Cryosurgery

It's a big name for a tiny procedure. Today was my visit to a new dermatologist, one of those full body skin exams. It's that time in my life where it gets to be done yearly, or should anyway. My last visit was ten years ago. 

Skin cancer runs in the family. Both my parents had it, tiny splotches on their skin which needed to be removed. I don't know whether back then they had them frozen or cut out, but something must have been removed for a pathologist to examine because they had a name for which of the three kinds they had. I believe they said squamous cell, but for sure neither had melanoma. It kind of surprised me because neither went out sunbathing, the way kids tended to do in my generation to get that desirable tan. They were blaming skin cancers on sun exposure, not something we'd heard about until then. It also wasn't something Mom warned us kids about till then. After that, she never let up with the warnings.

I hated sunbathing. Deliberate exposure to the sun always made me feel slightly ill. That doesn't mean I never did it, because every once in a while I forgot how it made me feel and laid out for a bit again. It was a good reminder for another year or so. I'm "blessed" with fair skin which never really tans, just one more way I never fit in with whatever was popular, like having unrelentingly curly hair when straight was popular.

That doesn't mean I avoided sun exposure. But mostly it happened on my left side, when the sun came in the car windows for the 29 years I was a courier, racking up over 2 million miles behind the wheel. If it's going to happen anywhere, I'll likely get skin cancer on my face. I thought I had some ten years back. There was a small bump on the tip of my nose, the left side of course. It was colorless, but it would grow, get picked off, regrow, and keep recurring. My then-doc sent me to the dermatologist's office down the hall. They looked at it, pronounced it benign, but cryosprayed it anyway. It hurt. The spray made no difference, the cycle continuing for another couple years but now with bumpy scabs that never quite healed, but came off with a washcloth. Then suddenly there was just a little white divot.

I never bothered going back. I was not impressed by them.

I noted a pigment change on the side of my jaw - left, of course. It was/is a light tan. It would easily be covered by makeup, but I don't use that. Several months ago a spot in the middle of that started to rise, and the texture of the skin felt different, rougher, something not quite a scab, but not going away. While I couldn't see it, my finger could always find it. I mentioned it to my new northern doc last week, and she recommended the dermatologist check it out. In fact, I should get the whole body check, given my parent's history and my work history. So I made the appointment, surprisingly quickly after she recommended it. Perhaps it had something to do with her description of it as "highly vascularized".

About the same time I read about a study where they appeared to be finding more fast growth in existing cancers after patients had covid, particular when it became long covid. More study is needed of course, but getting covid twice despite vaccinations got me moving to make the appointment. Today was the day.

Their office is in a wing adjacent to the hospital about 17 miles away, one very familiar from  early cardiology and allergy visits before I retired and moved south. I used to park in handicap parking back then, before knee replacements. Now it's a hike from a far corner of the parking lot. It's not all that's changed. They used to have a concierge desk where some actual human could direct you to which floor and how far your appointment was. Now they have signs, most in fairly small letters at each department, so you have to walk around to find your department the first time. (I was informed later that there is a small TV screen you can fight with to locate a map of the area. Of course you have to find the TV and know why it's there first....)

I'd also been informed that it would be a 90 minute appointment. OK, bring a book then. Check. I was the only patient in the waiting room when I arrived, no paperwork to fill out because it's all in their computerized system which had just been brought up to date the week before, no changes. I made it through two pages of the book before being called in, and once undressed and gowned as directed, had no more time for reading. They were very prompt, very thorough, and explained as they went why this kind of spot was harmless (a result of aging, get used to it) and why this other thing should get the cryospray on it.

If I was willing, of course. 

Of course I was. It was why I went in the first place. Why make another appointment when this one would just take three minutes longer? And it was, literally, three minutes longer. There were three spots treated for being suspicious, one particularly so but not the one I'd gone in for. The first spot was the one I pointed out to them. Zap zap zap from a little aerosol can. She called what it would feel like as a "cold burn." OK, not so bad, not like I remember from my first spray ten years earlier. Maybe the nose is just more sensitive. A second spot  was a couple inches away on the same jaw, one that was labeled with a "pre..." as she checked it, and was quickly treated. That hurt a bit more, zap zap zap, but was quickly over. A third one was located, hiding up in my left eyebrow. Again zap zap zap. I was given a sheet on wound care (like I never had to do that before!) but this time it was mostly using vaseline to keep stuff off the healing skin to prevent infection. I have some of that. A lot of my places benefit from that kind of moisturizing these days. I'd packed it where it was reachable.

It was over and done in 15 minutes. So of course I mentioned I'd been told to plan on 90 minutes.  They have no idea why the schedulers in their central office keep telling patients that. Their own schedule has them with a new patient every 15 minutes. Before they left me to get dressed, I was told to make a new appointment on my way out for a year from now. I didn't have to make it today, but be sure to make it at least 6 months ahead. 

Hmmm, and I got in for this one in just over a week? My doc must have been more concerned than she let on.  It sure beats the nearly year long wait just for an appointment after a positive Cologard test requiring a cclonoscopy, and the 8 months wait for a reschedule after it had to be repeated to get a complete result. I think I like when my possible problems get taken seriously, especially when one possible concern is cancer.

On my way out I hit the restroom out along the hall. When washing my hands I checked the mirror and found the new red spots from the treatment. I also noted that the water from the tap emerged yellow. SAY WHAT? Did somebody connect the pipes the wrong way? Didn't I just flushed that? So I popped into the pharmacy where there was an actual human to talk to and mentioned that they might have a problem, and where. They knew all about it. Yesterday they'd flushed out the entire plumbing system, as has to be done in all plumbing systems on a regular basis. Spring is a good time for it, once there is no threat of getting ice of the roads. When you see water spraying out from a hydrant when there are no fire fighters around, and no vandalism, it likely will be city maintenance crews flushing the system. Of course it knocks a lot of minerals off the inside of the clean water pipes, and it can take a day or so for it to run clear again. If not flushed out through the hydrants it can eventually block the pipes. This particular sink must not get a lot of use.

As soon as I heard the explanation I knew exactly what they were talking about. When I was on the city council we had to deal with that each year. As I drove through town while leaving there were two hydrants getting flushed out along the main drag, and cars driving through getting a free undercarriage flush while also splashing everything within 10 feet. Almost too bad the kids were in school, but it's still too cool for them to get soaked. It's barely spring here, with the snow finally melted. The earliest flowers are celebrating: