So it's been 2 years since my Mohs surgery.  You can see in the first picture what my nose looks like.  I do have makeup on but you can only just see the white area on my nose. Until now, I've been happy with the result.

Yet, I remember the plastic surgeon saying to me that if you roll the skin over your nose, you can see where the basal carcinoma is sitting.  Well I noticed a raised surface on my nose.  At first I thought it was scar tissue, but I became increasingly concerned. I had the doctor check it, but they weren't worried.  Then, rolling the skin on my nose, the outline became apparent, the was a circle, barely visible to the naked eye, in fact only I could see it.  I returned to the skin doctor and under special microscope glasses, she could see it.  So I'm using Picato treatment on my skin.  It costs around $150 and is used to remove solar keratoses.  Undocumented, it also has a good outcome for basal cell carsinoma.

So once again I am documenting the treatment.  First application (of 3) today.  My skin is red. It is stinging a little, much like bad sun burn.  It's going to get worse and blistering.

I've been told Picato is like a very mild form of chemotherapy and is like a chemical peel of the skin.

I suspect that I am using a chemical version of black salve.  My doctor has said that while black salve can be effective, it can also leave massive craters on your face and is a huge risk to take with something on the very tip of my nose.

So here we go. Stay tuned for the journey.

The Healing is Almost done

So it's been a while since I've posted some pics.  I know I should show the progression.  This is me when I've just got up.  No make up and oils on my skin.   You can clearly see the scar.  The irony is,  you can't see it much in photos, only in real life.  People do notice it if I draw their attention to it, otherwise I wouldn't say it's prominent.  The make up does well to disguise it.  I took some before and after pics recently of me getting ready in the morning.  so after I've applied the make up, you can decide for yourself the result.

The Home Stretch

 Okay so here is the scab (gross I know) before I went to the Doctor. I'm still keeping it covered all the time.  These pics are between replacing dressings. At the doctors surgery they removed the scab and left behind a red open wound but obviously shallow.  The placed on my nose a bizarre treatment called dermo...somthing.  (And gave me 2 supplies. See pics below of what it looks like) The dermo cover draws fluid underneath to help the skin heal over.  3 days later I was amazed to see a thin layer of skin had formed.

This is with the dermo thingy on my nose. It blends in so well with my skin colouring you can barely see it.  So much so, I decided to still cover it.  Because it looks like a really badly healed graft.  At least a tape over your nose clearly says "I've had surgery".   Tuesday I go back to the surgeon and THEN I can start scar treatment.

Good News Bad News

The Good News and the Bad News.

Well the good news is the grafting scar near my ear has healed incredibly well.  You can barely see it.  Some areas have a numb sensation but nothing bothersome.  My skin doesn't look crash hot in the pic because there is still the dressing tape glue.

Not so good news is that the graft didn't take.  It seems the graft skin and scab died before all the healing and tissue bonding happened underneath so a new graft needed to be done.  But the doctor is pleased with what he discovered under the scab.  Despite being a deep wound it is healing well.  I think the bleeding and perhaps the odd knock did not help the healing.
It's the cost that pains me the most.  First time was knee buckling, second time floored me and I had to call in some favours.

I washed my hair before the surgery today (oh the joy) as I know it's going to be a week or two before I can do it properly again.  Prior to that, I had my partner, David, wash my hair for me over the bathroom basin, so I didn't get the stitches wet.  I showed him the scene from "Out of Africa" so we could set the standards! Ha ha. We had a good laugh.  He complained I was not making the right "oh ah" noises that Meryl Streep made.  I complained his prose was not as good as Robert Redford.

Mohs Surgery - 1 Week After

It's been one week since I had the surgery. I didn't get my stitches out yesterday as I expected, but I now have less padding on my graft scar near my ear and the scab on my nose is looking very healthy.  It's too soon to put the oils on my nose but the doctor is very pleased with the healing.  I'm also going to try acupuncture to speed up the healing process and have started a very healthy dose of vitamin e.  hoping I will excrete the oil through my skin to help the scarring and healing on my nose. I didn't realise that the stitches on my nose are ones that dissolve  too!  So far, so good.

Post Mohs Surgery - Day 3 The nose is changing!

POST MOHS SURGERY - DAY 3
I just had to change the dressing again.  It seems the sebum from my nose makes the tape go sticky and yucky.  It itches like mad!  I knocked my nose 2 times in my sleep, I think in an attempt to scratch it in my sleep!
So after just 3 days, the graft is going black and scabby.  I'm hoping this is a good sign. I think the key is that the flesh is healing underneath!  Stitches out on Wednesday.  That's when the healing process really starts.  Back to work tomorrow.  Oh joy.

D-Day - The Mohs Surgery and stages.

So in the Plastic Surgeons clinic, I have the process begin.  It feels like the dentist!  I lay on the chair, a light is shone in my face and the chair is raised.  Ironically, I am terrified.  I've had 3 crowns and root canal.  THIS was feeling way more traumatic.  I can't relax myself in the usual manner of slowly breathing through my nose for obvious reasons!  I feel my blood pressure rising!!!!  I sit and wait in the waiting room.  I've read that the process can be harrowing.  As they look at the sample under the microscope and keep taking flesh away until no cancer is under the microscope.  My surgeon was very happy.  All gone, all good.  But I would definately be requiring a skin graft.  I had hoped to avoid this but onward and upward!

Post surgery

A few hours after general anesthetic I am still groggy but have the bandages from the skin graft.  I feel like I've done a few rounds with Ali.  They have taken a graft from in front of my ear.  Seems sensible.  I am mindful not to let the wound get wet but day 2 it seems to have been weeping a little. The nurse says this is normal. She's rung to check on me but says I can change the dressing if it gets wet. The dressing feels yucky and itchy and it's getting worse.  I think it's sweaty and yucky.  I follow instructions and change it.  Oh...my...god.

The graft is scary!  It looks like some alien piece of flesh stitched onto my face.  But I know that this "look" is normal for mohs skin grafts.
My main priority is to protect the wound and keep it dry.  I've bought some dry shampoo too.