I had been treating the annoying little spot on my calf for weeks as if it were a persistent wart, but the home treatments didn’t seem to work. Shortly before my husband and I left Moab in January to spend a few weeks in Arizona, I got all caught up on routine medical care, including the low-cost blood draw that Moab Regional Hospital conducts every year. When I was having a couple of other annual exams done, I told my doctor, “There’s a wart on my leg that just won’t go away, will you zap it?” She peered, a little puzzled, at the eraser-sized annoyance and said that she’d give it the deep freeze. And off I went to warmer climes.
A week or so passed and the blemish continued to hurt worse and even grow some. So I made an appointment with a local doc in Arizona who could fit me in within the week, as soon as my insurance was approved. By the time I saw her I was about ready to take a sharp pocketknife to the small protrusion. It bugged me when I crossed my legs, while crouching down, and while riding a horse. It wasn’t getting better.
The Arizona doctor took a look at it, estimated that it was something that sounded like a carrot-something-something (although it probably started with a “K”), and said she would cut it out then and there and send it to a lab for diagnosis. By the next day, the Arizona lab had returned a different verdict: squamous cell carcinoma.
In the family of skin cancers, this isn’t a life-stopper. But it’s something that shouldn’t be ignored. The squamous types can grow and become more uncomfortable, and I’d had enough of that already. My small-town Arizona physician said not to worry, that she would refer me to a suburban skin surgeon down the road on the outskirts of Phoenix who would get right on it. And she was right. Within a day I’d been contacted by a dermatologist’s office 35 miles away, and we set a date several days later for a doctor to dig deeper into my leg, to make sure to get “the margins,” as they call it in medical lingo.
I arrived at the skin surgeon’s office bright and early on March 1 to begin the Mohs surgery, so named for the doctor who devised the technique that was used on me. It begins with a surgeon taking one dig at the area in question, then taking a few skins cells beyond that to examine under microscope for cancer cells. As a patient, I was advised this could take several hours. If the first slice of skin came back with bad cells, the doctor would go back for more flesh, until only clean layers of skin were detected, then the area would be sewn back up.
“You will leave our office cancer-free,” the medical secretary told me. Fortunately, the first big scoop of skin tissues got it all, and I was able to leave within 90 minutes plus about 25 stitches. “You will need to come back in a couple of weeks to get your stitches out and to follow up,” the doctor said. But I responded, “I’ll be back in Utah by then, which means I’ll have to go to Colorado to see someone like you.” He scratched his head in puzzlement, wondering how all these states would be in my skin-care future, but those of you in Moab who need medical specialists know that we often have to leave town to get all the care we need. It’s just a fact of life. That same week I had flown from Phoenix to Salt Lake City for a follow-up medical visit at the University of Utah on an unrelated medical care issue that started last July and required a February appointment.
We in rural America get medical care where and when we can. Now that I have a skin doctor in Arizona, I’ll probably plan to see him annually there each winter just for convenience. Occasionally I’ll continue to see docs in Grand Junction. And when I really need to, I’ll go to Salt Lake City for appointments. My experience in Arizona was one of medical-care efficiency and expediency. I was in the right place at the right time.
By the time March ends, the embroidery on my leg may be a distant memory of the trip to the dermatologist on March 1. But it will also be a reminder to slather on the sunscreen, and not mistake a skin blemish whose effects may be more like a lion than a lamb.