Man On Fire Revisited

   Things (mainly my face) are about to get ugly. Again.
   Last night, I began another three-week series of Efudex treatments on my face. I kind of chronicled my first run of treatment with Efudex a couple of years ago and referred to it as a "Man On Fire" because Efudex is a topical chemotherapy cream which essentially burns away skin cells. The skin cells we're aiming for are pre-cancerous ones (which is good) but the treatment also does a bit of a number on ALL the skin cells it touches (which is bad) so the end result is somewhat akin to a nasty sunburn.

It's you 'n' me, Eff You Dex, just you 'n' me.....

   My original treatment was not nearly as bad as I was led to believe it could have been and this time around we're only talking about two or three tiny little spots I need to treat so no big deal. More of a pain in the....face...I guess!
   The last time around, I chronicled the experience pretty extensively (with pics, even!) and if you're at all interested in close-ups of my ugly mug with even uglier red spots on it you can go back to September of 2013 on the Blog Archive (scroll down the right hand side if this page) and click on it. Religious scrolling will then take you to a whole series of blog posts on the subject. Or you could just go cut the grass, instead! And, if you're a friend of mine who actually occasionally sees me in person and is wondering what the tiny blotches are, well, now you know! Cheers!

Man On Fire: My Face Falls Off

   It was a week ago that I stopped applying the Efudex cream. Oddly, my face started to feel less comfortable after I stopped. It became very dry and tight and sore to the touch.
   Then it began to peel.
   It peeled off in little chunks and large pieces. It was not the same kind of skin you end up peeling off after a sunburn, it almost seemed to have a charred steak look to it (very thin charred steak you must understand) and the skin underneath was still quite red-looking.
   I understand that it might take quite a while for normal-looking skin to re-appear---possibly weeks. This doesn't bother me too much, I put up with the already sun-damaged skin for years and am quite prepared to wait a long time for healthy stuff to emerge.

At the end of treatment...

...and a week later--slightly lighter
and you can see where it's been peeling.

   In the meantime, I am back to running and will soon be back to the gym as well. While the treatment was on, I'd been asked by the dermatologist not to do sweaty stuff and I attempted to heed her as much as possible. Hard as that was.
   My follow-up appointment is early in January. I'm hoping that this will have given my face the time it needs and we will go from there!

Man On Fire: Final Treatment

   Last night, I completed my final (I hope) Efudex application. Now to let the face heal and see what the outcome is!
   Along the way, I never experienced anywhere close to discomfort I'd been warned about by Dr. Horgan-Bell. I guess this is okay but, at the same time, I hope that the desired effect has been reached. I imagine that every patient is different and I hope that the level of sun damage I'd experienced was not severe enough to invoke a similar reaction as what I'd found on the internet or been warned about in the literature I'd been given at the doctor's office.
   Below is a pic of my face this morning. It still looks nasty but I can tell that it is changing for the better. For the last couple of days it has been, in very small sections, slowly peeling away. This was something I was expecting and , because I was expecting it, I find it gratifying and perhaps a little bit of evidence that the whole process has achieved its purpose. Time will tell!


Today. Perhaps a little lighter...

Couple of days ago.

   To the left is also the previous pic, for comparison sake. Not a lot of difference between the two!









Man On Fire: Day 16

   Today marks the start of my last week of Efudex treatment (unless you've been really paying attention, in which case it was actually yesterday) and apparently things are supposed to take a turn for the worse this week.
   I almost hope it does because so far there has been little change. I guess this is not unusual but I would like to start seeing some major progress here, discomfort or no.
   I have noticed one tiny little difference yesterday--as I was washing my face, a small little shred of skin peeled off. Hopefully this is a precursor to something a little more earthshaking. Then again, sometimes you need to be careful what you wish for...

Today's pic---maybe slightly darker...?



Previous pic.

   As you can see by the pics above, there hasn't been much change. I am a little more conscious these days, though, of being out and about and people looking at me. I don't really have a problem with them looking, I just feel this need to maybe explain.
   Hopefully, the next time I have a pic to post it will look a little more dramatic!
   Cheers!

