July 19, 2010

Skin Cancers

The skin like other organs in the body can be affected by cancer. Skin cancer is an abnormal and uncontrolled growth of skin cells that can be divided into three types:

  • Squamous cell carcinoma.
  • Basal cell carcinoma.
  • Malignant melanoma.

Squamous cell carcinoma:

This type of cancer originates from the squamous cells present in the epidermis which is the outer most layer of the skin (see the skin). Too much exposure to ultraviolet light of sun is the most common cause and that's why it is more common on areas that are exposed to sun light.

Certain factors increase the risk of squamous skin cancer which may include:

  • Sunlight exposure for a long time.
  • People with fair skin are more affected than people with dark skin because they have less melanin pigment which protects the skin from sunlight.
  • People who have been exposed to x-rays for a prolonged time.
  • Burns, ulcers and old scars on the skin.
  • Exposure to chemical substances such as arsenic.
  • Old age people.
  • Genetic disorders eg, Xeroderma pigmentosum.
  • People with suppressed or low immunity.
Squamous cell carcinoma can appear on any area of the body but it mostly appear on sun exposed areas such as the head and neck including the ears and lips, back of the hands.

Symptoms and signs:

  • In early stages the skin change may include a skin bump that may be pink or red in color with a rough or scaly surface.
  • A change in a pre existing lesion is a warning sign.
  • Actinic Keratosis is a precancerous skin lesion that may change to squamous cell cancer, changes in Actinic Keratosis may be a warning sign for developing squamous cell carcinoma, and these changes may include: increase in size, increase in redness, bleeding, thickening or pain.
  • This type of cancer has the ability to spread to the deeper layers of the skin and may also spread to other areas of the body as well.
Diagnosis:

Diagnosis is usually made by examining the lesion and confirmed by taking a skin biopsy, there are many types of biopsies and the patient is given local anesthesia before taking the biopsy to numb the skin.

Treatment:

The earlier the diagnosis is, the better is the cure rate. Factors that determine the treatment options are: tumor size, the location of tumor and whether or not the tumor has spread.

  • Cutting the tumor out (excision) after giving local anesthesia and then the wound is closed with stitches.
  • Curettage and electrodessication in which the cancer cells are scrapped away with a curette and the remaining is destroyed with an electrical current that generates heat. This type of treatment is used for small squamous cell carcinoma.
  • Cryotherapy: this method freezes the tumor cells using liquid nitrogen leading to their destruction.
  • Advanced surgery called Mohs surgery in which the surgeon after removing each piece of skin, examines it under a microscope to check if there is any cancer cells left behind, if tumor cells are still present another piece is removed until the skin sample is free from cancer cells. This type of surgery is mostly used for tumors on the face such as the ears or for difficult or recurring tumors.
  • Actinic keratosis and some cases of Bowen's disease which is the earliest form of squamous cell cancer can be treated with 5-fluorouracil containing lotion or imiquimod.
  • Radiotherapy: this method may be used when the tumor is large, in places where it is difficult to remove or to relieve symptoms when the tumor has spread to other parts of the body. Radiotherapy maybe used alone or in combination with surgery.
  • Chemotherapy: this method is used in cases where there is spread of the tumor to other body parts. In advanced cases, chemotherapy is added to surgery or radiation.
  • Photodynamic laser therapy: may be used in Bowen's disease.
Prevention:
  • As sun exposure is the most important factor, protecting the skin by wearing protective clothes which include hats, long sleeve clothes and UV protective glasses and try to stay out of the sun during peak sunny hours from 10am-4pm.
  • Using sunscreens with a sun protective factor (SPF) of at least 15. For children and persons with fair skin use sun protective factor of 30.
  • Regular checking of the skin for any lesion that recently appeared, changes in an existing lesion that may be suspicious include: growing, any change in appearance, bleeding, pain, itching, inflammation or a lesion that never heals completely.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

July 16, 2010

Discharge

Some patients when burned will need to be admitted to the hospital while others don't. When a patient with burns is admitted to the hospital, he/she will be assessed in the burn unit by a team called the burn team. According to the assessment, treatment will be provided to the patient. With time, most patients will improve and at some point a discharge plan will be set for the patient. The patient will be examined by the treating physicians and other members of the burn team before the patient is discharged. In almost all cases, the burn team makes the right decision.

