Mohs on the Nose

Archive for the ‘skin cancer’ Category

I’m sorry to say, I have another BCC. This time, it’s on my forehead, right at the hairline. I had a small, red spot that looked like a pimple. Because it had been there a few months, and because it hadn’t changed, I saw my surgeon. I hoped it would only need to be frozen. He took one look and said it needed to biopsied. It was a long week of waiting for the results, but they came back positive.  If you’ve already needed Mohs, the chances of needing it again, elsewhere, are very high, so the results weren’t a total surprise.

Biopsied Spot

The Biopsied Spot

As I did with Mohs on the Nose, I’ll be blogging about the upcoming surgery and recovery. The new blog is called Woes of Mohs, and you can find it here.

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The schnoz continues to heal, so much so that I’ve “graduated” to those mini-band-aids I bought a kazillion of. They could be just a s-m-i-d-g-e bigger, but they’re better than the size bandage I’ve been wearing. Here’s a pic taken today. This Friday will be week three since the surgery.

Taken 7/7/10

I’ve come a long way from this:

6/18/10

The inside of my nose is still swollen, and I still have a little swelling/bruising under my eyes. What’s weird is that I don’t have any feeling in the “new part” of my nose. I know it takes a while for everything to connect like it should, it just feels weird.

Foot Update: No change:-(

Question

If one of your friends – who is also your dentist – brings you candy, do you think there’s an ulterior motive involved? (Just kidding, Sandy.:-))

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I had my 2-week-post-op visit to the surgeon today. (Actually, it’s one day short of 2 weeks because of the long weekend.) Any remaining stitches were removed and he cleaned all the gunk off. I have to say, I think it looks pretty damned good…

2 Weeks Post Op

…compared to one week ago. Wouldn’t you agree?

1 Week Post Op

My next follow-up visit is in 10 days. Maybe I’ll get to stop wearing bandages by then.:-)

My “I Survived Skin Cancer” T-shirt was a huge hit at the doctor’s office. Everyone in the waiting room wanted to know where they could get one.

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I spent the morning moving the blog to this new site. It almost kept my mind off the fact that this bandage is starting to drive me crazy. It ends below my nostrils, and sometimes it makes me a feel a tiny bit claustrophobic. Not to mention, it looks like a beak. Hmmm…now I’m thinking my blogger name should have been Toucan Maiden:-/

At 4 pm, I have an appt. with my new internist to get a second opinion on the mysterious swelling of my right foot. This is day three on Keflex and there’s still no change. Having the appt. meant I had to take a shower and wash my hair again. My makeshift face mask didn’t work so well last time because the plastic I used was a little too stiff. It kept my face dry, but only long enough to wash my hair. Today I used a gallon size Ziplock freezer bag and cut it to fit my face, then I used waterproof tape to stick it to my face. This worked way better than last time, although there are a couple of drawbacks. 1.) The plastic is blurry, so it’s almost like showering in the dark. 2.) When I pull the tape off my face, it leaves a red stripe for a while. Still, a small price to pay for clean hair.

This is how I really feel....:-(

As you can see, I still have plenty of bruising and swelling around my eyes. I’m sure I’d feel a little more human if I could put on some mascara, but I wouldn’t be able to take it off without messing up my bandage. Maybe I should enjoy my “freedom” from having to wear any makeup right now.

Another minor irritation about the bandage is that it constantly fogs up my glasses. When I breathe, the air hits the bottom of the bandage then bounces up through the top, right under my glasses. Again, it’s minor, but a whole lot of minor things are the same as one big one.

OK, off to the doctor. I wonder how many wrecks I can cause by having people seeing my “beak”?

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My face is even more sore than yesterday. Then it only hurt when I moved my mouth; today, it hurts without doing anything:-( My nose is itching like crazy, but the doctor told me not to touch it for anything. I discovered that if I wiggle my nose like Samantha in “Bewitched,” it’s the same as scratching, so it’s not all bad.

