The Mohs Nose

After I posted Just Nosing Around, I joined a Facebook group for Skin Cancer Warriors. I was amazed how supportive they are. I never had any support with Cushing’s or Kidney Cancer pre-op, so it was really nice to be on the receiving end for once.

From that FB group, I learned that May is Skin Cancer Awareness Month and there is a fundraising page (of course) so I actually decided to give it a try. I figure at least it will be another tshirt. LOL This is my page, if anyone is interested: Skin Cancer: Take a Hike!

Sunday, April 25, 2021. I’ve been reading that handout I posted (below) and it’s made me start looking around for shirts that button, rather than pull over the head. I mostly have tshirts and some of those necks are pretty tight. I think I’m ok for at least tomorrow and the next few days.

Also, in preparation, I downloaded some books for my Kindle and started a few coloring images in Happy Color so that I wouldn’t have to use WiFi to download there.

Also, I remembered that I should stress dose tomorrow! I started packing my bag to include Tylenol and I’ll add extra cortisol, a bottle of ice water and my iPad tomorrow.


So, Monday, April 26, 2021 I had my Mohs Surgery.

I remembered to take my extra cortisone! We got there 30 minutes early, which worked in our favor – for once.

Tom could go in with me while I had my surgery and I stayed in room the whole time. The nurse came in and we went over basic questions. The surgeon came in and recognized where the location was – he could see it over the top of my mask. He explained what he’d do and asked if there were any questions, then used a marker to make a circle around the cancer.

He injected the pain killer. I started when it first went in but then it was ok. He asked if I could feel anything. I said no so he continued.

They bandaged everything, cauterized the blood vessels and took the cancer off to the lab.

When they came back, the surgeon said that the cancer was gone. He used dissolvable stitches and a skin graft. I could see quite a bit of blood during this. He did more cautery and the nurse put on lots of bandages which I had to keep on for 24 hours. Because of the skin graft, he called in antibiotics.

Tom drove home – it was hard for me to see over bandages. About 1 pm I took 3 Tylenol. I took first antibiotic about 2 pm – Doxycycline Hyclate 100 mg. I take those twice a day for 10 days because of the skin graft.

Then, I fell asleep and woke up about 8:30PM and had some dinner. 3 more Tylenol and another antibiotic.

I slept ok overnight and woke up about 5:30 am with pressure from the bandages on my face. I tried to sleep for about another hour, then just got up. No real pain just a dull ache. If I touch my nose, it does hurt…so – don’t touch!

Tuesday, April 27, 2021, I kept my video off for my work Zoom meeting so no one would see all those bandages. I skipped an in-person afternoon meeting but about 4:00 pm I got to change the bandages so I could see what I’m dealing with:

Right at the bridge of my nose it’s a little bit swollen and it’s uncomfortable to wear my glasses. I had a handbell rehearsal Tuesday night that I also skipped.

Wednesday is normally one of the three days a week I do water exercise but I can’t get this thing wet so I stayed home and did a little work. I didn’t take the antibiotics with food, just with coffee, and that really upset my stomach. I ended up cancelling my piano students for the afternoon. They had all asked last week about the biopsy bandage – I wasn’t sure how I would explain this one to a first grader. My stomach was still upset from the antibiotic anyway.

I had bought new bandages on amazon that were supposed to be latex-free. I think they skirted around that claim somehow because as soon as I tried them, my nose was itchy. At first, I thought maybe my nose was healing but I ripped off the bandage and went back to the old plastic ones that made my nose red. The itching stopped but after that, I had a lot of trouble sleeping and finally just got up about 3:00 am.

Other healing pictures:

April 30, 2021:

May 2, 2021

Update May 7, 2021. Big Day – I finally went back to water exercise after nearly 2 weeks off and it felt so good to be back, to be normal. Besides that, I ran into my son’s elementary school music teacher (I had also been her piano accompanist) and we chatted about how things were going.

I also went (nervously!) to my main dermatologist for a full body scan and no other skin cancer was found.

May 8, 2021, Healing better than I thought it would.

May 24, I go back to my surgeon where I will (I hope!) get more good news. Assuming it’s good news, this post is done.

If not, there will be yet another update.


I wrote this April 24, 2021:

It seems like my nose is always at the forefront of my medical issues. Cushing’s disease? Let’s do a whole surgery through her nose.

Allergies? Let’s clog up her nose so she can’t breathe.

Kidney cancer? Let’s stick tubes up her nose so she can breathe.

None of that stuff did her in, so let’s try playing with the outside this time.

I hadn’t thought much about my nose lately unless I was adjusting a mask over it for COVID. Luckily, I was never tested for COVID because that would have been a swab…up my nose.

In January 2021, I was just keeping my nose out of other people’s business when I noticed weird stuff on my nose. I made the obligatory doctor appointment. He thought that part of my issue was allergies to paper masks and gave me cream – guess what!?!? – Kenalog, a steroid cream form of the stuff they inject into my knee. Part of the description for that reads “Do not use it on the face, groin, or underarms unless directed to do so by your doctor.” I was directed by my doctor so I guess it was ok but I sure hate using additional steroids.

In the middle of the nose-redness to be fixed by Kenalog was a really weird thing. The doctor thought it would be useful to use liquid nitrogen on it and I figured that was relatively easy so I went for it.

The morning before the liquid nitrogen

So, he sprayed the nitrogen on and said to use the Kenalog twice a day – the thing should fall off in a couple weeks. A couple weeks spread out to about 5 and it fell into my mask a day or so after I had a dream about it falling into the swimming pool and infecting everyone there. Fortunately, my dream didn’t come true!

Unfortunately, when it fell off, it left a hard red bump which stuck around and started looking weird again.

So, February 22, I called the doctor again and made an appointment for March 10. He said he could do the nitrogen thing again and go a bit deeper. I thought, maybe no. Let’s move on to the professionals. So, I got a referral to a dermatologist on April 16.

Even with my mask on, the dermatologist could see the top peeking out of my mask and proclaimed Squamous Cell Carcinoma! She did do a biopsy, so I had a few days of hope. I thought the biopsy would be a smaller amount, though.

So, I put Aquaphor and a bandage on my nose twice a day…and my nose got red under the bandaid. Allergy to the adhesive? I know I’m allergic to latex, so we have plastic bandaids. Whatever.

April 21 I got the official results. The dermatologist was right the first time. Monday, April 26 I will have Mohs surgery.

Of course, I set out to watch this surgery on YouTube.


I downloaded the handbook mentioned at the above video. Find it at https://www.dartmouth-hitchcock.org/sites/default/files/2020-12/mohs-handbook.pdf.


Because I always “own” all my diseases, I bought a t-shirt which I will wear proudly. Of course, it has a butterfly and the words: “They whispered to her – you cannot withstand the storm. She whispered back – I am the storm.” and Squamous Cell Carcinoma Awareness.

I have so many t-shirts – not just for places but for causes, diseases, work, piano teaching… I hope this is the last non-fun one I get!

I am not anticipating any changes in this over the weekend so the next post will be sometime next week, after the surgery.

Thanks for any prayers, good wishes, whatever!

Just Nosing Around

It seems like my nose is always at the forefront of my medical issues. Cushing’s disease? Let’s do a whole surgery through her nose.

Allergies? Let’s clog up her nose so she can’t breathe.

Kidney cancer? Let’s stick tubes up her nose so she can breathe.

None of that stuff did her in, so let’s try playing with the outside this time.

I hadn’t thought much about my nose lately unless I was adjusting a mask over it for COVID. Luckily, I was never tested for COVID because that would have been a swab…up my nose.

In January 2021, I was just keeping my nose out of other people’s business when I noticed weird stuff on my nose. I made the obligatory doctor appointment. He thought that part of my issue was allergies to paper masks and gave me cream – guess what!?!? – Kenalog, a steroid cream form of the stuff they inject into my knee. Part of the description for that reads “Do not use it on the face, groin, or underarms unless directed to do so by your doctor.” I was directed by my doctor so I guess it was ok but I sure hate using additional steroids.

In the middle of the nose-redness to be fixed by Kenalog was a really weird thing. The doctor thought it would be useful to use liquid nitrogen on it and I figured that was relatively easy so I went for it.

The morning before the liquid nitrogen

So, he sprayed the nitrogen on and said to use the Kenalog twice a day – the thing should fall off in a couple weeks. A couple weeks spread out to about 5 and it fell into my mask a day or so after I had a dream about it falling into the swimming pool and infecting everyone there. Fortunately, my dream didn’t come true!

Unfortunately, when it fell off, it left a hard red bump which stuck around and started looking weird again.

So, February 22, I called the doctor again and made an appointment for March 10. He said he could do the nitrogen thing again and go a bit deeper. I thought, maybe no. Let’s move on to the professionals. So, I got a referral to a dermatologist on April 16.

Even with my mask on, the dermatologist could see the top peeking out of my mask and proclaimed Squamous Cell Carcinoma! She did do a biopsy, so I had a few days of hope. I thought the biopsy would be a smaller amount, though.

