A Day in the City

God is good! Rachel and I took Joshua over to UCSF yesterday and were very impressed with the experience. They really put us at ease as far as Joshua's condition goes. His doctor is Dr. Kelly M. Cordoro and we also got the privilege of meeting with the world renowned Dr. Ilona J Frieden and another pediatric dermatology doctor who happened to be visiting from Spain. What I was really amazed at was how many doctors, interns, and students could fit into a room the size of a large closet. I think there were 11 people total in the room at one point.

UCSF Dermatology Clinic

As far as Joshua's condition goes, he is at a lower risk for most of the concerns that we had. The size of the nevus on his chest was measured at 17cm x 14cm and the risk of melanoma is more significant if the measurement is 20cm or greater. They said that he is also probably at a lower risk for melanoma because of the "speckled" appearance. Most nevi of this type are more solid in color and are generally thicker. Because his is not a thick, dark solid color, there is a chance that the lighter areas could even fade a little over time and may not grow any hair. 

Another possibility was the chance of him developing or having neurocutaneous melanosis. This is where there are nevus cells on the brain or spinal column and if he were to have 20 or more satellite nevi, they would be more concerned about this but as of right now, he only has 7, so he is in kind of a gray area where they could go either way on an MRI. 

We are going to, as Dr Cordoro put it, "watch Joshua like a hawk" and do monthly visual and physical exams of his nevus to watch for any changes. We will go back in about 3 months and about every 6 months after that. I don't mind taking a road trip to SF every 6 months at all. Especially if the weather every visit is like yesterday's. It was so nice that Rachel and I took a ride down Lombard St. (in the 15 passenger van) and grabbed some chowder in a bread bowl at Fisherman's Wharf.

On a clear day, you can see forever.