2 Month Update

Its been almost 2 months since I have had Moh’s surgery. I feel like I have been through hell and back, but it’s done. I am starting to have shooting pains in my cheek, so I believe that the nerves are starting to grow back together now. Its still somewhat numb and I have a wonky smile. But you know what? I don’t have cancer on my nose anymore. And for that, I am genuinely thankful.

I think that I have come a long way in just two months. It will take about a year until its fully settled, in. At that time, my surgeon and I will make a decision about any revisions that need to be done.

I really thought that I was going to be so much more self-conscious than I am about it. I had it covered under a bandage for so long that when I was finally at the end of using the bandages, I was happy to be done. I had great fun packing up all the first aid tape and bandages into a shoebox and labeling it “Damn Cancer Box.” The chances are pretty good I will get another one within 5 years, so at least now, I am ready for it. And I am not scared. And as for leaving the scar out to the open, who cares what anyone else thinks? I can honestly say that if someone wants to stare, go for it. I can make you feel just as uncomfortable. πŸ˜‰

So, now that I am at this point in healing, I am just using a good skin care regimen (Roden & Fields Sensitive) and keeping my face as clean as I can. I am using a scar gel named Cicatricure on the nose and cheek. Hopefully, it will help. And as always, sunscreen. Although I will say that I have an intense fear of the sun now. I am sure that will pass, but for now, I am a shadow walker. LOL! πŸ˜‰

So, that is basically all for now. I am good, my skin is good, and God is good. All the time.

 

The Surgeries Are Done!

Today, I had the 2nd and LAST surgery on my nose. I am really happy it is over. I will go back next Thursday to have the stitches out.

This morning, this is what my nose looked like before the second procedure:

before second surgery

And at 1:30pm today, he detached the pedicle, debrided the necrosis off the tip of the nose and added some new stitches. I think it looks a lot better now. The raw, circular area was where the graft had died, so he is letting it fill in by secondary granulation. Secondary granulation means that you let it heal naturally from the bottom up. In a few weeks, there will be brand new skin covering that area. Until then, I still have to wear a bandage and gunk it up with Aquaphor every day.

Here is what it looked like after today’s surgery:

after 2nd surgery

I have to be honest with you guys. Today’s surgery hurt 1000 times worse than the first surgery. It feels like someone is holding a flame to my nose, continuously. I am on Norco and let’s just say that I am doubling the dose just to keep from crying. It is throbbing and it burns like hell. I will be sleeping sitting upright for the next few nights for swelling. My left eye is going to go for a repeat swelling like it did three weeks ago after the first surgery. Seriously, this one HURTS!

The doctor said it was important for me to rest, take it easy, and not get my blood pressure up so that this can finally heal correctly. I told him I have the next 12 days off and he said that is perfect. My blood pressure climbed the last time and part of the graft died, so I am going to stay one level up from comatose for the next couple of weeks. Just before surgery today, my blood pressure was 149/62. Yup, I was a bit nervous. πŸ˜‰

However, I am looking for the silver lining. I am cancer free. And that is all that matters.

 

Tomorrow is Stage 2 Surgery

Well, I am having the stage 2 part of surgery tomorrow. The flap they did is called a 2-stage nasolabial flap. Tomorrow, they will remove the pedicle and recontour down the skin. Basically, they will put everything back where it belongs. I watched a YouTube video of tomorrow’s surgery and well, let’s just say that I wasn’t expecting all that. It is what it is. I am expecting that the scar from my stitches down my face is going to be reopened, then closed with new stitches. More healing, but without that pesky weird flap.

The thing I am honestly most excited about is getting over the whole regiment of cleaning, gunking, and re-bandaging my nose. It’s getting old. Additionally, I am looking forward to letting my nose get some air finally. I wear a bandage each day at work and it’s gross when I change it…. four times a day.

After all this, I am grateful and blessed. First, I am cancer free. Second, I have such a big cheerleading team in you all. I am very self-conscious by nature, so this has been a test for me. I bought myself a beautiful Kate Spade silver bangle bracelet. On the inside, it says “Find the Silver Lining”. Truer words have not been spoken. Every time I look at it, I will count my blessings.

