Welcome to Part Four of the Skin Cancer Series. This post will be all about my reconstruction surgery.

In Part One of the Skin Cancer Series, we talked about how I was diagnosed. Part Two was all about options to cure basal cell carcinoma. In Part Three, I discussed my experience with Mohs surgery. Which brings me to Part Four, the reconstruction surgery.

Skin Cancer Basal Cell Carcinoma Recovery

After getting Mohs surgery on my forehead and resting at home for a few days, it was finally the day to get my reconstruction surgery. On Thursday, January 17, 2019, I was scheduled to arrive at the hospital at 12:30 PM. Michael drove me to the hospital with the bandage from my Mohs surgery still on my head. I checked in, and got taken into the in-patient ward. Here, I was given a hospital gown to change into and a hospital bed to lie on. I got in my gown and hopped in my bed. Michael kept me company until it was time for me to go. 

Reconstruction Surgery: Preparation **WARNING: GROSS PICS COMING** 

After a bit of a wait, my hospital bed and I were wheeled down the hall to the day surgery waiting room. Here, I was given a hair net and was checked in again. A short bit later, my doctor came over to look at the cut from the Mohs surgery. He reconfirmed what Dr Yiasemides said; it was a smart choice to get Mohs. He was surprised at the size of the cut. My doctor and his assistant went over the game plan with me. They told me how they would cut my head open to get the best possible result cosmetically, and be able to get the wound completely stitched up. 

My doctor told me that they would cut across the top of my head, from the middle of the right side of my head until the area of the left side where the cut was. From there, they would cut into the Mohs cut and down, forming a sort of “Z” pattern on my head. 

The anaesthesiologist came by to explain to me how the anaesthetic would work. He poked a needle into my arm to prep the drip, and soon enough I was being wheeled into the operating room. 

As soon as I arrived in the operating room, I was hooked up to the anaesthetic and within less than 5 seconds was completely knocked out. The next thing I knew, I was waking up in a waiting room with other people in hospital beds, all of them either knocked out or waking up from anaesthetic. 

Reconstruction Surgery: After 

A few minutes after I woke up, I was wheeled into a recovery room. Michael was alerted that I was finished with my surgery, and he met me in the recovery room. I was still a bit doozy from the anaesthetic, but the nurse asked if I wanted anything to eat or drink. She gave me a bottle of water with some painkillers, which I took right away. 

I was given another bottle of water with a sandwich (a vegan one!) while I waited to become more sober. I had a massive bandage around my head and felt doozy for about two hours after the surgery. 

My doctor called and asked if I would consider spending the night in the hospital. He told me that the pain from my procedure may be so intense that the strongest painkillers may not help. He offered to allow me to stay in the hospital overnight to be hooked up to an IV drip to be more comfortable. I am not a fan of hospitals, and really wanted to go home, so I decided to stay in the recovery room for a few extra hours and then go home. 

The nurse stopped by a few times to make sure I was okay and give me more painkillers when I asked for them. Who knew getting your head cut open would hurt so badly? 

She asked me to get up and walk around eventually, to make sure I was alright to go. I walked up and down the recovery room with Michael holding my arm. By 8 PM, I was heading out of the hospital, on my way home. 

Reconstruction Surgery: Recovery 

I went to sleep almost immediately upon arriving home. Surgery is exhausting!

The next day, I woke up with pain in my throat, pain in my head, and a swollen face. My eyes were puffy and swollen, my cheeks were swollen, and my throat felt like someone had shoved an oxygen tube down it (oh wait… someone did). I took painkillers consistently through the day as I facetimed my family and watched Netflix. After my 4PM nap, I looked in the mirror and saw my puffy face, now complete with two black eyes. I was a real beaut! 

Disclaimer: these photos are completely unedited and taken with my iPhone (I was not feeling up to a photoshoot with my DSLR but still wanted to document the process). 

I had the bandage on my head from Thursday post-surgery until Monday. I downed two Panadols every 3-4 hours during this time, and took the stronger painkillers (I was prescribed Endone) when I needed it. The prescription painkillers were the strongest that the doctor could prescribe, and there were times when I desperately needed them. They did the trick though, and helped me sleep. 

The black eyes were slowly starting to fade by Monday. By Tuesday, I was taking Panadol every 5-6 hours, and my black eyes were faded to yellow. The swelling and puffiness was gone by Monday, and the red, swollen inner corners of my eyes were starting to go back to normal. 

I had an appointment to get the bandage off my head on Monday. The doctor cut it off and told me to simply rub vaseline on the stitches a few times a day to help with the scarring. The doctor had closed my cut with a combination of staples, stitches, and dissolvable stitches. The stitches and staples wouldn’t come out until a week after surgery.  

