Don't Reach into the Alligator Cage

Today, Jim saw his dermatologist to remove his wrapping and splint.  The skin graft came off, which is ok.  (I was shocked, too!) The doctor said it was like when a scab comes off a skinned knee, but the skin underneath still heals - something called "granulation."  According to the professionals, it looks like it is healing well.  The stitches also look good and his incisions are healing.  All good news.  I'm including some pictures.... again, they aren't so pretty.  Take care while scrolling.  The skin graft site and the stitches are visible.  Also, the swelling is going down, but his left hand and fingers are still a little bigger than the right.

Jim's hands 6/30/14

Left hand 6/30/14

We were brainstorming stories to answer the inevitable questions Jim will face regarding the appearance of his hand.  We thought games of mumbley peg or a wicked bar fight (...should have seen the "other guy") were decent, but Erin's suggestion of, "This is what happens when you drop a penny in the alligator cage," was our favorite.  Meanwhile, Jim thinks his resemblance to Sally from "The Nightmare Before Christmas" is uncanny!  

The stitches will come out next week, with surgery for Jim's right hand still scheduled for the end of July.  The doctor is keeping a close eye on the confirmed cancerous spot at the base of his right thumb.  That particular spot has grown some and actually split the skin.  At this point, it can wait a while longer while Jim's left hand heals, but it is definitely on the doctor's radar.  

Things in our neck of the woods are going well.  We have been careful with Jim in the sun - much to his chagrin at times, but as careful as we can be.  It is kind of amazing how often our hands are in the sun without even thinking about it.  Poor Jim got an earful when he rested his hand on the door of the car when the window was down.  He's lucky he got it out of the way as I rolled it up. 

Aside from being the sunscreen and shade police, I'm also earning my keep as the lawn boy, although the "K" I mowed in the backyard isn't as obvious as I had hoped.  I guess I need more practice!  

The boys are doing well.  Neither one of them objects to sunscreen anymore and both are helping out with more chores around the house.  Our sensitive Quentin has had his fair share of emotions lately.  After the last surgery, he started crying and asked me, "When are they going to stop cutting pieces out of my daddy?"  Seriously, that just breaks my heart.  We talked through it as best we could.  It was good to remind all of us that Jim has an amazing doctor, whom we trust completely.  We are completely confident that Jim is receiving the best care possible and that the doctor is doing what is absolutely necessary.

Thank you to the friends and family supporting us along the way.  This isn't an impossible journey, but the kindness and caring of others definitely makes it easier.  We greatly appreciate all the love that has come our way, in all its many forms - meals, cards, messages, phone calls, thoughts and prayers.  From the bottom of our hearts, thank you so much.  

Update from Surgery #2

When I dropped Jim off this morning, the plan was to operate on his right hand, saving the newest confirmed biopsy (the one on his left hand, biopsied during the last surgery) to be addressed next month.  The doctor carefully examined both hands and felt like it was best to make a change of plans.  Consequently, today's surgery was again on his left hand.  Factoring into the change was that Jim's skin graft is not healing as well as the doc had hoped.  He felt that Jim has been using his hand and moving it too much, causing some of the edges of the graft to separate.  Regardless of which hand was operated on, he was going to splint his left hand to help the graft site heal.  Obviously, having both hands unusable could pose a problem for daily life.  In addition to those considerations, Jim had two new suspicious spots pop up on his left hand since his last surgery.  The doctor decided to operate on the known spot and biopsy the other two, all on his left hand.  This time, the team would read the biopsy immediately.  If the biopsies came back positive, he would operate on all three spots on his left hand today.  In the following picture, the location marked "A" is the spot that was biopsied last time and known to be cancer, "B" and "C" are the new biopsies.

Pre-Surgery 6/25/14 - Left Hand

Unfortunately, both of today's biopsies came back cancerous and all three spots were surgically removed.  On the upside, we are so grateful they biopsied and operated on the same day.  That is a huge, huge blessing, saving us an additional surgery to Jim's busy dance card.  Luckily, the doctor was able to stitch up each new surgical site without needing another graft.  That is also a huge blessing.    

Post-surgery 6/24/14 - Left Hand

 The following picture shows his hands now.  His left hand is splinted and well wrapped.  The stitches will come out in about two weeks.  The pen marks on his right hand are around one confirmed cancerous spot and another concerning spot.  We are very grateful that they are keeping a close eye on all of these spots - marking them and keeping a detailed medical photo journal.

Post Surgery 6/24/14 

So, for now we are doing very well.  Jim is under strict orders to seriously baby his hand and take it easy.  We will be watching lots of movies and relaxing quite a bit in the days to come.  Thank you for the concern, thoughts and prayers.  We will just keep taking each day as it comes.

Skin Graft Update

The wrapping finally was removed from Jim's left hand.  Whew!  We were so thankful to learn the skin graft took.  I don't know exactly what the plan would have been if it hadn't, but I can't imagine it would be super enjoyable.  Little by little, the swelling is starting to go down in Jim's fingers and hand, too.  The stitches also came out of his donor site.  It looks pretty angry right now, but is healing well.  So, by all accounts, things are going according to planned.  Our next step will be surgery on Wednesday.  I am including recent pictures as Jim really wants to chronicle as much as he can.  If you're a little squeamish.... skip these :)  

Jim's hands 6/18/14  The skin graft is between his last two fingers.

