THE LIBRARY VISIT THAT SAVED ME FROM CANCER

 

The Library Visit

Going to the library can be educational. It can also save your life. At least it did in my case.

When I was growing up my father would often take my brother, my sister, and me to the University City Library. He often stressed the importance of supplementing your education by visiting the library.

Although I moved out of University City in 1973, I still occasionally visit their library. Who would have thought that a visit to that library would teach me something about myself that could ultimately save me from the effects of cancer?

On the morning of Saturday, June 19, 2010, I visited the University City Library. As I was walking through the library I noticed a sign which said that there was a retired plastic surgeon providing free skin cancer screenings on the top floor. I was quite certain that I did not have skin cancer, but I figured it wouldn’t cost me anything to have it checked.

When I met the doctor I said, “I’m certain that I don’t have any skin cancer, but since I’m here anyway you may as well check me out.” The doctor asked, “What makes you so sure that you don’t have any skin cancer?” I replied, “Well, for one thing there is no skin cancer anywhere in my family history. Plus I live a healthy lifestyle. I eat a lot of foods that are high in antioxidants. These are supposed to reduce your risk of cancer.” The doctor asked, “Do you stay out of the sun as much as possible during the hours of 10 a.m to 4 p.m? Do you cover your body as much as possible and wear sunscreen when you do go out in the sun?” I said, “Well no. I guess that I don’t watch that as closely as I should.”

[In the above paragraph I mentioned that I told the retired plastic surgeon that I had no family history of skin cancer. After the surgery I happened to mention this to several of my family members, who informed me that this was not correct. Apparently there were several family members who had skin cancer, but I was merely not aware of that fact. So much for being able to rely on family history as an indicator of your chances of getting a disease.]

The doctor looked at my face with something that looked like a big magnifying glass. When he was finished he pointed to one spot on my face and said, “That has me concerned.” I said, “I noticed that a few weeks ago. It’s nothing. I probably just cut myself shaving.” The doctor said, “No, that’s not the right color, size and shape for a shaving cut. I think that’s a basal cell carcinoma, which is a type of skin cancer. Your first step is to set an appointment to see your family doctor, who will probably want to recommend that you see a plastic surgeon.”

The Doctor Visits

After leaving the library I decided to just forget about that visit. But after a few days I began to have second thoughts. The doctor was retired, so it’s not like he was telling me something just to get another patient. Nor did he mention the name of a specific doctor, so it wasn’t like he was trying to procure business for a former colleague. The more that I thought about it the more that I realized that I needed to get this looked at.

On Wednesday, June 23, I called Dr. Anna Niesen’s office. Dr. Niesen’s specialties are Internal Medicine and Gastroenterology.  She has been my primary care doctor since 1983. I explained the situation to her office manager, John, and asked if I could get an appointment to see Dr. Niesen sometime during the following week. John set me an appointment for Friday, July 2.

When I saw Dr. Niesen on July 2 she said, “I didn’t remember seeing that during your last physical exam.” I said, “I don’t think it was on my face at the time. What do you make of it?” She said, “I tend to think that retired plastic surgeon is correct. That probably is a basal cell carcinoma, which is an early stage skin cancer. You’ll want to see a plastic surgeon.”

Now I’m really getting scared. I asked, “Should I just try to find one from the telephone book or the Internet?” Dr. Niesen said, “No. I’m going to recommend someone. His name is Dr. Christian Paletta. I’ll write down his name, address, and telephone number for you. He is one of the best plastic surgeons inSaint Louis. His office is about two blocks away from here. The same building where my office was many years ago when you first became a patient. When you call to make an appointment tell them that you’re doing this on my recommendation, and that I suspect that you have a basal cell carcinoma. That will get you in quicker than if you just call as a new patient.”

The following week I called Dr. Paletta’s office and managed to get an appointment for Tuesday, July 20. July 20 also came on a Tuesday in 1993. On that day I took a friend of mine to the Jewish Hospital for some medical tests. (A reference to this was made in my article, “Messages From Beyond The Grave.”) So this Tuesday, July 20, I would be the one going in for the tests. Must be something about that day.

When I arrived at Dr. Paletta’s office on July 20, I was greeted by a Licensed Practical Nurse named Stephanie. She took my vital signs and asked me some questions about my medical history. She was a very nice person, and an interesting person to talk to.

A few minutes later a Registered Nurse named Barbara came in. She was Dr. Paletta’s clinical supervisor. She was also a very nice person, and interesting to talk to. She had me remove my shirt and checked my skin for evidence of other areas that might be skin cancer. Other than the suspected area on my face, she didn’t notice anything else that may be a problem.

Shortly afterwards Dr. Paletta came in and introduced himself. He was a very nice person, and had quite a sense of humor. I said, “It is nice to meet you. Dr. Niesen said that you are one of the best plastic surgeons inSaint Louis.” He laughed and said, “She must not know very many plastic surgeons if she believes that.” Now I was laughing also, which helped to make me less nervous about this visit.

As we were talking we realized that we shared a common interest in running, and knew many of the same people. He even knew Jack Frolichstein, who had been one of my running mentors. That was in 1965 when Jack Frolichstein was a math teacher at my junior high school, and one of the best long distance runners inSaint Louis. Today Jack Frolichstein is 81 years old, and he still goes out and runs 3 miles every other day.

After the opening greetings, Dr. Paletta checked my face, head, arms, and hands. He concluded that the suspected facial area was cancerous, and that there were no other problem areas. He said, “I can remove that for you as an outpatient at Saint Mary’s Hospital Same Day Surgery Center. You’ll come in early in the morning, and if everything goes according to plan you should be home by Noon that same day. Afterwards, you will want to come in to see me every six months to make sure no new  areas of skin cancer have developed.”

