Welcome to Part 3 of the Skin Cancer Series! This post is going to be all about my experience with Mohs surgery, and how it cured my basal cell carcinoma.
If you haven’t read Part 1, about how I got diagnosed, check that one out first. Then we had Part 2, which was about the options I was given for how to cure my basal cell carcinoma. Part two includes a brief overview of Mohs surgery, so check those before reading this one.
After my first consultation with Dr Yiasemides, I knew I wanted to go with Mohs surgery. I liked that Mohs surgery has a 100% cure rate – the cancer is completely gone after the surgery. I scheduled a surgery with her for a Monday and we scheduled the reconstructive surgery with Dr Sjarif for the Thursday of the same week.
I was told that on the day of my surgery, I’d need to be available all day, to be able to make as many cuts as necessary to remove all of the cancer. In Mohs surgery, the doctor will take the least amount of skin out, so as to incur the smallest scar and the easiest reconstruction surgery. This is why the procedure usually involves more than one cut.
Getting Mohs Surgery
The day of my surgery came quickly. I arrived at Dr Yiasemides office at 7:30 am, ready for surgery. I was given a hospital gown to wear over my clothes, and a little blue hair net to keep my hair out of the way. I put on my medical gear, and the nurse escorted me into the surgery room.
I was given a local anesthetic to numb the area which would be cut into. Because I would need to be moving around in between cuts, the patients are not put under full anesthesia during Mohs surgery. This meant that I was awake and aware during the entire surgery.
The nurse asked me how much information I wanted to know about the surgery before we started. She mentioned that some people like to take photos or videos while they are getting surgery – I told her I wanted to know the least amount possible, and I definitely didn’t want to see it happening. I’m not the greatest with blood, especially when it’s my own.
I was fully numbed as the doctor started to cut into my forehead. I couldn’t feel anything except the pressure of her hand against my head. I was grateful that the doctor and nurse kept up a conversation with me that was not around the surgery going on just above my vision. The cut was over quickly, just about 15 minutes after I arrived to the surgery room. The doctor finished by using a machine that sounded like it was freezing the area that she cut into. The machine made noises and smells that I was not a fan of, but it stopped the bleeding enough to bandage the wound.
I was given a new hair net and cleaned up before being escorted back to the waiting room where I was allowed to sit with Michael. For the patients who didn’t have someone with them, there was a recovery room full of snacks and magazines. While we waited to get the results of the first test, the nurse brought me a muffin and a black tea. I was a mess during this time. I tend to cry when I am nervous or very stressed, and there were a lot of tears on this day. I am so grateful to the nurse who helped me be brave; she’d even held my arm for support as I was getting my first cut.
The results didn’t take long, and less than an hour later the nurse came back to tell me that the edges of my sample tested positive for cancer. This meant I needed to go in for a second cut. I walked back into the surgery room with her, grateful that the cancer was going to be gone by the end of the day, but dreading going through the process again.
I was given another few shots of local anaesthetic. The doctor told me that they use two types of anaesthetic, one which will last about an hour and a half and is really strong – this is mainly used to ease the pain during the surgery. The second anaesthetic lasts about six hours, and will help avoid pain for the remainder of the day.
The second cut felt like it went much quicker than the first, maybe because they cut less or maybe because I knew what to expect. The machine which stopped the bleeding was used again, and then I was cleaned up, given a new hair net, and escorted back to the waiting room to wait for my results.
Another hour later, the nurse came back in and escorted me to the surgical room to wait for the doctors results. The doctor arrived and told us that the edges of the second sample came back negative – I was cancer free! I was very relieved that I wouldn’t have to do another cut, and happily laid back in the chair so that the nurse could put a more permanent dressing on my open wound.
Mohs Surgery: Recovery
The doctor and nurse gave me instructions to take Panadol (an over the counter pain medication made in Australia), and gave me a prescription for a stronger painkiller to take when necessary. The dressing was to stay on until the reconstruction surgery, and my only instructions were to not wet it.
For the next few days, I washed my face using only a washcloth and I avoided washing my hair completely, as I didn’t trust myself to go under the shower and not get the bandage wet. By Thursday, my hair had gotten completely gross, and Michael helped me wash it with a watering bucket that we use for the plants, while I sat in the bathtub holding the bandage to ensure it didn’t get wet. That actually worked really well, and though it was the same day I was going in for my reconstruction surgery, I actually ended up being very glad that I did that.
I noticed the day after my surgery that the top of my head was still numb. I was told that during the reconstruction surgery, I may lose a few nerves, but I wasn’t sure if I would also lose feeling in my head from the Mohs surgery. The nurse called to check on me the day after I had Mohs surgery, and when I told her about the numbness, she told me it is normal to lose some nerves in the surgery. The nerves on the top of my head could take months or years to grow back and regain feeling.
Aside from resting, taking my medication, and avoiding getting my bandage wet, there was not much that I needed to do in recovery from Mohs surgery.
Mohs Surgery: The Final Result
After I had my final cut and was given my dressing, the doctor told me that it was a good choice I’d gotten Mohs surgery. Though you could see the pink scar-like skin that was cancer, the skin around that had actually grown to be cancerous as well. This meant that the actual area of cancer on my forehead was much bigger than expected. The original guesstimate was about 1 cm diameter of a circle, and the actual cut ended up being about 3.5 cm in diameter. This meant that had I chosen to get a standard procedure done where the doctor would cut out everything he thought was cancer, I would not have been fully cured. When I went in for the reconstruction surgery that Thursday, Dr Sjarif told me the exact same thing – he would not have cut that much out, as it didn’t look cancerous.
Stay tuned for the next part of the Skin Cancer Series: The Reconstruction Surgery. This is the big surgery in which Dr Sjarif works his magic to stitch up the 3.5 cm hole in my head while somehow managing to keep my face from looking any different. The reconstruction surgery is the grand finale of the skin cancer series.