The doctor took a photo of the cut that he stitched up, which he let me have – it’s a bit gory but shows how big the hole was. 

This covers my experience with the reconstruction surgery. Stay tuned for the next post in this series, all about recovery! 

 

Follow:

I spent about 24 hours in Nha Trang. I stopped here more as a means to break up the long journey between Quy Nhon and Da Lat. Nha Trang is a bustling city full of market stalls, coffee shops, and long stretches of white sand beaches. It contains a pleasant mix of locals and foreigners, and has everything you’d need in a city – temples, beauty salons, massage parlors, loads of stores selling snacks, food, and water, and of course that gorgeous beach.

Nha Trang, Vietnam

Nha Trang, Vietnam

The easiest way to get in and out of Nha Trang is by train. The trains in Vietnam are easy to use, comfortable, and in my opinion, the best way to travel through the country.

Nha Trang, Vietnam

I stayed in an airbnb in Nha Trang (no surprise there!) and made sure to pick a little room that was close to the beach. I spent my time between the coffee shop, the beach, and my apartment. During the summer, Vietnam gets so hot and humid. I like to take breaks during the day to head back into the air conditioned airbnb, take a shower, and freshen up.

Nha Trang, Vietnam

Going to the beach and eating loads of Vietnamese food were my top priorities in Nha Trang. I did well, if I don’t say so myself.

Nha Trang, Vietnam

Nha Trang, Vietnam

The white sand beaches are beautiful. Though parts of them can get really busy, walk a bit down from the hotels and you’ll find some empty spots. During the day, the beaches are a little less crowded. Around sunset they get much busier.

Nha Trang, Vietnam

Nha Trang, Vietnam

Nha Trang, Vietnam

Look out to sea to spot Vinpearl, an amusement park just outside of Nha Trang.

Nha Trang, Vietnam

Nha Trang, Vietnam

Nha Trang, Vietnam

Nha Trang is a beautiful place to spend some time in Vietnam. Though I usually prefer smaller cities and more nature, I enjoyed the beaches in Nha Trang and the plentiful fruit markets. I’d definitely recommend a stop while traveling through Vietnam!

Other Posts from Vietnam: 

 

Follow:

As part of our Rail Plus 10 day trip through Italy, Jess and I spent two days in Milan, Italy. This is what we did with 48 hours in Milan & Lake Como, Italy.

Milan & Lake Como, Italy

We arrived in Milan by train using our Eurail passes, and oh my gosh is Milan Central Station beautiful! Not only is the station insanely gorgeous, it also is home to a Rosso Pomodoro restaurant, which is my favorite pizza in Italy!

Once we arrived in Milan, we headed to our hotel, which was conveniently located just outside of the station. We didn’t have to carry our luggage too far!

Milan & Lake Como, Italy

By the time we got into Milan, it was dark, so we went for dinner at a local restaurant and had an early night to prepare for a busy next day.

Lake Como

The next morning, we woke up early, got ready super quick, ate at the buffet breakfast in the hotel, and walked back across the street to the train station to catch the local train to Como. The train from Milan to Como is just under an hour. This makes Como an easy day trip from Milan. We grabbed a seat on the train and watched the Italian countryside pass us by as we buzzed toward Como.

Milan & Lake Como, Italy

When we arrived at Como station, it was just about 10 mins walking to the city centre. We wandered for a bit before grabbing a local bus to the tiny town of Bellagio, one of the most picturesque towns on Lake Como. The bus ride took about 50 mins, and it was an exhilarating experience – imagine a bus driving the normal speed limit on a tiny, winding road, with oncoming traffic. Like I said, exhilarating.

Upon arriving in Bellagio, we hopped out of the bus and stared in awe at this tiny little lake town. The architecture, the colours; it’s absolutely gorgeous.

Milan & Lake Como, Italy

We even spotted snow on the mountains far away!

Milan & Lake Como, Italy

We took a little wander and stopped for lunch in an adorable little cafe called B Style Cafe. The lady who runs the store is also the owner, and she made some great suggestions for us. We both had different styles of fresh, local pasta for lunch. We finished lunch off with a dessert recommendation from the owner.

Milan & Lake Como, Italy

The dessert was a chocolate salami – not actually meat, it was a dense, thick, chocolate brownie type of dessert, rolled in powdered sugar. It was one of the best desserts I’ve ever eaten in my life – I highly recommend a stop here if you visit Bellagio!

Milan & Lake Como, Italy

We wandered around the little cobblestone streets and other shops for the afternoon. It was mostly a ghost town due to being off season.

Milan & Lake Como, Italy

We decided to take the ferry back for a change of scenery.