Dr. Paletta further explained that the procedure would be performed using a local anesthetic. He admitted that the procedure would leave a scar in the affected area, but it would not look nearly as bad as what I could expect if I didn’t get the problem fixed and the cancer spread. He asked if I wanted to set up an appointment now, or if I wanted to check my schedule and call his office later. Since my schedule is on my Outlook Calendar at work I said that I would call his office later.

Should I have the surgery?

By the next day I was beginning to have some second thoughts about this. Not counting some oral surgery (dental procedures), I had not had any surgery since 1959, and I wasn’t anxious to have any now. I decided to forget the whole thing and hope that Dr. Paletta’s office would just let the whole thing slide.

No such luck. Several days later I got a call from Barbara in Dr. Paletta’s office, asking me when I wanted to set up the outpatient surgery. After beating around the bush for several minutes I agreed to have it done on Thursday, August 12. She told me to report to the Same Day Surgery Center of Saint Mary’s Hospital at 6:30 in the morning, and said that the actual surgery would begin around 7:30. I was glad that it was being done at Saint Mary’s Hospital. I knew from experience that Saint Mary’s is an excellent hospital. I had been in their Endoscopy Unit, their Emergency Room, and also a patient on one of the floors. During that time I never interacted with any doctors, nurses, technicians etc. who I considered less than excellent.

By the following week I was really second guessing myself on whether or not I should go through with this. Wasn’t it possible that if I just did nothing the cancer would remain dormant and not cause any problems? If so, wouldn’t the surgery be unnecessary? What would have happened if I had never been at the University City Library on Saturday, June 19? I would never even know about this.

That evening I sent an E-mail to my co-worker Bridgit, expressing my concerns. Although Bridgit is young enough to be my daughter, her approach to life’s problems are often more mature than mine. Last summer she spent a lot of time giving me pep talks to help me build up my courage to go through a colonoscopy exam. So I figured that I could get a straightforward answer from her.

And I did. Between the ++++ below are selected passages from her E-mail:

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

DAMN IT WAYNE, DON’T BE STUPID!

This type of thing won’t go away on its own. 

Life throws us into situations where we have to do things we don’t want to do.  Sure, you can avoid them, put them off, or forget them altogether, but that usually only makes things worse.  If you face things head on and deal with them, that’s the faster you can put them behind you.

  You don’t want to be kicking yourself later by putting off until tomorrow what you could do today.  There’s certain things you can’t go back on in life, and playing around with a carcinoma could be like playing with fire.

Please keep your appointment, and if you have concerns, let the doctors know.  Maybe they can give you a sedative or talk you through things.  That’s what they are there for, to help people.  Take advantage of it! 

++++++++++++++++++++++++++++++++++++++++++++++++++++++

That’s what I needed to hear! Any thoughts that I had of cancelling the surgery or merely not showing up had just gone out the window. This was something that needed to be done before the cancer spread, and a bad situation turned into a worse situation. I was going to have the procedure done at an excellent hospital by an excellent doctor. So it was time to stop being nervous and stop second guessing my decision.

I did some research on the Internet and learned that there are certain products that can help prevent cancer, and even slow cancer down if a person already has it. These products include Red Clover, Virgin Olive Oil, and Cardio Cocktail. (The latter costs about $70 a bottle). So I purchased these items and began to take them every day.

Maybe it was my imagination, but it did seem like after a few days the cancerous spot on my face had gotten smaller, and had turned a “less ominous” color. Maybe there was something to these alternative therapies!

During the week of July 26, 2010, I received a letter from Barbara, who I met during my visit to Dr. Paletta. The letter confirmed my appointment for the outpatient surgery on August 12. I noticed a statement in there which said that I should stop taking aspirin or any other products that are blood thinners at least two weeks before the surgery. I do take a low dose aspirin every day, so I would stop taking that for right now. I assumed that everything else that I was taking was fine. When I visited Dr. Paletta’s Office one of the questions Stephanie asked me was to provide a list of every drug, vitamin, mineral etc that I was taking. If any of those had the potential to thin the blood I’m sure that the letter from Barbara would have said to stop taking these as well.

Wait a minute! The Red Clover, Virgin Olive Oil, and Cardio Cocktail were things that I started taking AFTER my visit to Dr. Paletta. So Barbara would have no way of knowing that I was now taking these items. I researched them on the Internet and guess what? All three of them acted as blood thinners. Can you believe this? The very thing that I was doing to hopefully make the surgery go better actually had the potential to make the surgery more dangerous! Luckily, it was still outside of the two week time limit before the surgery, so I immediately stopped taking all three of these products.

On Tuesday, August 3, I was telling my co-worker Anna about my upcoming surgery and what had happened to date. Anna said, “Bridgit is absolutely right. Don’t even think about trying to cancel this surgery. Now what were you trying to do by taking all of those supplements? Were you thinking that you could magically make the cancer go away so that when you walked into the hospital next week the doctor would say that the cancer was gone and the surgery could be cancelled?” Yeah, that was probably in the back of my mind somewhere.

The following day one of the staff members stopped by at lunch and asked if he could talk to me about something. For confidentiality reasons I won’t mention his name. I assumed that it was a work issue, but he said, “No. This is something else. I heard you telling Anna that you were having some surgery to remove a Basal Cell Carcinoma. I’ve been through that procedure myself, so let me tell you what you can really expect.”

After the employee explained what was involved I said, “So it sounds like next Thursday won’t be the best day of my life, but it probably won’t be the worst day either.” He said, “That pretty much sums it up. It’s nothing to be afraid of. You will do just fine.” I appreciated the talk, as it seemed to give me extra courage.

On the evening of Thursday, August 5, I decided to watch “Boston Med” on television. Not sure why, since I normally don’t watch that show, which is a real life medical drama. On the show there was a 58 year old man who had been diagnosed with cancer. Because of the fact that the cancer had already spread to some of his lymph nodes, he was informed by his doctor that he would need to go through chemotherapy.

That is when the man said something that really hit home. He said, “That’s not what I wanted to hear, but I have nobody to blame but myself. My family doctor had been on me for several years to get this checked out, but I kept putting it off until the symptoms got so bad that I couldn’t put it off any longer.” That’s when I realized that I did not want this to happen to me. As Bridgit said, I could put this off and try to ignore it, but that would likely only make the matter worse. If I didn’t realize it before, I now realized that I had to go through with this.

Early the following week one of the staff members named Joyce came in my office before work and asked me how I was doing. I said, “I’m doing fine.” She said, “Come on, you’re not telling me the whole story. I heard you talking about the skin cancer that you’re having removed. I’ve known people who had skin cancer and just ignored it. Trust me; you don’t want to do that. If at any time you seriously begin to consider cancelling the surgery, don’t do anything until you give me a chance to talk you out of it.” I promised her that I would do this.

On Wednesday, August 11 — the day before the surgery — I got a call from Patti, who is one of the nurses at Saint Mary’s Same Day Surgery Center. She asked me some questions about my medical history, gave me an overview of what would happen tomorrow, and asked if there was anything she could do for me. I said, “Yes there is. Tell me that I’m doing the right thing by having this procedure, and that everything will go fine.” She assured me that I was doing the right thing. The sooner the cancer was removed the easier the procedure would be, and the less likely it would be to have complications. Especially since the cancer site was fairly close to me eye and my nose, it was important to get the cancer removed before it spread.

Before leaving work on Wednesday several people wished me good luck with the surgery. Bridgit said, “I want you to do two things for me tomorrow. When you get to the hospital call me right before you walk into the Same Day Surgery Center and let me know.  If I don’t answer the telephone just leave a message on my voice mail. When the procedure is over, as soon as you are able to make a telephone call, I want you to call me again and let me know how everything went.” I promised that I would do that.

The day of the surgery and the following week

I awoke around 4:00 in the morning on Thursday. Per instructions I had nothing to eat or drink since midnight. They were only planning on using a local anesthetic, but they wanted me to take this precaution just in case a general anesthetic became necessary.

I had planned on driving myself, but at the last minute I decided to take a taxicab instead. A round trip taxicab would not be cheap. But it would be a lot cheaper than if I had a wreck going to or from the hospital because my mind wasn’t on my driving.

I arrived at the hospital around 5:40, and decided to walk around the block a few times since I was early. I called Bridgit from my cell phone and left a message on her voice mail that I was getting ready to walk into the Same Day Surgery Center. Feeling like the sheriff in the movie “High Noon”, I walked through the doors and approached the front desk. I smiled at the receptionist, said good morning, announced my name, and hoped that I didn’t look as nervous as I felt.

I was called in and a lady asked me some questions about my medical history, checked my insurance card etc. Right now I’m not remembering her name, and I feel really bad about that, because she was such a nice person. I’m vaguely recalling that her name began with a “D”.  It was fairly obvious to her that I was nervous, and she went out of her way to put me at ease. As we were talking I offered to tell her what day of the week she was born if she told me her birthday. She found this so interesting that she called in several of her co-workers and asked if I could do the same for them. Suddenly I no longer felt like a scared patient. Instead I felt like the patient who was providing entertainment for the staff.

As we were talking one of the nurses walked over and wrapped the “patient ID band” around my right hand. I said, “I guess this means that I’m officially a patient, and that I’ve passed the point of no return.” I was taken into a room which looked just like a room on a regular hospital floor. I was instructed to undress and put on a hospital gown. I was told that if I needed anything I could push the “Nurses Call Button.”

Several minutes later a man entered my room and introduced himself as Dr. Franco. He said that he would be working with Dr. Paletta during the surgery. He examined the site, explained what all would be done, and answered some questions that I had. I said, “So it sounds like I will have two very fine doctors working on me.” Dr. Franco said, “Now don’t go comparing me to Dr. Paletta. I’m learning from him.” I said, “And a fine teacher turns out fine students.”

Dr. Franco left and about 10 minutes later a Registered Nurse came in and introduced himself as Gerald. He said, “You’ll be working with several nurses today, but I am the one who will be in charge of coordinating your care. I’ll also be with you the entire time in the operating room. My goal is to make everything go smoothly for you this morning.” I was telling Gerald about the pep talks that I had gotten from the people at work. He said, “It sounds like you have a good support system at work. That is a great thing to have.”

After Gerald left a Registered Nurse came in and introduced herself as Jan. She asked, “So how are you doing today?” I said, “I’m fairly nervous about the surgery.” She asked, “Is this your first time?” Stealing a line from the movie “Airplane”, I said, “No, I’ve been nervous a lot of times before.” Jan laughed and said, “No, that’s not what I meant. I mean is this your first time having surgery?” I said, “Oh, now I understand the question. Unless you count some dental procedures this is the first time that I’ve had surgery since 1959.” Jan took my vital signs, and reviewed my chart with me.

After Jan left, Dr. Paletta came in with Dr. Franco. The first thing that Dr. Paletta did was to make a face at me. I returned the face. He said, “Why are you making a face at me?”  I said, “Because you are making a face at me.” He said, “I’m allowed to make faces. I am the doctor.” I laughed and we shook hands. Dr Paletta explained how he would remove the cancer from my face and replace that portion of skin with skin that he would take from the area of my neck near my left shoulder. He said, “The worst part of this morning will probably be when we inject the numbing agent into your face and your shoulder. That will feel similar to what you feel when the dentist gives you Novocain. The rest of the morning should be fairly painless.

Dr. Paletta then began quizzing Dr. Franco on how he thought certain aspects of the surgery should be handled. At one point I said, “Can I try to answer that question?” Dr. Paletta held up his hand and said, “No you may not. This is a teaching moment, and I’m speaking to Dr. Franco.” I smiled and said, “Yes sir.”

