POSTED UNDER Mohs Surgery REVIEWS
MOHS on Side of Nose - Sacramento, CA
ORIGINAL POST
July 16, 2015 I am writing this blog because I...
sharonconJuly 17, 2015
WORTH IT$90
July 16, 2015
I am writing this blog because I hope to help others that have been diagnosed with Basal Cell Carcinoma. On the morning of my surgery I walked into the hospital and told them that I did not want the plastic surgery done. I decided this after surfing the web and finding others with BCC that opted to let the MOHS heal on its own with great success.
Over a year ago I noticed what I thought to be a pimple on the fold of my nose. It literally appeared overnight. It never popped so I knew it was not a pimple. When I went for facials I would tell the esthetician not to mess with it.
You can see it here on the left side of my nose. It was about the size of the clicker on the top of an ink pen. I had been to my personal physician a few times when it was on my nose, but she never asked about it. (Makes me wonder if she was ever looking at me during my office visits.) I don't know why I waited so long to have it checked out by a dermatologist. I'm kicking myself for waiting more than a year. My dermatologist took some photos then said,"Lets cut that right off." She gave me a shot to numb my nose. No pain whatsoever. She said it needed to go to the lab. I was just happy to get it off.
About five days later I received a call from Kaiser telling me that I had Basal Cell Carcinoma. I was in shock as I had forgotten all about it, never thinking I would hear the word cancer. They set me up with an appointment with the MOHS center to consult with the dermatologist that performs the surgeries to remove the BCC.
April 20, 2015 was my meeting with the dermatologist. She went over what the surgery entailed. Wear something comfortable the day of the surgery because you could be there all day, depending on how many times it takes to clear the cancer. After each surgery I would wait about 90 minutes for lab to bring the results. If there was more to get out then we do it all over again. Depending on the size of the hole she might either stitch it, take a piece of skin from behind my ear or I would see a plastic surgeon to repair it. She said I would have to wear a bandage on my nose until it healed.
Trying to soak it all, and still in a haze, the receptionist scheduled me for May in conjunction with the plastic surgeon (so he could see me the next day). I had barely gotten out of the parking lot when I call the receptionist back. I asked her to move the MOHS until mid June when I was on vacation for school's summer break. Not a problem she said.
I didn't think much about the surgery for the next ten weeks, but the day before the surgery I started freaking out. A spot had showed up on my cheek a couple of days before and I was so scared that it might be another BCC. (The MOHS surgeon froze the spot and said to keep and eye on it. It fell off.)
June 29, 2015 was the morning of the MOHS. I took all kinds of things to the office to keep my mind off of what was going on, but ended up not doing anything I had taken. Once in the room they gave me a shot to numb my nose. It didn't take long to take affect. After cutting a section out I could smell the burning to cauterize the wound. They bandaged me up and it was out to the waiting room to wait.
After about 90 minutes I was told what I didn't want to hear. "We have to cut out some more. Wider, not deeper." More shots to renumb. This time the assistant was rougher with my nose. Manipulating it to let the doctor get to it easier. Another cauterization, another 90 minutes. This time it was good news. All the cancer was out! I told the doctor that I wanted to see the damage. She handed me a mirror. [RS bleep]! Yes, I cursed in front of her when I saw the size of the hole. It was 9cc wide.
Needless to say I cried all the way home. After calming down a bit I hit Google for more information before my consult with the plastic surgeon the next day. Most of the surgeries for repairing the wound were done using the bilobed procedure.
*The bilobed flap is a double transposition flap commonly used in reconstruction of facial skin defects. The bilobed flap allows for the movement of more skin over a longer distance than that possible with a single transposition flap. This flap is especially useful when it is applied to facial areas where skin is less mobile (eg, nasal tip, temporal forehead), because it allows for reconstruction of the primary defect with skin of matching consistency and color.
The photos of the surgeries on Google terrified me to say the least. But I am someone that needs to have all information available and know my options.
The next day I met with the plastic surgeon. He took photos and said he would do the bilobed procedure on my nose. I asked him to draw me a picture of what the surgery would look like. I was in shock with all the cutting he said he need to do. A cut down from the bridge toward the tip of my nose and two flaps. I asked him was all this necessary and that it seemed extreme. He said there would be scaring, but nothing concealer wouldn't cover. He didn't make any other suggestions besides the bilobed. After he left I broke down. His nurse was very nice and consoling saying everyone was satisfied with the results after the surgery.
