Backyard soldier...

Winter Sentinel

At the kitchen island

inside eating lunch

I felt someone was watching me

- it was just a hunch.

Glancing out the window

I saw my hunch was true.

A stoic one-eyed face

was filled with attitude.

First he looked to have a smirk

 a challenge meant for me

to come outside and have look?

He'd wait there by the tree.

Outside, things looked different.

Of course, they always do.

The warm breeze, the shining sun

gave me a different view.

With the shadow of a frown,

he now looked rather sad.

What was the fella thinking?

Nothing's quite that bad. 

Sun was shining, warm breezes blew.

Clouds had disappeared.

Looking up, I noticed sky

where once were only leaves

and at his feet was cooling earth

no need for canopy.

Ahh..  I understand.  I feel it too.

I know this lovely day

will disappear, with chilling winds

soon turned to winter's gray.

I'm sorry you are stuck out here

to face the frozen blasts.

To weather winds and shoulder snow,

enduring bleak forecasts.

It does seem an unfair fate

to one who, weeks before,

had blessed the world with yellow notes

of autumn's glorious score.

       

I promise I will not forget

you're out here standing guard,

Mustering all your strength to be

spring's beau of the backyard.

While you're not the tallest soldier,

you're very much held dear.

You'll be the first I notice.

as you're the first to bring me cheer.

~ Becki B.

    

Cross stitch...

My colorful Dahlia blanket continues to grow and one of these days (or weeks) I look forward to showing it in its finished state. Until then, even though it's growing, a picture of it today would look pretty much like a picture of it a couple of weeks ago, so I'll not bother with progress pictures.

Thinking a little crafting variety might be nice, I went through some embroidery supplies and cross stitch projects recently, and I decided it was time to put some effort into finishing a small stitch I began before moving in 2021 - honestly, I think I started this during the early covid days of 2020:

There is another (finished) companion stitch on the other half of this fabric, so I look forward to soon sewing them both into small pillows. 

While I had my flosses out, it occurred to me that some might be interested in how I store these threads.  My system is nothing novel, but I like it because it's easy to keep neat.

I like to wind DMC floss skeins that I'm using onto cardboard bobbins.  Once finished with a project, the bobbins go into a divided plastic storage box:

I have another (empty) box like this waiting in the wings.  By the looks of the picture above, it appears I'm soon going to need to employ it.

I file the colors by number so they are simple to find.  I know some stitchers don't like using bobbins like this because they create folds in the floss (especially floss wound closer to the bobbin), but I've never found that to be problematic. I find that the floss tends to straighten out while stitching, and it doesn't affect how the floss looks in a stitched project.  And being able to find any color I want at a glance makes this an ideal storage solution for me.

That said, until I actually begin to use a skein of floss, I store it with other unused skeins with their bands on them, in zip lock bags, like this:

Again, I store them according to their numbers.  The flosses stay neat in these bags, and the numbers are always visible.  I don't have to handle the floss until I locate the right color.  Then I just reach my fingers in and retrieve the single skein I need.  All the other skeins stay in place.

And these bags are stored in a small-ish plastic tote:

You can't see the hand-dyed flosses, but I have a few on rings underneath the bagged flosses in this same box.  It's more floss than I need to own, but keeping it all in this one tote makes it feel like a manageable and respectable amount.   

While I had everything out, I also decided to pull flosses for another project that I'll try to work on this winter:

I doubt I'll finish it in time to display it this December, but I'll enjoy stitching on it in the upcoming weeks.

The flosses above are hand-dyed yarns like I mentioned above.  I don't have a large collection of these embroidery flosses, but they are interesting for their subtle variegation.  And fun to use on hand-dyed cross stitching cloth.

And that is a glimpse into my embroidery storage and prep. Hopefully, something will show up finished here soon!

Mohs - my recovery...

Today is nine days post mohs surgery, and I am happy to say that I am doing very well.  The worst part was the afternoon of the surgery - which I'll touch on below.  But beyond that, things have progressed nicely and relatively quickly. Again, largely for my record and a bit of catharsis, and possibly for the benefit of someone reading this some day, I'm going to share the progression of healing from a flap procedure on my nostril.  Up to today, anyway.  

As much as I want to discuss (and vent) about the situation of pain management and how woefully inadequate I have found it to be after three surgeries (now four) since the autumn of 2022, I'm going to just jump to the punchline and tell you I was in tremendous pain once the Lidocaine wore off - before I even got home from the surgery on Wednesday.  

Finding myself in serious pain, the instructions to "call on Friday if tylenol or ibuprofen are not working" were not only completely and obviously inadequate, they didn't even make sense.  Was I suppose to suffer until Friday?  The worst of the pain would be gone by then - surely!  If I was in this kind of pain come Friday, I'm thinking there is a serious problem that should have been dealt with earlier.

