Mohs Surgery - 2 Months later

I feel that I have been unfair to my surgeon. Maybe even unfair to some of you that care about me. The surgeon did such a great job of putting me back together that I am truly surprised. Pleased, but surprised.

I haven't posted anything about the Mohs Surgery since day 9 post surgery. I would like to explain it away, I've even been able to fool myself and say it's not that important. As the scar heals I can think a little less about the fact that I had skin cancer. Next month I have a follow up appointment with my dermatologist. So today I will think about it again. Face it for another few minutes anyway.

I took a photo a few days ago. You can see that the scar is healing much better. If you didn't know it, and don't look too close, it's hard to even see the scar. The people that see me regularly don't even comment on it anymore. I have never been worried about how my photo would look on the cover of GQ Magazine. They've never called me. So another scar isn't going to kill me. Much better than the alternative.

The truth is that I really like the photo that I took of myself. If you'll allow me to geek out for a second I used my Nikon D600 with the Nikkor 180mm F/2.8D. Nikon SB-600 flash off camera to the left bounced off of the ceiling. That 180mm lens is by far the best portrait lens I have ever used.

Okay back to me. Here is a close up of my nose. You can certainly see the scar. And the skin is a little uneven. I know they can fix that it I ask them to fix it. I just haven't decided if I will let them or not.

I've noticed that I don't go out in the sun like I used to. It's putting a damper on my landscape photography. It's hiking season here in Arizona. I haven't been out for a decent hike yet. I find myself being drawn to places with less sun light. I am even positioning myself to try a new style of shooting. If it works out I will tell you about it. I'm not sure how to go about getting out of this. I have a trip scheduled for work next week and I am hoping to get to do a little hiking and catch a sunset. I have good sun screen now. I even use it on the rare occasion that I go out in the sun. I tend to pay particular attention to my nose. Do you think that is odd? Who knows! For now I will plan my next adventure and wonder to myself: "Can the dermatologist do anything about the bags under my eyes?"

Early morning alarms. The Million Vet March and the Susan G Komen Race for the Cure.

The alarm clock on my phone went off at 4:25 AM this morning. All week I have been looking forward to joining some of my fellow military veterans in the Million Vet March. The Phoenix version was scheduled to be held at the Wesley Bolin Plaza near our state capital. Our purpose? We want to show our displeasure at the President and his administration for shutting down open air memorials.  I have an apprentice working with me this week. Even though he hates getting up early he is interested in going to witness this event as well.

 At 6:15 I picked up my friend at his hotel and we headed downtown. When we got close to the plaza I noticed a larger than normal amount of people wearing pink. Because of my day job I am usually more aware of pink and what it represents. I usually know where large groups of people will be gathering wearing pink. I missed it this weekend.

Breast cancer survivors and their supporters prepare for the race to begin.

I had heard that the Susan G Komen Race for the Cure was this weekend in Phoenix. Normally I would be interested in participating. I've been so busy and self absorbed lately that I missed it. I missed everything. I had no clue. The start line was at the Wesley Bolin Plaza, and the plaza was full of people wearing pink.

The veterans weren't going to be marching on the Wesley Bolin Plaza today.

 My friend and I walked through the plaza. It always makes me feel good to see the number of people that are willing to help a cause as worthy as this one. Tens of thousands of people are walking in the race today. The number of volunteers for this event is staggering. Even more than that, it is heart warming.

I can't begin to count the people in my life surviving or fighting to survive a diagnosis of cancer. Many of them are in this plaza this morning volunteering. It makes me feel a little ashamed at my reason for being there.

I went home and brewed another pot of coffee, turned on the TV, and watched the race at home.

Early detection is the key to survival. Please go get screened for whatever is appropriate for you. Breast, cervical, prostate, colon, skin. Whatever! Go get screened, for yourself and for those of us that love you.

Mohs surgery recovery - day 9

I haven't said much this week. There isn't a lot of physical change from day 2 until today. The eyes turned a little puffy and black. Then they turned a great shade of grey. I halted my workouts for the week and a half the stitches were there so I wouldn't rip them out of my nose. The last couple of days I could tell that the stitches were ready to come out. That is exactly what the doctor said when he looked at me. "Oh yeah, those are ready to come out." He went to work removing the 30 stitches from my nose while I sat there smiling inside. The anticipation building. Wondering what I will look like with my new nose. Janice has told me that it looks more straight since the surgery. The slight bump is less pronounced. I can't wait to see it.

With the stitches removed, the doctor and nurse gazed at my nose in wonder at their handy work. Then the doctor cleaned my nose with a pad and applied some tincture of benzoin and three steri strips.

I'm not going to see my nose today.

In a few more days they should fall off and. I think it is slightly more attractive than the stitches were. The stitches were very irritating for the last couple of days. There is still a little swelling above the suture site. I think it is going down already since he removed the stitches. I know it will take a long time for the physical scars to heal.