Well, I will update tomorrow after surgery. Looking forward to getting it over with. BTW, if you ever find yourself in this position, a Xanax 45 min before surgery does wonders for your bravery. Seriously, I hopped up on that table last time and said: “Let’s rock!” I had been scared shitless prior to that. This time, I will do the same thing, but I do feel somewhat calmer because I know what to expect now.

Yeah right…. ask me that on the ride down. πŸ˜‰

Well, damn.

So yesterday, I found out that the second surgery is going to be September 27th. In 9 days. And I noticed the healing has been kind of wonky, so the doctor asked me to send him a picture of the nose tonight. He got back to me and told me that part of the graft is necrotic (dying) and not to worry. Many things can cause it to not “take.”

That bums me out. I kind of feel like I went through all this pain and stress for something that isn’t going to totally work. He did say that I can still have a great result, I am just going to have to be patient with it. Underneath the bad tissue, new tissue is growing and will continue to grow and fill in. And the bad part protects it until the new skin from underneath kind of pushes it off when it doesn’t need it anymore. So, that part is good. It is just going to take a LONG time. Patience is NOT my virtue.

I went back to work yesterday because I just couldn’t take sitting on the couch anymore. Now, I am wondering if that was a bad move. I noticed some blood yesterday and enough today that I had to put on a pressure bandage to get it to stop. I know that my blood pressure was up because I got a pounding headache halfway through the day today. I love my job, but it is somewhat stressful when you are playing a mean game of catch-up from being off, plus just handling the everyday stuff. So, I think I will work tomorrow and then tell the boss I am taking Thursday off to give me a straight four days to rest and keep my blood pressure down, in hopes I can turn this skin graft around and get it to heal correctly. When you are trying to grow a skin graft, wonky blood pressure is not good.

Seriously, there is only so much ID channel I can watch.

One Week Down!

Well, today marks one week since the surgery. The pain is way down, swelling is almost non-existent, and the bruising is fading to a lovely pale yellow. Yesterday, I saw my surgeon to get the stitches out of my cheek. It feels so much better being able to open my mouth now. I had already popped two stitches by having the audacity to yawn and trying to brush my teeth.

My surgeon also took a look at the handy work that he did on my nose and overall, he is pleased with the results. There is a small area towards the tip of my nose that shows some maceration. Maceration is when the skin sloughs off due to having too much moisture. Kinda like when your skin sloughs off after being in the pool too long. That was most likely caused by the leaking of the wound under the bandages. So I have gotten my orders to keep Aquaphor on the wounds at all time. I can keep it uncovered at home as long as I have slathered the Aquaphor, cover it when I go out (after slathering it Aquaphor.) Trust me, I am covering it when I go out. It looks hideous.

So, here is the pic after the stitches were removed:

stitches out 13sep18.jpg

As you can see, its pretty gross. And you can also see that my cheek is really not liking the tape that is being used. I have added another picture that explains more what it is going on with this nose of mine:

 

stitches out explained.jpg

The surgeon cut a slice out of my cheek that contained an artery to make a cheek flap. The flap became a source of skin to graft onto my nose to cover the defect and the pedicle is what keeps it alive (remember there is an artery in there). In two weeks, I will have another surgery that will disconnect the pedicle. He will revise any edges, remove any stitches and close up the gap that the pedicle was sticking out of with more stitches (maybe; or he may choose to let it granulate, which means letting it heal from the inside out). Hopefully, the graft took and it becomes part of my new nose and after a year or so, you will never know all this crap happened.

I plan to go back to work on Monday, September 17th and work until the second surgery. Hopefully, I will just take a few days after that to recuperate and then back to work after for good. I honestly didn’t have any idea how bad this was going to wear me out. I am super exhausted after all this. I am sleeping a LOT!

Thank you to each one of you for your kind words, thoughtful gifts, texts, phone calls, and prayers. I appreciate all of you more than you will ever know!

