Doing the happy dance (Mohs surgery, part III)

You can find the history of this in Part I and Part II but today, with part III, I have weathered the surgery quite well and I’m doing the happy dance. Make that shuffle. I’ve just now shuffled into bed after sleeping on the sofa all afternoon. I highly recommend sleep as the best way to spend your first hours post surgery.mohsunk(The unkindest cut: Rich takes a picture of me sleeping, with my mouth hanging open and the dewlap in full repose…)

As you know, I was dreading this procedure and in retrospect, I think it was because the first time I had surgery on my face it was just so extensive. This biopsy was also BCC of the infiltrative  type so I was expecting the worst- a full blown forest of roots growing beneath the relatively small spot on the surface. It wasn’t so bad. (The moral of that is, “Don’t put off going to your dermatologist. The sooner you catch it, the less extensive it’s likely to be.”) Because I now scrutinize my skin constantly and go every 4-6 months for appointments, I think I’m doing a pretty good job of staying on top of it.

So, here’s a quick photo review of the day, with brief comments. I’ll follow up tomorrow with more (when I’ll probably feel worse because, if memory serves, the second day sucks) but tonight I’m going to watch 30 Rock and then read myself to sleep. If I last that long.

mohs1Waiting room, not smiling, not even sitting up straight. Xanax is starting to take effect. I like that it’s all done in Dr. Spencer’s comfortable and attractive office. It doesn’t smell like a hospital and I now know all the staff. Never wait for more than a few minutes. Today I met the perky woman who called with my biopsy results and I appreciated her happy and friendly manner. So now I apologize for being snappish about her overly cheerful initial report.mohs2La-la-la-la. A little pre-op discussion. I could care less. 1 mg of  Xanax is working nicely. Kind Dr. Spencer is optimistic with the proviso that he won’t know for sure without path results. I should mention that we had earlier discussed radiation as an option, one that apparently has a good success rate. The downside? Every day for 30 days and it can dry up-permanently- the mucus membrane on the inside of your nose. Sounds a little too buckshot to me so I opt for the Mohs.mohs3Hand comes up in defensive move. What Xanax? You take the cap off that needle and I might pop you one…mohs5owowowowowow! Although he’s fast, smooth, gets down to business when it comes to shots. owowowowo. Times 12 total today.mohs7Here we go. If you watched that video I posted in Part II you remember that during Mohs surgery they start small, read the path report while you wait in a nice waiting room with snacks, and go back again as necessary until the margins are clear of cancer cells. It can take hours but it means the smallest possible excision with a high cure rate. Because we told Dr. Spencer that I was going to be posting about this and Rich was taking pictures, he was especially good about talking us through the details as he worked. Rich found it pretty fascinating and said it wasn’t nearly as harsh as that first one 6 years ago.

mohs8Nasty, but not really. He’s cauterized the edges. He does this by putting his instrument on the exact spot and then his assistant touches the other end and sends the electrical impulse through it. Makes for extreme precision. We like precision. Now it’s off to the waiting room. Dr. Spencer had three of us going at once but it all seems to move smoothly, in order and on schedule. I think I napped a bit while Rich watched CNN.mohs9Oh, crap. Not this again.mohs10Dr. Spencer’s cheat sheet from the path report so he knows where to make the second excision.mohs13Yippee. More shots and then it’s time to close. This, as he described it and Rich went over it later, is pretty interesting. He lifts the skin away from the underlying tissue and removes bits of underneath tissue, skin and what have you that might make for little lumps. In the process of doing that, the round hole sort of reshapes itself into a more natural oblong hole. Dr. Spencer described it as sort of ‘finding it’s own shape’ which then guides him in his repair stitching. I figure this is where the art part of this procedure comes in. We shall see.mohs14As delicate as this work is, it feels like he’s doing upholstery repair. Tug, pull, jerk, tug. Skin must be thick and tough.mohs15That’s it for today. All stitched up and ready to go home. Tomorrow, probably more swelling and bruising.

Hey. Thank you for all the encouragement and support. And the pot roast. Rich says it was delish. I haven’t tried it yet. I think 2 Advil and a glass of  Chiefland Pure Florida Noble wine are just what the doctor ordered. Sleep well. I know I will.

20 responses to “Doing the happy dance (Mohs surgery, part III)

  1. Oh, the needle in the nose! I remember that. I couldn’t believe how it hurt. Having the needle in my scalp was not nearly so bad.

    Thanks for all the photos…I hope you recovery is swift.

