Mile 21 with Basal Cell Nevus Syndrome

A friendly reminder, my pictures are graphic.

So Mile 21 was on July 23, 2014. I am believing this was my last surgery day.  Not that I am anxious to start laser or photo dynamic therapy as they have their own sets of challenges to overcome.

I was actually in a good place mentally when I arrived.  The first test for my sanity for the day came with the announcement that I would have a different nurse attending me.  My surgeon knows me well enough that he made not one but two trips to my room to discuss this with me before ANY exam or marking began for the day.  I have had the same nurse for every procedure and follow up since I began this marathon over a year ago.  However, I am on a first name basis with most of the office now.  I have visited with the "new" nurse a lot so it's not like she was a complete stranger. 

I must have been visibly upset as they got my husband and brought him back.  He was not much help. LOL.  He said, "Really!  You are the first person to tell someone to suck it up.  Put on your big girl panties.  Life is one change after another.  God did not put this person in your way today, he put her in your path.  Now what you do with her is what He's looking at."  Ouch!!  Talk about getting hit with your own words.

To top it off the artwork in my new room with my new nurse was a pig jumping off a dock into a pond.  For you farmers out there, I do know pigs do not do this in real life.  Very appropriate for me that day though.  So I calmed down and we got down to business.

One of the previous biopsies over my lip came back positive.  After discussion and more shaving on my head my surgeon decides to operate on three tumor sites and biopsy a fourth.

Spot 1 over my left lip pre-op

Spot one is the tumor revealed by the biopsy during Mile 20. It took two stages and did go into the top of my lip.

Spot 1 Post op

The surgeon opted to let this site heal open.  What they call secondary intent, I believe.  His concern was that stitching this site would pull my lip line and leave it looking more deformed than having a minimal scar along the top.  We shall see.

 

Spot 2 over my left ear and 3 is behind

Spot 2 was the beast of the day taking 6 stages to get free of cancer.  Spot 3 was just biopsied on  surgery day.

Spot 2 post op and spot 3

I have had tumors with 5 stages and even bigger wound sites.  This site took 6 to get cancer free.  Every stage looked like it barely had any there so the stages were smaller than previous surgeries. The whole point of doing MOHS is to leave as much healthy tissue as possible and still get all of the cancer.

Spot 4 behind my right ear.

 

Spot 4 took only three stages to get clear. This was the one we thought might actually be a beast and go into the area above it where a previous tumor had been remove.

Spot 4 post op

It may be hard to tell but after three stages the wound site was slightly larger than a quarter.  The pinker skin behind my ear is a previous mile where no hair is returning. We will have to wait and see if hair will return when this new one heals.

I have a follow up in a week.  That is when we decide where to go from here. Yes, I have said that numerous times before. Time will tell.

Take Away Nugget: Don't Mistake Simple People As Being Simple Minded

Mile 20 with Basal Cell Nevus Syndrome

A friendly reminder all my pictures are graphic. They show before and after my surgical procedures.


Everyone I know is going through something. Some of us are gong through more than one thing at a time.

It was my intention to post quite frequently. Life and pain management have gotten in the way. My surgeries may be winding down but I am still facing decisions for the truly superficial tumors on my face and the extensive tumors on my back. I just won't talk about the others scattered over my body at this point.

So on July 2, 2014, Mile 19 began with  the usual "Hi! How are ya?".  Then my surgeon went to work around my mouth. I think my husband thought he was headed for a quiet week. That silly man. There were 7 areas of concern around my mouth. The surgeon just biopsied the 2 small ones on the top of my upper lip. The remaining 5 got the Mohs treatment.

Marked for surgery and biopsy

Multiple stages and several hours later. I once again looked like I had been accosted by a melon baller.

Ready for closing

The one on my chin to right in picture took 1 stage and is cancer free. The two on my chin towards the center took two stages and are cancer free. The one under my nose on the right side of the picture took three stages and the lovely crater on the left took four stages. All came back cancer free.

My lips were swollen and numb inside and out. Thank goodness you can't tell I was drooling on myself.

My surgeon is awesome. He talks to me the whole time he is doing stages and closing. I need to take in a recorder as I am sure I would learn more if I could replay the conversations later. During this surgery when he was stitching everything up my husband was standing over his shoulder supervising.

He used different types of flap closures this time. For the life of me I cannot remember what he called them. Hence, the need for a recorder.

After Closing

By the time my surgeon was done with closing. I truly felt my lips had to look like a baboon's butt. I sounded like Elmer Fudd. I asked for a mirror. I was not reassured at all when my nurse, surgeon and husband burst into laughter at the sound of my voice. Not funny, guys!

So I went home with my long straws and assumed I would be on liquids for days. The next morning I was able to eat yogurt in very small bites with a child size spoon. July 4, 2014, I had ribs and all the trimmings at my in laws. My ability to eat wasn't pretty and I was a sloppy mess afterwards.  Also, I bit the inside of my mouth several times as the internal swelling was more of a nuisance than any of the exterior challenges. One week after surgery, on July 9,2014, I returned to have my stitches checked.

Stitches on July 9

My surgeon was pleasantly surprised at how fast I healed. He said he probably could have removed the stitches a day or two sooner. My nurse was the one with the task of finding all the stitches and getting them out. This was the first time I can say I was truly uncomfortable during the removal of my stitches. Most of them had skin grown over them. The area around the mouth has proven to be more sensitive than any area of my face.

July 22, 2014 three weeks post op

 I truly thought I would complete a full marathon (26 miles) just in surgeries. Mile 21 is scheduled for July 23, 2014, and my surgeon thinks that may finish the surgical clean up at this point. We will see what he says at the end of that mile.


Take Away Nugget: A photograph is an instant in time. How many instants do you make truly memorable.