Doctor Eclectic

Doctor Eclectic
Doctor Eclectic

Saturday, June 29, 2013

Squamous Shamus

Once a year my church has a blood drive and I used to be a regular donor.  Then I had Prostate cancer and took a forced five-year hiatus that ended last year.  This year I was prepared to continue a habit started when I was a Naval Officer and a four-times-a-year donor.  After I completed the paperwork I was interviewed and told that I could not donate until next February.

Because I had been operated for a Squamous Cell cancerous lesion on my left ear.  Twice.

The operation was self-directed because I had virtually stopped going to Dermatologists because they rarely operated and generally just used Cryosurgery to take off dozens of spots on my balding dome.  But two lesions: one on my ear and one on my chest, had recurring scabs that peeled away at four to six month intervals.

So I asked my Primary Care Physician for an opinion and he suggested a referral for evaluation.  The ear was a candidate for Mohs surgery: a procedure that allows evaluation of borders immediately.  One corrective procedure and a follow-up cleanup procedure and I was pronounced cancer free.  The chest was treated with his freeze-gun.

An interesting article by friend and columnist, David Whiting in the OC Register this June discusses his experience with squamous cell cancer.  He had a lesion on his knee that didn’t heal and eventually was sent to a dermatologist who referred him to an Orthopedic surgeon because of the location of the lesion.  The Orthopedist sent him to a Plastic Surgeon who diagnosed it as an embedded thorn.  Mr. Whiting is a researcher and visited the Mayo Clinic website and the website for skin cancer and self-referred to a pathologist who diagnosed the Squamous Cell lesion on the knee and three other areas of his body.  David’s message?  Be your own advocate.

Mary, my wife is currently healing from 40 sites, treated by her dermatologist by Cryosurgery.  Perhaps it is my bias as a trained dentist, but I find it unusual that so many lesions be so treated without a biopsy of at least one.

My suspicious nature wonders if this is yet another treatment decision driven by the fact that we pay for services rather than for care.

One wonders also why there are so many restrictions about donating blood?  Some examples?  Malaria, five years (Mary and Tim, having contacted malaria on a Philippine Naval Base in 1983 have yet to donate); Travel to Europe during the time of mad-cow disease, forever; sex with a single male partner if you are also male, forever; and my squamous cell operation one year.

When I went in for my Prostate surgery I was encouraged to bank my own blood.  I think if asked I would have as soon tried some blood from a restricted donor.  Again, my skeptical self wonders if the logic is driven by liability risk rather than medical.

As I write this my 80 year-old brother in law is being treated for a radiation cystitis.  His problem?  In his home town, Freeport, there is not a medical facility or physician who has treated his condition.  I have another relative and friends who are in serious stages of dementia with limited resources to treat the condition.  All this at a time when we are preparing to expand healthcare to millions of people without access to the limited resources we have.

Which brings me to considering the subject of my next post.  With student loan rates scheduled to double in interest in two days, I think I’ll weigh in on the subject of financing post-high school education.

You might find my comments interesting.

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