 

Man On Fire: The Vampire In Me

   As part of this ongoing Efudex treatment I am currently in the middle of, one of the things my dermatologist has told me is that I should avoid direct sunlight.
   I guess this sort of makes sense, when you're talking about an area of skin which is slowly being stripped of its protective covering then keeping it out of the sun seems like a really good idea.

   What I have found is that it's a little tricky avoiding direct sunlight. Almost impossible, actually, short of carrying around a Hallowe'en mask or some frilly little parasol. What I do know is that you are definitely very aware of whether you're in the sun or not when you've been on Efudex for a few days. As I mentioned in a previous post, the sensation is almost exactly the same as a bad sunburn and we all know how it feels walking around in the sun when you already have a nasty burn.

A vampire fries---not for ME, thanks!

   So now I am even more conscious of the sun than I was before. I am vampire-conscious of the sun, in fact! I have seen way too many B-movies where the lords of the undead either melted in the sun, sizzled in the sun or simply exploded in the sun as they found themselves trapped beneath its solar rays. Not for me!
   I do now find myself thinking back to how I ended up in this uncomfortable situation. I believe the biggest part of my mistake was thinking that a ball cap was protecting my entire head from the harmful effects of the sun. I am quite religious about carrying head protection around with me (just in case) and I wear a cap even if I'm just walking down to the corner.
   The problem, however, is that a ball cap will cover the top of your head nicely and keep the sun out of your eyes but that's about it.
   Over the years, in retrospect, I think my weekly game of golf has been the biggest culprit. I can't tell you how many times I would get back from an hour and a half of golfing with a bit of a ruddy glow on my cheeks and chest, where my shirt falls open. I never considered myself having been burned by the sun but the cumulative effect now has me where I am.
   Stupid me! It's not like I didn't know the sun was dangerous! But I have still gone out and done an inadequate job of protecting myself and this must change.


Hmm...this Tilley cap seems to be shading
not only ME but part of the boat as well!

   I will be getting a new hat, and wearing it for any protracted stays out in the sunshine. No more golfing with just a ball cap on! The new hat will have a broader rim which will go all the way around, something like the one to the right. No more of the standard (and way cooler) golfing ball cap, pictured below.


Shades my eyes---not my face!

   More sunscreen than I normally apply will be the order of the day, as well. And not just the head and face will get it!
   Obviously, this has all been a bit of a wake-up call for me and I'm hoping that it will resonate a little with anyone reading or hearing about it. I can't say that I am particularly worried about it right at the moment but that's not to say that it isn't worrisome!
  

Man On Fire: Day Ten

   So here I am at Day Ten of the Efudex treatment for sun damage on my face. The clinical name for this type of damage is actinic keratosis (AK). Here is a link to the Skin Cancer Foundation info page if you'd like to sneak a peek. This page also provides all sorts of links to where they talk about prevention, risk factors, treatment, etc.
   The spot on my left cheek is now a deeper red and is somewhat more tender. It feels very similar to a sunburn and, so far, is not too uncomfortable. At this point, however, I am only about half way through the twenty-one day treatment. Dr. Horgan-Bell, who I saw this morning, says that the discomfort will be at its worst at the end of the three weeks. At that point, hopefully, the healing process starts!

Day 10--today

Day 7 (previously posted as
Day 6--my math sucks!)

   Dr. Horgan-Bell also re-iterated that there should be no running, as this would only irritate things. She said I could walk and that was about it. I guess the perspiration is one of the biggest issues. My plan had been to sweet-talk her into letting me run under certain circumstances but she gave me a rather stern look at this point and my resolve kind of just floated away on the air. She also noted that I was self-treating a smaller spot on the other cheek and she didn't have a major problem with that but did suggest that I not go overboard.

Just think a little higher up...

   She also performed a cryotherapy treatment on the spot on my leg. This involves freezing the affected area with liquid nitrogen and then letting it heal naturally. This stung quite a bit while she was doing it but settled quickly
   I am on my own now for a couple of months as I don't see the doctor again until early January. Hopefully she will see a face devoid of the blotchies! You, dear readers, will get to see lots of blotchies over the next couple of weeks!