The donor site

Biopsy Results :(

Yesterday, Jim received a call from his dermatologist regarding his biopsy that was taken during surgery last week.  With a scowl of frustration, he looked at me while still on the phone, and shook his head.  Damn it!  I heard him murmur a couple of responses and then said, "Yes, July 28th would be fine."  So, Jim will be facing another Moh's surgery, (#3 for those counting), on the 28th of July, the day before his birthday.  The biopsy was squamous cell carcinoma and the margins were not clear.  It is another spot on his left hand.  His second surgery is coming up next Wednesday, June 25th for his right hand, with this newest scheduled surgery following about a month later.  LAME!

We have had an interesting life since Jim's surgery.  Jim has been reading different websites regarding how to go about daily life with just one hand.  He has learned a few tricks, but still finds tying his shoes to be a little difficult.  Driving has been ok, thank goodness he has an automatic.  And, showering requires a special plastic bag that covers his hand.  He taped gallon ziplocs over his hand for awhile, but we found a thick plastic bag in the medical supply section at the drug store.  That has been working well thus far and will easily transfer to his right hand when the time comes.

The spot where the donor skin sample was taken from his upper arm is sore and tender, but healing well.  I was surprised at the length of it, probably about 2-2.5 inches.  Jim will see his dermatologist tomorrow and get his stitches out of his donor site and finally unwrap the bandages from his left hand to see if the donor sample "took."  His fingers, his hand, and his wrist have all been swollen and sensitive.  We are hoping that when the wrapping comes off and some of the compression is released, that the swelling will be relieved, too.

Jim's hands 6/16/14.
The dark spot visible above his wrapping is the latest in his cancer family.

As for life around here, I think we are doing pretty well.  Quentin, our 7 year old, had a rocky road at first.  We picked him up at the bus stop the day of the surgery, and the boy crumpled into a soggy ball of tears when he saw Jim's arm in a sling.  He really didn't understand the aftermath of surgery.  Unfortunately, we didn't realize that he thought "surgery" meant "Daddy will be all better."  I talked to him and calmed him down, but on the two block walk to our home, he grabbed onto Jim's legs and broke down again.  He recovered ok and clung a little more than usual to Jim's side.  The next day, he set off to school seeming just a little out of sorts.  Thankfully, when his sadness and tears persisted at school, his sweet teacher took his frustrating work away and had him write a card to Dad.  I get tears in my eyes every time I peek at his words.  We are so thankful our little man was in such kind, caring hands while at school and struggling with knowing Daddy isn't really invincible.  

Dear Dad,
I'm not feeling good at school.
I'm getting frustrated thinking it is something, 
but actually I'm scared for you.  
Sincerely, Quentin

Morgan is handling things fairly well.  He told me that the day of Dad's surgery, they were writing things that made them grateful on the board in class.  He wrote he was grateful his dad would have normal hands again.  I think of the things he could have written that would have been pretty typical for an 11 year old boy - his new video game, a lego set, his bike, summer vacation just a breath away - and am touched that his heart was with his father on that day, too.  I know they both can drive us crazy and test our patience, in fact they are quite skilled at that, but it is nice to see this side, too.  We have good boys.

As for me, I am learning to tie shoes without asking, "Did you ask three friends to tie it first?" and am not minding being the chauffeur at all.  I also make a pretty decent errand runner, but am hoping my days of late evening narcotics runs to Walgreens are a thing of the past!  We did make a recent trip to Costco that taught me a lesson about reserving my teasing jabs for private locations, too.  After pushing our overloaded cart through a very crowded Costco on a Saturday afternoon (never again!), I started hassling Jim while I loaded our things into the car.  I *might* have said something about my "one armed husband using 'cancer-lite' as some viable excuse to not load the car."   Oops, yeah, I saw the stares of the disturbed couple as they scurried past.  I don't think most people get our dry, crass humor.  Of course, it didn't help that Jim put on the perfect look of total dejected emasculation and only laughed when they were completely out of earshot.  Jerk!

In any case, we have coined the term "cancer-lite" in talking with our kids.  They really know quite a bit about breast cancer and we were trying to help them understand that while this is serious, it is different.  Daddy is going to live, it won't be easy or pain-free, but he will definitely be ok.  So, as we were talking with the boys one evening, I said, "What Dad has is like 'cancer-lite.'"  Well, the term has stuck.  BUT, teasing Jim using that phrase in front of strangers was a huge faux pas, my bad!

Jim is handling things very well.  Of course, we both had a moment or two of being completely pissed about the latest cancerous spot and another surgery, but we were distracted last night with some good company, pizza, and wine.  That seemed to help!!  Erin and her boys came over and I think talking to a cancer survivor was good for both of us.  It at least helped me keep things in perspective.  This really is "cancer-lite" in comparison.  Frustrating, annoying, painful, life changing, and total B.S., but he will be fine in the end.

Surgery #1 is in the books!

Jim's hands - 6/9/14, pre-surgery.

Jim had his first surgery this morning.  Thankfully, it was successful!  Today, they addressed the spot between his pinky and ring fingers on his left hand.  The doctor was able to get clean margins (i.e. all of the cancer in that location) with one sample. Whew.  Jim and I were both worried about how far they would have to go. He did have another concerning spot on the same hand, so the doctor took a biopsy from that location.  

In order to successfully close up the surgical site, a skin graft was needed.  The doctor took a donor sample of skin from Jim's left bicep area.  He had told us that was a possibility when we met with him in May, one we were hoping to avoid, but on we go!  So, for now, Jim's left bicep is healing from his donor site, his left hand has one biopsy and the surgical location.  Jim will need to really baby his left hand for awhile to ensure the grafting takes and his incision heals successfully.  His post-op visit and stitches removal will be next Wednesday.  Surgery for his right hand is scheduled for June 25th.

Q is in charge of the healing snuggles at the moment.