When I got home and told my husband he said to find another doctor and lets get a second opinion. Yet again it was back to Google I went. I found a few patients who had the BCC in the same area as mine and they opted to let it heal on its own. One had a hole even bigger than mine. Then I found a doctor who tells her patients to let it heal on its own. I called the doctors office a few days later to talk to the doctor. He called me back and I asked him if there were any other options besides the bilobed. Could I let it heal on its own, I asked? He mentioned two other procedures, but I couldn't find any info on them.
Fourth of July weekend and my family is seeing me for the first time. I had not told anyone, outside my husband and daughters, because I didn't want them to worry or bombard me with questions for two months, therefore worrying myself. They felt the surgery was too soon and being rushed. By this time the wound was looking better. Sunday night I still fasted just in case I changed my mind, but I was 99.9% sure that I wasn't going to go through with the surgery the next morning. All I kept thinking about was how depressed I was going to be looking at the scars all over my nose.
July 6, 2015-Monday morning I tried calling the surgery center and my doctors office. No answer or returned phone call. So I went to the hospital and told the receptionist that I wanted to cancel my surgery. She made a call and said, "Ok." I felt so much relief.
My ritual is cleaning the wound with 3% hydrogen peroxide on a q-tip morning and night and then applying a double antibiotic ointment. I keep it covered with a bandage to keep the wound from drying out and crusting. At least one more time, in the middle of the day, I will apply more ointment, vaseline or my Egyptian Magic creme. I have a huge assortment of bandages having tried different sizes and varieties. I always go with the bigger ones at night. For the daytime I use small ones and even cut off excess with scissors. Taking a shower and letting the water run down my face gets it nice and clean. I wash the rest of my face with a mild soap and let what may wash down over the wound rinsing well.
I feel I made the right decision in not having the surgery and am writing this blog to let others know to ask questions and know they have other options. Bloggers helped me get through my difficult time so I feel obligated to help others, looking for information, get through theirs.
I am writing this blog because I hope to help others that have been diagnosed with Basal Cell Carcinoma. On the morning of my surgery I walked into the hospital and told them that I did not want the plastic surgery done. I decided this after surfing the web and finding others with BCC that opted to let the MOHS heal on its own with great success.
Over a year ago I noticed what I thought to be a pimple on the fold of my nose. It literally appeared overnight. It never popped so I knew it was not a pimple. When I went for facials I would tell the esthetician not to mess with it.
You can see it here on the left side of my nose. It was about the size of the clicker on the top of an ink pen. I had been to my personal physician a few times when it was on my nose, but she never asked about it. (Makes me wonder if she was ever looking at me during my office visits.) I don't know why I waited so long to have it checked out by a dermatologist. I'm kicking myself for waiting more than a year. My dermatologist took some photos then said,"Lets cut that right off." She gave me a shot to numb my nose. No pain whatsoever. She said it needed to go to the lab. I was just happy to get it off.
About five days later I received a call from Kaiser telling me that I had Basal Cell Carcinoma. I was in shock as I had forgotten all about it, never thinking I would hear the word cancer. They set me up with an appointment with the MOHS center to consult with the dermatologist that performs the surgeries to remove the BCC.
April 20, 2015 was my meeting with the dermatologist. She went over what the surgery entailed. Wear something comfortable the day of the surgery because you could be there all day, depending on how many times it takes to clear the cancer. After each surgery I would wait about 90 minutes for lab to bring the results. If there was more to get out then we do it all over again. Depending on the size of the hole she might either stitch it, take a piece of skin from behind my ear or I would see a plastic surgeon to repair it. She said I would have to wear a bandage on my nose until it healed.
Trying to soak it all, and still in a haze, the receptionist scheduled me for May in conjunction with the plastic surgeon (so he could see me the next day). I had barely gotten out of the parking lot when I call the receptionist back. I asked her to move the MOHS until mid June when I was on vacation for school's summer break. Not a problem she said.
I didn't think much about the surgery for the next ten weeks, but the day before the surgery I started freaking out. A spot had showed up on my cheek a couple of days before and I was so scared that it might be another BCC. (The MOHS surgeon froze the spot and said to keep and eye on it. It fell off.)
June 29, 2015 was the morning of the MOHS. I took all kinds of things to the office to keep my mind off of what was going on, but ended up not doing anything I had taken. Once in the room they gave me a shot to numb my nose. It didn't take long to take affect. After cutting a section out I could smell the burning to cauterize the wound. They bandaged me up and it was out to the waiting room to wait.
