If you follow me on Instagram, you may be aware that I recently underwent Mohs surgery. What does this have to do with running? Since the purpose of Mohs surgery is to remove skin cancer and most runners spend a lot of time in the sun, they are definitely related.
What is Mohs Skin Cancer Surgery?
In a nutshell, Mohs skin cancer surgery is a technique where the surgeon will take a layer of skin from the cancerous area and study it to see if all the cancer was removed. If so, that’s it, you’re done except for any repair to the wound.
If the first layer reveals that there is still cancer, the doctor will take another slice and go through the procedure again. And again, if necessary, until no cancer remains.
Finally, the doctor will repair the wound. In some cases, this is done simply by allowing it to heal or using a few stitches. If the wound is large or deep, the doctor may choose to do a skin graft or skin flap, which will take longer to heal and may involve some plastic surgery to ensure the best outcome.
This is all done in one visit, usually with one doctor, so it may take hours to complete. However, Mohs skin cancer surgery is considered the best treatment for Basal Cell Carcinoma and Squamous Cell Carcinoma. Some surgeons are even seeing good results with certain cases of melanoma.
Learn more about Mohs Surgery here.
My Skin Cancer Surgery Story
I admit it. I had procrastinated visiting the dermatologist. I will not do that again. It was the esthetician at my work that really encouraged me to go to the doctor. I had a small sore on my nose that took a long time to heal. It did eventually, but then it came back. Kat, the esthetician, told me I really needed to get it checked out.
As it turned out, in addition to the spot on my nose, I had two other spots on my face that the doctor was concerned about. They were barely noticeable to me, but he wanted to do biopsies on all three locations. I also had two other locations, on my arm and shoulder, that he chose to treat with a prescription ointment.
Biopsy Results
It took about a week, but finally, the results came back. All were positive for Basal Cell Carcinoma. This is the most common type of skin cancer but it can be dangerous and disfiguring if left untreated. I was to be scheduled for Mohs Surgery as soon as possible.
Alan had Mohs surgery (on his forehead) several years ago and it was very minor. One layer, left to heal on its own, boom, and done. Silly me, that’s what I thought I was in for. When I was scheduling my appointment, I was told that I could bring my husband but that it wasn’t required. Boy, was the doctor mad when he heard that! At the scheduler, not me.
I actually encouraged Alan to stay home because I knew it could be hours of waiting. The big problem? My appointment was in Riverside, an hour and a half from home. He was planning to come anyway, but we didn’t have a dog sitter and he had other animals to care for, we decided he should stay home.
Surgery Day
I arrived, alone and on time, for my appointment. I was escorted to the Mohs waiting area. Mohs surgery patients have a special area in which to wait because much of our time there is spent waiting. After removing a layer, the doctor must test the tissue, which can take up to an hour or more.
The nurse came and took me to the treatment room, where she did the standard health history and got me ready to meet Dr. Beroukhim, my surgeon. I liked him immediately. He was young (I teased him that he was younger than my oldest son) and enthusiastic, but also very confident and positive. He started by marking the areas of my face which were to be operated upon. He told me right away that he thought the spot on my nose was wider than was marked, but that on the first layer he would keep it smaller. That was fine with me!
Because Mohs Skin Cancer surgery is potentially an all-day affair, it is done under local anesthesia. Aside from the pain of those shots, everything is pain-free. The first layer on all three areas went pretty quickly. I was sent off to wait. Because I would be in and out of the treatment room, the nurse taped me up each time I needed to use the restroom or went to the waiting area. The taping also helped stem the bleeding, so it really was necessary.
About the instructions, I received that my husband was not needed. Doctor B. was shocked that I had been told that. He said that when we were done, one way or another, I would have two black eyes (two of my spots were near my eyes) and my face would be bruised and bandaged.
I probably should have called Alan right then, but I held off. I have a friend who works close by a couple of days a week, so I thought I’d try her first. Plus, having Alan come would mean leaving my car there for probably at least a couple of days. Anyway, I held off.
After about an hour I was called back to the treatment room. Unfortunately, as the doctor expected, the spot on my nose was wider than the original spot, so he would need to do another, wider but not deeper, slice. On the bright side, the other two spots were clear, so they were ready to be closed. Because of that, I was able to keep the doctor busy for the rest of the day, no more waiting area for me!