It took me a while, but I finally screwed up the courage to get over my angst about the doctor perhaps thinking I was a weakling, or worse, an addict, and called the office explaining that tylenol wasn't touching the pain, and the instructions to call on Friday if I was still in pain were inadequate.

A kind sounding nurse immediately responded that of course, they could prescribe something.  She needed to get the doctor's approval, and she would call it in as soon as possible.  Why was this not said when I brought up the question of pain management in the office?

Putting my phone down, I was relieved just at the thought of soon having something that might take the edge off of the throbbing pain.  By four in the afternoon, I took the first of what would be three Tramadol (one every 6 hours) to get me through the evening and overnight.  What I didn't know was how everything would change the next day.

Twenty-four hours after surgery, I was allowed to take off the large bandage that had been placed over my nose and across part of my cheek - this was a larger, tighter bandage than the funny temporary one I showed in the last post.

Once I finally got all the tape pulled from my skin, and the bandage removed, the relief was immediate.  What was throbbing seconds before, quickly throttled down to just soreness. 

With the bandage off, the swelling was impressive, but nothing I didn't expect.  I started to bruise on my right cheekbone, but it went away by the weekend.  I was told to expect bruising and that it would be at its worst on days 3 and 4.  It was also suggested I drink pure pineapple juice to help with bruising.  Greg searched unsuccessfully for that, until I decided some canned pineapple in juice would probably work just as well.  It's bromelain, an enzyme in pineapples, that is believed to help with post surgical bruising.  I have no idea if eating canned pineapple and drinking the liquid is what kept my bruising to a minimum, but it was a delicious experiment.

The surgeon used dissolvable stitches to close the inside wound, and to secure the flap and stitch up the side of my nose.  Over the last few days, I've watched most of those stitches fall out or just disappear.  With the original bandage off, the next few days had minimal discomfort - increasing at night, or after a busy day. Tylenol and ibuprofen at bedtime on a few of those nights was all I needed to ease that discomfort.  And I haven't taken anything at all most of this week.

Mostly, since the first day, it has gone from a bit sore, to tingly, creepy crawly - like a spider was crawling across the tip of my nose.  I am happy to report even that the creepy crawly sensation has mostly stopped, and I am interpreting that as the nerves healing. There's a tiny bit of numbness on the tip and bottom side of my nose, but I'm expecting that to disappear soon. 

If I had not had the first awful, painful day - the afternoon of the surgery - I would call recovery from this a cake walk.  Except for that first day, this was a much easier recovery than when my dermatologist removed basal and squamous cell cancers from the same place on my nose.  While I didn't have as much swelling, the derm left an open wound, and that took about three weeks to heal to the point I could stop wearing a bandaid.  It was messy and worrisome all of that time.

Yesterday I got down to wearing one small-ish bandaid on the nose, and one smaller bandaid at the top of my nose where my glasses sit on top of a stitch that feels like it's still in there.  

I know from past surgical experience that internal swelling can take longer than we think it should to resolve.  I called today to ask when I'd know when the site was healed enough to do massage on it, and use silicone strips to reduce scarring (if I decide I want to).  I knew it was too early, but was surprised they told me to wait a month.  So I'm just going to be patient as I wait for it all to finish healing up inside, trusting that what I saw right after surgery, before any swelling began, is likely what I'll be left with eventually.  Like nothing had ever happened.

Next in series...  things I've learned

Mohs - the procedure...

The thing I was most dreading about the mohs procedure were the numbing shots. After three cutting sessions with my dermatologist in the past two years, my experience was that shots in the nose are an awful, if short-lived, little torture. At least the first shot is. And each shot gets less and less painful until you can't feel them anymore. At that point, if your eyes are closed, the only indication you're still getting shots is liquid lidocaine dripping down your numb check.  

I've tried to explain the experience to my husband, and this is the best I can come up with... It's like getting a punch in the nose without the punch. It's just all pain delivered in a concentrated spot at the end of a needle. It's short-lived, but it's the longest 15 - 20 seconds of your life. At least, that's how I've experienced shots in the nose.

Anticipating that, I mentioned as the surgeon pulled out the needle, "This is the worst part, I know."  To which he replied, "It shouldn't hurt too much."   Yeah, yeah yeah...  I've been gaslit about pain enough in the last few years, I should be glowing like a neon sign.

Not believing him, I braced myself and held my breath until the tiniest little sting landed on the side of my nose.  And then it went away. 

"Was that it?" I asked cautiously, sure that the worst was yet to come.

"That was the first shot"

"Wow. I barely felt it!"

"We pride ourselves on being as pain-free as possible."

