Detour From Heart Discussions to Skin Cancer

This entry in my blog is dedicated to a discussion on treatment for skin cancer.  I do not have skin cancer, but I am being treated by my dermatologist for the pre-cancer marks on my face.

Picato gel is:

Results of a new study suggest that Picato gel (ingenol mebutate, LEO Pharma) is efficient and effective in treating actinic keratosis (AK).

Now, what is actinic keratosis?

An actinic keratosis, also known as a solar keratosis, is a scaly or crusty growth (lesion). It most often appears on the bald scalp, face, ears, lips, backs of the hands and forearms, shoulders, neck or any other areas of the body frequently exposed to the sun. You’ll most often see the plural, “keratoses,” because there is seldom just one.

In the beginning, actinic keratoses are frequently so small that they are recognized by touch rather than sight. It feels as if you were running a finger over sandpaper. There are many times the number of invisible (subclinical) lesions as visible ones on the skin surface.

Most often, actinic keratoses develop slowly and reach a size from an eighth to a quarter of an inch. Early on, they may disappear only to reappear later. Most become red, but some will be light or dark tan, pink, red, a combination of these, or the same color as your skin. Occasionally they itch or produce a pricking or tender sensation. They can also become inflamed and surrounded by redness. In rare instances, actinic keratoses can even bleed.

If you have actinic keratoses, it indicates that you have sustained sun damage and could develop any kind of skin cancer – not just squamous cell carcinoma.

This is from my propensity to burn easy in the sun for 60 years!!  Plus not using enough sun block!  The first 20 years of my life I never heard of sun block!!!

Hear are some discussions on the use of picato gel.  I just finished my third & last day and I look like a "red" racoon!  I put the gel around the top & below my eyes & on my nose.

Discussion on the use of Picato Gel .015%

Test Results Are In From Stress Test!

Here we go.  Results are in.  I need to look up some new vocabulary to understand results!
Here is the summary from the stress test:

TECHNOLOGIST STRESS SUMMARY
The patient underwent an exercise sestamibi imaging study. The patient 
exercised for 10 minutes 56 seconds reaching 139 beats per minute which is 
86% of the predicted maximum heart rate. This is the equivalent of 13.2 
METs. The blood pressure ranged from 138/104 to 169/101. The test was 
terminated secondary to fatigue. The patient had no symptoms during 
stress. The patient was imaged on the CZT camera. The patient received 
5.6 mCi of sestamibi IV at rest and 15 mCi of sestamibi IV at peak stress.

Now, first what is "exercise sestamibi imaging study"?

 This test requires the intravenous injection of a radioactive blood flow marker followed by imaging of the heart.   The test is a well-established noninvasive method of assessing coronary blood flow.   The test is capable of identifying regional abnormalities in coronary artery blood flow and determining their physiological relevance to myocardial function and viability.

So, the radioactive marker (I now glow in the dark) allows the doctor to view the blood flow!

The test lasted 11 minutes & the final 2-3 minutes were "butt kickers!"  Had to get my heart rate to 139!  And with my beta blocker this is difficult!!!  I did it, but was huffing & puffing!!!  139 is 86% of my maximum heart rate.  I had no symptoms, but still had some PVC's.  Good news is the most I had was 3!!

The rules have changed with my stress test.  In the other tests I had, if I had 3, they stopped the test - know the person giving the test said the new rules say 10!!!!  Need to ask my cardiologist about this!

Other comments were:

IMPRESSION 
1. Good functional capacity with patient exercising for 10 minutes and 56 
seconds on the Bruce protocol. 
2. Normal hemodynamic response to exercise.
3. Patient did not have any chest pain on the treadmill.
4. No ST depressions diagnostic of ischemia were noted with exercise.
5. The patient had frequent PVCs including ventricular bigeminy, 
ventricular couplets, and two 3-beat runs of nonsustained VT at peak 
exercise.
6. Uniform perfusion was noted. There is no evidence of ischemia or 
infarction.
7. Septum is hypokinetic, likely related to postop state. Ejection 
fraction is 50%.

This added some new concepts!

What is the Bruce Protocol?  According to wikipedia:
The Bruce protocol is a diagnostic test used in the evaluation of cardiac function, developed by Robert A. Bruce.

ST depressions?  Again Wikipedia:
In a cardiac stress test, an ST depression of at least 1 mm after adenosine administration indicates a reversible ischaemia, while an exercise stress test requires an ST depression of at least 2 mm to significantly indicate reversible ischaemia

And ischaemia?  Ischaemia is a restriction in blood supply to tissues, causing a shortage of oxygen and glucose needed for cellular metabolism (to keep tissue alive).^[3] Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue. 

Well, how about infarction?
infarction refers to tissue death (necrosis) caused by an obstruction of the tissue's blood supply, which leads to a local lack of oxygen

What is ejection fraction?   This is a test that determines how well your heart pumps with each beat.  Mine was 50%, Below Normal!

Overall not bad!  That is the highest I had my heart rate in more than 3 years!!!  After my heart surgery I have been afraid to "take it up a notch".  Now these results go to my cardiologist and I meet with him in March!!

Cardio Rehab on the Conewago Trail

Today I did my cardio workout on one of my favorite trails - The Conewago Trail!  Today I parked along Route 743 and walked southwest.  Walked to Mill Road and back!  About a 50 minute walk.

Top of map show start of walk at Route 743

Lower Part of map shows Mill Road Crossing

It was a great walk - check out the pictures from Mill Road back to Route 743!

Here is were I turned around - Mill Road is the road you see.

On the way back I pass a cut that was made through the rock!

At the mile mark 1.5, a small stream goes under the trail.

Around marker 2.0, I walk across Old Hershey Road.

Walked under Route 283 & found a dear that did not make it across the road!

Just before Route 743 is a Watershed Project - 15 acres!

Just before Route 741 is mile marker 2.5!

Great walk - TRY IT OUT!