I receive more and more questions about what happened to my nose. I am often amazed by the people who have personally been affected by, or know someone who has been affected by skin cancer. Some of them know what happened without even asking me. The bagger at the grocery store high fived me as I left after I explained that the surgeon was sure he had removed it all.

I find being able to tell my story helps me. I still have some feelings to sort out. Hopefully I will be able to do that soon. I'm hoping to talk about other things in the near future, with occasional nose updates and reminders about getting your skin checked by a professional.

Mohs Surgery Recovery - Day 2

Day 2 since the surgery. If you are reading this in anticipation of having Mohs surgery please don't hesitate to have it. I am sure we have shared some of the same concerns (read: FEARS). I feel so much better even just two days after the surgery.

I got out of bed this morning with high hopes. I slept a little better last night, which is always good for your disposition. And the sharpness of the pain in my face seemed to have dulled a little. I didn't look as bad yesterday as I thought I would. And this morning wasn't too bad to start with. I showered and washed my face. It was a very gentle face wash to be sure. But I cleansed my wound, got dressed and headed out to work.

I stayed at my first customer's office right up until my nose started oozing. The doctor had warned me it would happen. I think that I was expecting to bypass that part of the recovery. Some pressure stopped the bleeding so I didn't get concerned about it. As I went through the morning I noticed that the dull throb had spread out from my nose to under my eyes. I wasn't very surprised when I checked the mirror and found my face swelling. The doctor had also warned me to expect that. Although he thought it might happen Friday. I am a little surprised that the swelling is enough that I can barely breath through my nose. It's not unpleasant, just weird.

One of my friends (you know who you are) kept calling me boxer today. It certainly looks like I've been fighting. I'm expecting to look worse tomorrow. But I believe it is a positive thing. It's part of the healing process. And even more important is that it means that the cancer is really gone. The closure looks really good when it is clean. I think the scar is something I can live with. Much better than the alternative.

Healing provides a powerful boost to your attitude. Now I have an odd curiosity about how bad I will look before I get back to normal. I can't wait for the kids to come home tonight so I can gross them out. Until then I will be grateful that my wife kept after me to get my skin checked. I encourage all of you to get a checkup. And don't forget to pack and use sunscreen.

Mohs Surgery Recovery - Day 1.

So the surgery was yesterday. The past 24 hours or so has been an interesting little journey. The emotional aspect was something that I hadn't expected. Janice and I were both exhausted when we finally settled down last night. I don't think either one of us expected terrible news yesterday. It's just not common with basal cell carcinoma. You really don't know until the day of the surgery. So even though we kept telling each other that it wasn't probable we knew deep inside that it was possible. The news that he was able to remove all of the cancer without taking all of my nose was fantastic to hear. I also found that I was much less concerned about my appearance after I got home. At least until the bandage came off this morning. It's not exactly what Janice wants to see first thing in the morning.

"Hey Honey! How does this look?"

I learned a few things about my body last night. First, the skin on my head is much more loose than I imagined. As I lay my head on my pillow it pulls on the stitches on my nose. In other words, my nose hurt all night. So I tossed and turned all night as it hurt. They don't give you pain medication for Mohs surgery. So Tylenol is my friend this week. I push the hours between taking it. But it hurts right now so I will take some soon.

When I first took the bandage off this morning it really didn't look too bad. But as the surgeon promised, it is swelling throughout the day. And the color is turning a little darker. And it still won't stop throbbing. I have learned more about neosporin and polysporin than I really wanted to know. My doctor was very specific in recommending polysporin. They actually advise against neosporin.

Summed up day one is relief, swelling and pain. Tomorrow I will go back to work. I'm going to try and take it easy but I know that is a tough promise to keep in my line of work. One more photo for you.

If you start protecting yourself young you can prevent this. Hats, sunscreen properly applied, they both help. If you're like me and didn't take care of yourself make sure you get a regular checkup. You know what, get a regular checkup even if you did take care of yourself. It can't hurt. Early detection matters.

Mohs Surgery

First a warning: I have added some photos that may be distasteful to some of you. I hope that they will encourage all of you to protect yourself from the suns rays. And please go see a dermatologist.


I woke up this morning anxious to get to the doctor and get this stuff out of my face. Coffee, always first on my list poured into one of my favorite mugs. Perhaps a little ironic that today it is this mug I drink from. Pink for breast cancer. But today it is my skin that we think of first.

Janice and I got to the doctor's office. We are strangely quiet. I think we both feel the stress of what today brings. We got to the office early but sat in the car, both of us quiet as we think about what will pass today.

Janice had packed a survival bag of computers and such, but I don't think she ever opened it. My appointment was scheduled for 8:00 AM as they allow for an entire day to complete the surgery. It was pretty close to 8:00 when they called me back and prepared me to see the surgeon. As I sat in the chair I stared at the light. Knowing that it would soon be shining in my eyes.

