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Well, after cancer surgery on the forehead, you don't cut a glamor shot...

twofbyc

twofbyc

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This ain’t funny, but it is kinda.
Only time I had MOHS (so far), on my neck, I was in a restaurant with some coworkers a few days after the surgery when my neck suddenly thinks it’s Vesuvius - freaked some people out, myself included. Had to go back to work with a bloody shirt, but it was only blood that pooled up just below the stitches and I guess between eating and flapping my gums it just decided to make an entrance/exit. Kinda embarrassing too.


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TIDE-HSV

TIDE-HSV

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twofbyc said:
This ain’t funny, but it is kinda.
Only time I had MOHS (so far), on my neck, I was in a restaurant with some coworkers a few days after the surgery when my neck suddenly thinks it’s Vesuvius - freaked some people out, myself included. Had to go back to work with a bloody shirt, but it was only blood that pooled up just below the stitches and I guess between eating and flapping my gums it just decided to make an entrance/exit. Kinda embarrassing too.


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Click to expand...
There are a number of things which can cause that - lifting something heavy too soon; going back on aspirin or similar therapy too quickly; drinking alcohol too soon, etc. I'm concerned now, given the size of the incisions - I guessed at 5-6", but after getting the bandage off, it was a little over 4" - that even what they thought was clear might have been a false negative. There's a friend here who put it off too long and lost an eye and part of his jaw on one side. They've done some reconstruction, but he's still wearing a black eye patch...
 
U

UAH

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TIDE-HSV said:
Well, success this time. Clear margins. If anyone needs a Mohs surgeon, contact me. This guy is great...
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Very good! I have plenty of Sun damage and have to stay on alert so I will make sure to remember!
 
Go Bama

Go Bama

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16outa17essee
I just saw this thread. Glad your surgery was successful.

I have a patient, also a lawyer, who is scheduled to have the Mohs procedure next week on his scalp. He's 92 now, still works a bit, and he's very funny. He told me last week to do my best to die before 85.
 
GrayTide

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TIDE-HSV said:
Well, success this time. Clear margins. If anyone needs a Mohs surgeon, contact me. This guy is great...
Click to expand...
Good to hear, Earle. I just go back to this thread, was not aware it was time for your Mohs surgery. I had a squamous cell carcinoma taken off my chest at my visit last month. No big deal, but glad I had it checked.
 
TIDE-HSV

TIDE-HSV

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Go Bama said:
I just saw this thread. Glad your surgery was successful.

I have a patient, also a lawyer, who is scheduled to have the Mohs procedure next week on his scalp. He's 92 now, still works a bit, and he's very funny. He told me last week to do my best to die before 85.
Click to expand...
I often get remarks about how lawyers just won't give up and retire... :)
 
TIDE-HSV

TIDE-HSV

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I hate to plaster my ugly mug in a post, but, in the interest of illustrating the difference between the two surgeries, the first is standard plastic surgery with interoperative pathology. The second is Mohs, with cauterization and controlled bleeding...

1) 3rd Day after surgery.jpg

2) Day Two - 12-11-18.jpg


3)Surgery Incision 12-13-2018.jpg

This whole thing started, as far as I knew, with a lesion about the size of a nickel, above and to the right of my right eye. Take care of anything even faintly suspicious-looking...
 
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TIDE-HSV

TIDE-HSV

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As he was stitching me back up, I asked how the bleeding was going. He replied "I'm not going to let you bleed. I'm cauterizing as I go." Wondered what that smell was. One reason he's so good is that he started as a surgeon and then got interested in dermatology, rather than the other way around...
 
GrayTide

GrayTide

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TIDE-HSV said:
As he was stitching me back up, I asked how the bleeding was going. He replied "I'm not going to let you bleed. I'm cauterizing as I go." Wondered what that smell was. One reason he's so good is that he started as a surgeon and then got interested in dermatology, rather than the other way around...
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Ah, the smell of burning flesh. Results look good.
 
TIDE-HSV

TIDE-HSV

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GrayTide said:
Ah, the smell of burning flesh. Results look good.
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Well, the bandage comes off today, so we'll see. He converted two incisions, which were basically a continuation of a wrinkle line, into one, because he thought it would heal more evenly. A bit over 4" total. When I told my friend and recently retired GE doc that, he just said "Whoa!" The plastic surgeon who did the first procedure didn't bother with cautery, hence the extensive bruising and swelling. I think it was basically old style vs. new style...
 
TIDE-HSV

TIDE-HSV

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GrayTide said:
I know it is easy to say when it is not you, but the scar and stitching look good to my eye.
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He used dissolvable for the surface stitching, based on two things - my skin grows rapidly and has a tendency to bury up stitches in a week's time. With the dissolvable stitches, this is immaterial, since they would just continue to dissolve under the skin. The other is the fact that they are only in HSV on Mondays, so it eases the burden on them, and they knew I had a followup visit set with the plastic surgeon on 1/7. However - I've learned since the surgery that dissolvable stitches cause more scarring. IDK if it's because they remain in longer or what. Anyway, I'm emailing them Monday to get the permission to go ahead and get them removed. After the first surgery, a very, very young RN left four stitches in. My wife's bestie (good friend of mine also) worked in a GP's office (her ex-husband, to be specific) for 40 years, removing many stitches. She came and removed the four hangovers. If the surgeon's office says "yes," I'll get her to do it. The young nurse was using no magnification. Norma uses jeweler's-type magnifiers and a big honking light which hurts your eyes, if you don't keep them tightly closed...
 
TIDE-HSV

TIDE-HSV

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GrayTide said:
I was not aware that dissolvable stitches caused more scarring, never too old to learn. Keep us updated.
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Actually, I think that was outdated info. They apparently used to take much longer to dissolve. They are mostly already gone after one week. It's really amazing. I see a little tendency at the extreme lower end to open back up. I'm supposed to continue daily wound care - soaking a weak vinegar solution and moistening with Vaseline - until there's no more discharge and no scabbing. I think that'll be no more than a couple more days. I might have mentioned it before, but this guy's route into Mohs was as a surgeon first, rather than the other way around. Most of them were dermatologist first...

Edit: We were discussing my colon resection from January and, after I described how the robots worked, he commented that they didn't have those tools back when he was resecting colons, so I asked the nurse about his background when he left. I'll try to remember to take another image today, when I'm changing bandages...
 
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