48 Hours After Surgery

Bleeding

Well, today was interesting. I started bleeding through the bandages. You know, the bandages that I am not supposed to touch until I go back on Thursday? It pretty much left me no choice than to change them out, clean the areas, goop on Aquaphor, and put clean bandages on. I didn’t really mess with the one on the graft, but I did catch a glimpse of it. Um, my left nostril graft is BLACK. I hope that is normal because it was kind of shocking to see that! And the very bottom stitch on the incision down my cheek had popped out. While that is concerning, the incision looks great, so I am not really worried. I am pretty sure that happened when I had the audacity to yawn. I felt a burning pain in that area yesterday, so I am sure that was the little thread popping. Try keeping your mouth closed when you have to yawn. It is a challenge.

Pain

Holy balls, my face hurts! Pain meds are working, but they wear off after about three hours. I am supposed to take them every six hours, so I am watching the clock, a lot.

Eating

Well, I can’t really open my mouth to eat. Couple that with the inside of left side of my mouth is swollen, and it makes for a hangry Missy. Folks, I didn’t get my girlish figure by not eating. I want pizza when I get these stitches out. Yes, I have already planned my food for Thursday. That is what happens when you are hangry.

Swelling

Thankfully, the swelling is coming down in my eyes. My vision is better today. The bruising seems to be starting. Yay for having natural eyeshadow! The swelling on the left inside of my mouth is still pretty bad.

Shower

I was able to take a shower today as long as I didn’t get the bandages wet. That did wonders for me. Felt a LOT better afterward, and I successfully kept the bandages dry.

All and all, nothing too exciting to post. I am bored already and I haven’t even missed a day of work yet. I have my online class so I will throw my effort into that.

Pizza on Thursday! Keep your fingers crossed I can open my mouth wide enough to shove that in. πŸ™‚

 

Day 2 – Holy Swelling, Batman!

I expected some swelling. Some swelling is normal, and then there is my swelling. It’s obscene.

Morning After.jpg

And 24 hours after surgery, to the minute, this was me.

24 Hours.jpg

Yeah, this swelling is out of control! I’m expecting both eyes to be affected tomorrow. You can see it on its way.

Today was very painful. I have been taking my pain meds faithfully but OMG, its horrible pain. Ice seems to help very little. And I cannot eat anything that has to be chewed because my mouth is swollen on the inside. Maybe a pleasant side effect will be some weight loss. πŸ˜‰

The Deed Has Been Done!

So, September 7th, 2018 was the day of surgery. It was also the day my father died 15 years ago. So, it was a bittersweet day, and yet I felt like my Dad was with me in spirit all day long. A major source of comfort for me.

Tony and I woke up at 4:00am to get ready to leave to make it to the 7:00am appoint on-time in Riverside, CA. Surprisingly, I woke up very calm and ready for this to happen. We stopped at Carls Jr in Beaumont to grab a couple of breakfast burritos for the 2-hour drive to the hospital. We chatted, kept it light, and complained about stupid California drivers. At 6:00am, I dropped down a 0.5mg Xanax to relax me. We arrived at 7:00am, got my vitals out of the way, met my nurse Kelly and Dr. Dennis Nguyen. Tony went to the waiting room for the beginning of a very long day, Before we started, Dr. Nguyen and I had a serious conversation about the tumor in my nose with a picture of my pre-biopsy nose on the screen.

Before Biopsy.jpg

I asked him “it’s bigger than you thought, isn’t it?” And he agreed yes, it was. He also said, “I also think it’s bigger than YOU thought too.” I told him that’s what I was afraid of. I had explained all the research and reading I have done, complete with analyzing pictures like a mad woman. He asked where I work and I said “NCIS.” He said, well, that explains you not going in with your eyes closed to all the possibilities. LOL! And he was right. The bubbling above the biopsy and new bleeding below the biopsy was HUGE red flags.

After Biopsy.jpg

As you have read in my past posts, I have expressed fear and trepidation about doing this. I watched the tumor grow while I was waiting to have this done. I knew it was a good sized tumor. I truly tried to express that to people. I appreciate everyone’s optimism for a very easy, piece of cake surgery. It’s amazing how many people have had this done and you would have never known by looking at them. I know there were also a good number of people who thought I was obsessing over it and making a mountain out of a molehill. I understand why they felt that way, but what they didn’t get was the massive feeling of dread in my gut. I just KNEW this was going to be more than a couple of stitches.

Back to the story…..

Getting Ready.jpg

Dr. Nguyen drew a circle around the biopsy spot for reference and I hopped up on the operation table. Let me just say Xanax is my friend. I was VERY calm and ready to get this done. The only thing I feared was the lidocaine injections. The dermatologist that did the biopsy was really rough with me, slammed that needle in, and depressed the plunger with force. Not Dr. Nguyen. His skills with a needle are outstanding! I can honestly say I didn’t feel the majority of the shots.

He was very proficient and made the first cut and removed a LARGE area in the first stage. It’s not normal to take that much skin in the first stage, but he could see the tumor, so he tried to get it all in one cut. It was not more than 30-45 minutes and I was bandaged up to head to the waiting room to see Tony while they check pathology on the tissue.

After First stage of MOHS.jpg

After about an hour, I was told that there was still more cancer cells to get so we will have to go to stage 2. Again, it was very fast and I was sent to the waiting room with Tony again.

After second stage of MOHS.jpg

After the second stage, I was really hoping that it would be the end, and I will be leaving fast after some stitches. It was a 3 hour wait until they called me back the second time. By then, the lidocaine had worn off and I was getting cranky FAST. The pain was intense!

I go back in, and I am told they got all cancer cells out, and we discuss the repair. My worst fear would be a forehead flap. They look outrageously strange and I REALLY didn’t want one. Instead, he suggested a cheek flap to cover the defect in the nose (those fat cheeks finally came in handy.) But first, more shots, LOTS of shots. I would venture to say that I got 70+ shots yesterday. He proceeded to draw out the plan on my face:

Drawing for cheek flap.jpg

You can see his plan was to slice a pencil shape, twist it, and use it to connect it to the hole in my nose. The pencil-shaped piece has a good artery to feed the graft that will cover the defect.

Reconstruction.jpg

And so he did his magic. He is a true artist with the way he put Humpty Dumpty back together again. I was so grateful to be told, “You are free from cancer!” Best words I heard all day!

One funny part was when he was cauterizing the blood vessels. It smells like burning flesh. From under the blanket over my face, I say “Do I smell bacon?”Β  They had to stop for a second cause they were laughing so hard. Other funny parts were listening to 80’s music on Pandora in the surgery room, and the doctor and I were playing a roaring game of “Name That Tune” while he operated. And he is pretty darn good, but I named the song AND the band. Music runs deep in my soul. Even when I am in the most inopportune place. LOL!

By the time we left there, it was 4:00pm. Nine hours to fix it all.

We left after picking up a script for antibiotics and a very inadequate script for a painkiller.after surgery.jpg

According to Tony, I slept the whole 2-hour ride home. I was in SERIOUS PAIN. Dropped down two of the tiny Norcos, and I passed out immediately in the car. I am sure that the adrenaline drop also had a lot to do with it.

I slept sitting up last night in the recliner in the living room. I don’t remember waking up, but I do remember the pain, and I am sure I moaned a few times.

All the FB messages of love and support were so uplifting to me.

PS: I go back in a week to get the stitches out of my cheek. Two weeks later, I am having the cheek flap revised and any defective areas fixed and re-sewn. Bandages are not to be removed until then.

4 Days to D-Day

Well, I am four days away from having my MOH’s procedure. I have tried to come up with a solution for everything I can possibly encounter during my recovery:

Leave: I have three weeks of leave on the books for the worst case scenario. I am placing bets with my boss now. I say I will need one week and he thinks I will need two. We will see who wins.

Medical Supplies: I have gotten all the medical supplies that the patient care sheet said to get. Aquaphor, gauze pads, tape, silicone strips and Tylenol. Does anyone really even use Tylenol? I might as well eat M&M’s. Oh yeah, I got some of those too. πŸ˜‰

Additionally, I have gotten a BCozzy. It holds your head upright when you are sleeping. Apparently, I will have to sleep sitting up for a while for swelling so this will do the trick. It’s actually pretty comfortable.bcozzy

Housework: This long weekend has afforded me the opportunity to get stuff in order so I don’t have to deal with it after surgery. Laundry done, check. Dishes done, check. Bathroom clean, check.