  2. I know I should always proofread before I hit publish. That should be your recovery.

  3. Miss you. Laughing at the couch pose.

  4. Disregard my email, since this very well done post has alleviated the need for an answer. You are providing a wonderful public service here, Vicki. I am very pleased to learn that it didn’t need to be so extensive! I heard today from a friend that her dad had nose surgery today for a melanoma, and his was more extensive than they thought would be necessary. So your report is a silver-lining, although it may not feel like that right now. Continue to heal, quickly and painlessly, my friend!

  5. What an incredible job — all of it– you going through it, Rich photographing it, and the good doctor doing it. Very well done, and you were incredibly brave for going through it and showing us how. I hope the the recovery goes very well. Thinking of you.

  6. I know this is very serious. I promise I read every word. However – this little tag right here – “and the dewlap in full repose” – I have nearly PMP laughing. I ❤ you, Vicki!

  7. I really appreciate knowing all this and seeing the procedure,since I suspect it’s in my future. (both my parents have skin cancer and I’m a moley sort of person) Sleep is the best way to heal and the nose is already looking good. Take care!!

  8. Rich did a great job with the pictures! You did a great job of staying still and sleeping… you do know that sleeping is an art form… thank goodness. I presume the final report was free and clear. Hope your second day is also.. not as bad as you think it will be.

  9. Oh, so glad to hear all is well and Rich enjoyed the pot roast. Hope tomorrow is an even better day than you expected.

  10. I’m glad to hear it went well. I hope today goes better than you remember. And I recommend lots of naps.


  11. Oh yippee, it’s over! Rich’s pictures are fabulous and you are a peach for putting it all out there for us to see and learn from. Rest well this weekend, Vicki. If you are looking for something to amuse yourself with, go to Hulu dot com and watch all 3 seasons of Arrested Development (if you haven’t already).

  12. Owie owie–just seeing that needle near your nose sets my mucus membranes atwitter.
    That’s why it hurts so dang much–all the quivering nerve endings, all that blood supply in tiny little capillaries.
    BUT–the goodness is, only two Mohs cuts.
    And you can (and did) sleep.

  13. Glad it’s all over and you are doing well. I had surgery on my ear but elected not to do the Mohs procedure. The ear is so elastic the dermatologist did a wide pie-shaped resection and got everything in one whack, then stitch the ear back together. Of course, that doesn’t work well on the face, especiallly the nose. Here’s hoping tomorrow is better than you imagine.

  14. While you recuperate, may I recommend Perfect Health by Deepak Chopra, M. D. ? It is a guide to harnessing the healing power of the mind by applying the wisdom of Ayurveda, the 5,000 year old sister science of yoga. It provides a total plan, tailor made for each reader, to reestablish the body’s essential balance with nature, to strengthen the mind-body connection, and to use the power of quantum healing to transcend the ordinary limitations of disease and aging. And, it is really fun to study!

    The importance of meditation, yoga, rituals and a healthy diet that supports your unique and special being cannot be emphasized enough when skin or any other physical problems begin to show themselves. We need to keep moving toward balance and Ayurveda reveals our neglected physical, emotional and spiritual needs and divulges what changes we should pursue to move toward perfect health now and as we age.

    I love you, Vicki!
    P. S. Chopra is not a Lutheran. And, for some reason he leaves out the miracle drug known as Vernors.

  15. Bonnie is SUCH A HIPPIE!

  16. Bless you girl. I hope the wine and the good post-op care of Rich has you feeling well soon.

    And thank God for a kid who paid attention in science class and grew up to be a hell of a dermatologist.

  17. They have a good Moh’s clinic here at the U of M too, I’m sure you know. My mother-in-law and one of my supervisors both had the procedure done so I’m familiar with it. Aren’t you supposed to be wary now of exposure to the sun? I suggest you move back to A2 where the sun is likely less intense.

  18. Sorry for the late response. Rich is right . . . this is extremely interesting. I had a mole removed from the very tip of my nose when I was in college and the worst part of it was the injections of whatever-the-heck-they-injected-to-numb-my-nose. So, that hand going up to defend your territory, yea, I get that! I can’t wait to see how it all heals up. Seems like your doc is so careful and skilled that it will be hardly noticeable! Hope your recovery is going smoothly! And, you are staying calm and resting up!

  19. I’m having this done in a week– the nose, just a bit further down.
    I am so anxious and scared. Can’t seem to calm down.
    Thanks for the pictures–I think. Mary

  20. Thank you for sharing! I had Mohs yesterday (tip of my nose, 1 round) and I completely agree with your owwww- those shots were horrible. There were tears. The nurse was totally right when she finished and said “that was the worst of it, and it’s over.” Indeed! Thanks for sharing your story- I read it before I went and it helped me to know what to expect.

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