Let's catch up here

Note:  This blog was started about a month AFTER I had been diagnosed with MCC.  This initial post is supposed to bring everyone up to speed with my current posts.  For now, I'm updating this little by little until it catches up with reality.  Stick with it -- it'll all make sense one day.


I just started this blog and I'm already behind.

I first heard the word Merkel on November 16, 2010 during a phone call from my dermatologist reporting the results of a recent shave biopsy.  Since then I've already had surgery, consulted with a medical oncologist, a radiation oncologist, and learned that I'll probably be getting radiation and chemotherapy.

This first, very long post is an attempt to give explain and give a background for everything that's happened up until the current posts start.

My MCC was diagnosed from a skin biopsy taken around the beginning of November 2010.  It was in the same spot where I had a squamous cell carcinoma (SCC) excised back in February of the same year.  Why the excision of the SCC?  For that, we need to go back even further.

My first kidney transplant was performed in November of 1978, back when the earth's crust was still warm.  It lasted only about 6 weeks before rejection caused the graft to fail and hemorrhage leaving me on dialysis.  The rejection episode even blew out some kind of artery in my right leg that kept me in bedridden for nearly a week.  It was a big deal.  On October 15, 1979, I received my second transplant which was an qualified success. It lasted a full 24 years before it began to gradually decline because of chronic rejection.  On July 8, 2005, a few weeks after it I became medically eligible to dialyze,  I received my third transplant (thanks Bruce!) which continues to function beautifully to this day.  I think I've finally gotten this transplant thing down.

So why am I bothering you with transplants?  Because for the last 32+ years, I've had a suppressed immune system that allowed my body to host a foreign object (someone else's kidney) that kept me alive and essentially normal, but also made me more susceptible to infections and cancer.  Additionally, the drugs available for transplants back in '79 were not particularly kind to the skin, making me even more susceptible to skin cancer.  Oh, and since I was 18 when all this started, I was immortal and not really careful about sun exposure for the first few years of transplantation.

So from here on out, there will be minimal mention of kidney transplants except as related to immunosupression and the consequences thereof.

About 15 years into my 2nd transplant, I had my first Basal Cell Carcinoma removed.  My primary doctor thought it was a wart, kept freezing it, but it wouldn't go away.  I was recommended a dermatologist who naturally did a biopsy and determined that it was a BCC.  To him, not a big deal, but to me, it was like boulder had dropped on my chest.  Ever since the first transplant, I had been told that I was more susceptible to cancer, but like most of us, I thought it would never happen to me.  Now I had been officially diagnosed with Cancer.

The BCC was excised and I made it a point to notice new lumps and bumps and growths on my skin and take them to a doctor.  I can't say I got complacent, but I was lulled by the statistics: BCCs and SCCs are the most common form of skin cancer, are slow growing, and are highly treatable; hardly anyone dies of them and I'm seen pretty regularly by a doctor anyway, so I'll catch them before they get out of hand.  I figured as long as I was vigilant and stayed out of the sun, I'd only be inconvenienced by dermatology appointments and some pain going through the actual excisions.  The thought of something like MCC screaming in from out of the blue never occurred to me.

The BCCs and SCCs started ramping up around 2000, and later on, I was getting at least four or five excisions done every year.  Because of changes in insurance plans, I've had several dermatologists over the years and have lost track of how many excisions I've had, but I know for a fact that I've had over 50 excisions done by my current dermatologist.  I can't begin to count the number precancers and suspicious stuff they've frozen off with liquid nitrogen.  They have three fat volumes on me and I'm angling for my own parking spot.

Our strategy is for me to go in every few weeks for a skin check, and freeze the bejesus out of anything that even looks like it's thinking about turning into a cancer.  The stuff that grows back gets biopsied, the stuff that's positive gets removed.

The frequency of my visits is what saved me. .

To be continued...