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 Mohs nose surgery report from this morning
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Posted - 05/14/2010 :  23:27:39  Show Profile  Reply with Quote
I've benefited a lot from reading this forum, and thought I'd post my story, since it is so recent. I'm very sensitive to pain, and was very nervous about Mohs, so I hope this will help someone. I'll put in absolutely everything I remember.

I'm 50, was diagnosed with a small (two pinheads sized) bcc on my nose, on the left nostril, last October. It was slightly discolored and had been crusting and peeling, leaving new, raw skin beneath every few days. This began in January, and slowly happened more frequently. I first visited my dermatologist in April about it, and she tried aldara and freezing it, but it came right back. So the biopsy came back bcc, she recommended Mohs, and from reading some horror stories, I did not want to schedule it. In fact, I cancelled three times before having the Mohs this morning.

In the meantime, I tried alkalizing my diet, drinking daily apple cider vinegar, and the vitamin C spot treatment. That seemed to work in the way it does for everyone--it burned like heck, eventually producing a black crust, which healed over. But when I tried the orange oil after a month or so, it still burned. I figured the bcc was quite deep. I didn't have the nerve to try bloodwort or spurge.

I was very, very nervous about the surgery last night. Did my breathing, visualization, took Rescue Remedy and calcium-magnesium-zinc just before leaving the house. My appointment was at 9. My husband came in with me, and held my foot. :) The surgeon was the first to do Mohs in our county, and he's been practicing for about 10 years.

After having the biopsy, I knew the numbing shot would probably be the worst part. I can't have epinephrine (I'm very sensitive to it--even at the dentist's, my heart pounds out of my chest and I get so nervous and then enraged and feel like I have to run around the block!), so he gave me several shots of lidocaine. The downside of lidocaine is that it doesn't clot the blood like epinephrine does, so there is a little more bleeding, and it wears off much faster, so you if you need a second round of Mohs, you also need more shots. Honestly, that first shot did hurt badly--for about 3 whole seconds (I counted!), and then everything goes numb. I kept my eyes closed throughout, and concentrated on breathing in to a count of 8, holding for 3, breathing out for 8, which kept me very calm. I felt light tugging on my skin, and dabbing for a few minutes. Then I heard beeping and a whooshing noise which he told me was the heat of the cauterization tool he was using to stop the bleeding. The scent was like burning hair, but it was gone quickly. Then they bandaged the wound.

Then, he and his assistant left the room. I was fuzzy headed and spacey and glad my husband was there. I really wanted to go home at that point! My nose started to hurt about half an hour later, from some of the lidocaine wearing off. We talked and I read a magazine, and 40 minutes later, the assistant returned to say they needed to go back in. The surgeon showed me what they had found: a significant amount of bcc still in my nose. He said he thought he only needed to take a little more.

So it all repeated again, except this time I knew what to expect, so it wasn't so bad. Also, a little of the lidocaine was still in my nose, so the shot wasn't as painful. Afterwards, we waited about 60 minutes, and during that time, I realized that, although I wouldn't like it much, I could definitely do this all day if I had to, every hour--that is, that I could get through it, which was a significant accomplishment for me.

Fortunately, he came back in, and the margins were clear! So he asked if I wanted stitches, or if I wanted to just let it heal the way it was, which would leave an indentation slightly deeper than the biopsy scar was. He said if I wanted to have it stitched later, he could do that, too. I was fine with leaving it as it is. It is in a pretty obscure area of my nose.

So we left, and after a walk with my husband, I felt normal again. My nose hurt a bit, so I took a tylenol, but only needed one all day.

I just redressed my wound with antibio ointment and a bandaid to get that wad of gauze off of there (he said I could shower, lift heavy weights or whatever I want to do--'it is a like a deep cut you might have given yourself'), and it is a round hole about maybe 2 mm in diameter, and black at the bottom, from the dried blood. It is kind of weird to see a hole like that on your nose! But I know from the biopsy that it will fill in a lot and it will heal. Now, it is just a little bit tender, and I have some electric-like twitch feelings from the nerves, which he said is normal and will stop after a few weeks. I remember that from the biopsy, also. I'm really tired, but I did clean the house and run errands today, and we went to the movies tonight. There is only very little swelling, and that's under my left eye.

Basically, the whole thing was very much like my biopsy, except for having to do it twice.

I would recommend this procedure, for sure. Chocolate also helps afterwards! I feel better knowing it's gone (at least for the moment) and I'm so, so, so glad I didn't wait any longer until it was bigger.

Feel free to ask any questions!


170 Posts

Posted - 05/15/2010 :  19:18:15  Show Profile  Reply with Quote
Best wishes for a complete and speedy recovery. Thank you for the detailed account. Fear is definitely part of the process and hearing some live reports like this can help.
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Posted - 05/15/2010 :  23:15:16  Show Profile  Reply with Quote
Thank you! Update: one day later, the hole doesn't really look like a hole, more like maybe a freckle, unless you look closely at it. It's draining a little bit of fluid when I chew (good for my diet! :) but doesn't hurt, isn't red, is healing quickly and nicely!
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Disclaimer: The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. While melanoma is the most dangerous type, keep in mind that any cancer and potentially some cancer treatments can cause injury or death. The various views expressed in these public forums should not be considered as medical advice. See your qualified health-care professional for medical attention, advice, diagnosis, and treatments.