Basal Cell Carcinoma – Entry Two

Basal Cell Carcinoma – Entry Two

Welcome to the second entry of my basal cell carcinoma series. I hope that the series is small, however, I would be naïve to think that I will never have skin cancer again. However, from here on out, my skin will be monitored closely by my dermatologist and me, and I will continue to carry out strict skin protection practices to prevent further skin damage.

You can read my first basal cell carcinoma entry here. On my first entry, I mentioned that I was to have my surgery on February 24th, however, I rescheduled the surgery for March 6th and had a pre-surgery consult on February 26th.

Health Insurance

On the 6th of February, I turned 26 and under current law before that age, a young adult is covered by their parent’s health insurance. Since I was no longer covered by my parent’s health insurance policy, I needed to switch to my husband’s health insurance starting March 1st. I still had coverage 31 days after February 6th, so the end of coverage date would be March 9th. I had a several day period between March 1st and March 9th where I had dual health insurance coverage. My surgery was scheduled on March 6th which fell within the range of the dual coverage, meaning I could receive the benefits from both insurances.

Pre-Surgery

Before I had the procedure, I met with the surgeon and asked him questions about basal cell carcinoma and the Mohs surgery. I asked specific questions because I really wanted to see how much the surgeon thought he would have to take out of my face. We discussed repair plans and if I needed a plastic surgeon to close my incision.

Initially, I was a bit of a mess trying to figure out when I should have the surgery, what to do with insurances, what kind of coverage I had, and for what amount I would be financially responsible. However, I made a lot of calls to the insurance companies and dermatology office and was able to sort out the issues.

After I figured out as much as I could on my own, I went to the Ogden Utah LDS temple to think about my decision. I chose to go there for a number of reasons, but one of the main reason was that I wanted a place of solitude where I could thoughtfully decide if I was making the right decision about my surgery. After prayer and reflection, I felt like my decision about my surgery was good. Therefore, I planned to have my surgery on March 6th.

Basal Cell Carcinoma Mohs Surgery

On Tuesday, March 6th, my husband drove me to the dermatology clinic for my surgery. We dropped our children off at my parent’s home on the way there. We arrived at the clinic and went into the room where the procedure would be performed. The physician’s assistant came in and with a marker drew some marks on my nose and face for surgery prep. The medical assistant numbed my nose and gave me anti-anxiety medication. My Mohs surgery was not under general anesthetic so I opted for some medication that would help relax me.

The surgeon came in and excised the first portion of tissue. During a Mohs surgery, the surgeon takes the first portion out and then takes it to a lab for examination of the basal carcinoma cells. The first excision did not remove all the basal carcinoma cells, therefore, he came back a second time and removed more tissue. They were able to remove all the abnormal basal carcinoma cells with the second excision. They examined the second biopsy and the borders were clean.

The spot was small enough that there was no need for plastic surgery. The physician’s assistant came in and closed up the spot with stitches and covered it with a bandage.

Basal Cell Carcinoma Removal Surgery
Post-Mohs Surgery

Recovery

Post-procedural care entailed me not exerting myself for the 48 hours after surgery. I was to not elevate my blood pressure, lift heavy items, or strain myself. I rested and took it easy for those two days and felt pretty good. My family helped me a lot, however, I still performed mom duties. I was instructed that I could remove my bandage 48 hours after surgery. I woke up at three in the morning that third morning and couldn’t stand having the bandage on my face any longer. It was itching and irritating my face.

Bandage over Mohs Incision Site
Bandage Over Mohs Surgery Site

The dermatology staff encouraged me to take off the bandage in the shower to aid in removal. That morning, I jumped in the shower and let the bandage soak for a couple of minutes. I pulled it off and started cleaning the incision with the recommended hydrogen peroxide. With a hydrogen peroxide soaked q-tip, I started to clean it. My nose was still swollen and my left nostril was pulled up by the stitches. So, my nose was asymmetrical and slightly disfigured. The inside of my nostril was so swollen that I couldn’t breathe out of my left nostril.

Emotional Shock

The visual of the slightly deformed nose and stitches caused me to have a minor emotional shock reaction. I became light-headed and had to sit down in the shower to get more blood back to my head. I called out to my sleeping husband to get me a glass of juice. After I drank some juice and gained my bearings, I stood up and finished showering. I got back in bed but couldn’t fall back asleep because I was fretting.

Therefore, I grabbed a tablet and watched some Netflix in our living room to get my mind off of my nose. I texted my mom a picture of my nose while I was watching a show, not thinking that she was awake. However, she texted back wanting to call me. I told her she couldn’t call me because if I were to talk to her, I would burst into tears. So through text, my mom who also is a registered nurse, reassured me that the swollenness would die down and that my nose would be more symmetrical once the stitches were out. I felt a bit better after being reassured by her. Nevertheless, I was still emotional that whole morning and before my husband left for work, he made sure I was well enough to take care of our children.

Rest

When my children got up, I made them breakfast and I let them play in their room while I sat near them resting. However, late morning I continued to feel unwell, so I put us all down for early naps.  After I was able to rest, I felt better. As the hours went by that day, my nose was looking better. All in all, the incision actually looked really good. However, my physical and emotional equilibrium was out of whack and I wasn’t able to process my emotions very well.

Mohs Surgery for Basal Cell Carcinoma

Healed

A week after my surgery, the dermatology P.A. removed my stiches. I am very pleased with how my incision and nose look post-surgery. As of this moment, my incision is healing well.  I was instructed to keep it wet with petroleum jelly. As the incision heals and becomes less tender, I can massage it to promote healing and softening of scar tissue.

This whole experience has been a reminder of how lucky I am to be surrounded by such supportive family members and friends. I am grateful that I was able to have my skin cancer removed by skilled medical staff and that the surgery and repair were successful.

Resources:

Basal Cell Carcinoma Removal Surgery Recovery
Mohs Surgery Recovery


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