Nose/School Updates

1. Nose

I got my stitches out yesterday and my nose looks pretty good. Where the stitches were looks like a cat scratch at this point. Considering I had a huge hole there only two weeks ago, I say it's major progress. It still feels tender and a bit odd (parts of it are still numb, etc.). But overall I'm happy with where it's at. It was so lovely to actually wash my face with soap last night.

2. School

Major bummer of a remedies midterm today. 30 MC questions, many of which made me feel like a big fat idiot. I had a 40 page outline and still have major gaps in what I know. Totally discouraging. But at least it only counts toward my grade if it helps me.

Corporations midterm Friday. Right now I'm just avoiding studying for it because I have no f*cking clue what's going on in there most of the time. I have a start to an outline, and I have learned some stuff, but the thought of actually going and taking a test on Corporations law at this point fills me with such dread that I feel like I have to go lie down. Seriously.

God, I can't wait until law school is over.

Major paper due in 4 weeks. I've done a little research but that's it. I need to make significant progress this weekend because I won't have time to work on it when I'm studying for finals.

Feeling lazy, tired, and a bit overwhelmed.

Doctors

I forgot to add this to earlier posts. The doctors who treated me were excellent, although both were quite businesslike and busy. But if I had questions they would answer them, and they didn't sugarcoat anything that would be happening.

If you are in the Los Angeles (S.F. Valley) area and have the need for the type of treatment I received, I recommend them.

Dermatologist:
Dr. Martin Kay
Kay Aesthetic Dermatology
Burbank, CA
http://www.martinkay.yourmd.com/

I found Dr. Kay because he is a member of the American Society for Mohs Surgery and is listed on their Web site.

Surgeon:
Dr. Sam Carvajal
Glendale, CA

Dr. Carvajal is not online. I was referred to him by Dr. Kay.

On the Road to Recovery

So I went back to the plastic surgeon today and he took the "stent" (rolled up piece of gauze) out of the one side of my nose. That was gross. But the aftermath absolutely NOT gross. All I have on my face is a stitched-up cut. When you look at my nose from straight ahead, the nostrils look completely in proportion. It is like a miracle. Of course, when you look at it from underneath, the nostril opening on the surgery side is very depressed, so it is obvious from that view that there was trauma. But since I'm shorter than everyone except, well, kids, I'm not too concerned about that. The doctor said that he could do a procedure to fix that, which would involve shaving off some of the scar tissue that is developing inside that nostril. OUCH. He saw my look of panic and patted me on the shoulder, saying, "Later, later. Let's see how it does after the swelling goes down. Maybe we can even wait a few months for that."

There still is a lot of swelling, but all things considered it looks a million times better than I thought it would at this point. I think even the doctor was surprised how well it was healing and how well the skin had re-shaped itself around the stent. I am totally awestruck by my body's ability to heal itself and to recover from the kind of physical trauma I've been subjected to this week. There is still a risk of infection, and I still need to be vigilant. But the doctor said I should return as much as I can to normal life. He even told me I should go and watch my Golden Girls play hockey tonight, even though he said I should not play for a few weeks until I've healed more. He thought it would be good for me to go and see them and to be in a supportive environment like that.

So a week that started out terribly has turned out to be pretty positive in the end. I am still a little sore, and I still have a big gash on my nose. But I am healthy, I no longer have skin cancer in my nose, and I'm on the road back to normal life.

A Visit to the Plastic Surgeon

So Mohs Surgery is now two days behind me, and today was the day to see the plastic surgeon. He was a no-nonsense kind of guy -- he came in and took the bandage right off, then told me my options. He said if it was his wife, he'd recommend option #1 -- stitch up the wound, which would probably leave a little scar, but would mean the site was closed and I wouldn't have to have a big bandage on my face. Risks -- mainly infection, exacerbated by the fact that it wasn't happening within 24 hours of having the surgery (this was not my fault -- I had an appt for yesterday but his office rescheduled it because he was in surgery). Option #2 -- wait a little while for the wound to heal more, then do a skin graft. Downside of that = mainly appearance (skin would look obviously different) and having an open wound for another two weeks. So we decided to agree with him that option #1 was best.

We had to wait about 20 minutes, and then we went into a little outpatient surgery room. I do not have words to describe the pain I felt next as he did six injections of anesthetic into my nose. I thought the injections on Monday during the Mohs surgery were bad. I have never felt pain like that in my whole life, and I wouldn't wish it on my worst enemy. SP said I was pretty much howling through it. I didn't mean to -- I wanted to be tough but it felt like he was driving ice picks into my nose. Holy motherf*cker.

But soon enough I was numb, and then he started sewing me up. He was done with that relatively quickly, which was good because I was shaking like a leaf after the pain from the injections and just wanted him to finish so I could get the hell out of there. He seemed surprised when he was done, because it was not as bad as he thought it would be. In fact, once he rolled up some gauze and inserted it in my nostril (which was fun, AND it gets to stay up there until I go back to him Friday), the injured nostril had almost the same shape as the normal nostril. He was happy about this, and so was I. It didn't look quite as bad as I expected it to, which was a relief. But it is obvious that I was injured and it was sewn up.

I'll tell you what really got me. The doctor was talking about how great and resilient skin is, and how it has a wonderful capacity to heal itself. That got me thinking about everything my nose and skin have been through over the last week. It really is a miracle to think that I could recover from something like this and not look like the Bride of Frankenstein, but according to the doctor, the scar should be minimal, and the nostril on that side should only be slighly disfigured compared to the other one. I was getting very worked up over this, because I was thinking about how tough I am on my body all the time. I don't eat well, I don't exercise as much as I should, and most of the time I look in the mirror and end up hating my fat stomach, big butt, ugly face, etc. But that is the wrong way to look at things, I think. Any body that can recover from trauma like that which I have gone through this week is pretty incredible.

