Post MOHS surgery x3- 5 days later

 

 

I have had so many people checking in on me over the last few days, I just wanted to say thank you so much. I am so grateful to have so many friends and family members who have taken the time to call or text, or order my family dinner, drop of gifts and goodies, bring me drinks or offer to go get me more pain meds when the ones prescribed to me just weren’t cutting it!

I thought I would update everyone real quick as to how it’s going! First off, I drove today! That was a pretty big deal, and probably just a little too soon. While, I’m not really in as much pain, I’m still babying the incision on my leg, it’s probably at the biggest risk of the stitches busting or becoming infected. It also seems that if I’m on it too much, my ankle and foot begin swelling…so for now, I’m still on the couch. Luckily I work from home and have plenty to keep me busy!

We changed all of the bandages on Sunday…even though I have pictures and I was there and knew full and well what was happening, it is still a shock to look in the mirror and see.

First was my head as this was the bandage that was bugging me the most, the tape was stuck in my hairline, so of course I lost more hair that I didn’t have to spare…I’m TRYING to let it grow again, but it seems like it’s just going to stay short. Anyway, overall it didn’t look too bad, and if I try to find a positive from it, it’s kind of like a mini botox or face lift or something….on one side of my forehead….wonder if I can get insurance to cover treatment for the other side? The incision site really never bothered me too terribly, unless I was laughing, yawning, eating, talking….ok, so I guess it did bother me, but I can assure you that the headaches were WAY worse. I don’t know if it was from all the numbing medicine or the tugging and pulling or both maybe, but I am talking full blown migraines. EVERYTHING

was getting to me, the light, noise, everything…and I was already cranky and tired…so it wasn’t good. 

In comparison, this was a much longer incision than my last MOHS on my forehead, 2 years ago….and interestingly it runs right into that first scar. This time my doctor chose to run my stitches in a line on my head rather than vertically like the previous doctor had, I’m interested to see how it heals and if it scars bad?

Why do I look so angry???

My leg was next, I was so scared to unwrap it, but it actually wasn’t as bad as I had feared, just have to remember to keep taking it very slow!

I know you’re probably looking at that and thinking I must be crazy, but really, I’m most concerned with that spot right in the middle opening up! There is a big indention that she warned me about, but I can live with that, the alternative was cutting a longer incision, down through the top of my foot. Um nope, indention is fine! The bruising wasn’t too bad when we checked this one on Sunday. It’s a bit more sore today, so I’m thinking, it’s probably beginning to bruise more.

Last was my chest, I don’t know why or what happened, but that tape would not budge. It had became one with my skin and did you know that the skin that’s kind of under your arm is the worst place in the world to have tape stuck to? Just don’t stick it there. Trust me. After 30 minutes of Kelsey taking a little off, waiting for me to stop screaming, then taking a little off…etc…OH and I almost forgot to mention the stitch that had somehow managed to weave itself into the tape…yeah, it’s a good thing Kelsey saw it before she ripped it off, that would not have been a pleasant moment.

Ok, there’s no sugar coating this one, it looks bad. It looks awful. The lighting is not good, but it’s yellow, and blue, and a little black, maybe brown…purple and did I mention red? And it hurts. And it’s swollen, it looks like I’m growing some weird thing off the side of my chest. And my poor skin is being pulled and tugged in ways it just wasn’t meant to. And one more thing I would like to address…because maybe someone will come up with some really cool answer to this…how on earth am I supposed to wear a bra?! And yes, I need to wear a bra…one because I was blessed in that area, and two because of the gravitational pull of the earth and kids, well lets just say my skin is getting even more abuse from the tightness and whatever. It’s awful, I can only walk around holding myself up for so long. I spent hours last night looking online for a post surgery bra. All I could find were ones for breast augmentation. Ugh. I don’t need that! I even looked into things like shoulder surgery, there were a few recommendations like strapless bras and camis, but again…that blessing I mentioned and strapless bras are of the devil. So, this morning I found a very old, very stretched out, cotton bra from Victorias Secret vintage 1990 and that is what is working. I’m not sure how long it’s going to last before it gives out though, it has seen better days. So if anyone has any good ideas, please let me know because I’m at a loss and I still have over a week before the stitches get to come out!

Anyway, that’s how I am. I’m so ready to get past this bump in the road and move on, but I think it’s going to take a little longer than I originally hoped! I will update you all again soon!

 

Dear Skin Cancer, you can go now.

***** THE FOLLOWING BLOG POST HAS GRAPHIC PICTURES FROM MY MOHS PROCEDURE, DO NOT CONTINUE IF YOU DO NOT WANT TO SEE THEM*****

Dear Skin Cancer,

We have had a tumultuous relationship over the last 10+ years, from the first time you showed up, and I tried to get rid of you, only to be left with the first of many scars to remind me that you were here…that the poison you had maimed my skin with may be gone, but the jagged line would always remain. To today, when I had 3 of your ugly little tumors deeply cut from my tired body. I am done. I know that  you aren’t though. I know that you will pop up again and again. So, I’m here to tell you, that although I’m exhausted and the pain may feel excruciating. I will fight. I will rise above this and you again. So skin cancer, really, you can just go now…because you will never win.

.

.

.

.

.

Well today was difficult. I went in, thinking it would be, but not really preparing myself for the magnitude of how difficult it would be.

My mom and I arrived at the new doctor’s office this morning at 11am, everyone was extremely nice and I immediately liked (loved) my new doctor. She was extremely informative and knowledgeable and also used to be THE MOHS surgeon for Tulane University, but above all of that, she was so incredibly personable and kind and REAL. She’s officially my favorite, and forever more, anytime I need something cut off of me, I will be giving her a call! 🙂

So, anyway, there I am, back in that fun little reclining, raising, chair thing…bright lights shining down on me as I explained my story, my background, my spots, my tanning history, my genetic history, my belief that this goes so far beyond just normal sun damage. She examined the areas that were to be removed, one small one on my forehead, right at my hairline, near where the last one was removed; one on my upper left chest area, and one on my lower left shin. The shin I was really worried about. The one on my chest she was really worried about. Then we began, all while my poor mom sat and tried not to watch. If you’re not familiar with MOHS, there is no general anesthesia, it’s just local numbing medicine. Medicine that I have an extremely high tolerance against, so it takes a LOT of shots…and even then, I still feel “things”. I think the numbing was the worst part. That stuff HURTS! Anyway, after all of the areas were good and I couldn’t feel any sharp pain, everything was marked and measured so the doctor knew what to remove.

Now comes the fun part…not really. With a MOHS procedure, they remove the main tumor area, then they slice a little more, those sections are then sliced into very thin segments and carefully examined under a microscope until they have sections that have “clean” edges, meaning no more cancer cells. I prayed for a one and done type scenario but wasn’t surprised to hear that my leg and my chest would both need more removed, luckily they were small parts, so it wasn’t too invasive, and after the second time, she got it all.

As I have always done in my past posts about my skin cancer journey, I take pictures and post them here. Some people don’t understand why. When I first had MOHS surgery on my face, I was terrified. I knew how it worked, I knew that there was no certainty that it would be a small scar, and it was my face. I researched and looked all over the internet, but I could never find a real account, from a real person that had been through something like what I was facing. After that surgery, and those posts…I had an outpouring of support and people just thanking me for sharing, I somehow had helped them by doing something that I wished had been there for me. I was contacted by the local news station and interviewed, teachers and doctors from all over asked me if they could share my blog with their colleagues and students, MD Anderson shared my story, and even Good Morning America did a piece about me. Unfortunately, this was all around the time that the “tanning mom” story was going viral, and I got tied in with a lot of tanning bed stories. While I did use a tanning bed in my younger days, I’m still not convinced that, that is what has been the sole contributor to my condition. I’ve been told it could possibly be genetic or perhaps even auto immune related. The whole problem is no one can tell me and I don’t know where to begin to get the answers, I’ve been searching for so long.

The area on my forehead was the least of my concerns, I knew it would be ok & could be stitched up nicely.

This is actually a picture of a picture, the white card in the picture are the actual pieces sent to the lab to examine.

My chest really worried her, this had been an area of concern for me for about 6-7 years, however, I was told by several doctors it was nothing to worry about. 😦 The white spot on the edge of the wound is where the cancer still was after she removed the large portion and had to come back in for another piece.

My poor leg. This was after the first portion was taken, dead center of the wound is where she came back and had to go even deeper. It’s hard to tell be cause of all of the swelling, but this one was really deep, while the others were more wide. Luckily it had not made it to the bone, thank you God!

Once, everything had been deemed, clean, it was time to start stitching. One thing that I failed to mention about my doctor was that she also prides herself on her stitching skills! She felt very confident that my scar on my forehead would be barely noticeable and with good care the same goes for the one on my chest. My leg, however, is another story. Because of where it is, right on my shin bone and the fact that there isn’t much skin to pull together there, it may not heal well. Leg injuries, rarely scar pretty either. I’m just planning to take it as easy as I can until my follow up appointment in 2 weeks.

