Tuesday, August 30, 2016

Well *that* was fun. Basal-squamous carcinoma excision, graft, and repair.

You know how you hear about those people who notice something odd on their skin and ignore it, waiting months – or even years – to have it looked at by a dermatologist? Well, that wasn’t me.

Until now.

Knowing that I have something called Dysplatic Nevi, I am at my beloved dermatologist at least every six months for a full body mole check. I’ve had lots of resulting biopsies, but never a cancer diagnosis.

Until now.

My last mole check was in May and was I given a happy “all clear, thumbs-up.” A few days after my appointment we went camping and took a few photos.


Do you see anything on my nose?

May 13-A

I don’t. And neither did my dermatologist. Thus the all-clear.

We had quite a few out of town guests this summer, and we went on vacation, so I have a steady stream of photos. Let me know when you notice anything on my nose.

June 6-A

June 6th. Nada.

June 7-A

June 7th. Nope.

June 12-A

June 12th. Hmmmm, maybe a tiny bit of dimpling? Maybe?

June 13-A

June 13th. I don’t see anything. Do you?

June 25-B

June 25th. All I see are freckles.

July 9-A

July 9th. I think I see something. But certainly not enough to concern me. I didn’t give it a second thought – especially because we were on vacation (in the sun, along the Oregon Coast).

July 10-B

July 10th. Yeah, there’s a little nothing of a bump.

July 12-A

July 12th. Yup, there’s a little something there. It didn’t even occur to me for a second that it could be something – and keep in mind that I’m hyper-vigilant!

July 13-A

July 13th. Even with the sun shining right on it, it’s barely noticeable!

July 23-A

July 23rd. AHA!! In those 10 days, the little “pock” started to bleed just a little.

I called the doctor on the morning of July 25th and was seen that morning, due to a fortunate cancellation. I told Dr. Voss that I called it “my little Molakai” because it was sort of a small rolled half circle under my skin. The minute Dr. Voss saw it, she said, “Yeah, this could be something.” And it was!

She took a little cone sample. No big deal at all.

July27-Post biopsy

At that point, I fully expected that it was cancer and wasn’t surprised at all when I got a call a few days later to confirm that it was a basal-squamous cell carcinoma. An appointment was made right then to have it excised. Dr. Voss is a cosmetic dermatologist, known for her great surgical and repair abilities.

But I had to go all Dr. Google and decided to opt for a Moh’s procedure followed by plastic surgery instead. Dr. Voss is trained in Moh’s (I learned later) but chooses not to do this method. Although both Moh’s and excision have cure rates in the mid-to-high ninety percent, Moh’s rates are very slightly higher, so I figured I go that route. Due to the nature of the procedure (removing a layer, testing it, removing another layer, testing it, until margins are “clean”), Moh’s potentially takes quite a few hours. Then I’d be put under general anesthesia that afternoon for the repair, done by a partner plastic surgeon.

The consult call with the surgeon was a nightmare! He began the call with “Wouldn't it have been nice if we’d met at Whole Foods, you looking for peanut butter and I looking for jelly…” The he called me “hon” and “babe” repeatedly. I was looking for a good surgeon, not a date! To make things worse, every time I asked a question he was belittling and condescending and treated me like I was some bimbo. (Ya know, every great once in a while I just want to throw the whole “I have a graduate degree, summa cum laude, from Stanford University; you can talk to me as if I understand” thing in people’s faces!) I hung up the phone and dissolved into tears. I did not want that surgeon near me! But I resigned myself to it because by then all the plans were in place.

Two days later I found another suspicious mole and headed back to Dr. Voss, who asked why I’d cancelled the original appointment for the excision. I told her the whole convoluted story – at which point all four eyes were rolling!

Long story short (because the anesthesia is wearing off and I want to lie down), I cancelled the Moh’s and plastic surgery and Julie Voss did the excision today. It was a relatively quick procedure, in which she dug out the cancer (and then some, to be safe) and grafted some skin from near my ear to repair the resulting crater wound. No general anesthesia (but lots and lots of local anesthesia because, you know, I’m a redhead!), Queen and the Stones playing on the radio, and conversation as if we were all having coffee together! It was a perfectly pleasant experience! (Keep in mind, I’m still numb as I write this, so….)

Wanna see photos? OK, take a breath!


Dr. Voss and me, pre-op. She had hoped to do some “flap” procedure, but when she saw the actual size of the cancer – mostly subcutaneous, thus the lack of external signs till very recently -- she decided she’d have to graft instead.


We’ll operate right… here.


I have no idea why it’s covered up!


Maybe to keep it moist while they harvested some skin from near my ear?


Malakai is now a crater!



Ta da! I have a honkin’ bandage on my swollen face, and will for a few weeks, but I’m glad to put all this behind me.


Yes, there is a miniscule chance that she didn’t get all the cancer, in which case she’d need to go back in, but she said she’s confident she got it all. The pathology report should confirm that.

The lesson for you? I’ve been yelling it from the rooftop for years: never ignore anything suspicious on your skin! If in doubt, get it checked! Please. Mine was an “iceberg, not an ice cream cone” -- in other words, mostly under the surface, not above the surface. Can you imagine if I’d ignored it?!

If you’ve been meaning to get that mole checked, please promise me that you’ll make an appointment right…



ADDENDUM (September 14, 2016, 15 days since surgery):

Best things first: The cancer is GONE!  The lab result from the surgery indicates “no residual basosquamous cell carcinoma identified.”


Here are a few photos of the healing process. Faces sure heal quickly!

1 day post-surgery: Nice stitch job. Dead-looking graft.


2 days post-surgery: Still no blood supply to the graft.


3 days post-surgery: Look – a blood supply has begun to establish itself!


4 days post-surgery: I puffed up! So swollen!


5 days post-surgery: Less swelling, a bit smoother.


1 week post-surgery: Swelling is gone. Suddenly the wound isn’t so blatantly obvious.


9 days post-surgery. Looking pink… and scabby. No more Band-Aid!


12 days post-surgery. A bit smoother.


13 days post surgery. The scab came off!


15 days post-surgery. A bit scabby again, but I went to a workshop today and no one even mentioned it!


I have an appointment to have a CO2 laser treatment next month, but I’m thinking that I might not even need it – especially since it costs $500 and insurance doesn’t cover it.

I’ll try to remember to post an add-addendum at some point down the road. If I forget and you’re curious, let me know!

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dferrier said...

Just had an appointment this afternoon. Routine and everything was fine but better safe than sorry. Thanks for reminding us all to be vigilant. Don't want cancer for a 2nd time! Hope you recover quickly.

Margaret said...

I'm glad it's taken care of, Carol, and you can now start to heal. xoxo

Carol said...

So glad you went. And so glad all is fine!!

Renate said...

I had something similar happen to me. I had this little red dot on the side of my face for quite a while and didn't make anything of it even when it started bleeding once in a while. Upon insistence of my Hubby (who had several skin cancers and Melenoma) I went to see his dermatologist. Sure enough, it was cancer and I now have a two inch scar on my face. After several months now it is hardly noticeable.

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