So, I put Aquaphor and a bandage on my nose twice a day…and my nose got red under the bandaid. Allergy to the adhesive? I know I’m allergic to latex, so we have plastic bandaids. Whatever.

April 21 I got the official results. The dermatologist was right the first time. Monday, April 26 I will have Mohs surgery.

Of course, I set out to watch this surgery on YouTube.


I downloaded the handbook mentioned at the above video. Find it at https://www.dartmouth-hitchcock.org/sites/default/files/2020-12/mohs-handbook.pdf.


Because I always “own” all my diseases, I bought a t-shirt which I will wear proudly. Of course, it has a butterfly and the words: “They whispered to her – you cannot withstand the storm. She whispered back – I am the storm.” and Squamous Cell Carcinoma Awareness.

I have so many t-shirts – not just for places but for causes, diseases, work, piano teaching… I hope this is the last non-fun one I get!

I am not anticipating any changes in this over the weekend so the next post will be sometime next week, after the surgery.

Thanks for any prayers, good wishes, whatever!

May is Melanoma Awareness Month

 

I’ve posted about our family’s experiences with melanoma before.  We were lucky and caught it in time but a good family friend didn’t.

May is designated as National Melanoma Month.   Included in that designation is National Melanoma Monday, which is the first Monday in May.  The American Academy of Dermatology has set aside this day to raise awareness about skin cancer.

Melanoma is a type of skin cancer, and it is the deadliest of skin cancers.

There will be many events focused on skin health, sun safety, tanning prevention, and skin cancer screenings and resources.

All are asked to join the American Academy of Dermatology in wearing orange and encouraging others to wear orange for skin cancer awareness.

Know the warning signs and check with your doctor if any of them appear.

Early signs of melanoma are changes to the shape or color of existing moles or, in the case of nodular melanoma, the appearance of a new lump anywhere on the skin. At later stages, the mole may itch, ulcerate or bleed. Early signs of melanoma are summarized by the mnemonic “ABCDE”:

  • Asymmetry
  • Borders (irregular with edges and corners)
  • Color (variegated)
  • Diameter (greater than 6 mm (0.24 in), about the size of a pencil eraser)
  • Evolving over time

These classifications do not, however, apply to the most dangerous form of melanoma, nodular melanoma, which has its own classifications:

  • Elevated above the skin surface
  • Firm to the touch
  • Growing

Metastatic melanoma may cause nonspecific paraneoplastic symptoms, including loss of appetite, nausea, vomiting and fatigue. Metastasis of early melanoma is possible, but relatively rare: less than a fifth of melanomas diagnosed early become metastatic. Brain metastases are particularly common in patients with metastatic melanoma. It can also spread to the liver, bones, abdomen or distant lymph nodes.

 

Melanoma Monday

melanoma

 

May is designated as National Melanoma Month.   Included in that designation is National Melanoma Monday, which is the first Monday in May.  The American Academy of Dermatology has set aside this day to raise awareness about skin cancer.

Melanoma is a type of skin cancer, and it is the deadliest of skin cancers.

There will be many events focused on skin health, sun safety, tanning prevention, and skin cancer screenings and resources.

All are asked to join the American Academy of Dermatology in wearing orange and encouraging others to wear orange for skin cancer awareness.

HOW TO OBSERVE

The 2016 theme is Looking Good in 2016 so use #LookingGoodin2016 or #MelanomaMonday to post on social media.

HISTORY

Founded by the American Academy of Dermatology, National Melanoma Monday has been raising awareness since at least 1984.  For more information on prevention and screening visit www.melanomamonday.org.

Read more at http://www.nationaldaycalendar.com/national-melanoma-monday-first-monday-in-may/

 

Mohs surgery

tom-earMy husband had a Mohs surgery on his ear a couple months ago and it was a really good way to get rid of ALL the cancer.

His surgeon did it in really interesting way. I had thought that they would take the first slice, then wait in the room where he was while they looked at the pathology, then take another, etc until all the cancer was gone.

Instead, they took the first slice, then back to waiting room. Next person, first slice while they were looking at the pathology, then another person, first slice…

Then a round of second slices, then thirds.

It took longer than I’d thought but it was really good talking to other family members and patients during that time.

 

 

From the Mayo Clinic

Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. Mohs surgery is also known as Mohs micrographic surgery.

The goal of Mohs surgery is to remove as much of the skin cancer as possible, while doing minimal damage to surrounding healthy tissue. Mohs surgery is usually done on an outpatient basis using a local anesthetic.