Gerald wheeled me into the operating room while Dr. Paletta and Dr. Franco walked alongside.  As we were traveling to the operating room, the four of us talked about whatever came to our minds. Which is another of saying that I really don’t remember what all we discussed. We entered the operating room with the bright overhead lights and at least five (maybe more) people in scrubs waiting for us. We greeted each other, and introduced ourselves. Now I was really beginning to get scared. Why had I agreed to do this with only a local anesthetic? Would it be too late to ask them to put me out completely? I needed to get some courage fast. So I pretended like Bridgit, Anna, Joyce, and some of the other people from work who had given me the pep talks were all standing there watching me to see how brave I would be. That seemed to work!

Dr. Paletta once again recapped what would happen. They put some warm towels on my face to “condition the skin”. They gave me a shot in the area of my face where the cancer would be removed, and another shot in my shoulder where they would remove the skin for the grafting or transplant — if that is the proper terminology. The shot in the face was fairly painful, but tolerable. And the pain didn’t last long. The shot in the shoulder produced moderate pain for just a few seconds or so.

As the procedure began, Dr. Paletta was giving a narrative of what he was doing and why. My first thought was that if I had to listen to this detail I would get sick right then and there. But it didn’t happen. Instead I found it quite interesting to listen to a master at work. Here was a man who was obviously exceptional at what he did, and he liked to share his knowledge with others. I felt secure in knowing that someone of that caliber was doing my surgery.

I wasn’t allowed to talk during the procedure, because they wanted me to keep my face muscles absolutely still. However, on several occasions I did give the people a thumbs up to let them know that I was doing fine. I heard the telephone ring and somebody said, “Dr. Paletta, it is the pathology lab.” A few minutes later Dr. Paletta said to me, “The pathology lab won’t have a final report for several days, but the preliminary report says that we got all of the cancer and it hasn’t spread anywhere.”

A few minutes later Dr. Paletta said that the surgery was over, everything had gone fine, and that I would be taken back to my room where a nurse would be in to give me the “post discharge” instructions, and help me get checked out. He said, “I know you told me that you sometimes lift weights and do pushups, but you’re going to need to put that on hold for a couple of weeks while your shoulder heals from the skin that we removed to put on your face.” I said, “No problem. That will give me an excuse to be lazy for a few weeks. Thank you for everything. You really are a very fine plastic surgeon.” He said, “How would you know? You’re not even a doctor, much less a plastic surgeon.” But he smiled as he said it. He then said, “When you get home today call my office and set up a time to come to see me next week. I want to check out the surgery sites and see how the healing is coming along.”

A few minutes after I was returned to my room a Registered Nurse came in and introduced herself as Melody. She asked me how I was feeling. I said, “I actually feel fine. They only used a local anesthetic, so I’m not sleepy or anything like that. What time is it?” Melody said, “It’s 9:15.” I said, “Dr. Paletta promised that we would be done before Noon.  I’d say he kept his promise.” Melody asked me if I wanted her to bring me something to drink. I said, “If you could bring me a glass of ice water or a glass of apple juice that would be fine.” She said, “How about if I bring you one of each.” She left and returned with a glass of ice water, a glass of apple juice and some graham crackers. I decided to skip the graham crackers since that is a little more sugar than I wanted to have on an empty stomach.

Melody left and returned about 10 minutes later with the written post discharge instructions and a prescription for some pain killer tablets that I could take as needed. She reviewed the written instructions with me in case I had any questions. I asked Melody when I could return to work. She said, “Dr. Paletta said that you can return to work tomorrow.” I said, “So I can return to work on Monday.” She said, “No, I said tomorrow.” I replied, “I know that I heard you say Monday.” She laughed and said, “I guess people really do hear what they want to hear.”

She then handed me an envelope with a card inside. It was a get well card signed by the Nursing Staff. I smiled and said, “I haven’t even been here for three hours and you’re already going to miss me when I leave. I want to thank you and every other staff member for everything that you did for me this morning. This procedure was much easier than I ever imagined possible.”

Melody asked me how I was going to get home. I told her that I would take a taxicab. She asked if I wanted her to call a taxicab to pick me up. I said, “No, that won’t be necessary. I want to go down to Saint Mary’s Cafeteria and eat some breakfast. When I’m done I will walk next door to Saint Mary’s Pharmacy to get the prescription filled. When that is all done I can call a cab from my cell phone.” Melody then told me that I was free to leave.

Now it was time for me to find out just how bad my face looked after the surgery. I hadn’t yet looked in a mirror, so I walked up to the mirror for that first look.  My face looked like I had gone a couple of rounds with a heavyweight professional boxer. But it didn’t look as bad as I had been expecting. And the swelling was the type which would eventually go down.

As I was getting dressed I noticed to my horror that my wallet, keys, cell phone, and watch were missing. The watch was one that I had bought about 5 years ago from Walgreens for $25. So that was no big deal, but missing the other items were going to cause me some big time problems.

I made a beeline for the nurse’s station and said, “Somebody get Security up here right now.” Jan asked, “What is the problem?” I said, “The problem is that while you were all operating on me, somebody walked into my room and stole my wallet, keys, cell phone and watch.” Jan said, “No they didn’t. We have your valuables locked up here at the nurse’s station for safekeeping.” She handed me a bag, and everything was there. Jan asked, “We put all of these items in a bag when I came in your room earlier. Don’t you remember?” Suddenly I did remember. I said, “Yes, now I do remember. Sorry about that. I had so many things going on this morning, it’s a miracle I even remember my own name. I’m getting ready to leave now, so I would appreciate it if you would tell all of the staff members thanks for everything that they did for me this morning. I consider any day a good one where I meet at least one nice person who I didn’t know before. This morning I met many nice people who I didn’t know before.”

