Healing and Peeling

It has been about two and a half weeks since surgery and Jim's hand is healing well.  His skin graft came off last weekend, which did cause a little anxiety for both of us.  As we talked about it, though, we agreed not to freak out until we heard from the doctor on Monday.  His doc reassured us that as long as the site didn't appear infected, this would be ok.  The graft kind of worked liked a bandage, and would eventually come off just like the last one.  So far, to our amateur eyes, it appears that there is no infection and healing is progressing as expected.

Jim's left hand 8/14/14.
The healing graft site is at the base of his middle finger.

Jim's left hand 8/14/14.
A closer view of graft site.

 Jim's hands have started to peel more, too.  That is a result of the oral retinoid medication, acitretin, that he has been taking all summer.  The idea is it will help slough off the precancerous cells, helping the doctors determine which spots to address.  This week, some of the peeling has extended to his palms.  According to Jim, the peeling isn't painful at all, but some of the precancerous or cancerous spots are slightly painful, feeling like the exposed part of a blister when the outer layer comes off.  There are only a few spots like that, so it is not too bad.  In all, his hands do look better than they did a few months ago.

Jim is noticing some limited movement in his left hand, which we are hoping will be relieved in time.  He can't make a fist with that hand and has trouble grasping and holding things, especially things that have even a little weight to them.  He has enough swelling and tight areas that wearing his wedding ring has been uncomfortable.  For his birthday this year, he asked for a chain to wear his ring around his neck.  I told him he could put it away for awhile and it wouldn't bug me at all, but he said he wanted it with him.  So, he got a chain for his birthday.  He is so lucky that the fat gold, Mr. T chains were way out of my price range.  

Left hand 8/14/14.  The best fist Jim can make.
Some palm peeling is visible, too.

Left hand 8/14/14.
Jim's tightest fist and a little peeling.

Both of Jim's dermatologists, (the civilian doctor who has been doing the surgeries and his VA dermatologist) believe a good next step is chemo cream.  We're not really clear on the timeline yet, but will be moving forward after the left hand heals completely from surgery.  When the possibility of chemo cream was discussed earlier in this process, the plan was to use it for about 6 weeks per hand, one hand at a time.  We do have the cream and many pairs of gloves to cover the hand being treated.  When he starts using the cream, it will be essential that the treated area receive no sun exposure.  So, instead of Mr. T, he will be headed into the world of Michael Jackson!

Our little family is doing well.  The boys are enjoying summertime and bemoaning the inevitable approach of school.  They both seem to be handling the emotions of watching their dad's journey very well.  Quentin has moments of exasperation with how long this is taking, but generally is doing much better than at the beginning.  I have been slowly getting my own classroom ready to go and actually feeling excited to head back to work.  (I know, my teacher friends are all groaning at me right now!)  Maybe I just need the laughter, smiles, and excitement of first graders?  In any case, remind me of that feeling at the end of the first week when I am heading to bed before the sun, rubbing my feet and my head, while complaining about needing to build up my sore "teacher voice."  Jim has been really enjoying his job, feeling completely supported throughout this medical journey and his many appointments.  That has been a huge blessing for us.  He has also been working tirelessly on completing his latest audiobook, which is due by the end of August.  So, all in all, things are going well.