Although I think I’ve created the perfect solution for protecting my bandage while showering, I couldn’t muster the energy to actually take a shower. I’ve been napping a bit, reading a bit, watching “Breaking Bad” first season on DVD. (Awesome, btw.) 

So far this whole experience is making me think seriously about some things, such as vanity. I think I’m about to let that whole thing go. I’ve reached a period in my life where I have amazing, true friends, and I know how to reciprocate. While it’s always nice to make new friends, I could be perfectly happy with the ones I have right now and not have any more; I’d say they’re “high caliber” friends. You can’t put a price on a true friendship. They are/will be the ones to help me through this ordeal. Knowing I have their full support is what’s important right now. No matter how small the gesture, it means so much on the receiving end. I want them all to know that. 

OK, tomorrow I’m having a shower for sure!

My face hurt the minute I woke up today, but I expected it. I discovered that when I moved my mouth to eat or talk, it pulled on the tape covering the bandage, which applied pressure to the surgery site. OK, I can go without talking (for a little while), but I can’t go without eating. I was also feeling depressed about the whole situation, in general. The realization hit me that 1.) I had had cancer, and 2.) That I’d had major facial surgery, and 3.) I would be the latest Bride of Frankenstein once my bandage came off. 

One of my girlfriends had planned to come over this morning and bring me a latte. It sounded like a great idea at the time, but this morning, it wasn’t a good idea at all. I had to call and cancel, even tho I really wanted to see her and catch up on things. 

I managed to give my two dogs a bath and get some laundry done, but other than that, it was a low-key day. I noticed as the day went on that the soreness when I moved my mouth was lessened. 

Tomorrow I’ll attempt to shower and wash my hair, which should be interesting, considering I can’t get my bandage wet under any circumstance. I have some clear plastic that I’m thinking about cutting to fit my face, then using waterproof tape to hold it in place while I shower. We’ll see how it goes. 

Originally I hadn’t planned to share my surgery pics with anyone, but the more I thought about it, the more I thought, “What the hell?” It is what it is, and I can’t change that. I know how much I appreciate seeing actual patient photos, so I hope mine are helpful to the next person. 

For now, it’s been a long, blue day. I felt the need for some comfort food, so DH brought home some ice cream. It helped…a little:-)

This blog has been moved from site to site, and in the process has lost some formatting. The info and photos remain the same. 

How could I have known, back in the 70s, that all those weekends on Panama City Beach would come back to haunt me in a big way decades later? Well, they did, and I hope my experience helps anyone having to deal with Mohs surgery and its aftereffects.

A Little Background

For the past year, I’d had a small sore at the very tip of my nose. It would get red, then peel single layers of skin for a couple of weeks. Eventually it would be raw, and it would bleed. My dermatologist froze the spot twice, and we really hoped it wouldn’t return. Unfortunately, it did, and this time it didn’t heal. My dr. decided it was time for a biopsy, and while he was taking the tissue, he thought maybe it was superficial, and that if he took extra tissue, I might be able to avoid any further treatment. Two days later, tho, he called and said the biopsy came back positive for Basal Cell Carcinoma. The good news is that BCC is the easiest type of cancer to deal with, providing you catch it early. My dr. said he would be forwarding my biopsy results to a Mohs specialist, and that doctor’s office would call me to schedule the procedure.

I researched Mohs surgery pretty thoroughly online, so I had a good idea of what I was facing. What I couldn’t know until the actual surgery was just how advanced my cancer was. I understood the basic process: The surgeon would excise a layer of tissue, then freeze it, then slice it, then examine it for cancer cells. This process would be repeated until no cancer cells could be detected.

My surgery was scheduled for two weeks from the date of the biopsy call. I dreaded it simply because it was surgery on my face, but I also kept reminding myself that a scar was better than having cancer. Not only that, I’ve had close friends with types of cancer way worse than the little spot on my nose.