I walked out into Saint Mary’s Lobby where I pulled out my cell phone and called Bridgit at work.  When she answered I said, “Hi Bridgit. I just couldn’t go through with it so I decided to cancel the surgery.” I waited about five seconds then said, “No, I’m only kidding. The surgery is over.” Bridgit said, “I want to know the truth. You sound too happy for someone who just had surgery. Besides, how could it be over already? It’s barely 9:30.”  I finally did convince Bridgit that I was giving her a straight story. I thanked her for everything that she did in terms of convincing me to go through with the surgery and also in giving me pep talks to make me less scared of the procedure.

I then went downstairs to Saint Mary’s Cafeteria where I ordered some scrambled eggs, bacon, hash brown potatoes and grape juice.

As I was walking out of the cafeteria I saw Maurie walking by. Maurie is one of the Registered Nurses who works in the Endoscopy Unit. I met her during June 2007 and August 2009 when I had colonoscopy exams from Dr. Niesen. I said, “Hi Maurie. It’s nice to see you outside of the Endoscopy Room. I guess you’re wondering why my face looks like this. I just came from the Same Day Surgery Center where I had an early stage skin cancer removed.”

I went across street to Saint Mary’s Pharmacy and had the prescription filled for the painkillers. As it turned out, however, I never used the painkillers. While my face and shoulder were intermittently sore for the next few days, the soreness was never so bad that I felt that I needed any pain medication.

I then called a taxicab and went home. I took off work on Friday as well. As I’m typing this article on Sunday Night my mind is going through a bunch of what ifs. What if I had never gone into the University City Library that Saturday Morning and met the retired plastic surgeon? What if I had ignored his warning? What if I had decided not to go through with the surgery? Eventually the cancer would have probably spread to my nose, my eyes or my bones.  I prefer not to think about those consequences.

I also realize that this is not the end of the risks. As Dr. Paletta explained, once you get skin cancer your chances of getting it again are increased. So I will be making some lifestyle changes. Avoiding the sun during peak hours, wearing proper clothes when I go outdoors, using sunscreen, visiting Dr. Paletta’s office every six months for skin checkups etc.

I returned to work on Monday Morning. I was the center of attention as people came into my office and asked me how the surgery went and how I was doing. I work with a lot of really fine people!

When I mentioned that my plastic surgeon was Dr. Christian Paletta, and that he was one of the best plastic surgeons in Saint Louis, one lady said, “He’s not just one of the best in Saint Louis. He is one of the best in the entire nation.” I said, “So I guess you know Dr. Christian Paletta.” She said, “I used to work in the accounting department at Saint Louis University Hospital. Dr. Paletta is practically a living legend in the field of plastic surgery. When plastic surgeons encounter tough cases, he is the doctor that they turn to for advice.”

On Thursday I have an appointment at Dr. Paletta’s office to see how everything is healing.  Hopefully the visit will go well. I considered myself lucky last Thursday to have had such a good staff of doctors and nurses working on me and watching over me.

And at the risk of crossing a line that might be better left uncrossed, perhaps I even had a few other people watching over me.

Every Monday the Saint Louis Post Dispatch runs an article on a different old car. Last Monday (August 9, 2010), the old car covered in the article was a 1950 Buick.  Rather a coincidence, in view of the fact that my mother’s very first car was a 1950 Buick Special 4 door sedan. My father bought the car for her in 1955.

If my parents were still alive last Monday would have been their 64 Year Wedding Anniversary. They were married on August 9, 1946. The following day (Tuesday) would have been my mother’s 30,900 Day Birthday. And going back to Monday, that was the 11,242 Day Anniversary of the death of my grandfather, on my father’s side of the family. The significance of 11,242 — that is the number of days between the day that my father was born and the day that I was born.

So perhaps my parents and grandparents were also watching over me that morning. Or perhaps not.

Right now I’m considering myself lucky to have such a fine health care team. Doctor Anna Niesen (who is my primary care doctor and gastroenterologist), Dr. Lisa Reis (who is my cardiologist), Dr. Michael Gabel (who is my ophthalmologist), Dr. Peter Pagano (who is my dentist), and Dr. Christian Paletta (who is my plastic surgeon).

One week later

On the afternoon of Thursday, August 19, 2010, I returned to Dr. Paletta’s office for my post surgery visit.

Dr. Franco came in and said, “Right now you probably want to know the final results from the pathology lab. Good news there. The final results matched the preliminary results that we got last week. We got all of the cancer, and it hasn’t spread anywhere.” I said, “In other words, I won’t have to deal with radiation, or chemotherapy, or the $1,000 a month cancer drugs that cancer patients so often have to cope with.” Dr. Franco said, “That’s exactly correct. Stephanie will be in soon to remove the stitches from your face and your shoulder. Then Dr. Paletta and I will be in to check the surgery sites.”

Stephanie came in with a pair of scissors that had a rather odd shape to them. She asked, “Are you fairly brave?” I said, “I guess that I’m going to have to be. I’m beginning to wish that I had brought somebody along to stand here and hold my hand while you do this.” She said, “I’ll bet that you are a lot braver than you think.” I replied, “Well, if you have confidence in me then it’s only right that I have confidence in you. So let’s do it.”

Having the stitches removed wasn’t too bad. A few times it felt like somebody was sticking small needles into my face and shoulder, but I handled it without complaining or anything more than minor discomfort.

Afterwards I walked over to the mirror to see how my face looked with the bandages removed. I almost fell over on the floor when I saw how horrible my face looked.

Dr. Paletta and Dr. Franco came in and examined my face and shoulder. I said, “My face looks horrible.” Dr. Paletta said, “It looks horrible to you. But it looks fine to me. It looks exactly the way that it should look at this stage of the healing process. During the next three weeks or so you will see a little improvement every day, which will eventually turn into a big improvement.” I said, “That’s great for three weeks from now. But what do I do in the meantime? Wear a sign around my neck which says that my doctor likes the way that I look?” Dr. Paletta said, “Put on a bandage, just like you’ve been doing. Except now that the stitches are removed I want you to change the bandage every day, and before you put on a new one apply some Polysporin to the surgery site. If you use a clear bandage you will be surprised how easy it will be to cover up the surgery site.”