Mohs surgery is an improvement to standard surgery (local excision), which involves removing the visible cancer and a small margin of surrounding healthy tissue all at once. Mohs surgery allows surgeons to verify that all cancer cells have been removed at the time of surgery. This increases the chance of a cure and reduces the need for additional treatments or additional surgery.

Melanoma skin cancer guidelines for NHS updated – BBC News

New guidelines for diagnosing and treating melanoma skin cancers have been issued to the NHS in England.

The National Institute for Health and Care Excellence (NICE) hopes they will end a wide variation in the diagnosis and treatment of the disease.

They include advice on diagnosing how far the cancer has progressed, identifying the best treatment, and improvements to follow-up care.

Melanoma is a form of skin cancer that claims more lives than any other.

In 2012, the UK saw more than 2,000 deaths from melanoma and the number of melanoma cases is growing faster than any of the 10 most common cancers.

Experts believe this is largely down to the boom in foreign holidays over the past 40 years and, more recently, a big increase in the use of sunbeds.

Safe sun

Prof Mark Baker, from NICE, said everyone wants to enjoy the sun, but there are safe ways to do so.

“Using a sunscreen with a high SPF, spending time in the shade between 11:00 and 15:00, ensuring you don’t burn, and covering up with a hat, T-shirt and sunglasses.

“But overexposure to ultraviolent light from the sun can have very serious repercussions.

“Melanoma causes more deaths than all other skin cancers combined. Its incidence is rising at a worrying rate, faster than any other cancer.

“This new guideline addresses areas where there is uncertainty or variation in practice, and will help clinicians to provide the very best care for people with suspected or diagnosed melanoma, wherever they live.”

Experts warn that even though more people are now aware of the dangers of too much sun, it will be a generation or so before the number of melanoma deaths starts to fall.

via Melanoma skin cancer guidelines for NHS updated – BBC News.

Biopsy 2 of 4

I mentioned in an earlier post that I was having some biopsies done.  It had been planned for 3 of them today  2 on my right leg, 1 on my left.

Up at 6:30 to put Lidocaine/Prilocaine cream on the places, covered with waterproof bandages.

I arrived at my doctor’s at 8:30 and found that my insurance would only allow one biopsy at a time. <sigh>

 

leg1

The doctor removed most (or all?) of the largest one. There are 3 internal stitches and 7 on the outside.  When those 7 are removed in a couple weeks, the doctor will remove the second one, on the other leg.  Then, when the stitches come out for that, she’ll remove the 3rd.

My summer at the doctor’s.  LOL

Meanwhile, we were hoping the pathology report would come back today for the forehead one I did last week but it hasn’t yet.  No news is good news!

 

Patient Instructions for Biopsy Site Care from Johns Hopkins

  1. Leave your wound dressings in place for the rest of the day of the biopsy and keep them dry.
  2. Change band-aids daily starting the day after the biopsy.
  3. Showers are fine starting the day after the biopsy. Leave the band-aids in place while you shower and change them after you dry off.
  4. During the time period of daily band-aid changes, do not soak in a bath or swim.
  5. The average time for daily band-aid changes is 5 to 6 days (range is from 1 or 2 days up to 2 weeks).
  6. If you need to use anything to clean the wounds, hydrogen peroxide is recommended. If the wounds are fine (i.e., no signs of infection), all that is required is a daily band-aid change.
  7. The wounds may or may not form a scab as they heal; either way is fine.
  8. Continue to change the band-aids daily until there are no open wounds.
  9. The local anesthetic used for the biopsy will usually last for 1 to 2 hours after the procedure. After it wears off, you may have some mild, localized soreness and tenderness at the biopsy sites over the next day or two. You may find regular Tylenol is helpful for the discomfort.
  10. Refrain from doing extremely strenuous activity for the rest of the day of your biopsy (such as running or heavy lifting).
  11. Once you are without the band-aid, the biopsy sites may look slightly red or darker than the rest of your skin. This discoloration will gradually fade and blend back with your normal skin color. This fading process may take anywhere from a few months up to a year.
  12. It is very rare for people to have any problems during the healing period. It is normal for the biopsy sites to bleed a little bit or drain pink fluid for a day or two after the biopsies. They should not bleed excessively (i.e., through the band-aid) after that time. They should never drain pus. If you do experience problems with significant bleeding, redness, infection, or other problems, call your doctor’s office.

Skin Cancer

biopsy

 

 

We have a new melanoma in the family, so I’ll be posting a bit about that for a while.

I just had a shave biopsy above my eyebrow last Tuesday and I’ll have 3 punch biopsies on my legs next Tuesday.  Results to follow!

For the non-squeamish: