Random Thoughts: September 01, 2011

MOHS on the Nose: Laughing at the Dark
by Jasmine Sailing

Yesterday I went to my regular periodic appointment with my hematologist at the cancer center (oncologists are also hematologists, though they donít necessarily need to practice it outside of treating cancer).

Iíd been in for blood tests the week before, but I still had a bandage on my face then so I wasnít really thinking about things. Iíve been going to the cancer center for many years now, and initially I was there every week. Several staffers, nurses, and phlebotomists (aka nurses, at a cancer center many nurses can give full-blown phlebotomies and chemotherapy and they can all at least draw blood for tests) know me and easily recognise me. I donít know if they would notice my swollen face and, even if they did, theyíre probably too accustomed to people being in worse states of disrepair to really note it.

Yesterday, with my last bandage finally off (as of the day before), I was still calling myself Frankensteinís monster with my nose sewed on (still am today, in fact). But it was kind of humbling to go to the cancer center like that.

You might think ďWell, at least you had some kind of cancer instead of merely getting treatments and watches for various types of cancer that you have a strong predisposition towardĒ. But actually it turned into more of an ďEr, I had a little patch of not serious cancer... and even if my face is puffy and sewed all the way down my nose from my eye to a little above my mouth, it will heal and the cancer is all goneĒ. And I felt like a lucky little bastard amongst people who are getting chemo and amongst those who may never hear ďthe cancer is all goneĒ.

Sure, Iím not THAT lucky of a little bastard. I have Multiple Sclerosis, which no one would consider lucky unless theyíre uneducated about it, I have Graveís Disease which was untreated and running amok in my body for years. That caused a lot of damage. Including premature Osteopenia (and some Osteoporosis)... and I donít take the pills I should take for bone loss anymore because I have an inactive ulcer (would like to keep it that way) and early Barretts Esophagus (which can cause a particularly fatal cancer). And I donít take the pills Iím supposed to take for Barretts because they can cause Osteoporosis.

How circular is that?! The main cancers they regularly screen me for due to my hemochromatosis are abdominal: liver is #1 because the liver stores most of the excess iron (eg cirrhosis in alcoholics), followed by kidneys, spleen, and pancreas. Iím also on breast and cervical cancer watches. And now Iím on skin cancer watch. Thatís 5 specialists regularly checking me for signs of cancer. Lately Iíve been wondering if specialist #6 (endocrinologist) should check me for thyroid cancer (again), because my thyroid levels have stabilised (again) but my thyroid is still puffy.

Add to those time bombs the MS one, with its periodic sudden dehabilitations that I donít fully recover from, and it can all make a person a wee bit nervous.

So what do I do? The same thing I do every ni.... No, sorry, the same thing Iíve always done to keep sane amidst the never-ending stress. I laugh at it, and I laugh at myself.

Itís like when I got this yearís periodic bone density screening (I donít get those every year, I hardly need that much radiation). I hadnít been happy about gaining weight from quitting smoking in June 2009. Weight gainís another time bomb for me. But when the tech started giving the spiel (all of which Iíve heard and read plenty of times, not that I donít look for updates) about improving bone density I quipped ďI quit smoking so I could gain weight and do a lot more weight-bearing exercise!Ē. She laughed. It is at least true that both quitting smoking and being heavier (if you are mobile) help improve bone mass.

So while I was at the cancer center yesterday, feeling strangely insecure about ONLY looking like Frankensteinís monster from successful cancer removal, I realised that this trait must be particularly common in the cancer community. As Iím sure it needs to be, though I feel bad for the people who donít know the healing powers of laughing at your problems.

First I saw the nurse practitioner. Aside from discussing whatever 800 tests Iíve had since my last visit, and whatever 800 tests are upcoming, I reported my insanity in getting both oral surgery (bone graft and sinus augmentation) and MOHS, aka the form of skin cancer surgery I got, within 5 days of each other. Eh. Might as well have all the pain and all parts of my face swollen at the same time, right? Too bad I hadnít taken nose problems from both sides, and eye problems from both sides, into account when I made that decision.

When the doctor came in she told him about all of it, and that I got MOHS. He asked where, I turned my head so he could see the left side of my face. Then he quipped ďOh! MOHS on the nose!Ē.

It was clear enough that this was a regularly made quip that sprang immediately to mind.

Which made me remember something from all of my time in the transfusion room there, where they do both chemotherapy and phlebotomies. I used to be in there every week, then every 2 weeks, then fortunately less... until this year when I was approved for donating blood on a doctorís order instead. One thing I never could help but notice in the transfusion room (besides that I was the lucky bastard who was only getting a pound of blood removed, instead of being one of the people spending possibly hours getting chemicals transfused into their system) was the sign on the refrigerator: ďI love the smell of chemo in the morningĒ.

I was never sure if that was in poor taste or amusing, because the thought of chemo scares me several times more than Multiple Sclerosis does. It took the double joke of remembering that + hearing ďMOHS on the noseĒ to fully register that it would indeed be a plus for cancer patients to have something to laugh about during their unnerving treatments. Most of the staff probably have themselves well trained in being jovial when it seems appropriate, and being serious when it doesnít (though there will always be the times when someone canít find any humour in their situation, and then I suppose you think oops and feel awkward... Iíve certainly been there in other situations in life, with someone tearfully telling me ďItís not funny!Ē... and then of course I shut up while thinking ďI know, but thatís why I need to laughĒ.).

I wouldnít have been saying I look like Frankensteinís monster without any joviality. That would be a lit or horror geek joke. ďMOHS on the noseĒ sounded like an insider oncology joke from people who are used to worse cancers. Though MOHS on the nose (and near the eye) is indeed a nuisance compared to, say, MOHS on the cheek.

Of course there are also the lighter levels of humour, like the sign by the chairs outside of scheduling. It informs you that parking is for chocolate lovers only and everyone else will be towed. Chocolateís a mood improver, and Iím a big fan (that pun was purely accidental). I need not worry about sitting there. Though it makes me wish they would give out chocolate. I could possibly find some in the transfusion room, but even precious chocolate wonít tempt me in there unless Iím ordered in there. My veins would probably rebel and flee the building.

It can be difficult to figure out how to feel about cancer-related jokes when cancer is only something you are afraid of, not something you have (or something youíve only had mildly so far, like my minor skin cancer).

Interestingly, the revelation that at the cancer center Iím not unusual in my tendency to laugh at the dark made me feel less out of place though. They can chuckle at my MOHS on the nose all they want. Maybe laughing at the dark wonít scare it and make it run away, but at least it can make you feel better and a little more in control of something.

Back to the Thoughts Index.