FYI: I'm getting one assertive billy-goat station wagon!!

[elagache]

Dear WeatherCat faithful,

Much has changed since my Christmas card in which I described my current struggles with skin cancer tumors.  The first week of January I met with a doctor (and professor) from the University of California, San Francisco's division of Facial Reconstructive Surgery.  That's about as specialized as things get.  Things didn't get off to a good start.  One of the residence (doctor in training) spotted a large growth on the right side of my nose.  Another Ear's Nose and Throat specialist had already uncovered this back in October, but it was concluded it must be removed at the same time as the very large basal cell cancer tumor on the left side of my nose.  Doing so would involve scooping out some of the cartilage of my nose.

Until then, I had been told there would be 2 surgical procedures: a first operation to remove the tumors performed by a specialist in so-called Mohs surgery, then a second operation to reconstruct the nose.  Having the problem before him, the reconstructive surgeon immediately proposed, not 1, but 3 reconstructive operations.

This Wednesday (January 26th) is Mohs surgeries to remove the tumors.  They will remove the tumors, control the bleeding, and check that they have "clear edges" (confirm that every last been of cancerous tissue has been removed.)  Once this has been achieved, they will bandage the region as best as they can, and send me home.  The following morning, Thursday, the 27th will be the first of the 3 reconstructive surgeries.  The reconstructive surgeon will make the skin graph from my forehead and repair the nose to first approximation.  He will in the same operation remove the growth that is blocking the other nostril.  That will leave damaged cartilage and effectively turn my nose into a blob of flesh without structure.  However, that assembly will need 3 weeks to heal before the next step.

Sometime in late February, the surgeon will perform a second operation which will graph in some cartilage to repair the structure of my nose and give it a normal appearance.  It will require another 3 weeks to heal from that.  Finally, in mid-March sometime, he needs to perform one more operation to complete the restoration of the nose, which in part, involves completing the separation of the skin graph from the forehead.  This is definitely a long-haul of medical procedures.

Based on my previous surgeries,  I'm expecting to be in really difficult straights for a while.  I finally have some instructions for the operation, and as expected, my face will suffer from a lot of swelling.  Removing the tumor over my right eye resulted in sufficient swelling that I had difficulty seeing.  Since this procedure will involve both my nose and the forehead where the skin graph will be taken I suspect my face will swell up like I had been stun by a dozen bees or more.  Under those circumstances, I suspect using a computer will become difficult.  As a result I might be scarce on this forum from time to time.

I'm not supposed to wear glasses until my nose is fully repaired.  Since I need glasses to drive, the current assessment is that I won't be driving until the end of March.  Last Friday, I took Biquette out for one last outing before I'm out of commission.  While there I took this photo on front of some winter trees:



Thanks for your support.  I'll try to keep everyone posted as I attempt to navigate the long and difficult road ahead.

Edouard

[Blicj11]

Edouard, I sincerely hope and trust you are going to come out the other end in as good as, or even better shape than the Buick. My prayers are with you.

[The Grand Poohbah]

We'll look forward to your healed and healthy return.

[271249horst]

Hello Edouard,

I wish you interventions that make your life decent.

Horst.

Translation from French

[xairbusdriver]

I'm just hoping you end up looking as good as that Buick! But just not as assertive!!

[elagache]

Thanks everyone,

First surgery tomorrow morning at 9am.  I'll just have to take the blows as they come.

Edouard

[elagache]

Dear WeatherCat faithful,

I wanted to update everyone as to how this week's two surgeries went.  As feared, it has been quite an ordeal.  The Wednesday surgeries were extremely tough.  As usual, the cancer surgeon should have used more anaesthetic and it took a very long time to completely remove all the cancer.  The surgery started at 9:30 am and there was a long wait while the pathology lab looked over what was removed.  The surgeon made a decent guess but there was still some cancerous tissue left.  So there was a second round of cutting in the early afternoon.  They didn't finally bandage me up and send me home until around 3:30 pm.

That night wasn't so bad.  I'm not sure why though.  I had to get up at 4:15 to be at the second surgery site at 5:30 am on Thursday.  I guess the pre-operation process went okay.  I don't remember anything about it.  However, when I woke in the recovery room I was obviously extremely weak.  I could hardly move, much less being able to make it to a car to come home.  I didn't have to argue much, the reconstructive surgeon concluded I would have to spend the night in the hospital.  However, that didn't go well.  For whatever reason, they couldn't manage to find a bed for me.  I stayed in the recovery room from about 12 noon to 9:30 pm.  I'm extremely thankful to the recovery room nurse that stayed with me long past her shift.

When I finally got a bed in the hospital the night nurse was also kind and helpful.  The pain medications allowed me to sleep a bit so that I could recover my strength some.  By the morning (Friday) I could walk to the bathroom and felt strong enough to be discharged.  It took some fumbling to make that happen, but I was finally home at noon.

I'm not much to look at.  My face is a bloody mess and, as expected, my new nose is an ugly blob of flesh.  The surgeon ran into some sort of problem securing the flesh on my nose.  As a result I have stitches along the left side of my cheek to my lip and probably another mysterious stitch in the middle of my lip.  The flesh around my left eye is badly bruised and swollen.  The skin graph from my forehead has a blob of flesh carrying the blood supply from my forehead to the reconstructed nose.  That blob is also obstructing my left eye making seeing difficult.  My body seems to have effectively shutdown and it is taking time to get all systems operational once more.  I've had to write this in small periods of time before my eyes became too tired to continue.  With time my forehead is finally starting to complain about the theft that made this whole thing possible.

