Thursday, April 12, 2012

My Mohs Surgery is over

Well, I've finally had that basal cell carcinoma removed from my nose.
We arrived at the clinic at 7:30am yesterday and was it packed!  By the time the preamble instructions were covered, it was 8:30am before the first three patients were being ushered into the treatment rooms.
My turn didn't come until 9:30am.
The doctor who is filling in for the regular surgeon (who has just given birth to her first child - a boy) is a very personable man.  It was actually he who established the Mohs Clinic in Ottawa.  He has since relocated to Houston but has agreed to come to Ottawa for one week of each month while my dermatologist is on maternity leave.  Very nice man indeed, I'd say!
Anyway, the area being treated was first anaesthetised and then he started cutting, very carefully.  Once done, packing was applied and I had to put pressure on it for five minutes to stop the bleeding. But I was sent back to the waiting room for the duration.  Ten minutes later, I went back to the treatment room for more dressing.  I was bleeding quite heavily.  I was told to try pinching my nose until they came for me again.
That second call came at 10:30am.
He would have to do another cut, he didn't get all the cancer cells with the first cut.
I was still bleeding so he had to clean me up and stop the bleeding.  Wow, did that burn!
Again, the area was anaesthetised and he cut wider and deeper.  This time, he had me stay on the treatment table while I applied pressure for five minutes.  When I was sent back to the waiting room, I was told to continue putting pressure for another 20 minutes, since I had bled so much with the earlier cut.
At 11:30am, I was called back into the treatment room.
They had gotten all the cancer with the second cut!
Now they just had to close me up.  When the doctor came into the room, he told me there were two ways he could close up the wound:  skin graft or skin flap.   He would make the decision based on what would give me the best results.
I asked him where he would get the skin for a graft, if he went that route, and he suggested that he had a spare supply under the table, *wink wink*.  Then he explained that he usually takes it from along the front of the ear, where no hair grows (which is where the graft was taken for John's eye repair in January).  So I asked him if he would please take it from my right ear if he did a skin graft -- my left ear is my telephone ear.  He was amused that I expressed a preference and replied, "Sure, I take requests."  Which caused me to become a smart ass and suggest that in that case, "Perhaps you could take it from my throat and rid me of some of my turkey gobbler excess skin.  Or how about helping with the tummy tuck I've been wanting -- oh, I guess that's a little more skin than you'll be needing huh?"  We had a good chuckle.  That in turn prompted him to comment that it always amuses him the interesting places patients suggest for taking skin grafts.
There was an intern assisting him and they were "talking shop" throughout the procedure so I didn't get to ask many questions.  But when it became evident that he was stitching me up and he hadn't cut anywhere else, I knew he hadn't opted for the skin graft.
When finally he asked me how I was doing, I assured him that I was OK but I was very curious as to what he was doing with my nose.  That's when he explained that he had done a skin flap repair by taking skin from the top of my nose and pulling it down to cover the wound on the side of my nose.
We left the clinic shortly after noon, and arrived home on time to catch the last few innings of the ball game.  And my boys won too!
On Friday, when I have to take the dressing off to clean it and re-dress it, I'll have John take a photo so you can see the delightful mess of stitches I have for what was a little tiny dot of cancer that needed to be removed.
In the meantime, this is what I will go around looking like for the next two weeks:
Of course, when I change the dressing on Friday, I will only be applying gauze and a bandage, not quite all this compression dressing that you're seeing here.  But it will still be a sight to behold!

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