year the owner grew soybeans instead of corn.  Maybe next spring he/she will plant timothy or wheat.

See?  It's just an ordinary field.

Umm...Greetings?

Ever wonder what Santa does in the off season?  Here are two possibilities (photo above and video link).

     https://vimeo.com/81979873

Happy holidays, everybody!

(PS: Check out the flag behind Santa.)