I love hot weather and the sunshine, (I’m a SoCal girl after all), but I have never been one of those people who baste themselves in the sun. I always thought this was to my benefit. My doctor explains that the skin cancer is more than likely the result of having been sunburned as a child. This sparks a memory. My grandparents had a summer house. I remember my grandmother telling me I was so fair as a child that I would get blisters on my nose and cheeks just walking the short path from her house to the beach.
Because of the visibility of where the scar will be, my dermatologist schedules an appointment for me with Dr. Hall, a prominent plastic surgeon who specializes in minimal facial scarring. I am re-checked by him and it is confirmed. I have squamous cell. He is calm and very understanding. He tells me that there are two ways I can go with this, I can use a form of chemotherapy in cream form and have the site checked regularly, (a sort of wait-and-see approach), or I can have surgery and he will “close up the incision and then do a scar revision on the area after a few months of healing.” I opt for the surgery. My dermatologist, who specializes in skin cancer, will do the operation, and the plastic surgeon will then close it up. We are set.
My operation is scheduled at a hospital that specializes in a surgery known as MOHS, which is micrographic surgery. This, I learned from the internet and my new doctor, is the most progressive surgery for skin cancer. It saves as much of the healthy skin as possible. Instead of the usual procedure of cutting deeply into a site, taking out healthy tissue as well as the cancerous part, the MOHS procedure begins by slicing very thin layers of skin, one at a time, and checking them under a microscope for cancer cells. The patient waits in the operating area or returns to the waiting room, as the doctor takes the sample to be checked, then comes back to remove another thin layer of skin for the microscope. When no more malignant cells appear and clear samples are seen on the slides, the operation is over. You can be in the hospital for two to six hours, however, depending on how long it takes before there are clear skin samples. I write this in layman’s terms but, basically, that’s it.
Hospitals today look more like fancy hotels than places where operations take place. As my husband and I enter the lobby, I am reminded of entering the grand foyer of the Ritz-Carleton in Sarasota, Florida. We are sent to the third floor where “everything-you-ever-wanted-done-to-your-skin” is situated. Not only is this the floor for MOHS patients, it is also the place for the newest in “age-defying mini-operations.” Corrective skin surgery, therma-cool, (the procedure that tightens the collagen in your skin to get rid of sagging), processes that take brown spots out of your skin. You name it, you got it. I find myself wishing I was here for one of the age-defying fixes.
I am glad she is doing the surgery. The first dermatologist I went to was very gruff and handled my face as if it was a piece of dough. He did not specialize in skin cancer surgery and became impatient when I asked questions. Not being comfortable with him, I did my research (of course) and found Dr. Rogaschefsky who is kind and understanding. She smiles, tells me to relax and leaves the room. I am alone with the music playing on the Bose sound system and my thoughts.
Let me say something here about my nose. I have always liked it. It has never given me a problem. I never worried about it being too fat like other parts of my body or not looking good in jeans. My nose has always been pretty good for me and, except for some seasonal allergies, I really never gave it much thought. It is a perfect match for my face, not big or small. Now, in a little while, I’m going to have someone, albeit someone I trust, slice thin pieces off of it. I am scared.
Dr. Rogascefsky is about seven months pregnant and, as she leans over me, I feel her belly pressed against my shoulder. It is a strangely comforting feeling. She pokes the tip of a scalpel to the side of my nose and I feel nothing. Thank God! I am numb. She tells me to relax, tilts my head and begins the operation. With my eyes closed against the bright operating room light, I feel nothing as she begins the operation, but I hear everything. I even hear the sound of the scalpel making the initial cut, a soft slicing sound, as she is removing the first thin sample. And I smell my own blood. This is a little disturbing. She takes two samples, bandages the area, and sends me to the waiting room.
I go see Dr. Hall two days later. He removes the bandage and stitches, then hands me a mirror. It doesn’t look as bad as I thought it would but it does looks as if someone had put a dime’s worth of putty on the side of my nose. Dr. Hall tells me that it will take from three to six months for all the swelling to go down. Also he has pulled over a little extra skin because it is better to have more skin to work with for scar revision. He is confident and reassuring. This is a man who deals with major trauma victims. Working on my nose is a simple thing for him.
The episode with skin cancer did make an impression on me. Even though I had one of the most curable cancers, it is, after all, still cancer. That word alone strikes as much fear in the human mind today as the word leprosy did in the past. That word also lets me know that I am not immortal and it tells this very mortal person that she is indeed lucky; that a tiny scar is a small price to pay to be healthy again.