After about 90 minutes I was told what I didn't want to hear. "We have to cut out some more. Wider, not deeper." More shots to renumb. This time the assistant was rougher with my nose. Manipulating it to let the doctor get to it easier. Another cauterization, another 90 minutes. This time it was good news. All the cancer was out! I told the doctor that I wanted to see the damage. She handed me a mirror. [RS bleep]! Yes, I cursed in front of her when I saw the size of the hole. It was 9cc wide.
Needless to say I cried all the way home. After calming down a bit I hit Google for more information before my consult with the plastic surgeon the next day. Most of the surgeries for repairing the wound were done using the bilobed procedure.
*The bilobed flap is a double transposition flap commonly used in reconstruction of facial skin defects. The bilobed flap allows for the movement of more skin over a longer distance than that possible with a single transposition flap. This flap is especially useful when it is applied to facial areas where skin is less mobile (eg, nasal tip, temporal forehead), because it allows for reconstruction of the primary defect with skin of matching consistency and color.
The photos of the surgeries on Google terrified me to say the least. But I am someone that needs to have all information available and know my options.
The next day I met with the plastic surgeon. He took photos and said he would do the bilobed procedure on my nose. I asked him to draw me a picture of what the surgery would look like. I was in shock with all the cutting he said he need to do. A cut down from the bridge toward the tip of my nose and two flaps. I asked him was all this necessary and that it seemed extreme. He said there would be scaring, but nothing concealer wouldn't cover. He didn't make any other suggestions besides the bilobed. After he left I broke down. His nurse was very nice and consoling saying everyone was satisfied with the results after the surgery.
When I got home and told my husband he said to find another doctor and lets get a second opinion. Yet again it was back to Google I went. I found a few patients who had the BCC in the same area as mine and they opted to let it heal on its own. One had a hole even bigger than mine. Then I found a doctor who tells her patients to let it heal on its own. I called the doctors office a few days later to talk to the doctor. He called me back and I asked him if there were any other options besides the bilobed. Could I let it heal on its own, I asked? He mentioned two other procedures, but I couldn't find any info on them.
Fourth of July weekend and my family is seeing me for the first time. I had not told anyone, outside my husband and daughters, because I didn't want them to worry or bombard me with questions for two months, therefore worrying myself. They felt the surgery was too soon and being rushed. By this time the wound was looking better. Sunday night I still fasted just in case I changed my mind, but I was 99.9% sure that I wasn't going to go through with the surgery the next morning. All I kept thinking about was how depressed I was going to be looking at the scars all over my nose.
July 6, 2015-Monday morning I tried calling the surgery center and my doctors office. No answer or returned phone call. So I went to the hospital and told the receptionist that I wanted to cancel my surgery. She made a call and said, "Ok." I felt so much relief.
My ritual is cleaning the wound with 3% hydrogen peroxide on a q-tip morning and night and then applying a double antibiotic ointment. I keep it covered with a bandage to keep the wound from drying out and crusting. At least one more time, in the middle of the day, I will apply more ointment, vaseline or my Egyptian Magic creme. I have a huge assortment of bandages having tried different sizes and varieties. I always go with the bigger ones at night. For the daytime I use small ones and even cut off excess with scissors. Taking a shower and letting the water run down my face gets it nice and clean. I wash the rest of my face with a mild soap and let what may wash down over the wound rinsing well.
I feel I made the right decision in not having the surgery and am writing this blog to let others know to ask questions and know they have other options. Bloggers helped me get through my difficult time so I feel obligated to help others, looking for information, get through theirs.
Replies (46)
July 18, 2015
Im glad you waited for additional surgery. Let it heal as much as it can. Then interview drs..... and no lasers! They cause more damage.
Good luck!
Good luck!
July 19, 2015
Im in Sacramento too. My face was destroyed by fractional laser at supposedly the best place in town 95 Scripps Dr. Choose your plastic surgeon carefully. Kaiser is not necessarily the best option.
Interview other Drs outside of your network. This is a small inexpensive procedure. Get the best. Regardless of cost.
Good luck!
Interview other Drs outside of your network. This is a small inexpensive procedure. Get the best. Regardless of cost.
Good luck!
July 19, 2015
As far as bandaids go when you get out of the heavy weeping wound period, duoderm thin spots cut down to size work very well and can stay on for up to 2-3 days before changing and give you a better chance at tissue migration to a flat surface on the final scar.