"Wow," was all I could say in stunned disbelief.

There were more shots. Lots of shots. One of them, I did feel deep in my nose, but by that time I was so numbed up, it was mostly just annoying. Not pleasant, but not exactly painful.  

Done with the shots, I relaxed a bit as I thought, "Okay, this is going to be easy, because I know I shouldn't feel anything once I'm numb. "

After a drape (with an opening for surgery) was put over my face, I started to settle more into the chair.  I didn't even flinch when I felt a tiny sting move down the side of my nostril.  It was so tiny and so slow, it didn't register to me, at first, what it was.  But I must have made a noise, because the doctor asked if I was okay.  I casually said, "Yeah, I just think I feel a little burn." and he immediately got the needle back out.  "We don't want you to feel any of this."  Another shot or two later, he was at work slicing.  It was only then I realized I had felt his first slice.  It didn't hurt, exactly, but it makes me squirm a tiny bit to think about that.

I couldn't see or feel anything that was happening, but his surgical assistant was responsible for keeping my nose out of his way. She started by just gently bending it to the side, but eventually, it felt like she was using both hands and putting all her weight into flattening my nose to the opposite side of my face from where the surgeon was working. The pressure got so intense I asked with all sincerity, "Is it possible that you could break my nose?!?" She assured me she wouldn't break my nose, but there was no more relaxing for me!

I don't doubt that another tiny groan must have come out when the doctor told me to breath with my mouth, and to breathe deeply.  I tried, but with a drape covering my face (and mouth), breathing (at all) wasn't very satisfying.  Trying to breathe deeply didn't do anything to help - except for maybe it gave me something to think about while my nose was literally being bent out of shape. I guess that was really the goal.  Him cutting on me was nothing. Her pressing my nose to the side for the duration was...  well, I already said it - intense!

I'm sure mohs is a different experience depending on where the skin cancer is being removed from.  Not to mention differing skills and techniques of surgeons and assistants will likely create different experiences.  

I have no idea how long it took, but finally he had done all he was going to do, then he left to go on to the next patient while a nurse put a temporary dressing on my nose.  When I felt ready, I headed back out to the waiting room.  As I walked out, heads turned and I suddenly felt eyes on me.  I wasn't wearing my glasses with the dressing on, so I couldn't see anyone's faces, but I felt their eyeballs following me to my chair where I would sit and wait for who knows how long until I was called back again.

By this time, the waiting room was packed.  Assuming about half the people there were drivers for someone getting mohs, I estimate that there were at least 10 patients in the waiting room, and I have no idea how many were back in rooms.  And at some point, I heard the check-in person telling people they could wait outside - meaning out in the hallway.  Finally, putting my glasses on-ish to look around, I noticed everyone else had cute little bandages on their foreheads, noses, and ears.  A couple of people looked like they had little paper ketchup cups on their foreheads.  Thankful I wasn't sporting one of those, a glance around the room told me I was probably the funnier-looking one with my whole nose enclosed in gauze and tape.

Now that I look at the picture, I betcha there's a little ketchup cup under that bandage.

An hour or so later, and after watching many others go back to surgery and come out again into the waiting room, I was finally called back. As I got back into the surgical chair, I told the assistant, "I'm pretty sure I had the biggest bandage of anyone out there."  

She laughed.  

But she didn't deny it!  

She got me ready for the doctor, and I sat there nervously waiting for the verdict - prepared for the doctor to have to do more carving. But when he walked in, he announced, "We got it all!" 

"Really?!?"

"Yep.  I'm just going to stitch you up and you'll be able to go home". 

"How big was it?"

"About the size of a nickle, and about 3/4 inch deep."

"That deep?"

"Yep. I almost had to go all the way through."  I understood he meant making a hole right through side of the nostril.

Taking a deep breath, I sighed my relief as he explained the repair he was going to make.

Another drape, and I have no idea how much time passed as he worked on me again. First, he sliced down the entire length of my nose and about a half inch below my nose (about four inches in total, he said) and pulled cheek skin over to form a flap to cover the wound and he stitched me up.  I think he might have given me some instructions about getting right in for mohs if I should ever have another skin cancer show up before he left the room.  It was pretty anticlimactic.

Only thinking then to ask how many stitches were put in, the assistant said typically 6 stitches were used inside the wound, and she, right then, counted twenty stitches on the outside.

I happened to have my phone on my lap at this point, so I pulled it out to look at the situation with my phone camera.  I wish I had taken a picture of it at that moment before a bigger bandage was put on, because it was a beautiful stitching job. Before swelling commenced, all I could see was a nose that didn't look like anything had happened to it.  