The surgeon is about my age and a very pleasant man who speaks easily about many subjects. He made sure that I understood the surgery then prepared to go to work.

Mohs surgery is done in stages. The idea is to get all of the cancer while leaving as much of the healthy cells as possible. So they start by taking a layer of skin and cells then immediately looking at it in an on-site lab. As they were preparing and looking at the first cut I went to the waiting room to sit with Janice. She was unwilling but took a photo of me as we waited for the results of step one.

The surgeon said I was lucky. As long as the cancer had been there it hadn't spread beyond what we saw. Him and I both had been prepared for a long day of steps to remove the cancer. One was all that it took. So my next session in the chair was to close it up and try to minimize the scar.

I've called my doctor a surgeon throughout this today. The truth is that he is board certified in both surgery and dermatology. So he performed the Mohs surgery, which is normally done by a dermatologist, and he performed the closure which is often done by a plastic surgeon.

No matter how much I begged he couldn't make me look like Robert Redford. Janice is a little upset at that. But in time I should at least look more like myself. And he did get rid of a few of the wrinkles in between my eyes. I'm having some pain this afternoon. And it is hard to get ice anywhere close to my nose. But I feel pretty lucky right now. The cancer is gone. My face will mostly recover. And I have a lot of friends and family who have been here to help me. For that, I am the most thankful.

The chances of getting shin cancer again are increased for me. So I promise to get checked regularly. I also promise to reduce future damage by using hats and sunscreen. I hope you will all do the same. For no matter how much fun I made this seem, it wasn't fun. Not at all.

It's my wife's fault.

That's right. My wife, Janice, is the one responsible for me finding out that I have skin cancer. More precisely I found out that I have basal cell carcinoma. If you have to choose a cancer this is the one that you would want. At least that is what I understand after reading everything possible on the subject. That might be an exaggeration but you get the idea. Here is how it happened.

For quite a while Janice has been bugging me to get a mole on my back checked. A few weeks ago I had a little discomfort in my scalp and I decided that it was finally time to go see a dermatologist. The dermatologist that I knew and liked was out on maternity leave so I found another office to go to. The mole on my back, well it is just a mole. My scalp is fine, a little sun damage but nothing remarkable. A sample from the spot on my nose was taken for biopsy. That spot has been there for years. The previous dermatologist that examined me wasn't concerned about it. Of course my last visit with her was a few years ago so it's possible that the spot has changed. In any case that spot is the cancer.

When the office called to give me the results of the biopsy I was a little shocked. First I was shocked that it was a carcinoma. I knew it was possible but I didn't really expect it. Second I was shocked that they broke the news over the phone. Sure it is just basal cell carcinoma, but it is still cancer. And frankly it was a little disarming to hear. She wanted to schedule a procedure to remove it right then. I had to tell her that I would get back to her. I wasn't prepared to do anything. I needed more information. A lot more information.

They recommended Mohs surgery to remove the cancer. In Mohs surgery the doctor removes a layer of the area then checks the margins of what they removed for cancer cells. This is repeated until the cancer is gone. Then the area is repaired. Sometimes the repair is done by a plastic surgeon. Mohs surgery is largely successful in treating my kind of cancer. Unless something very unusual happens I should know I am cancer free when I leave the doctor's office.

The spot on the bridge of my nose is about the size of a dime. Of course I don't really know how big it is under the surface. It is impossible to tell until they get in there. I do expect to lose a pretty big chunk of skin on my nose. Which really brings up the second worst of my fears right now. A large ugly scar down the bridge of my nose.

I typically dress respectably and I don't consider myself unattractive. Perhaps not attractive enough for the cover of GQ Magazine. But I spend a lot of time in front of customers. Some I know well. Others I don't know at all. A certain amount of self confidence is important. I am concerned about the damage to my self confidence if I end up with a nasty scar on one of the most prominent features of my face (my mother insists my nose isn't big, I think it is a little large). This concern seems valid, at least to me.

Since the initial shock I have been trying to keep all of this in perspective. I did this to myself. I estimate that I played between 350 and 400 rounds of golf here in Phoenix, all without sunscreen. Not to mention afternoons by the pool and hikes through the desert. And summers fishing in Alaska. And really, this is most likely nothing and will end with at the most a scar on my nose. I hope!

It does mean that I will need to be more vigilant about checking myself for unusual looking things on my skin. I will also have to be a lot better about using sunscreen. In fact, I cancelled my plans to hike by the lake this weekend. I have postponed any future hikes until I find a sunscreen with a SPF of about 5,000. I am guessing that I will need a SPF that is something closer to reasonable as my nose heals. But you can be sure that sunscreen will be a part of my pack from now on. And I will use it.

The surgery is scheduled for this Tuesday. I'm sure glad Janice kept after me to go to get the examination. I should have listened earlier. I will concentrate on keeping my sense of humor in tact through all of this. After all, isn't laughter the best medicine?