nose job

Removal of skin cancer on my nose by Mohs Micrographic Surgery.
Dr Kevin Kiene January 9, 2014
Skin Cancer and Dermatology Institute.

Tamera Van Dyke, my regular dermatologist discovered a possible skin cancer on the bridge of my nose in late October. It tested positive, so she made an appointment with Dr. Kiene to have it removed by Mohs surgery.

Carol and I arrived at 640 Moana Lane a little before the appointed 9:45 (I should have a companion for company and in case I need a ride home). I was ushered into an examining/operating room at 10:15 and situated in a “dentist type” chair. The nurse gave me a name tag and marked my nose in the suspected area (don’t want wrong guy or wrong body part). She numbed my nose. She laid out the tools and adjusted my chair so I was lying flat, pretty high.

After a few minutes the doc came in with the nurse (or a nurse, I couldn’t see, they’re behind my head out of my peripheral vision — again, like at the dentist) and a male resident. It didn’t take long for him to make a cut and take what he needed. He noticed my Red Sox World Series tee shirt, so we talked a little baseball while he was working. “We’ll examine this tissue and see if we got everything,” he said. The nurse bandaged my nose and took me to fetch Carol from the main waiting room. We were then guided to a small waiting room stocked with drinks, snacks magazines and books. Four other males (a cheek, a nose and two ears) were in the room, two with companions. The instructions said to allow at least three hours for my procedure and it was around 11, so we had the better part of that time to go.

I started reading the NY Times Magazine, “The Lives They Lived, And the Things They Loved” issue; James Gandolfini’s 1968 Cadillac Convertible on the cover. From time to time, a nurse would come and get a guy. For a couple of guys she said, “You’re done.” I read my NY Times Magazine from cover to cover. Very interesting. They focused on a subject’s interests, rather than their lives as in an obituary. George Sauer the great NY Jet in Super Bowl 3 hated football; Dr. Joyce Brothers talking down a potential suicide on her call-in radio show; Elmore Leonard loved westerns more than crime, but crime paid better; the impact of Doris Lessing’s novel “The Fifth Child,” on couples wanting large families; Lou Reed’s custom made Davide de Blasio glasses with flip-up lenses so he didn’t have to take them off to read. Just after I closed that and picked up a New Yorker, a nurse came in and said, “You’re done. Come with me to get closed up.” Whew, I’m almost done.

Not really. I was put in a different operating room — each Mohs doctor has three — and was situated. “The doctor will be in in ten minutes, once he finishes closing up another patient.” The radio was tuned to Sunny 106.9; “music of the 80’s 90’s and now…” I would have chosen something different, but it wasn’t terrible. I waited. I couldn’t see anything but the wall in front of me with three framed pictures, about 12 by 12 inches, landscapes, the center one had a black matt, the other matts were light colored, one hung crooked. I heard an occasional voice behind me in the hall. Way more than 10 minutes had passed. After more minutes, I loudly said, “Hello!” the nurse in the red 49ers tee shirt instantly appeared beside me. “I’m still here,” I said. She said the last patient took longer than expected. Almost done.

The doc came in. He said, “Sorry for the delay, sometimes that happens. Let’s get you closed up and outta here.” He was wearing a short sleeved, cotton Hawaiian style shirt, although I could only see his arm and part of a sleeve. While he was working, he and the nurse talked about massage. She was about to get one at a spa, he had only had a massage in Thailand, deep-tissue, very painful he said, but he felt great the next day. He said the spa massages at the resorts were just fru-fru and she agreed, but she liked the way she smelled after.

Just when I thought he had to be finished, he would start another stitch. And again, he would pull the thread tight, holding it with a forceps about 12 inches above my face. And again, and finally, “Done.”
http://en.wikipedia.org/wiki/Forceps

Sweetest word I had heard all day. The nurse asked if I wanted pain pills. I said, “Not unless I have to.” The doc suggested they might help with the swelling if I got some throbbing pain. He left and the nurse bandaged me. On my way out, she gave me his prescription for Vicodin for pain.

Across the parking lot, we saw Kinder’s BBQ. We love their sausages that we’ve purchased at the supermarket. Didn’t know they had stores in Reno. It was almost 1pm. We had lunch. Ribs for me, sausage sandwich for Carol. Excellent.

Once home, I laid on the bed with an ice pack on my nose from 4 to 4:15 (“15 minutes each hour”), 5 to 5:15, 6:30 to 6:45, 8 to 8:15 and finally about 9:30 to 9:45. I never experienced throbbing pain or anything more than minor swelling. The bridge of my nose with the bandage felt like I had on a pair of really heavy glasses.

For dinner Carol made Fatted Calf sugo to sauce Bartolini Strangozzi, a spaghetti-like pasta from World Market. I was poised to take Vicodin with the meal, but I really wasn’t in pain, certainly not throbbing pain, so I took two Tylenol instead.

My nose, especially my right nostril, would periodically run like I turned on a faucet. I hated that. No alcohol, I hated that.

I was supposed to sleep on my back with two pillows and I did. Went to bed about midnight and slept pretty well. Got up at 4 to pee and take Tylenol.

When I got up to make coffee at 6:30, I felt fine. No more runny nose, little or no swelling, no pain. And so it went for the remainder of the 48 post surgery hours.

Saturday, on the stroke of 48, I took a shower and the bandage came loose and almost fell off. I removed it, dried, and took a look. Looked good. Swabbed with soap and water, slathered on Vaseline. They gave me two types of band aids; squarish and regular. the squarish had a larger pad and I cut off the top part and used that. Fits great. Done.

I go back Thursday to have my stitches removed.