Follow ups and follow ups never end.

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One thing seems to keep leading to another.  We finally got seen by the surgeon who would do the 'eyelid' lift to increase Rich's vision.

After examining him and then calling in another doctor, the decided they wouldn't do any eye surgery until he saw Dermatology.  They poked and prodded around his face and asked many questions.

History of skin cancer? 

NO.

Anyone in the family have skin cancer?

NO.

A lot of sun exposure as a child?

YES.

Chemical exposures?

YES.

"We can't do the eye lid surgery until after dermatology does surgery on these multiple areas."

The doctors poked on his face some more and then their fingers brushed his forehead. 

"We may have to use all this nice excess skin to make skin grafts to cover up scarring. Dermatology will use the Moh's Method to take out the lesions and depending on how deep they are well, that will determine the scarring."

Rich shrugged.  I cringed.  I'd seen photos of the Moh's Method and well, it was not pretty but usually it healed up quite nicely.  Multiple spots? To not do surgery was inviting the cancer to spread and kill him.

I wondered how long had those spots been there?  Of course it wasn't something that a normal person would recognize as cancerous.

Cancer.

Hate hate that word.

We ended this appointment with a promise that Dermatology or Derm, would call and set up an appointment.

We are now one year an 12 days out of the Throat Cancer diagnosis.

More on that later.

Appointments and February Blahs

Rich still feels as if he has no energy and he is not really gaining any weight back.  This of course is a hard time of the year for him anyway.

Right now he is having the doldrums.  The overcast days have got him in a down mood.  Well, as he said. "I'm depressed.  I'm not getting better, I'm not getting my energy back."

When he is like this, there is no discussions to be had.  One just has to listen.  I can't point out to him that he is still alive and that he did have a great day out on Saturday when he went to an auction with the neighbor.

These things don't really matter much to him at this moment.  It is how he feels internally what matters.  He has stopped doing Tai Chi. I tried to get him to do it again.  But he just gives me the look.
He is supposed to be doing physical therapy but he has dropped the ball on that too.
  
I think part of it is that it is so muddy that doing anything outside right now is a huge chore.  When it was so cold two weeks ago, he had some trouble with doing things outside and breathing.

He has COPD and I think that the Throat Cancer and treatments may have made it worse.  That makes doing daily things a lot tougher. And unfortunately he feels that he should somehow be much better.

I have pointed out to him that he actually is doing more than he was pre-cancer.  But he can't see it.

I know once the winter blahs go away and the weather gets nicer, he will go into his 'spring' mode. At least that is what I am hoping.

We go for the CT scan and meet up with the Eye Doctor tomorrow.  I will ask the doctor how long of a recovery time he'll have with the eye surgery.  Rich is under the impression that he will be back at things the next day.

I am trying to be very positive for Rich and sometimes getting the dark look of gloom doesn't make it easy.
We take this time of year one moment at a time.
One foot in front of the other.

Another 13th Visit

Just when you thought it was safe to go back into the waters...

Rich went to his Dental appointment as was scheduled.  During our short two visits to Palliative Care, Rich had complained about 'floaters' in his eyes.

Dr. Loconte didn't give it a thought, they seemed more concerned about his overall well being.  Let's just say that Palliative Care is a good thing, but it didn't work out for Rich very well.

After his Dental appoinment, Rich walked over to see the Eye Clinic. He thought he'd see if he could get an appointment to see an eye doctor about the floaters.  They seemed to really bother him quite a bit.

As luck would have it, an appointment opened up and 'could he please wait for the doctor?'  Rich agreed, it was rare that you ever got in on a same day at any clinic at the VA.

The UW eye doctor showed up and listened to Rich's complaints.  Rich's eyes were dilated and examined.  He told Rich about the floaters.  If they got worse or he saw flashes of light, he was to 'get in' immediately. 

Then he asked Rich if he'd had any family history of skin cancer.

I think that took Rich by total surprise.
"Nope."

The doctor said that he was scheduling Rich for a biopsy in a few weeks as he had skin cancer under his eyes. These areas would be removed as cancer near the eyes was not a good thing and they didn't want it to spread to his sinuses nor his eyes.  He told Rich what kind of cancer it was called and that ... he the doctor was 99% certain that these spots were cancer.
And by the way his drooping eyelids would require surgery as they were blocking at least 30% of his vision.

When Rich got home, he walked in the door and said "I saw an eye doctor today, they are going to do surgery on the lids so I can see better and did you know I have cancer under my eyes?"  He paused and thought a moment.
"I think he called it 'Eye Cancer Lymphodemia'."

I shook my head and said, "I doubt that is what it was called!"

Then I did some research and found the spots that Rich was talking about.  Indeed when I compared them to Basil Cell Carcinoma 'on the face and below the eye' I was surprised.
Indeed I could see it plainly.

And we wouldn't have had a clue except for a cancellation on the 13th.

Now we have another wait and see.  Another cancer diagnosis that happened on the 13th of all dates.

However this cancer...if it is Basil Cell Carcinoma and it has not spread deeply into the tissues, has a 99% survival rate of 5 years or better.

And so it goes.