But I'm getting ahead of myself.  Back to before the surgeon left the room... I asked about pain management. I started to tell him my normal M/O is to suffer, and I paused trying to think of the next words to say - with clearer head, those words might have been something like, "only to find out later I didn't actually need to suffer".  But I didn't get anything else out.  He took the opportunity the pause gave him to say, "Most people do fine with just tylenol - and ibuprofen once the bleeding stops."  By that time, I was exhausted and a bit dazed by the whole experience, and I accepted what he said - hoping it would be true.   

He left the room, on to the next patient or biopsy, and his assistant bandaged me up good and tight.  Giving me at-home instructions, she did tell me if I had pain into Friday to be sure to call them before they closed for the weekend.  Again, I was in a daze at this point, just wanting to go home and maybe take a nap.  I didn't question that those instructions could have been clearer. I was just relieved to be done with this thing I'd waited 10 weeks for. 

As I walked out into the waiting room, once again heads turned, and I imagined the looks I was getting now that I was sporting an even larger bandage.  Greg told me after we exited the building a little girl (who was at the entrance with her mother, he presumed) just stared at me with an open mouth as I passed.  Poor thing. I didn't even see her.

Next in the series:  the recovery

Arriving for mohs...

Wednesday of last week I was the first patient to arrive at the mohs cancer center at 6:45 am. Probably four or five people arrived within minutes of me, but I was the first one called back.

In case you're unfamiliar with mohs surgery, patients are typically scheduled on top of each other because the surgeon goes from patient to patient, and from biopsy to biopsy throughout the whole day - though I have no idea in what order all of that happens.  

The surgeon uses great skill in cutting off only as much tissue as necessary to remove all cancer cells and to obtain clear margins.  If all the cancer isn't removed on the first round, a patient gets more cut off, and that process is repeated until there is no more cancer and the wound is then dealt with (in my case, by the same surgeon).  The whole process really is pretty fascinating.  It's not just slicing some skin off and hoping for the best.  The surgeon studies the removed tissue under a microscope, mapping the exact location of remaining tumor and any "tendrils" or other cancerous tissue.  There is lots of information online if one wants to understand it better.

The surgeon came in and introduced himself and started getting the information on my situation.  He was kind, but seemed like a serious fella when he first walked in.  Kind and serious - two qualities I'm partial to in a doctor.  Though, if I had to pick only one, I'd pick kind.

I don't remember exactly how the conversation flowed, but it took a bit of back and forth between him, his surgical assistant, and me before he fully understood that my dermatologist had cut on this same spot three different times in the last two years before referring me for mohs. I was trying to be as clear as I could be, but I think he had only gotten the most recent pathology report from my derm's office - not the two prior ones on the very same spot.  Nevermind, that when I sent a picture of the cancer site (as requested the week before) I mentioned the previous two biopsies in 2022.  That information must not have been added to my file.  I wish I'd remembered in that moment that I had explained all of this in the email they requested - this really shouldn't have come as a surprise to him. 

He grew more serious as he got the story straight in his mind that this was the fourth time my nose would be carved on in the same spot.   He expressed his disappointment, and told me the more times a site is worked on, the harder it is to complete an effective mohs surgery.  

I told him I had just read that very thing online last week, and, shaking my head I offered, "Believe me, I'm not happy about it either."  He said something else - it seemed he was kind of repeating himself, and that didn't feel good.  I didn't want to be rude, but I think subconsciously I probably did want to interrupt what felt a bit like a rant starting, when I said, "Patients can't know this if they're not told, or like me, find out for themselves online."  He softened and replied, "Of course, you're right."  That exchange turned what was starting to feel like I walked in with his biggest headache for the day into us being on the same team.  

I was very glad right then that I had gone online and came across this information.  I think I might have taken his frustration personally, if I didn't fully understand for myself that I was not responsible for what my dermatologist had done.  I had no reason to not trust she was doing exactly what she was supposed to do.

In reflecting on it later, I've wondered if his expressing his frustration like he did was his way of preparing me that removing all of my skin cancer may not be easily accomplished on the first pass.  He didn't know I came in understanding that already.  He didn't know I had mentally prepared myself for every possibility (except for any worst-case scenarios - I drew the line at preparing myself for that).

He asked what my dermatologist's name was, and I told him.  It was a weird moment. I felt like a child tattling on another child, and the other child was going to get a whuppin'.  While he didn't strike me as violent, I wish now I had asked him what he was going to do with that information.  I wondered if he knew her personally?  Was he going to say something to her?  Give her the what for?  Or if nothing would happen.  My guess is likely the last thing.  That said, he asked me if I'd like a referral to a different dermatologist - a colleague of his.  With a vigorous nod, I replied, "Definitely.  I was going to ask before I left."

Next in the series:  the procedure