Man On Fire: Day Seven

   Almost a week ago, I started the Efudex treatment and, so far, there has not been a lot of change. The discomfort has been almost non-existent. If anything, the patch of skin on my cheek is a slightly deeper red now although this is hard to see on the pic I took.
   I've been reminding myself that, according to all the literature, the discomfort increases greatly during the second week of treatment. I am almost looking forward to this as it should give me more confidence that the Efudex is actually doing its thing. Right at the moment, it just feels like a mild sunburn.

Once again, my "before pic".

   I go back to see my dermatologist, Dr. Horgan-Bell, this Wednesday morning. If there's another side-effect (benefit) from all this it's that I'm now paying a little more attention to all the other little spots on my body and am planning on talking to her about them this week.


Day 7--not a lot of change but
a little more tender to the touch

   This weekend has constituted my "off" days--no application of the Efudex. This is to give my face some time to recover and I actually have a whole other cream to apply, to facilitate this. Because I was in such minimal discomfort, though, I haven't yet felt the need to apply any. I'm not sure if I'm being a good boy or not! Maybe later today...
   At any rate, it's back to the Efudex tomorrow and we'll see what the next week brings! Cheers!

Man On Fire: Before Pic

   Today was the day I began my three week Efudex treatment and I wanted to get a pic of what my face looked like before the treatment begins.
   Now, taking a close-up of my own face is something I rarely do and I now have several different versions on my phone. I'm including what I think is the best (believe me, there are no handsome versions...) to include on this particular blog post.
   At this point, I have no idea how fast things might change and I have no plans to post four or five days in a row if, for whatever reason, they all look almost identical. I also don't think anyone wants to look at my face every morning over coffee, not the best way to start the day
   As per instructions, I applied the cream twice today and, so far, I've felt no difference. One of the hardest tings is remembering not to touch your face in that spot. I've absent-mindedly done this a couple of times, just brushed my hand up against it, and it's really not something you want on your hands and fingers. After experimenting with Q-tips today, I've discovered that it's a touch more effective to use your finger, just have to remember to wash them thoroughly afterwards!
   I think I will continue to use the "Man On Fire" title whenever I have one of these updates, just for consistency's sake, so if you see that title pop up, you'll know it's another Efudex post. At that point, please feel free to either skip it or read it at your leisure and I will try and keep these posts as light as possible.
   Below is the "before pic",how my face looked just before I applied the cream.

Won't miss that red spot!

Man On Fire

   Tomorrow morning, I begin my three week adventure with Efudex cream. My dermatologist, Dr. Horgan-Bell has prescribed this treatment in order to clear up a case of keratosis on my left cheek.
   Keratosis is sun-related skin damage and is often a precursor to actual skin cancer. What Efudex does is destroy the already damaged skin cells so that they can be replaced with healthy ones. Unfortunately, along the way it also will destroy existing healthy cells as part of its "shock and awe" regimen. In its simplest terms, I will be giving myself what will feel like a really, really bad sunburn. As with most sunburns, the dead skin will eventually exfoliate, leaving healthy skin.

My new best friend...sort of.

   Several months ago, during my yearly physical, I spoke to my family doctor about a circular spot on my right calf which had not totally healed from a long course of cream application. He said that he would refer me to a dermatologist but that, due to a shortage of them here in London, it would likely be several months before I heard back. Well, it was several months but I finally got in.
   I had only been referred due to the spot on my leg but I asked her if it might be at all related to the spot on my face. Long story short...she decided to biopsy both and, then, not to take any chances with the spot on my face.
   So here I am.
   I have already run across a couple of blogs dedicated to peoples' adventures with Efudex and I am in the midst of trying to decide whether or not to spend a lot of time documenting my own. Frankly, the descriptions and pictures other people have posted are somewhat difficult to hear about and look at. I am sure that I will be documenting the journey for myself. The only thing I'm not sure of is how much of it to share. What I do know is that someone else sharing their trials and tribulations has helped give me a much better understanding of what might be in store. In return, I imagine it's possible that sharing mine might help someone else. So we'll see!