Pretty long incision scar on my leg.

She followed my natural “wrinkle” lines…Oh joy.

Definitely going to have a lot of bruising with the chest site, it was already starting to change color.

Overall, we were there from 11am until 4:30 pm. I am exhausted. I hurt everywhere. I have a horrendous headache I guess from the pressure and tugging on my forehead, I don’t know how I am going to sleep tonight, or even if I will be able to. I’m not supposed to move much, or put any pressure on my leg for a minimum of 48 hours. My pain meds aren’t really working and I still know that I have more of the battle left to fight, I have so many superficial areas that I’m hoping to speak to my dermatologist about next week and see about having PDT treatments done. Through it all though, I am thankful that it wasn’t worse. I am thankful for my mom being there with me today, even at my age, I still need my mom. I am thankful for my  church family and all of the prayer warriors that were praying so vehemently for me today. I am thankful for sweet friends who are offering to bring my family dinner and asking how they can help, if you know me, you know I never ask for help, but this time I am accepting and I can not thank them enough! I am thankful for a Father who will not leave me, who knows His plans for me and has provided me with strength to not be afraid and continue confidently through this battle, my battle is also the battle of so many others and it brings me comfort knowing that by sharing what I am experiencing, that maybe I am providing a little peace to someone else.

5 days post op MOHS shoulder surgery

So the bandages came off on Friday evening, the steri strips were still on so it was hard to tell anything other than it was pretty swollen. As far as pain goes, this seemed to be a lot more painful than my previous MOHS procedures on my face. My assumption is that I use my shoulder quite a bit more than my face! Anyhow trying to stay still has been a challenge to say the least. I took Wednesday and Thursday off from work and tried an attempt at going back on Friday which didn’t go so well. By lunch time I was in some serious discomfort and went back home to take some pain medicine and plant myself back on my sofa. 



2 days post op-bandage removal

Saturday my family and I headed to the Houston Livestock Show and Rodeo with the kids. If it weren’t for the fact that my aunts from Alabama were in town, I probably would have opted not to go.  Overall, I felt ok, I was achy sore, and tired but most of all I was more concerned about being in crowds and being bumped! Fortunately that never happened. 

This morning we changed the bandage again, this time the steri strips were starting to peel away. After a nice hot shower they came comepletely off and we were able to truly see the incision site. Overal the stitching looks great, I was a little surprised by the overall size of it and concerned about the amount of swelling that is still there.  It is also still fairly bruised., which is to be expected after all of the pulling and tugging on my skin when he was putting me back together. I’m starting to feel a little like Frankenstein! 







So anyway, just wanted to share an update on how it is going and if you are facing something similar I want to let you know it’s not as scary as it seems! It’s definitely not a fun experience and having to sleep on only my left side really sucks….but as they say, “this too shall pass”. 

Deja Vu

As most everyone knows, I have been battling skin cancer for quite a few years now.  In my early 20’s I had my first basal cell carcinoma removed off my back.  I also went through, laser treatments, freezing spots, trying various creams, including a chemotherapy based medication, and also participated in a photodynamic treatment at MD Anderson.  3 years ago, I had MOHS surgery on my face, to remove a spot from my nose and from my upper lip.  I blogged and documented the entire procedure here with the goal of educating other people who may be facing the same situation.  I also wanted to bring attention to the dangers of tanning beds and how important it is to protect your skin.  I was featured on MD Andersons webpage and even had Good Morning America feature me in a piece they aired on skin cancer.  I started an airbrush tanning business and constantly posted about recognizing skin cancer signs, using sunscreen, staying out of tanning beds…ect.  I stayed on top of my spots, I went to MD Anderson and stood BUTT NAKED in front of one of my closest friends and 3 doctors and had my body scrutinized from top to bottom, only to learn I had 22 lesions, and even questioned as to whether or not I had ever lived near a radiation plant.  I treated my spots with Tazorac, hoping to see them disappear, a few did but for the most part, it definitely wasn’t enough.  Which leads me to where I am today…

I had a particular lesion on my right shoulder.  It had been there for some time.  Maybe 2 years, possibly 3.  It started out small and red, and eventually grew much larger and became angry, scabbed and never really healing.  I often stood in front of my closet staring at the cute tanks and sleeveless tops that I couldn’t wear, I was so self conscious of the disfiguring growth that was beginning to get worse and worse.  Finally one day I realized that I could no longer put off what I had been dreading doing since my last MOHS experience.  I located a new doctor, this time at the Skin Surgery Clinic in The Woodlands, we met and agreed it was time to start “cleaning” me up as he said.  I made an appointment to have a mini face lift, um, I mean 3 basal cells removed from my forehead for the end of March and went on my way, thinking we could deal with my shoulder and chest and arms and back and lower legs later…oh how wrong I was.

