Mile 25 with Basal Cell Nevus Syndrome

I can see why the term "Hit the Wall" is used in a marathon. Somewhere in the race your body just decides enough is enough.

My head is done with surgeries for now. I will do some photo light therapy over the winter. My face is done with surgeries for now as well. Mile 25 is a laser ablation over my entire face.Again I get grand ideas of waking up 25 years younger the next day. The truth is this is to soften the edges of my scar tissue and new skin to be more elastic and happy with my old skin. 

I arrive for my procedure an hour early. The nurse had called and thinks we can start early. Well starting entails having my face cleaned with acetone. This lovely treatment is followed by being slathered up with numbing cream and left to "cure" for a while.  Just like with some other numbing agents my skin swells. Great all I can smell is acetone. My eyelids are puffing up and my lips are tingling. I am ready to get on with this. After all people do this on purpose all the time right?

All numbed up and ready for the main event

Once I am numb. Well as numb as I am going to get I go into the procedure room. This is different, there are three machines in the room that I have never seen. 

My nurse explains each to me by name and in detail. This is what I get from the conversation: the big box on wheels is the chiller, the smaller box on top of that is like a mini shop vac and the tall skinny guy on the other side of the chair is the laser itself.

The surgeon comes in and makes sure I understand what is going on then gives me protective eye gear. Once he is convinced that I am Data from Star Trek he tells me he is going to give me a sample of the sensation on my cheek. 

It felt hot and immediately irritated. Ok so this is when the chiller becomes my best friend. The surgeon operates the laser, his nurse uses the shop vac to remove the skin being blasted  off and I get to blow this wonderfully frigid air across my face. I was clenching my jaw just a bit and he asks if I want to stop. "Does that mean I get the feel good gel?", I ask. Not until he is completely finished. How long does it take to do your whole face? Roughly 10-12 minutes. Why would anyone intentionally stop and prolong this. Nowhere in the literature does it say you will have the sensation of walking through a swarm of wasps. I believe I made a comment similar to "get to stepping". Exactly 11 minutes later I am handed a mirror. Still clutching the chiller in one hand I take a look at myself.

 

Immediately following procedure

My face went to Miami with out me and got stuck in a perforating machine on the trip. I am covered with little white dots. The had to pry the chiller out of my hand. No I am not kidding. Next comes the laser balm. I am slathered up for the ride home.

Covered in laser balm

I did not see myself after they prepped me for the ride home. So I took this selfie in the car. It does not do justice to the half inch of goo I am covered with. You can see it in my hairline. 

Once I get home I realize he got right into my hairline and I have some missing and loose hair in the laser balm. Even though my face is beet red I can see that the procedure has softened the edges of the graft across my nose. This is very promising. 

24 hours later

I was told the discomfort should be minimal if not gone by the next morning. That was not true for me. I was still very itchy and had a low grad fever the next morning. I was to have another surgery on my back November 21. My dermatologist  told me I looked a little beat up and had probably "hit the wall". My back was rescheduled to December 8.

I was told to use the laser balm for the first week at least and the redness could stay for a couple of weeks. Whenever the redness went away I could use my regular creams as long as I use ones with sunscreens and avoid sun exposure. That was not true for me the redness was gone in 5 days so I switched to my regular creams and apply them 3 to 4 times a day.

November 26 my face is barely pink

My family was prepared to see a lobster at Thanksgiving. Instead they asked if I changed my mind. Some are more curious than others and got up close and personal to look for the changes. There are no ridges between the old skin and new skin or scar tissue from my facial surgeries. The laser did not remove my scarring but it did smooth things out a lot. The jury is out on doing this again. We shall see where things are this time next year.

I had a follow up visit on December 2 with my eye surgeon. It has been just over 6 months since he reconstructed my forehead and across my nose. Another bonus that may reveal itself from the laser procedure is the elasticity of the skin on my forehead has greatly improved. My eye surgeon will check me in another 6 months. There is a portion of my forehead where the initial graft died. He is hoping my new skin will become supple enough to rework that area surgically and get rid of the small crater in my forehead. It is hard to believe that exactly one year ago I had my first consultation with him. 

Well 2015 may be a happier adventure than 2014 after all. I will complete this marathon between my appointments on December 8th and December 23rd. For 2015, i will continue to work on my back and explore more aggressively the options that stop the growth of this disease.

Take Away Nugget: It is the Season of Thanks and Giving. Do your part and pay it forward. Even I am not the worst off in my neighborhood.