In some cases:

  • If the burn team decided to discharge you from the hospital but you think that you are no ready to be discharged, (either you are not feeling well or for some reason you think that you shouldn't be discharged) and you disagree with the decision to discharge you have to tell the team that there is something wrong with you, and you are not feeling well enough to be discharged. If the team still thinks that you should be discharged you can contact the patient's services representative or anyone who you think can help. Tell them that you disagree with the burn team's decision to discharge.
  • When the burned patient is a pediatric patient, this makes the situation harder as these patients can't speak, communicate, or express their feelings. Parents usually know their children better than anyone else. If your child has been ordered to be discharged but you feel that he/she is not doing well eg, he/she is not playful, not eating well, doesn't hold eye contact, the wounds don't look well or any other reason that leads you to think that your child is not ready to be discharged, you have to tell the doctor in charge or any of the burn team staff that you think your child is not ready to be discharged. If you don't get a satisfactory response you have to seek other channels. Contact the patient's service department and communicate your concerns. Write down the names of the people you speak with and what they say in response to your concerns. You should not be intimidated... Make your feelings known firmly and respectfully.


This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

July 14, 2010

Face Facts

From the book "I Will Not Be Broken" by Jerry White

No matter what trauma you are exposed to, you have to face the fact that it happened, that it is in the past and you can't change it but what can be change is the future.

When the writer was in the hospital after losing his right leg in a landmine explosion, when he had to wheel himself down to the lunch hall during the recovery time, at the beginning he didn't appreciate that he was the one who is doing that. He would think to himself "don't they see the bloody stump?". But he did it and wheeled himself. When he reached the lunch hall he met a lot of people who were exposed to a different kind of trauma. He remembers an old guy who had been in the hospital for months going through rehabilitation having a prosthesis above his knee, telling him "don't worry you'll have your own fake leg one day". These people helped him to get through a very difficult time.

Being in the hospital, Jerry had to face the fact that he lost his leg and he had to deal with it. He started to appreciate his stump. He had six months of rehab to go through. The staff really helped him. If the staff was too sympathetic or pitying, he would probably have sunk into a funk, Jerry says.

People react differently to trauma, some will have intense emotions, some will react with denial, anxiety, frustration, guilt, anger, hopelessness, depression, etc. Dealing with these feelings is the way to get over them and proceed to recovery. Feeling self pity is normal but when it progresses it will lead to negative effects on the survivor. At one point a survivor has to stop feeling self pity and start to move on with life by accepting the facts. For the writer, the key to preventing self pity was outing it. Every survivor has the options and choices to change his/her life to the better by focusing on the things that they have and the things that they can change and do rather than focusing on what they lost or can't change.

July 13, 2010

Reaching Out

From the book I Will Not Be Broken by Jerry White.

Humans are social in nature and can't survive without communication and socializing with others. Some people isolate themselves and retreat into a shell after being exposed to trauma thinking that they are protecting themselves. Reaching out to others and finding people who can understand what you are going through is essential. Surprisingly strangers that we don't know can be of great help and support to us while people we are close to may disappoint us. There will always be people who are willing to help and support us and they are always there when we need them.

The writer benefited a lot from social support while he was in the hospital in Israel after stepping on a landmine. This accident led him to lose one of his legs; he said "with so many people coming and going, it was clear that social support-a primary integrant for overcoming crises-was not missing from my life". Most survivors' testimonies that the writer interviewed were "I would never have made it through without my family. They saved me during the darkest moments. I am closer to my family now, after my accident, than before".

At the time of crises most people need support and it's part of the survival process. Some reach to family and friends while others reach out to god praying and asking him, we need someone, anyone out there to understand what we are going through.

Successful survivors are those who reach out and communicate with family, relatives, friends and support groups in order to get over the loneliness and isolation that accompany the tragedy. It is amazing that many times the inspiration of another survivor, a family member's help, a new relationship or a prayer is all that is needed to make a great change in the survivor's life. You have to be willing to reach out even if you don't want to because the results will be surprising and one day other survivors will reach out to you for help and support.

July 9, 2010

Escaping Victimhood

From the book I Will Not Be Broken by Jerry white.

Some people stay victims which is a type of defense mechanism that follows trauma. Sympathy is welcomed at time of need but some people continue to invite that sympathy because it is comfortable. Every survivor eventually has to take responsibility for his/her life and break this habit of victimhood.

Saying things like "if only I return back to the past to make this right" or "if I didn't drive the car on that time", if only so and so hadn't happen and so on will not change anything and will keep you attached to thoughts that will pull you in the darkness of the past. People who can't let go of their Victimhood will not be able to think positively, take positive actions or relate in a healthy way to others. They will not participate in daily life in an effective way.

You have to make choices to nourish the survivor in you and others. Finding your inner thriver and ignoring your inner victim. By tracing how you think and speak, you can climb out of victimhood. Try to do things that you like such as listening to your favorite songs, donating money to charities, volunteering charity work or other things that work best for you which will help you to find your thrive within you.

July 8, 2010

Survivor Story

From the book I Will Not Be Broken by Jerry white.

A burn survivor who was a passenger in a car when it was rear-ended woke up in the burn unit without knowing that she was burned, she doesn't remember the treatment given to her in the emergency room or at the site of accident. Waking up in the burn center and being told that she was burned gave her the impression that she was burned in a war, she asked "Oh, there was a war". Amputation of part of her right hand is one of the first things she recalls after the passage of two to three weeks of being in the burn center. Her memory of what happened in the first few weeks was vague. On the first day in the burn unit, she remembers that she kept asking for her best friend who came and was beside her although that she couldn't see because her eyes were swollen as a result of the burn. She remembers later on how she was in pain and how it was painful especially after the removal of the bandages. She remembers the nurse feeding her and brushing her teeth as she couldn't do anything with her hands. Morphine injection was given to her by the nurse to be followed within 20 minutes by removing the bandages. Despite Morphine injection, the pain persisted. Taking the bandages off in the morning, putting a sheet around her that could not touch her burned head as it causes pain and then wheeling her to the hydro room, returning to the burn unit and putting the bandages again, all caused her pain that she doesn't want to remember. During her hospitalization, she had visitors that provided her with support during this critical period, as she says "I would have died without them". She firmly believes that she would never have been able to go through this experience without the help and support of her friends and visitors as her family was abroad.

She had to wear a face mask as a result of her facial burns, she wore it and it became routine over time. When the time came to permanently remove the mask, she was afraid that people would see her scars and reject her. With time she was able return back to the community and find positive meaning in her injury that allowed her to continue living and thriving.

July 7, 2010

Burn Camps in Oklahoma

Tulsa Firefighters Educational Clowns Burn Camp:

Oklahoma

This is a 5 day camp for burned children and children who have any disfiguring type of injuries. More than 100 counselors and volunteers participate in this camp ranging from firefighters, burn nurses and many other volunteers. Camp activities include western town theme, go cart track, petting zoo, team building games and much more. Children in this camp have fun, learn and have an experience that they won't forget. Every year there is a different theme and each child will receive many things including a burn camp shirt, hat, camp packet, toys and much more.

For more details see the website.

Email: huffytheclown@cox.net

Phone number: 918- 857-6351/ 918-698-8812 /Cellular: 918- 693-3376

July 6, 2010

Burn Camps in Ohio

ACBC Burn Camp:

Contact person: Mary Mondozzi

The organization: the Paul and Carol David Foundation Burn Institute

Area: Akron Children's hospital, one perkins square

State: Ohio- Akron.

Phone number: 330-543-8813

Fax number: 330-543-9998

Email: mmondozzi@chmca.org

No website available

This camp is during the Summer which is the first full week in August for 6 days.


ACBC Camp Phoenix:

Contact person: Linda Powers

The organization: 3100 East 45th Suite 214

Area: Camp is in cool pines by Prescott, AZ

State: Ohio-Cleveland.

Phone number: 216-883-6633

Fax number: 216-883-6655

Email: lpk39@hotmail.com

There are two camps that are held per year. One is held in the Summer in mid August for 4 days and the other one is held in Winter during the President's day weekend for 4 days.

July 2, 2010

Burn Camps in Georgia

Georgia Firefighters Burn Foundation: Camp Oo-U-La

Georgia

This camp is sponsored entirely by the Georgia Firefighters Burn Foundation and is totally free of charge. It's the first and only camp serving children who survived a burn injury. In this camp survivors will have the opportunity to face social and physical challenges among their peers in a friendly, family type setting. The camp has goals, in this camp an atmosphere of conditionless love and acceptance is provided. Many activities will be provided that give the survivors a sense of accomplishment. Survivors will share their similar experiences and will form a social network that will help building self-esteem. In this camp the child will be seen on the inside not just the scars on the outside. The staff is dedicated to do their best to help and support these children and many of them are burn survivors themselves.

For more details see the website.

Email: campdirector@gfbf.org

Phone number: 404-320-6223

July 1, 2010

Burn Camps in Illinois

Illinois Fire Safety Alliance Burn Camp:

Illinois

This Camp is open to children ages 8-16 that have experienced a burn injury requiring hospitalization in Illinois. A safe environment will be provided for these children were they will enjoy various activities including swimming, row boating, canoeing, fishing, archery, crafts and much more. Survivors will make new friends, built their self-esteem and share their experience with other survivors.

For more details see the website.

Email: ifsa@ifsa.org

Phone number: 847-390-0911

June 30, 2010

Burn Camps in Missouri

Missouri Children's Burn Camp:

Missouri

This camp is for children ages 6-17 who have been hospitalized for burns. In this weeklong camp, campers will participate in biking, boating, swimming, horseback riding and many other outdoor activities. Survivors will have fun, learn, share their experience with others and know that they are not the only ones with the burn injury. Survivors will develop new skill, make new friends and will have an experience that will not be forgotten as their lives will be different after this camp.

For more details see the website.

Email: brsg@sbcglobal.net

Phone number: 314-997-2757 or 866-997-BURN or 866-997-2876

Fax: 314-997-0903

June 29, 2010

Burn Camps in Virginia

Central Virginia Burn Camp:

Virginia

This camp was established in 1994 by the Charlottesville Professional Firefighters Association. Children between the ages of 7 and 17 can attend this camp and participate in various activities in a safe and a fun environment. The staff does their best to meet the physical, social and psychological needs of theses survivors. This camp gives firefighters who are part of the burn staff the opportunity to share their experience with these children. Since its inception firefighters from across the Commonwealth and numerous organizations have assisted in making the Central Virginia Burn Camp a success since.

For more information see the website.

Email: cvbc1999@yahoo.com

Phone number: 434-263-6566

June 28, 2010

Burn Camps in Louisiana

Louisiana Burn Camp:

Louisiana

This Camp is held in June every year at Camp Alabama in Choudrant, LA for Children ages 5 to 17 who have survived burn injuries. Many activities are practiced including fishing, arts & crafts, swimming, boating, canoeing, volleyball and much more. Campers enjoy air-conditioned cabins, pavilion, dining hall, playground, canoeing, swimming pool, and much more.

For more details see the website.

Email: burnfoundation@percyrjonhson.org

Phone Number: 318-675-6853

June 25, 2010

Burn Camps in Texas

Camp I-Thonka-Chi:

Texas- Dallas

This camp is sponsored by Parkland Memorial Hospital; the meaning of the camp is "a place that makes one strong or fearless, not afraid to face life". Survivors in this camp participate in various activities which include fishing, canoeing, arts and crafts and much more. Adult burn survivors join the Parkland Burn Center staff to serve as volunteer counselors to the children. Participation by adult burn survivors provides role models who, in spite of similar injuries, have gone on to lead normal, productive lives. Children in this camp share with others burn survivors their experience and what they have gone through making them feel that they are not alone and that there is support.

For more information see the website.

Email: dcrump@parknet.pmh.org

June 24, 2010

Burn Camps in Texas

Texas Burn Survivors society- Camp David:

Texas-San Antonio

This camp is designed specifically for pediatric burn survivors aged 7 to 15 and is open to all survivors, regardless of ethnicity, language, or religious affiliation. In this camp which is a week of fun and adventure, children will gain self confidence and learn from others who have been through the same experience. With the help and support of the dedicated staff, these children will learn that nothing is impossible and that there is no limit to their potential. The camp also hosts Teen retreat twice a year which is a three day event, designed for young adults aged 15 to graduating high school senior. Survivors or children and siblings of burn survivors who have been impacted by the burn injury can attend this retreat and participate in various activities.\

For more information see the website.

Email: tbssinfo@sbcglobal.net

Phone number: 210-824-8499