Now, of course, there are no guarantees. The doctor today was pretty concerned about the infection that could set in -- he said if that happens the stitches will come out, they'll wait for it to heal some, and then do the skin graft thing. He was emphatic in saying that we really don't want that. He put me on some antibiotics, and he put some neosporin over the top of the stitches, but that was it. Now it's up to me to heal the best I can from it.

I have been home about 6 hours now since this happened. I have some pain now, even though I took a vicodin (didn't work today as well as it did yesterday), and the site itches some as well. But it is on the road to recovery. I have had a hell of a week, and I have to be prepared for the possibility that it may get worse before it gets better. But I am still here, my nose is still attached, and I am on the way to recovery.

So far, it's been one unbelievable spring break.

Mohs Surgery -- The Day After

Well, I was supposed to go and see the plastic surgeon today, but his receptionist called me this afternoon and postponed the appointment until tomorrow because he was "in surgery." Hmmmm.... I guess that meant someone was worse off than I am, and I should be grateful all I need fixed is a little nose cutting, but I only have a few days before spring break ends and I'm supposed to go back to school. Hopefully I can get the surgical repair done by them. I am also very worried because I will probably have to get numbed up again for him to do whatever he will be doing, and it hurt so much last time that it makes me want to puke to think about going through with it again, especially considering how sore and injured my nose is right now.

SP changed the bandage today and I just couldn't bear to look at it. He said it looks bad but not too bad, whatever that means. Poor guy, I keep asking him to describe it and he can't really. Anyway, apparently it is not bleeding anymore, which is good, but there is a lot of stuff oozing from it. I keep thinking to myself, "That's good, that means it's trying to heal and feel better." I guess, anyway. All I know is it feels very wet and uncomfortable under the bandages.

I am also feeling quite tired, even though I haven't done much today. I think so much of that is the stress and trauma, as well as the fact that I took one vicodin last night and another this morning. Plus there was a big accident involving a truck that wiped out the center divider on the freeway near our house last night (early this morning), and we slept with the window open because it's been summer-like warm around here the last few days, so there were a ton of helicopters flying around out there, which started probably around 4am and lasted a few hours. That's LA for you!

I have to say I like vicodin. The one I took this morning was especially nice -- I felt very calm and relaxed for the first time since I went through this, and slept pretty blissfully for a while. I can understand how it can be addictive, though. It was also weird for me to feel like I had a hangover (dizzy head and yucky stomach) once it wore off a few hours later. I was not expecting that.

So now I wait and see what is next for me. My appointment is for 10am tomorrow. I am really hoping he can do whatever he needs to do tomorrow and just get it over with, so I don't have to wonder how bad it's going to be anymore.

Mohs Surgery

Today I had Mohs surgery. This is a special type of surgery that is done on people who have basal cell skin cancer in visible areas. I have had a spot on my nose for a while that just wasn't healing. I had a biopsy on it a few months ago and it came back as "inconclusive." It was a basal cell, as it turns out. So it all got removed today.

Mohs surgery is very intense. They do it under local anesthesia. Initially, they do 4 injections, which he did right into my nose. That was some of the most intense pain I have ever experienced, I have to say. It was all I could do to not start crying. The doctor said that noses are all veins and nerves and hair follicles and oil glands. That means doing this type of surgery on the nose is very difficult. The injections are painful because of all the nerves, it bleeds a lot because of all the blood vessels, and the cancer itself grows down into the tissue, rather than as a raised bump. Because there are so many things in the way like the oil glands and hair follicles, it weaves its way through all that stuff, and often you have to take out quite a lot of tissue to get everything.

That was the perfect storm that I faced today, and it was not pretty. I was in the doctor's office a total of about 5 hours. They numb, take some off, then treat it and look at it under a microscope. If they determine they didn't get it all, they repeat that process as many times as it takes to get all the cancer out. For me it was 4 times altogether. When he came in before the last time and said he hadn't gotten it all, I almost started crying. I figured he would take half my nose off before it was over. The good thing about Mohs is that the layers they take off each time are small, and they do that to minimize the tissue that gets removed. However, SP was with me in the doctor's office, and he saw it after the last section was removed, and he told me I probably won't want to see it because it's a sizeable hole.

The doctor said he didn't feel comfortable doing the plastic surgery to repair the damage himself, and referred me to a special plastic surgeon that specializes in head/neck stuff. I see him tomorrow. I am on spring break from law school this week, so I really want to get everything done ASAP. But that is hard to do when it comes to medical procedures. I hope that this guy will be able to fix it.

Now that the anesthetic has worn off, the pain is quite intense. The doctor gave me some vicodin and I took one. I have never taken vicodin before so I don't really know what to expect. All I know is I took it 20 minutes ago and it still hurts quite intensely.

I have learned a few lessons here:

(1) I put off having this taken care of for WAYYYYY too long. An inconclusive biopsy doesn't mean you should be complacent. Get it taken care of.

(2) Always wear sunscreen. In fact, if you're fair, blonde, and blue-eyed like I am, just avoid the sun altogether. I think about all the sunburns I had as a kid growing up in San Diego. It's just not worth it.

(3) I'm tougher than I thought I was in terms of dealing with pain. Those injections hurt like a mother. And it hurts quite a bit now. But I can handle it and be tough.

More later as the next phases of treating this thing happen. Thank God I have spring break this week and don't have to leave the house if I don't want to.