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