The good news is that the reconstructive surgeon did what would seem to be the impossible.  He created from a flap of forehead skin a first approximation of a nose.  Moreover, while it is ugly, it is already doing its job: allowing me to breath.  I was really dreading these first few days being only able to breath through my mouth, but even at this early stage the nose allowing me to breath a bit when eating.  That's a big improvement in the comfort level.

That's the status report to this afternoon.  The first follow-up appointment with the reconstructive surgeon is this Tuesday.  I hope things will start to improve from here, and that the worst has over.

Edouard

[xairbusdriver]

I hope things will start to improve from here, and that the worst has over.

I know that's the same hope of all your friends here (and maybe even those others, who shall remain nameless!)! I didn't want to ask how you are doing. I figured you'd be along when possible.

Your assignment, should you agree, is to simply behave like a dog and "Heal"! Good to hear you can eat! At least one enjoyable activity in which you can partake! Just rest up, gather some strength and behave yourself!!

[271249horst]

The news seems rather encouraging, in any case you have to trust the surgeons.

As far as pain is concerned, you have to accept it and I am paid to know that at the end of the operations it will be nothing but bad memories.

Sincerely.

Horst.

Translated from French.

[Steve]

Thank you for the update, Edouard.

That sounds like a rough couple of days. When you first talked about only two rounds, I thought "that's not too bad. My first time was eight rounds." But that doesn't sound the case at all. They must have gone much deeper, whereas all of my Basel cell carcinoma surgeries have been pretty shallow, and all but that first time only one or two rounds. You're gonna be a sore boy for quite a while.

I'm sure they told you that the swelling and discoloration will get worse before it gets better. A bag of frozen peas or corn works wonders to relieve the discomfort. What's going to be the longest odd feeling is as nerve endings start to grow back. Especially in normally tender areas like around the eyes, nose, and mouth. It doesn't hurt. It's just a strange sensation as even a feather-light touch seems like a mild electric shock. You'll definitely know weather changes before those around you!

Take care, and heal up. It'll definitely be better in the long run!

[Blicj11]

Edouard:

Thanks for making the time to give us an update. Our thoughts, faith, and prayers are with you in your post-op recovery adventures.

[elagache]

Dear X-Air, Horst, Steve, Blick, and WeatherCat faithful,

Thanks for your kind thoughts and prayers,

That sounds like a rough couple of days. When you first talked about only two rounds, I thought "that's not too bad. My first time was eight rounds." But that doesn't sound the case at all. They must have gone much deeper, whereas all of my Basel cell carcinoma surgeries have been pretty shallow, and all but that first time only one or two rounds. You're gonna be a sore boy for quite a while.

Yes, I believe the surgeries I'm going though are must more complex and severe than any standard Mohs surgery.  The cancer on the left side of my nose has basically gone through to the interior of the nasal passage.  So essentially all the flesh on the left side of the nose had to be removed.  There was significant cancerous regions on the right side that to be cut out as well.  Under those conditions, it was necessary to literally reconstruct the nose from flesh coming from somewhere else.  In my case the reconstructive surgeon scooped out a roughly 4 inch by 4 inch section from my forehead and folded and twisted that over onto the top of the damaged cartilage that was left of my nose.  Right now there is a strange blob of flesh from my forehead that is literally wrapping an artery providing blood to that region of flesh.  That's the only blood supply for flesh that will become my nose.

Unfortunately what seemed like a "slight adjustment" has proven to be serious difficulty.  The surgeon had difficulty securing the flesh into to the approximate shape of a nose and had to add some additional stitches on my cheek and lips.  These are now causing me a lot of pain when eating.  This afternoon is the first post-operative appointment.  I hope that at least those stitches will be removed so that eating is no longer such a risky and potentially painful experience.

That's the update to this morning.

Edouard

[elagache]

Dear WeatherCat faithful,

Here is another quick update.  On Tuesday the stitches from the first surgery finally came out.  I don't fully understand the purpose, but the skin graph for the new nose had to be secured to my cheek and lip.  Getting those stitches out was unexpectedly painful and the left side of my mouth is still partially numb.  The whole region is finally healing and that is something of a strange experience.  As the doctor described, there is a blob of flesh secured to what was remained of the right side of my nose.  There is an abrupt transition from the graphed skin to what looks like a normal nose.  The new graph is, not surprisingly, swollen so there isn't much air flow on the left side.  So I'm vulnerable to congestion.  To avoid that, I "try" to sleep almost sitting up.  However, that isn't exactly the most restful position!

I hadn't shaved in over a week.  Finally the itching was too much and I timidly removed the "jungle" of beard in stages.  You don't realize how pleasant it is to be clean shaven until you can't do it for a while!

The next surgery is scheduled for Thursday, February 17th.  In that operation, the reconstructive surgeon will insert some cartilage to turn the blob of flesh into a normal nose.  He will also "thin" the flesh of the nose to a more normal thickness.  I'm not sure I want to know how he is going to do that!

In the meantime trying to get back more to a normal life.  I still don't have very clear vision, so computer time is limited.

Thanks again everyone!

Edouard 

[xairbusdriver]

Thanks for the update!

Don't try to think too much about how things will be done. Enjoy the sausage but don't visit the kitchen!

[271249horst]

Hello Edouard,

On the positive side, it seems to be going according to the doctors' forecasts, so be brave, there are still some unavoidable steps to be taken.

Best wishes.

Horst.

Text translated from French.