Day of Surgery

We had to be at the clinic at 6:30 am. I was brought back for removal of the first layer of tissue about 15 minutes later. The absolute worst parts of the procedure were the numbing shots. Imagine having needles stuck into the tip of your nose, and even then, you can’t imagine that pain. My eyes watered like I was crying, although I wasn’t. While the surgeon waited for the anesthetic to take effect, he went into the next room and I could hear his conversation with an older lady who was also having the procedure that day. She literally screamed as she was given her injections, so I didn’t feel quite so bad about being such a wuss getting mine.

The surgeon came back to me and cut out the first layer of tissue. I had DH take a picture of the “hole” with his phone camera. The nurse put a temporary bandage on my nose and sent me back to the waiting room. By now, the small waiting area was full of patients – all of them quite a bit older than I.

Layer 1 

One of my friends in the UK sent me an excellent book, and I brought it to the appointment to help pass the time. I sat and read until the nurse called me back to the treatment room and said they needed to take another layer of tissue. The surgeon gave me a numbing “boost,” which didn’t hurt as much since I still had some numbness from the original shots. He took the second layer of tissue, then the process of taking a picture, applying the temporary bandage and sending me back to the waiting area was repeated. Again, I sat and read until I was called.

The nurse came to get me about 15 minutes later and said they needed to take yet another layer because my tissue still showed cancer cells. Geez… Another numbing boost and another layer of tissue removed. Another picture was taken. This time I was allowed to stay in the treatment room and read while I waited for the results.

It wasn’t long before the surgeon came in and said my cancer had developed “roots” and had spread beyond the small spot on my nose, and that he needed to take a 4th layer of tissue. More numbing, another layer taken, another picture taken, then more waiting. Again, I stayed in the treatment room afterward. This time, I stretched out on the table and tried to relax. The more tissue they removed, the more anxious I became.

Finally the surgeon came in and said I was free of cancer cells. Now it was time for “closure,” meaning, closing the hole left by the surgery. Unfortunately, the hole was too large to just sew it together, and I needed a skin graft to cover it. The surgeon said it would be a lengthy procedure, and he closed two other patients before it was my turn.

“Closure”

I was brought back to the original treatment room and the surgeon said I wouldn’t like this part very much. I had to have more numbing shots, not only ON my nose, but also AROUND my nose. After about six injections, I told him to stop, that I needed a minute to breathe. Then he injected 5 or 6 more, and I needed him to stop again. The last few injections were the worst. One to my left nostril sent a pain all the way to my toes, and I literally saw stars. My eyes were watering like I was having a good cry. Even tho I wasn’t, I really felt like I could. My stress level had reached about a 9 on a scale of 1-10.

As the surgeon got ready for the procedure, his nurse and another assistant joined him. I told him I’d be forever grateful for some Valium for my anxiety. He said he didn’t have any, and that he couldn’t give it to me if he did. If he were to administer those types of drugs, his clinic would have to be classified as a surgical center, blah blah blah. OK, I understood. I was wishing I’d brought my own from home, but it was too late for that.

The surgeon covered the upper part of my face and then my chin, leaving only my nose exposed. While I didn’t feel any pain, per se, it felt like he was building a house on my nose. There was so much pulling, pushing, tapping, and lots of pressure. At one point, I thought he was taking tissue from my forehead; there was so much pressure there. I hadn’t had any numbing shots there, tho, so he must’ve been using my forehead as a work space of some sort. He had removed tissue from my upper nose to graft over the hole in the tip of my nose.

After about 50 minutes, he was finished with the surgery and the tech was left to apply a considerable bandage to my swollen face. I was physically and emotionally exhausted, after all, it was now 2:00 and I’d been there since 6:30. I felt pretty shell-shocked on the drive home, and the first thing I did was to take some Tylenol, as the doctor had advised, then I took a Valium.

I slept until 6:30 pm, then got up to eat something and watch some TV. The more time passed, the more my face started to hurt. I was able to get a good night’s sleep, for which I was really thankful. I was expecting to feel worse the next day.

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