Milan & Lake Como, Italy

When we arrived back in Como, we strolled through the Christmas markets. We sipped mulled wine while the sun set over the lake.

Milan & Lake Como, Italy

Milan & Lake Como, Italy

After the sunset, we took the train back to Milan and had an early night.

Milan

The next morning, we woke up and had brekky before heading back to the train station. We got on a local train and went just four stops to the Milan Cathedral (aka the Duomo). This is one of the things I was most looking forward to seeing in Italy. I was not let down!

The cathedral is so big and grand, it’s truly mind blowing how stunning it is.

Milan & Lake Como, Italy

Milan & Lake Como, Italy

We walked around the galleria next to the Duomo. Next, we stopped in a cafe for a mid morning coffee and croissant. Then we tried to take in as much scenery as we could before we had to head back. We were on a schedule to check out of our hotel and catch the next train to Bologna.

Milan & Lake Como, Italy

Milan & Lake Como, Italy

We made sure to grab a pizza and prosecco on our way to the train at Rosso Pomodoro – a must do at Milan Central Station. Stay tuned for what we did in Bologna, and make sure to check out what we did with 24 hours in Venice!

Follow:

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. 

Mohs Surgery for Basal Cell Carcinoma

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

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. 

 

 

Follow:

Welcome to Part 2 of the Skin Cancer Series! If you haven’t read Part 1, where I discuss how I was diagnosed, I recommend giving that a read before diving into this one. Today will be all about the options I was given for getting rid of my basal cell carcinoma.

Curing Basal Cell Carcinoma: Finding A Doctor

Once my biopsy came back positive for basal cell carcinoma, I was immediately referred to a surgeon. My doctor referred me to Dr Adrian Sjarif. I made an appointment with Dr Sjarif and visited him soon after my diagnosis.

At my appointment, Dr Sjarif looked at my cancer and gave me a run down of the best options for me. He mentioned that surgery would give the best results, and we talked mainly about surgical options. He did mention that there were some other options, but none had as quick and as precise a cure rate. Surgery on basal cell carcinoma can yield up to 100% cure rate.

Dr Sjarif told me that because I am so young compared to most of his patients, it may be a bit more difficult to cut out all of the cancer and create the least amount of scarring. To remove the cancer involves two operations: the first will remove the cancer, and the second is considered a “reconstructive surgery,” which will stitch up the hole caused by cutting out the cancer.

To remove the cancer, I had two surgical options: the first would be a surgeon guesstimating the area of the cancer and cutting a bit extra around it, and the second option is called Mohs surgery. Mohs surgery is a type of surgery in which the doctor will cut out what they think is the cancer, plus 5-10 mm extra. They will then test the piece that has been cut out (on-site), and within an hour will give you a result as to whether the edges had cancer or not. If the edges of the cut test positive for cancer, you’d go in and get a second cut. You’d repeat the process until the edges of your sample no longer test positive for cancer.

Basal Cell Carcinoma & Mohs Surgery

When I told Dr Sjarif that I was interested in Mohs surgery, he referred me to Dr Yiasimedes, who is a Mohs specialist. She was the woman who would cure my cancer. I made an appointment with her to talk about Mohs surgery. In our consultation, she told me all about Mohs surgery and how it works. Mohs surgeons go through an extra year of medical school to be able to do what they do, and they are highly specialized. I knew after my first consultation with her that I wanted to do Mohs.

I decided to go with Mohs surgery because it has a 100% cure rate. The doctor told me that if I went with the standard option, there is a possibility that the cancer may not be all cut out. In my case, it was a very good decision to go with the Mohs surgery – you’ll read why in the next post.

The doctor gave me other options (aside from surgical options) as well, like radiation and special creams, but none of those options had a 100% cure rate. I decided to go with surgery because that would give me the peace of mind that the cancer was all out on the first go, instead of trying things like radiation or creams. I wanted that cancer out of my head as quickly as possible.

For the reconstruction surgery, I was also given a few options. The cancer was not small enough to just cut out and stitch up, so we had to look at what we could do.

The first option was a skin graft, in which a piece of skin from another part of my body would be cut and stitched into the hole caused by cutting out the cancer. The downside of this would be that the patch of skin would never match the skin on my face, and I would still have a scar around the patch of skin. Dr Sjarif told me this would not be his first option, because I would have this little patch on my forehead for the rest of my life. He recommended a “flap.” The flap involves a more intensive surgery, where there would be a cut across my head, and then around the cut from the cancer. This would then be used to create a mini face-lift, which would help close the gap from the cancer.

I thought about my options for a couple of weeks, and then made an appointment to see him and schedule the surgery. I told him that I wanted to try the flap and I would use Mohs surgery to get the cancer cut out.

Follow: