336- B12 and DFSP updates

If you recall from 2 previous entries, I had B12 deficiencies, which had the nasty but logical side effects of worsening my battles against depression (at least according to some sources, though the role isn't fully known), and pernicious anemia. Last summer, I had such a severe low B12 level (under 50 units) that my anemia and battles were horrendous, causing me to stay at home due to both depression and lack of energy (anemia induces). I hadn't gone hiking or to breath fresh air often enough, and so, my supplementation was daily, for 2 months. 

Then, after blood work, I had a weekly dose, which wasn't enough ; it was followed by 2 weekly doses, and this brings us to this week's blood-work, showing yet another deficiency, but not as deeply seated as of yet. Anemia, for instance, didn't really start this time over, which is good. 

I'm now passing to another couple month's supplementation, raised to one dose every other day, and then have an updated blood-work once more. I just cannot afford more deficiencies, as my struggles with depression, stemming from childhood traumas are already quite difficult, and the additional strain due to lack of B12 just doesn't help me at all.

B12 results from 12/02/2018 (click to view bigger) 

What does, however, is receiving good, and in this case, great news, which is the second part of this post: I saw my GP this morning, who prescribed the new B12 dosage mentioned above, and gave me the results of my DFSP biopsy, coming clear. 

You can see all the samples and their sizes in this image (I omit personal data). Each is between 1.2 & 1.5 cm ; the "debulking" is 3.6x1.5x2.3 deep. 
From adding up all these sizes, you can see why my bandage is large (10X6cm) and why my recovery's announced at 4 months - my body has to rebuild a deep and large area.

Microscope indications: (with hyper links to medical terminologies)

Debulking : 
Shows a fusocellular and storiform dermal tumor proliferation. The aspects are monomorphic with little atypia and minimal mitotic activity. 
There is a hypodermic infiltration that creeps into the septa and between non-dystrophic adipocytes.

Immuno histo-chemical study (procedure XT iVIEW DAB ...): 
CD34 : positive.  (if you want to know more about this genetic test of CD34, this is a PDF I didn't read yet but include it due to the link of genetic stuff and DFSP). I think the positive indicated that I had this form of cancer, that is all. 
Ki67 : under 1%  (about this indicator). If I recall this was at 5% in a previous test. 

Conclusions : 

Debulking indicates DFSP cancer cells. Mohs surgery & biopsy in sano, meaning healthy zones. This is such a great news, as the surgeon took out all my cancer cells out in one operation, and that I won't have another surgery to schedule in the near future.

I will, however, have to continue checking my skin, and the operated area, and especially all my other moles, for any signs of change, as there are 10% risks of recurrence with the year. 

I will also continue my current post-op recovery, which is going on rather well. 
My swelling has gone down ; my area is still red, but a tad bit less (my wife does the viewing, as I don't feel ready to look at it more than the once I did a few days ago). 

Pain has been thus far manageable ; exceptions are those few moments of electrical jolts, that used to last 30-45 seconds and which have extended to 2 minutes, but luckily aren't very frequent ; and at night, where my wound throbs, aches and sometimes also have those jolts. 
I've been taking pain killers ; sometimes during the day, but mostly after dinner and before bed time. 
Consequently, the use of painkillers reduced my pain, but also weakened my stomach. Last night, I needed to take a break, and risked having extra pain.

I've also been sleeping rather badly ever since my surgery (25/01), so in the past 3 weeks, my nights have usually been segmented into 5-12 portions, the pains waking me up, making me toss and turn as I never find a single position in which I can sleep comfortably for the entire night. 

Last night was a slight improvement, despite not taking my painkiller. I slept slightly better, waking up only 3 times, and didn't have any additional pain. Last night and yesterday, I didn't even have noticeable jolts.

As our stocks of paracetamol are almost finished (only had 3 boxes prescribed by the surgeon, to start with), The GP added 10 more boxes (each has 8 caps, and don't worry, I'm very responsible taking meds), until I need more (at this rate, they might suffice until the very end of my 4 months recovery, or halfway, depending on frequency and pain levels).

I still haven't taken a proper shower, due to the surgeon's post-op rules ; I've been cleaning with a washcloth, but hope that soon, I can finally take a proper shower and find a way to protect my wound.

After my GP (and an errand), I asked my wife to take my bandage off, so my skin could breathe a bit, and tonight, we'll have to put a new one instead, as I don't wish to inadvertently scratch at it. I feel the bandage's presence, and it reminds me not to reach for that area when it itches. 

Throughout this entire period, I have received emotional support by wonderful friends, in person and online, checking on me, cheering me up, making me laugh, chatting on twitter, Facebook, Skype, phone or coming to visit. As some prefer to remain anonymous on twitter, notably, I won't name anyone, and let each friend recognise themselves, you know who you are. Thank you each for your presence, your support and your friendship. 

One friend helped taking my wife and me, each in turn, for grocery shopping, and 2 evenings ago, he not only drove me to 2 shops, but also pushed the cart and carried all the bags from the car to our apartment. He's an ace friend, his name's Antony, and he's been one of the best friends I ever had. We invited him to dine with us that evening, and shall watch movies together on another occasion, just like we had done before. Thank you, mister, you're a gentleman, a scholar and great friend!

Lastly, and most importantly, I want to thank my wife, for being there to support me every day ; to change my bandages ever since the nurses finished their duties ; understanding my short fuses and irritability caused by depression and lack of sleep. You're my star!

That's all for today!