Last November I went to my dermatologist for micrographic Mohs surgery for a skin cancer on my face and there are two posts about that experience, here and here.   Last week I went again to have a second squamous cell cancer removed from the left side of my nose and came home looking like this.    This is a lot of bandage for an itty-bitty wound but it seems to be necessary for facial surgeries which tend to bleed and need a pressure bandage for the first day.  The next day it was off and a little band-aid was sufficient to cover the wound.  Don’t let this scare you.  The stitches were removed on day 7.   Today, ten days later, I am walking around without a bandage and you would hardly notice I had been under THE KNIFE.

I have to admit I was afraid before the first surgery but feel like I’m an old hand at it now.  What’s to be afraid of?  Once the area is numbed with anesthetic (using such a tiny needle) you feel nothing whatever during the cutting and the stitching and the bandaging.  I needed one Tylenol at bedtime for some local aching but that was that.

When you walk around looking like this you’d be surprised how many people can relate.  One old geezer (only 84) told me he’d had three such surgeries and you’d never know it to look at him.  Everyone has had a least one such experience or knows someone who had it.   Mohs facial micirographic surgery is going around nowadays.   Ten years ago you never heard of it.

It is about 5:30 AM.   As I write this post I am also getting dressed, cooking bacon and eggs for breakfast,  and watching Fox News for the results on last night’s Nevada event.  See you later when I’m a little bit more focused.

I’ve had three biopsies in my entire life, so it is not likely that this post will  be all about biopsies, but biopsies are what are happening in my life right now – so, for those who have never had one — here’s what I know.

My first biopsy was ten years ago of a small bump above my left eyebrow that refused to heal, sort like a small hard pimple.  My dermatologist just sort of scooped it out for examination.  The site healed quickly and beautifully. ” Why don’t we just leave it,”  I said.  “It would grow back,” he said.  The pathology report read “basal cell carcinoma.”    When I returned for a more complete excision with a “couple of stitches”, the doctor injected the site with anesthetic and took off, leaving me unattended on the table.  Could have been a coffee break – who knows!  When he finally returned and started cutting I said, “I can feel that!”  More injection of anesthetic and he finished the job.   Very neat – seven tiny stitches — and now, ten years year, I have a white almost invisble scar.  Mission accomplished.

Three months ago I presented with an array of actinic keratoses (AK’s) on my face, which we older folk tend to get, especially if we are of the fair, blue-eyed, freckly kind who burn easily.  AK’s are said to sometimes progress to malignancies.   This was not the first time I had had AK’s zapped (frozen) with a nitrogen spray.  The skin would redden, sometimes blister a bit, but in a few days it was off with the old rough, scaly skin, and in  with brand new skin.  This time the dermatologist (a different one) zapped over 15 areas and again, within a week, I was pretty presentable.

Last week, as new rough areas began to appear on my face I browsed through 38 photos that could save your life. As I browsed I came across of photo of a fingernail that seemed to have bluish flesh under it.  The caption read: ” Here’s a black-and-blue nail, right? Not hardly. It’s a melanoma of the nailbed, and lesions like this can be deadly.”  My immediate reaction was, “I have one of those!!!”  Just this past month I had noticed that it looked like I had a bruise under one of my toenails.  It was no trouble, did not hurt, and did not concern me until this very minute.

Now I know of a girl who had a melanoma on her arm, and they took the whole arm off, including the shoulder joint!  Those things love to metastasize.  When I called the Dermatology office as soon as the office opened for an appointment, she was going to give me one in two weeks.  “I’d rather not wait,” I said.  “I’m worried about a melanoma.”   It was about 8:30.  “If you can get here by 9:45,” she said, “I just had a cancellation and we can see you then.”

I took the picture from the computer with me and showed it to the doctor.   After inspection he thought I  might have an “ecchymosis” under my toenail.   I had no recollection of injury.  ” Ecchymosis,” I said.  “Bruise,” he explained.   We decided we needed to watch it for a month or so.

Then on to my face.  “What’s this?” he said.   There was a little spot on the left side of my nose where my glasses tend to rest.   I had thought it was irritation from my glasses and had even put a bandaid on it to spare it annoyance.  He thought it looked kind of thick and was also  intrigued by another spot nearby.   He decided biopsies were appropriate and told his nurse to prepare.    She started by injecting anesthetic with the tiniest needle you could imagine.   “Are you taking aspirin, Coumadin, or other blood-thinning drugs?” she asked.  I wasn’t.   “You’re a bleeder,”  she said.   Doc returned and painlessly removed the two lesions, and nursie (Kate) put them in little vials she had already labelled.    He said I should have a call about the biopsy results in a week to 10 days.  If they were negative, I was all done.  If positive, I should make an appointment with their Mohs expert for removal.

It is now one week from the biopsies.   I was told to wash the area daily and keep it covered with bandaids.  For two days the two areas seemed to ooze just plain serum but finally settled down and today is the first day I though I could go out without  bandaids but just a little make-up over the scabs.

Also today I received a call to make an appointment to see the Mohs expert in mid-October.    Both areas were positive for squamous cell carcinoma.    Enough for now.  Check back in late October.

~~~

Squamous cell?  You’re Irish!  You never should have come to this country! — Mary W.

Mohs surgery for basal cell and squamous cell carcinoma