Mohs on the Nose

This Blog Is Moving To A New Site

2010-06-23T13:36:00.000-07:00

After much thought, I've moved Mohs on the Nose to a new blogging website. As much as I love google, their Blogger leaves a lot to be desired. Couple that with the fact that they have zero customer support, and there you have it.

The same blog is now located at http://sapphiremaiden.wordpress.com/. See you there.:-)

Wicked

2010-06-22T21:24:00.000-07:00

After I had my biopsy done, I had a sizeable sore on the tip of my nose. One of those little "mini" Band-aids was the perfect size to cover it. The doctor gave me a few extra because he said we could no longer buy them. Huh? I was pretty sure I could find them somewhere. I looked in every drugstore and grocery store near me, and they simply did not exist. I even emailed Johnson and Johnson and complained about it (only to receive a form letter, btw).

To date, I don't think there's ever been anything I've searched for online that I didn't find. "Mini" Band-aids were no exception. :-) I found them on a website for school nurse supplies and I ordered 200 of them, knowing I was going to need a lot of them after my Mohs surgery. Ha ha. Very funny. Unless I use 10 at a time, they'll be useless when my bandage comes off. If anything, it'll be hard to find a bandage big enough! Mother Universe has a very wicked sense of humor sometimes.

True Confession

2010-06-22T19:54:00.000-07:00

At least one of my readers thinks my dermatologist is responsible for the extent of my basal cell carcinoma. I need to clarify that, and it includes a confession.

That little pinprick spot on my nose actually appeared three times - not just twice. After I had the first spot frozen, it took a few months before it showed up again. The second time, my doctor gave me a prescription for Fluorouracil, which I referred to as "chemo in a tube." I applied it to the spot twice a day, for 10 days. It would kill the cancer cells, and then there would be a healing period of another week. The advantage of this over freezing was that it left minimal to no scarring.

Once the spot healed and my derm rechecked it, I was so glad to have that troublesome spot behind me. Unfortunately, a few months later, it came back. I didn't call my derm this time; I used the Fluorouracil without consulting him first. After I'd used it for 10 days, I called his office and asked if I should leave use it longer this time. The nurse put me on hold, and my doctor came on the line. OK, he was pissed, as he should have been. He said I should never use that cream without his supervision because it would interfere with his monitoring of that spot.

This doctor has been my dermatologist for over 20 years, so we know each other pretty well. That particular phone call was the closest I've ever come to hearing/seeing him angry. He made me promise I would consult him regarding anything to do with that spot. After it healed that time, I really, really, thought it was gone for good, so I was really surprised when it showed up again rather quickly. This time I knew there was a bigger problem, and I went in for the biopsy.

So, could the extent of my cancer have been lessened if I'd listened to my doctor? Probably so, and I'm the first to admit it. I'm responsible for this entire situation and I don't want anyone being blamed for something they did/did not do.

Day 4 After Surgery

2010-06-22T19:21:00.000-07:00

When I looked in the mirror this morning, I was hit by a flash of yellow - under my eyes - and much more than yesterday. The bruising has spread and my eyes are more swollen today. So far, I'm feeling a little blue, but I'm used to that. Let's face it; ain't nuthin' cheery about this situation. That is, unless you consider my horoscope for June:

...It's also possible that you've had a lot of interaction with medical professionals lately, for the twelfth house rules health and healing. Perhaps you had surgery, needed long-term treatments, or required physical therapy. If so, you were doing so at the right time - your chances of success are strong.

Unfortunately, it goes on to say:

June 25: Mercury in hard angle to Uranus, creating very difficult events that could rock your world.

June 25th is this Friday, when I get my bandage off, so here's my strategy: I'll go in pretending to expect a perfect nose under the bandage, and when I see the scarred-up mess that actually lies underneath, I'll pretend I'm shocked/having my world rocked. Hopefully that will satisfy Mother Universe. Actually, I like to expect the worst since anything less than that is a pleasant surprise:-)

I'm very happy to hear that many of you are being encouraged to visit your dermatologist, based on my blog. I love hearing that, and I hope more of you will do the same. And don't forget to slather on that sunscreen like you're putting jelly on toast.

AFTERTHOUGHT:
One of the things I forgot to mention in my initial post was about the cauterization that took place after each layer of skin was removed. The zapping sounds were bad enough, but the smell of burning flesh was truly sickening. The nose is a very vascular area, so there was a lot of cauterizing that had to be done. The surgeon said one patient told him she thought it smelled like Arby's. Nope, sorry, even being a vegetarian, I'm here to tell you it didn't smell like anything you'd ever want to eat. In all honesty, it made me think of Auschwitz.

Isn't It Ironic?

2010-06-21T22:52:00.000-07:00

Today I was watching tourists on TV helping to clean up Destin Beach and Panama City Beach, my ol' beach weekend haunts. I remember one Saturday afternoon my boyfriend and I walked along Destin Beach, then spread out on a blanket and fell asleep all afternoon...in the sun...without sunscreen. C'est la vie.

Day 3 After Surgery

2010-06-21T10:47:00.000-07:00

I had a dream last night that I was walking through a store, pushing a grocery cart. I was wearing a purple silk shirt and tight jeans with pumps - and my bandage. In the store, I walked past a couple of male employees, and one said to the other, "Now I could go for that...minus the Ironman face." Hello?? I never saw "Ironman," so I don't know if he wore a bandage at any point or not. I guess the good thing about the dream was that, in it, I looked good from behind:-) (Note: I haven't worn tight jeans and pumps for close to 30 years.)

Today my face is more swollen, and I have yellow circles under my eyes. Maybe they won't get black and blue, but I'll have to wait and see. I'm very conscious of the fact that there's a major sore place on my face. On a scale of 1-10, I'd say the pain level is about a 3.

Some of my friends are shocked that I'm posting my surgery/post surgery pics. Hey, what do I have to hide at this point? The time for vanity is gone, AFAIC. Now I'm just trying to get through this experience the best way I know how. I don't understand why blogging about it is cathartic, but it is. At this point, every little bit helps.

Last week I saw my orthopedic dr. because of my swollen right foot. After an exam and X-Rays, he diagnosed it as gout. OK. I've never known anyone personally who's had gout, so I knew nothing about it. Well, except that old people got it a lot. After researching it online, I learned it was an "exceptionally painful" type of arthritis caused by too much uric acid in one's system. The uric acid forms needle-sharp crystals in the joint, which cause the pain. He gave me Prednisone and said I should feel much better the next day. Unfortunately, I didn't feel better. He also ordered lab work, so I made my way to the lab and had the blood drawn.

This morning, the doctor called and said my lab results didn't show any uric acid abnormalities, as he had expected. He said it showed I have an infection of some sort. He's phoned in a prescription for antibiotics. OK, this shouldn't really cause me any alarm, but it does. I've had knee implants since I was 42, and I've always been warned by my doctors that an infection has to be treated aggressively ASAP, because they can "settle" into artificial joints. doG forbid that should happen to me, because it would mean I'd have to have my implants removed, lie in a hospital bed with IV antibiotics until the infection cleared, then have the implants reinserted. This happens more than one would think.

The good news today is that I had a shower and washed my hair. OMG. What a difference it makes when you feel clean:-)

Day 2 After Surgery

2010-06-20T10:47:00.000-07:00

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!

Day 1 After Surgery

2010-06-20T00:40:00.000-07:00

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:-)

In The Beginning....

2010-06-20T00:24:00.000-07:00

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 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.

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.