Mohs Surgery

Today was the big day for Mike's Mohs Surgery...the one to remove his skin cancer.  We had been feeling a bit uneasy with the whole thing this week...especially as the procerdure day/time got closer.  We both did our fair share of reading about Nonemelanoma Basal cell Carcinoma and about Mohs Surgery.  I think we both felt some-what knowledgeable about both, but the location of the cancer is what made us uncomfortable.

I think Mike is beautiful on the inside and the outside.  I love his face...especially his blue eyes.  He can still melt my heart just by looking at me.  I would love him no matter what he looked like...if he always looks this good, when he looks old, if he was to be disfigured, etc.  But if there is no reason to scar up his perfect face, I would rather not.  I know I would not want my face to be scarred if it could be avoided.  The few scars he does have are endearing, however, I completely understand his desire not to add any more to his collection.

We discussed (and were referred to) using a plastic surgeon instead of having a Dermatologist do the Mohs Procedure.  Everything we read stated the Mohs Surgery is the most efficient way get rid of this type of cancer...and a plastic surgeon wouldn't be performing Mohs.  A plastic surgeon would cut the cancer out...and hopefully get it all in one chunk.  He would then close up the wound beautifully.  If there happened to be more cancer, the procedure would be repeated...possibly at another time. 

If Mike's cancer hadn't been A) on his face and B) so close to his right eye, I highly doubt we would have thought twice about any of this.  But it was THAT close to his eye and it IS his face.

We agreed that Mike did not have to go through with the procedure today.  We decided we would talk to the doctor and ask our questions...and then decide what to do.  So we did.  She was wonderful.  She answered all of our questions and I felt at peace with going ahead with the surgery.  I don't think Mike felt quite as comfortable as I did, but he is the one who was being cut on, so I would assume there isn't a lot of comfort to be had.

She told us she could not be certain how large the scar would be...and said there was no way to know until all the cancer ws cut out.  She explained that Mike's tumor could have rooted itself down into the eyelid, or up on his face...and it was unknown how deep.  It was also possible it hadn't done that.  The type of tumor that Mike had started on the top of his skin, which she explained was in his favor.  Other tumors can start under the skin and not show themselves for years...leaving the cancer to grow and root very deep and a large part of the face (or wherever) would need to be removed (like an entire cheek). 

Dr. R did not believe that would be the case with Mike's tumor.  She also explained that if the tumor had rooted itself too close to Mike's eye or eyelid she would refer us to an ocular plastic surgeon.  I didn't even know such a person existed.  (Of course, I never knew there were doggie neurologists until I had a reason to know.)  We asked if she did the surgery, could he close the wound if we were unhappy.  She said of course.

I felt going through with the Mohs Surgery was the best way to eradicate the cancer.  We also had options for a plastic surgeon if the tumor appeared to be more than hoped for...so we agreed to go forward.  I really liked Dr. R and felt comfortable with her.  She was confident, but comforting.  Mike asked her how many Mohs Surgeries she had done...her answer: 1,000 a year for 15+ years.  I'd say she has some experience with it. 

I knew by looking at her diplomas she wasn't brand new, but it was interesting to see her skin...it was perfect.  No wrinkles, no acne, no ance scars, no aging at all.  I should have asked her what she does to her face...or what products she uses.  Cause damn.  I don't want to look old...and I hate that I still have stupid acne.  Stupid genetics.

I was allowed to stay in the room for the surgery (which made my curious brain very happy).  She told me I was allowed to stay...as long as I did not become the patient.  Mike just laughed...she clearly doesn't know either one of us.

The nurse numbed the area...and told us Mike would most likely get a black eye.  The doctor came back in, picked up a cutting tool and went to work.  She cut for a few minutes, put the skin she cut off on a slide, put some colored dye (or something) on the skin and said we were done for the time being.


We were shown to a waiting room to wait until the lab finished testing the skin for cancer cells.  After 30 minutes-ish, the nurse came back for us.  There were cancer cells found on the biopsy, so the doctor needed to take another layer.

She drew a picture to show us the two small spots of cancer she needed to remove and where they were in relation to the original tumor.  Luckily, they were near the top...away from Mike's eye, eye lid, tear duct, etc.  It was relatively good news.  Dr. R made one more incision, cut out the pieces she needed, placed them on a new slide, did the dye thing and was done.  


We walked back to the waiting room...and waited.  We were lucky and met some very nice people.  The mother of a Phoenix Sergeant, a fraud investigator and his wife...and a nice little old lady.  Mike and the fraud investigator actually worked on the same case a few months ago...they hadn't met and didn't know that information until today, but what a small world.

The nurse came to get us.  She walked us back to our room.  She sat Mike down and numbed the area again...then we found out Mike was all clear!!  There was no more cancerous tumor to go in and cut out.  It was great news!!  

Dr. R explained she wanted to leave Mike's wound open to heal on its own.  She said it would definitely be a bad scar if she stitched it.  She also said she didn't think doing a skin graft was right either.  She told Mike that if she put a graft on the wound the scar would always be that size, that color, etc.  She then said if it were her face, she would leave it open.  She said it would have a better chance to heal and look natural.

We asked what happened if we didn't like the way the healing process was looking.  Dr. R told us we could always do something different in a week or two.  She said she would be happy to refer us to an ocular plastic surgeon at that point...if we felt it was not healing nice enough.  We felt comfortable with what she explained and said okay.


The nurse cauterized the wound a little more and then bandaged it.  She then explained how to care for it.  Dr. R wants to see us back in two weeks to evaluate the healing.  Mike will leave the dressing the nurse put on for two days.  After that, he can wash it with soap and water in the shower...and then we are supposed to dress it with a dermabond dressing we bought from the office.  

If you Google Mohs Surgery and look through the images, it will sicken you.  I'm glad I hadn't looked through the images prior to today.  Mike had...and after doing it myself, I completely understand why he was so nervous.  The pictures are awful.  I think Mike's wound looks better now than almost ALL of the pics I found on Google.

Mike is cancer free. I am so thankful we got rid of the tumor before it rooted further or caused other problems.  I'm most thankful the cancer was nonmelanoma.  I love Mike and need him here with me, so I'm glad he decided to stick around to help me feed this kid in the middle of the night.