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Thursday, 29 July 2021

MOHS Surgery for Basal Cell Carcinoma

Let me start by saying I don't sit in the sun. Don't get me wrong I do like the sun, that beautiful big yellow thing in the sky, I'm just not a sit or lie in the sun kind of person. So, when I ended up with a BCC in the crease of my nose I couldn't understand how it got there. How on earth did the sun strike into the crease? I found out that it could have been there since my teens and appeared many years later due to stress.

It started with a spot and then it went, disappeared. Six months later it came back and stayed. I mentioned it to my doctor as I thought it was a wart. Straight away she said it wasn't anything to worry about but referred me to a Dermatologist who would see me within a fortnight. That was the end of December 2019. 

I was seen within a fortnight at Harrogate Hospital, a great start to 2020. A biopsy followed and sure enough further treatment was necessary. I then saw a Consultant in the Maxillofacial Department who referred me to Chapel Allerton Hospital for MOHS surgery. 

Then we had lock down. I guessed that I wasn't going to have this minor surgery within the next few months.

Fast forward to March 2021 and my appointment with a Consultant at Chapel Allerton Hospital arrived. A trip to Leeds was necessary. I didn't relish this trip because I have a vestibular disorder, accompanied by anxiety, I don't travel well especially on motorways. Anxiety certainly isn't my favourite travelling companion and I suspect it is the same for many others.

I would receive a letter within three months for MOHS surgery the consultant told me during our consultation. However, a couple of weeks later I received a phone call asking if I'd mind changing consultants and I'd be seen in April instead of May. Of course I looked up the Consultant Dermatological Surgeon Dr Walayat Hussain online, and found he was one of the best in the business. So, I rang back and said yes please.

On the day of the operation 22nd April 2021 I had to be there at 9.15am. The traffic to Leeds wasn't too bad, thank goodness. I was accompanied by a friend who would have to drive me home. 

When I met Dr Hussain for the first time he was wearing a mask, gloves, gown, and a scrub cap. The only part of him I could see were his eyes. They were friendly eyes, and I could tell he was smiling as he spoke to introduce himself. Two nurses attended, Staff Nurse Rose and Sister Lisa who were pleasant and friendly too. Everyone did their best to make me feel at ease in a strange situation.

Once I was on the operating table I was fitted out with a gown. My hands had to stay underneath the cover placed on me. Then came a cap, and then my eyes were covered. Nothing but my feet exposed. I felt like a mummy especially when my nose was plugged to stop the anaesthetic going down my throat.

Oh the joys!

I won't go into detail about the operation only to say it wasn't akin having a trip to the Spa. But, the nurses and doctor talked to me all the way through it and we even shared a few fun bits.

They do MOHS surgery in stages. The surgeon takes away the BCC and off it goes to the laboratory to be looked at on a machine. It takes about an hour. They leave your wound open (covered with a pressure bandage) to the elements until the results are back. I was eating a small sandwich when Rose, the nurse, came back for me. The doctor needed to take a little bit more of the surrounding skin away, but the area was still quite numb so he didn't need to inject much more anaesthetic. A great relief. I didn't have my eyes covered this time so the next thing I saw was a needle and his hand bobbing to and fro sewing my nose. 

All done and the surgeon asked me if I wanted to see his work. I politely declined. I really didn't feel brave enough. He was disappointed and assured me it looked good. I felt I couldn't refuse, so very reluctantly I agreed. He handed me a mirror. I looked. He was right, it was good. So neat I had to ask, 'Where did you learn to sew like that?' He replied, 'YouTube!' We had discussed YouTube while he was operating so we had a laugh and he did a little jig.

Then a pressure bandage was fixed like cement to my nose and it covered my nostril. I couldn't breathe. Dr. Hussain told me that I should take the bandage off in four days and that I would need to sleep upright until the bandage was removed. Also that the stitches were dissolvable. Very important, I had to do no bending or lifting of anything heavy for at least seven days from the operation. When I removed the bandage I had to apply Vaseline to the wound for a specific time to keep it moist.

While the bandage was on my nose I looked like I was auditioning for Phantom of the Opera. I thought I'd turn a negative into a positive and make a TikTok video.



I didn't need any painkillers. The only problem was not being able to breathe properly. But, the second week I started feeling extremely anxious and started having flashbacks to the surgery day. I spoke to my GP, told him how I felt weird and panicky when having my hair cut and my check up at the Dentist, and he said it could be a control issue. So, I re-listened to Dr Claire Weekes (MBE) CDs. What an amazing women she was. I definitely recommend her books and CD's for anxiety issues. I bought her book Self Help for Your Nerves a few years ago and keep it close. I also bought her Pass Through Panic CD. 

Three months later on the 26th July I had an appointment to see Dr. Hussain. The anxiety had not levelled. Leading up to the journey and while travelling on the Motorway it was horrendous.

Dr. Hussain was pleased with how good the surgery site looked. You can hardly see what's been done. He did say it will take around eighteen months to heal properly, which is why I'm still having a tingling feeling and sometimes a cold nose. But, I'm glad to say, I'm discharged. And what a wonderful word that was to hear.

While all of this was going on I decided to look online for natural remedies and found a Skin Cancer  site with some very good information. Then another informative site Dr Cynthia Baily.

Another site I found for the prevention of skin cancer puts a great emphasis on diet. 

Little did I know when I wrote a previous blog in June 2011 for my local Kirkby and Masham Surgery when they received their first Dermatoscope, that it would spot, pardon the pun, my BCC. I have to say all of our doctors and staff at the practice are absolutely brilliant.

I found and joined a Facebook MOHS Surgery support group and it was lovely to chat with people who had gone through the same thing. 

Always respect the sun. Wear a brimmed hat, sun shades. Dr. Hussain recommended suntan lotion anything above factor 30. So, now I have factor 50+!  Try to keep stress levels down and maintain serenity.

Ellen Dean recommends Dr Walayat Hussain.

 



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