After Dr. B. took that wider slice from my nose, he started closing my other two wounds. One, which was to the side of my nose under my eye, he was able to stitch up, a relatively simple procedure. However, I also had one next to my right eye (on the inside near the bridge of my nose) and I was told that I needed a graft. It was a small spot but simply stitching could pull on my eyelid.
He took the skin for the graft from the area in front of my right ear. We laughed it was like a facelift that was covered by insurance. Because it was so small it was done quickly and he then stitched up the skin by my ear. That one healed very quickly too, I almost forget about it now.
The doctor then went to check on my lab results. When he came back the news wasn’t good. He had to go deeper. That meant more local anesthetic, more slicing, and more bandaging while we waited. At this point, I was just kept in the treatment room as he finished up with closing the other two wounds.
In the end, we had to do four layers. Layer two was just wider, not deeper, then three and four had to go deeper. But then I finally got the good news. They got all the cancer. Now to close.
Skin Graft
So now, the cancer was gone but I had a fairly large hole on my nose! Dr. B. decided that a skin graft was the right way to deal with it (as opposed to a forehead flap thank goodness)! This link is to a forehead flap photo which is quite graphic. It also shows the final results, which are very positive.
Dr. B. said that he could take the skin for the graft from my neck (which I have plenty of!), but he thought taking it from my cheek would match better. We decided on the cheek. Because the graft needed to be quite large, the cut he made started just below my nose and ended just under my chin. On the bright side, he lined it up with my smile line so it will eventually look quite natural. He did a great job, actually, and just three weeks after surgery and 10 days after stitch removal, I can tell that it’s healing well and doesn’t look too bad!
The skin graft on my nose took a long time to complete. More local anesthetic! Plus by now, my skin where I was getting bandaged each time was getting raw and sore. I was tired, hungry, and still wasn’t sure how I was going to get home. And for some reason, I had to pee every half hour or so!
Finally, though, I was done. Just as Dr. B. had said, I was bruised from my eyes to my neck, my eyes were really swollen, and the bandaging came up over my nose making it difficult to see very well. So, of course, I decided to drive myself home.
All told, I was there for 10 hours.
The Drive Home
I’ll just say that driving myself home was not the smartest thing I’ve ever done. I drove slowly and was very careful, and obviously, I made it. I wouldn’t do it again though.
Post Surgery Care
I was sent home with instructions on how to care for my wounds. First of all, I was not to touch the bandage that covered the grafts. They are very fragile and it was important that they aren’t disturbed at all. The other wounds (the stitches by my nose and the two areas where the grafts were taken from) could be cleaned and re-bandaged. And I was told to use a lot of Vasoline. I was also given a prescription for an antibiotic. And to come back in 10 days.
Before my skin cancer surgery, I presumed that I would be back at work the next day. I laugh now. I didn’t even drive for 10 days! In the end, I was out for two weeks. Fortunately, it’s summer so I didn’t have to cancel too many appointments.
For the first two days, I stayed in hiding. When I had to go out I wore a floppy hat, sunglasses, and a mask (grateful finally for the normality of wearing a mask). Alan drove me wherever I wanted to go, which wasn’t much. I felt okay, just tired and my face was so uncomfortable! Weirdly, one of the most uncomfortable things was a roll of gauze that I had to keep in my nose to keep it from caving in (yikes!). I still have another week of that and I can’t wait to get it out of there.
Stitch Removal
I had my stitch removal appointment at 10 days. I was so excited I could hardly wait. I felt that the real healing would begin after the stitches came out. Plus, for better or worse, I would finally see my skin grafts.
This time Alan came with me. We were sure that it would not take 10 hours this time! Once we arrived at Kaiser in Riverside, I was quickly brought in to the exam room. Alan stayed in the waiting hour to finish up some work.
The nurse who removed my stitches was very nice and very thorough. It took a while (a lot of stitches!) but finally, they were all out.
The Big Reveal
I admit I was shocked to see my face when all the bandages were off. My nose was still very swollen and bruised. And yes, I understand that healing is going to be a process. A long one, it can take up to six months for the grafts to heal. Still, nothing like putting your vanity to the test. On the bright side, my microdermabrasion will be covered by my insurance!
Dr. B. came in and was pleased. He said everything was looking good. And that I could start running in another week!
Since then, I have been religious about my wound care. Nothing like a scary story from the nurse about what happened to someone who didn’t follow instructions (it turned black!). I’ve gradually reduced the size of my bandage so that it covers my nose but doesn’t make me look like the Mummy. And yes, my face is still uncomfortable. A kind of itchy, tight, feeling.
Back to Work!
I went back to work the Monday after my stitches were removed. My plan was to wear my mask at work but I decided pretty quickly to skip that. We’re very slow right now so with fewer people around I don’t feel quite so exposed. Plus, considering most of our members are my age or older, a lot of them have been through this same surgery. They understand. The downside of removing the mask is getting a lot of questions about what happened to my face. So I’ve told this story quite a few times!
What’s Next?
My next appointment is in about three weeks and I will know a little more about my progress. I expect I will be bandaging my nose for the foreseeable future. The other scars are healing really well and I am mostly leaving them unbandaged (but with a lot of Vasoline!).
I’m back running, though it’s so hot here right now I didn’t miss it all that much. I’m coating myself in sunscreen, by the way.
The Lesson
While most of the skin damage I have sustained came from years ago (I was raised in the era where we coated ourselves in baby oil and lay out on the beach) I have a new respect for wearing sunscreen always. Always. And you should too. Yes, I have very fair skin but sun damage happens to everyone. So please, wear your sunscreen year-round, whether it’s sunny or cloudy, hot or cold. Believe me, you do not want to go through this.
And if you have had or are scheduled for Mohs Skin Cancer Surgery, feel free to reach out with any comments or questions that you might have. Remember, take it seriously but also know that it has a 99% success rate.
And Now It’s Time for the Runners’ Roundup!
Weekly Linkups
My weekly linkups! Please stop by and check out all of the great recipes, workouts, and information that all these awesome bloggers share every week!
Meatless Monday with Sarah and Deborah
Inspire Me Monday with Janet
Tuesday Topics with Kim and Zenaida
The Runners’ Roundup with Deborah, Lisa, Jenn, and Me!
The Weekly Run Down with Deborah and Kim
Fit Five Friday with Darlene, Michelle, Renee, Jenn, and Zenaida
Ultimate Coffee Date with Deborah and Coco
Oh my, what a scary surgery, Debbie! So sorry that you had to go through this experience.
Your story is definitely a timely warning to always wear sunscreen. Easy to do, but also easily forgotten!
Wear sunscreen and have your skin checked regularly.
I’m sorry you had to to through this! Im glad you recovering and getting back to running now. Sunscreen is so important! I wear it every day now but I definitely didn’t when I was younger.
Because I run so early (as you usually do) I was a bit negligent in my sunscreen use. Not anymore!
Thank you so much for sharing your story. Skin cancer is truly an epidemic in our generation, isn’t it? I can’t imagine how it is going to be for the tanning booth folks.
After you had your surgery, I scheduled myself for a skin check with a derm PA. I had one before the pandemic, but none since. I am happy to report that she said everything looks good. My appointment for next year is already scheduled.
I’m glad you will have a good outcome after all this. Fingers crossed that you are done!
I hope I’ve inspired many people to see their dermatologist. I’m glad you are clear!
wow you had quite an ordeal! I also had Moh’s surgery a few years ago and mine was more like you describe Alan’s. It is amazing how much damage we can do and have without realizing it. I know go to my Dr every 6 months for a full check up. She usually finds something to freeze off every time. I am religious about sunscreen now as well
What’s sad is that we did so much of the damage before we knew better. I will be much better at getting checked from now on.
Thanks for sharing our story.
I grew up in the same era
Fortunately I have darker skin that doesn’t burn easily.
But as a older adult, I now wear sunscreen and religiously on my face.
My husband has darker skin and he still had issues (though much less than I did). The important thing is to keep up with the skin protection from here on out.
What a terrifying ordeal! Also difficult was have to make decisions about where to take grafts from in the heat of the procedure!
I would say to bring Alan for sure next time, but let’s not have a next time!
Hugs!
Hopefully I’ll never have to do this again but if I do I’ll definitely be bringing my husband!
Yikes. So glad you’re on the mend though. Skin health is so important, and these personal PSAs are so helpful
The video of your pups when you got home was so cute