My Lip

When I was a young man little was known, or at least little was spoken, about the dangers of sun exposure.  We knew that too much exposure meant sunburn and the goal was to stop right before reaching that point.  I remember debating between Coppertone 4 and Coppertone 6 at the CVS.  I do not recall ever seeing sunscreen for ones lips, perhaps it was available.

I mention sun exposure because the sore displayed on my lower lip in the photo above is the result of in-office Mohs surgery I endured three days prior, to remove a squamous-cell carcinoma.  77-year-old Dr. Schleve performed the procedure.  Nice guy.  I have no choice but to trust him and no reason not to.  I mention his age because he offered the information and because he is the oldest practicing doctor I have met.  He could have said "67" and I would have believed that, too.

During the surgery the surgeon removes the tissue that appears cancerous, sends you back to the waiting room, and tests the removed portion.  If those tests show cancer on the edges then you return to the operating chair.  This continues until the tests no longer show cancer; I required the initial and a subsequent sit-down, roughly thirty minutes apart.

I have a low tolerance for pain and blood.  I can and have given blood and that is probably my limit.  I have fainted or nearly fainted three times.  One, when giving blood for the first time.  Two, watching the OB/GYN insert the epidural needle during the birth of my first child.  Three, watching the oral surgeon insert the needle before the removal of my daughter's wisdom teeth.

Recall that Mohs surgery can consist of one or more "sessions" and that I had two.  During each the surgeon used heat to cauterize the blood vessels that were bleeding.  I could hear the sizzle and smell the burning.  Between sessions I sat in the waiting room.  I could hear the office sound system:  a portable boom-box tuned to KOSI 101, which plays only Christmas music (without a DJ) between Thanksgiving and Christmas.  I do not object to Christmas music, but I object to listening to a radio station when the office can subscribe to ad-free internet radio for ten bucks per month.  I think they should be able to manage that expense.

My wife accompanied me because I wanted the company and did not know if I would be feeling well enough to drive (it was borderline).  That I was here at all was her fault.  My lip had been chapping on-and-off for six months, always in that one spot, even during the Summer when the air is moist.  She repeatedly asked me to have a doctor look at it, and I did.

That dermatologist identified the spot on my lip, and two other spots on my face, as possibly basal-cell carcinoma.  Her recommendation, which I accepted, was to freeze them off.  While that diagnosis was ultimately incorrect I find no fault with her.  At the time she said it was not a firm diagnosis, that additional tests would be necessary if the symptoms returned, and there was no risk to the treatment.  So, because of my wife, a stranger was applying liquid nitrogen to my lip.

That took a full week to heal and a few weeks later my lip again started chapping.  I scheduled another appointment, then another with a different office because the original office had a one month wait.  In this second office the dermatologist recommended a biopsy.  That seemed reasonable, so I assented, and he took a chunk out of my lip for that purpose.  So, another week of recovery.  His office called to alert me to the finding of squamous-cell carcinoma and scheduled me with Dr. Schleve.

It is now fifteen days after the surgery.  For pain relief I have been taking ibuprofen:  six, 200mg tablets each day, tapering off but also fluctuating higher.  After three days the pain was reduced to the point that I was able to enjoy Thanksgiving with the first brined turkey I had ever made.  However, a few days later it increased to the point that I was miserable.  It decreased again for a few days, now it is a little worse.  I visisted Dr. Schleve yesterday for a routine follow-up and he said it will be another two weeks, though I recall he originally said a total of three weeks of recovery time.

For most of my adult life I have been pretty diligent about applying sunscreen, though less diligent than my very fair-skinned wife.  I imagine this experience will keep me on the wagon.