Although I was skeptical at the time, once I put on a clear bandage I realized that Dr. Paletta was correct. One clear bandage on my face was all that it took to make my face look presentable. But I also realize this. If I hadn’t gotten the cancer removed in the early stages, and I had waited for it to spread to have the surgery, it would have required a lot more than a bandage to cover things up.

One Month Later

 

On September 16, 2010, I returned to Dr. Paletta’s Office for a follow up visit. Stephanie and Barbara both examined the surgery site and concluded that the healing was coming along well.

As Dr. Paletta had predicted on August 19, over the past four weeks the surgery area began to look a little better every day. I was now using a much smaller bandage than what I used several weeks ago.

Dr. Paletta examined both surgery sites (the face and the shoulder area), and said that the healing looked as good as, if not better, than he would expect at this stage. He told me that I no longer needed to put Polysporin on the surgery site. He did remind me to keep the area moisturized. He said that either Vitamin E oil or Coco Butter Lotion should work well for this. He told me to return in November for a follow up visit.

When I was checking out at the front desk,  I learned that Dr. Paletta would be leaving his practice at the end of the year. He will be going to work at the Walter Reed Army Medical Center in Washington D.C. In his new position he will be working with the soldiers who had very serious wounds and needed the care of a top quality plastic surgeon. I’d say that Saint Louis’s loss will be Washington D.C.’s gain.

However, his practice in Saint Louis will continue with the fine doctors Bruce Kraemer, Michael Bernstein, and Christina Plikaitis, as well as two fine nurses, Barbara and Stephanie. Not to mention his fine reception staff which includes Serena.

March 2011 Update

 

On March 14, 2011, I returned to the doctor’s office for a follow-up visit.  Dr. Paletta had left the practice on January 1, and was now working at the Walter Reed Army Medical Center in Washington D.C. His patients were now being seen by Dr. Bernstein. Dr. Bernstein was also recognized as one of the finest plastic surgeons in Saint Louis.

Dr. Bernstein examined my skin and said that everything looked fine as far as seeing no potential cancer sites. He did remind me to keep my skin moisturized. (OK, I probably hadn’t been watching that as closely as I should.) He set me a follow-up appointment for September, but told me that if I noticed any suspicious areas I should call him sooner to come in.

June 2011 Update

 

The weekend of June 17-19, 2011 (Friday through Sunday) was the One Year Anniversary of when I visited the University City Library and was first diagnosed with skin cancer. Several things happened that weekend to remind me of the incident.

On the evening of Friday, June 17, 2011, I was invited to a Relay For Life by my friend Linda Schreier.  Relays For Life are about offering support for people who currently have cancer, cancer survivors, and caregivers, as well as keeping in memory people who have died from cancer. Not to mention raising money for cancer research. There was a huge turnout of dedicated people that evening.

It was during that relay when I realized that I was in fact a cancer survivor. I had never thought of myself that way before. Unlike most cancer survivors, I never had to deal with radiation, or chemotherapy, or big dollar cancer drugs, or extended periods of missed work. So as cancer survivors go, I went through a lot less than most of them.

The following day, Saturday, June 18, 2011, I visited the University City Library. There was something that I knew that I had to do. I had learned that the free skin cancer screening that I had gotten last year was through the Health Protection and Education Services. I determined that they would be at the University City Library that morning.

I found the retired plastic surgeon who had diagnosed my skin cancer this same weekend last year, and told him the story. He said, “As long as you are here, let me check you out and see how things look today.” After looking at my face he said, “Everything looks good, except for one area that I want you to keep an eye on.” He pointed to one spot on the right side of my face and said, “It’s too early to tell if this is a problem right now, but if it doesn’t disappear in about a month or so, call Dr. Bernstein and have him look at it.” I said, “That is amazing that you picked that out. I can’t tell the difference between that area and any other area on my face. I guess that’s because I’m not a doctor.” He said, “Most doctors couldn’t tell the difference either, unless they were plastic surgeons or dermatologists.” (The suspicious spot that the doctor noted disappeared several weeks later. So apparently it was not cancer.)

As I was getting ready to get leave the area, Dr. Cathy Remus came over and introduced herself. She was one of the doctor’s who was coordinating the morning’s activities. I told her the story of why I dropped by that morning. She said, “Well I appreciate you giving us that positive feedback, but you can’t just walk in, say hello, and leave. You may as well stay around and get some of the other medical tests that are being offered this morning. After all, they are free.”

Dr. Remus pointed to the next table and said, “They are doing blood sugar screenings over there. Some of the student nurses from UMSL are drawing the blood.”  I said, “No, that is the one table that I don’t want to visit. I don’t handle needles real well.” Dr. Remus said, “That’s all the more reason to have this done first, so you can get it out of the way. Take that chair on the left and Amanda will take care of you.”

As Amanda was working on me, I turned to Dr. Remus and said, “Can you maybe ask one of the students to come over here and hold my hand until this is over?” Dr. Remus smiled and said, “I don’t think that will be necessary.” I asked, “Why not?” Amanda said, “Because I’m finished. We’re all done.” I hardly felt a thing.

With the worst test over, I visited the other stations. These include height and weight, vision and eye pressure testing, hearing tests, EKG (for the heart), and blood pressure. All of these test results looked good.

As I was leaving I realized what a great service the Health Protection and Education Services provides. They provide all these key medical tests at no charge. The testing is done by doctors, nurses, retired doctors, retired nurses, technicians, student nurses, and medical students.

 

September 2011 Update:

 

On September 12, 2011, I had a follow-up visit with Dr. Bernstein. His nurse named Deborah reviewed my chart with me and checked my face.

