All that worrying about the Mohs surgery is over and done. I had the procedure this morning, and it wasn't nearly as bad as what I had been imagining would happen. Dr. Siegle explained what to expect if the tumor was more extensive than what it appeared to be from the surface. That would involve going in several times to take successive layers until all of the tumor was removed. Instead, he was able to excise the tumor in one go and I didn't even have to have stitches. I'll have to spend some time each day cleaning the wound and changing the dressing, but everything should heal without any complications. Given where the tumor was, it won't be very noticeable, especially when I wear glasses.
Dr. Siegle took photos with my digital camera so I could post pictures (before and after shots) of the procedure. So, here is a sequence of pics showing what the basal cell carcinoma looked like before the biopsy, after the biopsy, and during today's surgery. If you're the sort who gets light-headed with medical procedures, you might want to skip the rest of this post. It's not gory or anything, but it does show what to expect with this procedure.
This is a photo Mildred Holder took of me at the Desert Woodturning Roundup. It's the only one I have that is at the correct angle to see the basal cell carcinoma prior to the biopsy done in February. The cancer was up by my left eye on my nose.
Here's a closer view, but a small picture because I cropped the previous photo.
This is the same picture I posted earlier to show the lesion after the biopsy. If you look very closely, you can see a small mole that is on the opening of my upper eyelid (just where the iris intersects the eyelid on the left). This mole was biopsied today.
The room where the surgery was done reminds me of a dentist office with all the bright lights above the table (kind of like a dentist chair that has more positions, but no arm rests).
A local anaesthetic was used to numb the area and then a bit of the surface layer was scraped off so Dr. Siegle could see what he needed to before marking the area with a felt tipped pen. Those marks are for mapping the tumor. My eyes were then covered with a cloth so I wouldn't have to be bothered by the bright lights, or see what was going on with the scalpel. The next step was to actually cut out the area just beyond where the marks were made, and then down through the skin to the basal layer.
Here's the hole left behind after the cauterization step. They have a high voltage, low amperage unit that burns and seals the blood vessels. It smells like burning flesh - just like when I slip with my woodburning pen and brand myself. Oops - I'm not supposed to admit that has ever happened to me. . .
Hurray! Only one slice and all of the tumour is removed. That made the day much shorter than I was expecting. Here's what the pressure bandage looks like - it's much smaller than I was expecting, too. I was able to get some of that flesh-colored paper tape at the Target across the way, and I'll use that each day for the dressing. After cleaning the wound, I'm supposed to put some antibiotic cream in the wound, followed by cutting a piece of non-stick dressing to fit inside the wound, cover that with gauze that's cut to size, and then hold it in place with the paper tape. Sounds complicated, but I'm sure it's not a problem.
Dr. Siegle also did a biopsy on the mole that was on my upper eyelid, just below the lashes. This was pretty tricky, and much more difficult for me than the Mohs surgery. He numbed the area by sticking the needle into my eyelid just above the lashes. I had to be careful to not jump during any part of this procedure. The worst part was that I could see everything that was going on. He also did the cauterization, which wasn't much fun with my eye open, but everything is fine now. The anaesthetic is worn off now - a few hours after the procedure. It's a bit uncomfortable with the swelling and the pressure bandage, and the cuts made, but manageable with some Tylenol. I can't take ibuprofen or aspirin for a few days, but should be able to manage ok without it.
Anyways, I'm glad to have this procedure over and glad to be rid of the cancer. Everything should heal in 3 - 5 weeks and as long as I take care of all the details, there shouldn't be any other stuff to worry about with this lesion.
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