Food: Thankfully my Hubs is good about going to the store when I need him too. So when I am feeling sorry for myself and need more ice cream, he is Johnny on the spot. πŸ™‚

Homework: I am starting a new class this week so I am getting all my assignments done now so there will be very little due after surgery. But I am not worried too much because it will give me something to do afterward.

I am nervous, scared, and anxious. I am not going to lie. I just want this to be over with. I am not sure what the outcome is going to be, but it is what it is. There isn’t anything I can do about it now. I am still looking for a one and done phase on surgery. Cut once, say you got all, and send me on home. Reality says I think it will be more than that. I have a new area that bleeds all the time below the biopsy spot, so I think that the doctor will have his work cut out for him. Cut out. I kill myself sometimes. πŸ™‚

If you can’t laugh, you will just cry. I am choosing to laugh.

 

 

Sun Protection and Your Skin

Well, sun care has become a factor in my life. I have a real fear of being outside now. Since I live in the desert, the sun is brutal. I have become a shadow walker. Home is my refuge, and I look outside a lot at how pretty it seems out there. And let’s be honest. Its 106 degrees out there right now. I am not feeling the overwhelming urge to get out there and frolic. It’s hot, I am fat, and I am good in the house. Our A/C rocks.

I started researching sun care products, and I have come across a few things that I want to share.

First, growing up, my house had a pool. I am blonde hair, blue eyed and fair. But growing up, a deep, dark suntan was what I was always striving for. Baby oil and iodine was my elixir of choice. I would slather that on and let the sun fry my skin. More than once, I would end up with blisters from a nasty burn, and I would be out there again the next weekend. All summer long, I was laying out by the pool or at the beach.

Now, if I knew then what I know now, I would NEVER have done that. I would have never laid out, always put on sunblock, and stayed in the shade. Could’ve’s, would’ve’s, and should’ve’s, right? I could seriously kick myself in the ass now. What an idiot I was!

Most of the sun damage you do to your skin is done when you are a child. It takes years to develop into skin cancer. So, what I am reaping today could have started 40+ years ago. And let’s face it. The 70’s and 80’s were not known for skin protection. And, of course, I always thought “it will never happen to me!” Surprise! Bad decisions still have a way of rearing their ugly heads. And this one seems to be a serpent with a lot of heads.

However, this is nothing I can change. I cannot turn back time, I can’t undo the damage I have done. But what I can do is protect myself from this point forward. When you are diagnosed with skin cancer, you are told that you are now susceptible to getting more. In fact, you have a 60% chance of getting it again within 10 years. And a 61.5% chance of getting it back after having a second one.

According to The Skin Cancer Foundation, “If you’re one of the millions of people who have been diagnosed for the first time with either a basal cell carcinoma or a squamous cell carcinoma (also called BCC and SCC, the major nonmelanoma types of skin cancer), you have better than even odds of getting another. About 60 percent of people who have had one skin cancer will be diagnosed with a second one within 10 years, says a 2015 study inΒ JAMA Dermatology,” (Skin Cancer Foundation, 2018.)

So, here is where I am going to get a bit preachy. SUNSCREEN, HATS, COVER UP! Parents, coat those babies in sunscreen from the first time they will be out in the sun. Coat yourselves when you are outside. Weeding, gardening, and washing your car are all ways to get a burn when you are not even thinking about it. Throw a hat on, use sunscreen. I have found the sprays don’t protect as well as a lotion. Find one with AT LEAST 30spf to wear. I have found an excellent one to wear on my face by EltaMD.

eltamd

I use the tinted and its a perfect match for me. Goes on easy, smooth, and light. This one is recommended by most dermatologists. Its about $27.00 a bottle but it lasts a long time. You don’t have to use much.

And for your body, I like this one from the same maker:

eltamd2

Some clothing that is actually made for sun protection is made by Coolibar. There are some cute things in there, and the hats are adorable.

Coolibar, sun protection you wear

And finally, if you see a spot on you and it doesn’t look or act right? Get to the dermatologist pronto. They can put you at ease and possibly stop something before it starts. If you have a partner, have them look at your back regularly. It’s an area that you cannot see, but they can. Melanoma can kill you. Squamous cell is highly invasive and Basal cell can invade and cause damage. Wouldn’t you want to catch that before more damage is done?