Several minutes later Dr. Bernstein came in with a lady who was a Medical Resident specializing in plastic surgery. They checked out the surgery site (which was now barely recognizable unless you looked really hard) and checked to see if any new potential areas of cancer had developed. None were noted.

Dr. Bernstein said, “It looks like your healing from last years surgery is complete. I see no knew areas of concern. So there is no more need for you to come to see up unless something new comes up. I am going to give you names, addresses, and phone numbers of some dermatologists. Choose one of them and make a point to get a skin examination at least once a year. If any of the skin examinations show a problem, then give me a call and we can take it from there. But hopefully this is the end of your problems.”

I shook Dr. Bernstein’s hand, wished him good luck,  and thanked him for everything that he and the Staff had done for me since my very first visit on July 20, 2010. I said, “And just an interesting piece of trivia. Friday will be the 400 Day Anniversary of my surgery. I’m going to miss you and your staff. So don’t take it the wrong way when I say that I hope that I won’t have a reason to have to return.”

+++++MORE SKIN CANCER ISSUES++++++++++++++++++++++++++++++++++++

In March 2020, COVID hit the world hard and fast. I was lucky to have never caught that disease. At least a contributing factor was that I got the COVID shots, and continued to wear a mask, even when the majority of people had stopped wearing masks.

In early 2022, I noticed a sore on the left side of my nose.  I assumed that it was the result of the masks that I was wearing rubbing against that area. I purchased some lotions, and began applying them to the area.

At first that seemed to solve the problem, but after a few months the sore returned.  Over the next few months several people (my brother Howard, my sister-in-law Patti, some people at work including Connie, Lisa, and Karen) suggested that the sore was more serious than just a reaction to the COVID masks.

When I had my annual physical exam with Dr. Heidbrier in July 2022, he and his nurse (Lisa) both shared the concern of the people who I mentioned in the paragraph above.  Dr. Heidbrier said, “That is not just a rash. The fact that it has lasted this long makes me think that it may be an early stage skin cancer.” Dr. Heidbrier and Lisa recommended that I visit a dermatologist, Dr. Lucian Hruza.

On September 19, 2022, I visited Dr. Lucian Hruza’s office. Her nurse practitioner, Marissa, met with me, and performed a biopsy of the area. She said, “I suspect that this is cancerous, but we will let you know once the results are in.”

The following week, I got a telephone call from Marissa, who confirmed that the area was cancerous. She said that would likely involve surgery, and referred me to a doctor who specialized in that type of surgery. Dr. George Hruza. If the last name sounds familiar, Dr. Lucian Hruza and Dr. George Hruza are related.

On October 19, 2019, I visited Dr. George Hruza’s office. Dr. Hruza said that he could fix the problem in his office, using MOHS surgery. I was set an appointment for Monday, November 28, 2022. That would be the Monday after Thanksgiving. I was told that it may be an all day procedure, although much of that time would likely be spent waiting for the “next step”.

In the meantime, my co-worker Karen, offered to drive me to and from Dr. George Hruza’s office on November 28. I happily accepted that offer. Karen is the same person who drove me to and from Saint Mary’s Hospital on July 28, 2018, when I had my seventh colonoscopy.

On the morning of Monday, November 28, 2022, Karen picked me up from home and drove me to Dr. Hruza’s office for the 7:40 surgery appointment. Karen stayed with me in the waiting room until I was called in. She said, “When you are called in, I will go to work. Call me when you are finished and ready to be picked up. Good luck with the procedure.”

A Registered Nurse named Mary Beth said it was time for me to come in and get ready for the surgery. She said, “I will be one of several nurses who will be working with Dr. Hruza during your surgery today. “ I said, “Sounds like you have some good teamwork here. Hopefully I won’t be too bad of a patient.”

Much of the day was almost a blur. Probably was the most painful part of the procedure was (ironic as this may sound) when they injected the pain killers into my face. However, once the pain killers took effect, I didn’t feel much more pain during the day. A lot of the time was spent just waiting for the results of when the skin cancer was removed, and the remaining area tested.

The technical name for the procedure was MOHS Surgery. It was named for the person, Dr. Frederic Mohs, who invented the procedure. Turns out that Dr. Hruza learned the technique from Dr. Mohs himself! Don’t get much better training than that!

With so much that went on that day, I feel bad about the fact that I don’t remember the names of all of the staff members who worked with Dr. Hruza during the surgery. I remember Mary Beth, Donna, and Ashley. Every one of the staff members were great, and helped to make what could have been a terrible procedure into one that wasn’t too bad.

It was around 2:00 or so in the afternoon when Dr. Hruza announced that the surgery was finished, and that they had all of the cancer. When they handed me a mirror, almost my entire face was covered with bandages. Dr. Hruza stated that many (although not all) of the bandages would be removed after 48 hours.

I called Karen on my cell phone to let her know that I was ready to leave. I said, “Before you pick me up I had better warn you that my face looks horrible. Just telling you that so you won’t be too surprised when you see me.

Karen picked me up from Dr. Hruza’s Office and drove me to Walgreen’s to get some supplies that Mary Beth had told me to get in order to take care of the surgery site etc.

The Recovery time was somewhat longer than I had expected. I missed work during that entire week. For the next several weeks, whenever I left the house I would wear a stocking cap, and a mask to cover the parts of my face that were healing. So the mask actually had a dual purpose.

I had follow up visits with Dr. Hruza on December 5, December 19, and December 28. Slowly but surely the surgery sites began to look better, and the bandages, coverings etc. continued to get smaller.  Each time Dr. Hruza, and one or more of the fine staff members would check me out and do additional “post surgery work” on my face.

On my December 28 visit, the final stitches were removed, and I was told that the healing was coming along very well. The cancer that had been on my nose had been cured, and I would not need to return until March 2023.