This is what my shoulder looked like this past week, and this was on a good day….IMG_1965

For the most part, it stayed flaky, scabby and sore…it itched like crazy and I felt it all through my shoulder, which was a little worrisome.  My doctor and I decided that it was time to go ahead and get this one off.  He was able to fit me in his schedule and I was arrived at his office yesterday at 1pm, fully anticipating an easy, one cut, clean lines and stitch and go.  I think I was in denial.

A brief description of how MOHS surgery works.

The Mohs technique consists of meticulously removing cancerous tissue one layer at a time. After removal, the specimen’s surface area is examined under a microscope. If there are any cancer cells seen at the outer edges of the specimen, more of the surrounding tissue is removed and the process is repeated until the sample’s margins are examined and come up OK.

If, on the other hand, no cancerous cells are found on the outer edges of the tissue, only a small wound is left. This technique eliminates the guesswork from determining tumor margins, and is less likely than other surgical techniques to damage healthy skin that surrounds the lesions. Its precision is especially valuable for recurrent or aggressive skin cancers, and for high-risk lesions (such as those near a facial nerve). It also boasts the highest reported cure rate and lowest recurrence rate for basal and squamous cell cancers.

After, removing the first piece, which was the entire tumor including the surrounding the margins, I was left with an open wound about the size of a small egg.

image2(1)

The procedure itself took about 10 minutes, once again, it wasn’t painful (I had been thoroughly numbed with Lidocaine first) but there were some uncomfortable parts, tugging, pulling the feeling and sound of the cutting and the worse part the cauterizing, nothing is more disturbing than smelling your own flesh burning.  I will never be ok with that!  They then took the sample to the lab where it was studied for clean margins.  After about an hour the results were in…he didn’t get it all, and would have to make a second cut.  So once again, more numbing, more slicing, although this was a much smaller piece.  More waiting and then the results, he didn’t get it all.  Third round, more numbing, more slicing, more waiting…and then the results, he didn’t get it all.  At this point he sat down to discuss options.  The cancer had spread.  He described it as miniscule, hair follicle size tumors that were spreading like seedlings throughout the skin on my shoulder.  My options were to leave the last spot and close, possibly with a lateral incision, OR go back for another, slightly larger slice and try to get the rest.  This would result in a more difficult closing technique, leaving me with a larger “Y” shaped incision.  Of course, I just wanted it all gone…FOREVER.  So back under the knife for the fourth time of the day.  This was the wound after he removed the larger portion.

image1

At this point, the office was closed and the nurse, the doctor and I were the only ones left.  We joked and talked, keeping my mind off of the severity of this MOHS procedure.  The sample was taken to the lab and this time, finally, came back with clean margins!  All of the cancer was gone! Now came the hard part, how to close this up.  My doctor is a perfectionist, he promised and I fully believe that he was going to be meticulous in his stitching and his goal is a hairline scar, however, a lot of that will depend on how easy I take it on the use of my arm.  My right arm. The one I use everyday, for everything.  This is definitely going to be a challenge over the next 2 weeks.  14 days in stitches, lots of soreness today and lack of sleep as I don’t really know HOW to sleep.  Overall, it’s not a bad incision, the stitches were the worse part.  There isn’t a lot skin on my shoulders, imagine pulling a pair of shoelaces as tight as you can and then imagine pulling them even tighter, that is what it felt like as he tried put me back together.

image2

The moral of this story of course is take care of yourself, love your skin, KNOW your skin and don’t be like me, if you have a suspicious spot, just go get it taken care of.  I put this off for way too long and paid the price.  I’m fairly certain that my doctor and I are going to become great buds, we will definitely be seeing a lot of each other over the next few months as we rid my body, the best we can of the basal and squamous cell skin cancer that is trying to take over.  I’ve got news though, I won’t be beat, it may suck and it may not be easy or pretty, but I won’t give up until I have won.  So if you are facing MOHS or fighting the same fight, just remember to keep moving forward.  Kick it now!  And if you know someone who is still using tanning beds, stick this blog in their face! Show them these pictures!  Show them my previous experience, scare the mess out of them…because we all need to really love and take care of the skin that we are in.