July 20, 2015
Thank you for the advice on the duoderms Dr. Stibich. Since they don't need to be changed as often should I still lift them up and keep applying medication to keep the area to keep the wound supple and not let it crust?
July 20, 2015
Wow, it's healing really nicely! Do you plan on exploring any other options once it's healed or are you going to do more of a wait-and-see?
Whatever you decide, good luck and keep us posted on how you're doing!
July 21, 2015
Hi, my name is Lisa. I too had BCC removed from my rt. temple on 4-28-15. This was so scary. My pimple sore had been growing for two years and I didn't know it was cancer. My Dr., Dr. Bradley Mudge had to cut three times to get all cancer cells out. This was all so scary, I felt like a frightened child. There was blood, awful burning smells and weird sensations during surgery. Luckily my husband was with me and comforted me. Dr. Mudge is a skilled physician and I'm very grateful that he removed cancer. But the day after surgery, when we were home and changed bandages, I saw the severity of my wound and I fainted. Luckily my husband was there and helped me to go lay down. He was great changing bandages for me and applying Vaseline. The wound was almost 2" wide and 1/4" deep. Now with over two months healing, the scar is size of quarter and not gory any more. I wonder if I should feel better now that cancer cells are removed, but I still feel pretty much the same as before. I still have a lot of questions I need answered....I especially want to get my hair colored but don't know if I can yet!!! Hope I don't sound insensitive, but beauty is still important to me, and I don't want to feel run down from this cancer stuff.
July 21, 2015
Lisa, go get your hair colored! It will make you feel better. I did my own the other day, but yours is close to your scalp. I would have a stylist do it this first time around. Just cover it up real good with a bandage. I can't even imagine having a 2" hole. So happy for you that it is getting smaller.
September 20, 2015
Thanks Sharon. Yes I did get hair colored, was a bit too much brunette for me as I'm naturally dark blond, but glad to get pretty color. Next time I'll go with highlights!! I live here in desert and have to wear sunscreen and hat when outdoors, everything gets so tedious when your trying just to survive.
Replies (3)
July 22, 2015
Looks really good!!
Replies (5)
August 1, 2015
Looking good! I also healed by secondary intention, it was definitely the best thing for me. I guess there is a financial incentive to do more surgery rather than less. Really glad you were able to make an informed decision amidst all the conflicting opinions from doctors--I doubt I would've been so clearheaded. ;)
August 2, 2015
I don't understand what the "financial incentive" would be for a doctor that would be sending the closure out to a plastic surgeon would be? Or is the incentive to a patient that is getting more out of their insurance than to just let something heal in by secondary intention. Informed decision takes into account many factors some are financial but the overall goal to any surgeon is a great outcome and if that is better achieved by secondary intention then that is what should be done, sometimes doing less is better and doing more may not give you a better result. The problem with it all is that you sometimes have to have a crystal ball to know what is going to give you a better result and unfortunately patients and doctors don't have those. If the patient is happy that is usually what makes a doctor happy. Personally as doctor you should understand that more a doctor does on a patient the LESS he gets reimbursed for the procedure you as weird as it sounds you will find many of them will not take on the closure as it is a decreasing return on work let alone the issues of a good looking closure and difficulties of a patient that is not happy with the outcome of his work that bizarrely enough is the reason many find a forum such as this to help with answers. In the future try to always find someone you trust and you believe has a good heart. As with many things in life it will carry you far. Best
August 2, 2015
I'm sorry but I spoke to several MOHs surgeons in the U.S. before deciding to have my surgery here in London (I live on London but my family is in the U.S., where I'm from). All three of them charged extra for the reconstruction or would refer me to a plastic surgeon they worked with to do the reconstruction. So the financial incentive to do more seems pretty obvious. I'm not saying the doctors aren't also thinking about what's best for the patients but something is wrong. I've heard from so many people since my surgery who hated their complex flaps/skin grafts etc. I'm so glad my doctor did less rather than more.
August 5, 2015
Thanks for sharing. I'm also scheduled for Mohs surgery for a BCC on the side of my nose. I like your approach to healing naturally and am looking forward to hearing more follow ups.
August 26, 2015
Our stories are nearly identical, although shame on me as a trained R.N. for ignoring my "bleeding pimple" for so long. Glad you are healing so nicely.
Thanks so your starting this blog. I needed to vent.