So hopefully things are now back to normal..

2023 UPDATES

On February 21, 2023, I visited Dr. Luiann Hruza for a follow up check. This was the first time that I actually met Dr. Luicann Hruza, . She is a brilliant doctor, and had quite a sense of humor. Turns out that she knew my original primary care doctor, Dr. Anna Niesen, as well as my current primary care doctor, Dr. Edward Heidbrier.

She noticed to more areas on my face that she suspected were early stage skin cancers. She took biopsies, and told me that her office would contact me when the results were in.

The following week I got a telephone call from Dr. Luciann Hruza.   Bad news. The biopsy showed that the area was cancerous. She told me to contact Dr. George Hruza to get the area removed. As it happened, I visited Dr. George Hruza on March 7 for a follow-up visit. When I saw Dr. Hruza on March 7, his staff set me an appointment for Wednesday, March 29, 2023 to have the surgery.

Once again, my co-worker Karen offered to drive me to and from the appointment. She picked me up and drove me to Dr. George Hruza’s Office. She waited with me in the waiting room until I was called in. She said, “As you know, I have several meetings today, so if you call and I don’t answer, leave messages on my work phone and my cell phone, and I will call you back when I am free.”

After I was called in, I saw Mary Beth, who had worked with Dr. George Hruza during my last surgery. We exchanged greetings. She said that this time, Amanda, Heather, and Donna would be involved in the surgery.

Amanda gave me the shot to numb the area where the cancer would be removed. Because this time the cancer was smaller, and in a different area, it was less painful than the shot that I had on November 28.

Dr. George Hruza came in about 15 minutes later, and we greeted one another.  The cancerous area was less extensive than it was the last time, so he completed the removal of that area in less time.  About 45 minutes later, he got the results of the removed skin, and said, “All clear. We’ve gotten all of the cancer.” He said, “We’re using dissolvable stitches, so you won’t even need to get these removed.”

As I was getting ready to go into one of the procedure rooms to get the bandages etc placed on my face, several of the nurses asked if I could guess what day of the week Heather was born. She told me her birthday. I said, “You were born on a Thursday. You were also born on one of my former co-worker’s 3,400 Day Birthday.” She turned to the other nurses and asked, “Is this for real, or is he just joking?” Donna said, “It is for real. He correctly guessed several of our birthdays the last time that he was here.” I said,

A few minutes later in the procedure room, I said, “The number 3,400 has a meaning in my family. That is the number of days between the day when my mother was born, and the day when her younger brother, my Uncle Irwin, was born. Maybe that is a sign that they are watching over me right now.” One of the nurses said, “I guess that you could look at it that way.”

After the bandages were put on, Donna gave me some a list of post operative instructions, explained the key points, and asked if I had any questions.  When we were finished, she said that I could leave. I told all of the staff members goodbye, and thanked them for everything that they did.  I then went into the lobby,  called Karen, and said that I everything had gone well, and that I was ready to leave.

Karen picked me up, and asked how everything had gone with the procedures. She called my brother Howard on her hands free set, so that I could let him know how things had gone. After I had filled him in, he said, “Karen, thank you for driving him to the appointment and taking him back home.” I said, “I will second that. Karen is a very fine person, both at work, and away from work.”

So right now it is the following day. March 30. I am at home, putting the finishing touches on my article. I feel very little pain from yesterday’s procedure. Just kind of tired, which they told me could happen for a day or two.

So hopefully this is the end of the problem.

 

Other Articles Written By The Author

 

I have written a handful of articles from 1997 through 2010. To date, none of these articles have been published. My articles include the following:

Climate Control Nightmare — The time that it took me over two years to get a heater fixed on an old Cadillac.

The Rise in Bowling Averages — Discusses the rise in bowling averages from the 1950’s through around 2000 or so. Gives numbers along with potential reasons.

The Bird Mystery — Have you ever tried to prove that something did NOT happen? That’s what I had to do if I wanted to keep my sanity. Funny to read about today. Very aggravating at the time that it happened.

My Colonoscopy Experiences — What it is like to go through this test from a lay persons perspective. It’s not as bad as it sounds. And it may have saved my life on at least two occasions.

My Encounter With A Collection Agency — I never thought that I’d find myself in a situation where I would have to deal with a collection agency. But I recently did. And I survived.

Semi-Hustler — Another article about bowling. This one talks about experienced bowlers who attempt to portray themselves as beginners. Some people do it just for a few laughs. Other people do it for money.

Messages From Beyond The Grave — A somewhat controversial article on the subject of life after death. It offers no conclusions. Rather it gives some facts and leaves it for the reader to come to their own conclusion.

Trials and Tribulations of My Probation Period — I’ve worked for the same employer for over 34 years. However, there was a time when I didn’t think that I would make it past my 90 day probation period.

The Library Visit That Saved Me From Cancer — Cancer can’t happen to me. It only happens to other people. Or so I thought until a recent visit to a library taught me otherwise.

No Good Deed Goes Unpunished — Be nice to other people. But not too nice, otherwise you run the risk of being accused of harassment. Yes, it happened to me.

Carburetor Nightmare — Sort of a sequel to “Climate Control Nightmare”. When I couldn’t find any auto mechanic who really could work on the carburetor on my 1970 Cadillac, I found help from an unlikely source.

My Family’s First Luxury Car — Back in grade school, junior high school, and high school, I often wondered if my father would ever add some prestige to our family by purchasing a luxury car. It finally happened during my senior year of high school. But the outcome wasn’t exactly what I had been expecting.

The Man Who Inspired Me To Become A Distance Runner — I’ve been interested in running since I was about 14 years old. While a lot of people were instrumental in me getting and keeping that interest, there was one man who had a profound effect on me getting and keeping this interest.

Eccentric Uncle and Other Stories — When I was in school I could at times be quite a trouble maker. This article gives just one example of that.

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