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InnocentCat
10-15-2005, 03:26 PM
I had a flesh colored bump on the side of my nose that had been there for years. It never gave me any problems and I never thought anything about. I had seen similar bumps on other people and figured that is just the way I looked. Not long ago I nicked the bump during the course of blowing my nose when I had a cold. To make a long story short, it never healed. That was the first inkling that I had that this was more than 'just a bump'.

In September I finally made an appointment with a dermatologist who performed a biopsy which came back positive for Basal Cell Carcinoma.

I saw my Mohs surgeon this week...he explained the surgery to me. Then he said that after he does what he needs to he will send me directly to another nearby surgeon for reconstruction...as he believes that the defect may go quite deep and they will basically have to rebuild one side of my nose. There will be no prior consult with the reconstruction surgeon. So I don't get the chance to find out if there are any options to the skin flap, etc. The Mohs surgeon said that they would take a flap of skin, possibly from my forehead, and attach it to my nose and that I will look a 'little funny' for awhile. Seems from that description that I would look more than 'a little funny'. Do they allow you to cover the piece of tissue (and stiches) that is connected to the donor site if I need to go out, to work, store, etc., and keep it uncovered when at home ? For the reconstruction the Mohs surgeon said that they will have to put me under. Oddly enough of all that is going on that seems to be what is concerning me most. I have never been under anesthesia before...and it seems abit frightening. Has anyone experienced these feelings? Why is the necessary that the put you under as opposed to a local anesthesia like they will use for the Mohs surgery ? I am having this done at Southwestern Medical School in Dallas, TX.

This will be covered by my insurance...at least I should say to an extent. I guess my question is how much does the Mohs surgery and reconstruction cost on average ? I know that until the procedure is actually done the doctor won't know how many times that they will have to take tissue and this will effect cost. I am definitely having the procedure done....I was just curious on how much I might expect the procedure to cost. Then of course I know that it will be up to my insurance to decide what part they will pay...then there is the cost of the reconstruction.

Thanks in advance for your support :)

Tauri79
10-18-2005, 11:47 AM
InnocentCat,

I've not been in your position but I can offer you a little reassurance about the anaesthesia. It isn't nearly as bad as you think it will be. I was very nervous when I had one for the first time a few years ago. But it was fine in the end. It really was. Try not to let that stress you out too much.

As for the rest, I do hope your op goes well. I'm sure it will. These surgeons are very good and having seen a few people who have had BCC's removed from the nose area...well, I would never have known.

I hope someone can answer your other questions.

Take care:)

AprilPow
10-19-2005, 06:31 AM
I dont know much about the other stuff. But the anethesia is easy. I've had it several times. I was always a bit nervous thinking of 'what could happen'. I never had one problem though. It was actually quite neat. Falling asleep knowing what they are goign to do, then waking and realizing its done!

Good luck on everything! Write those questions down for your surgeon.

April

Belle2003
10-20-2005, 11:07 PM
I too had a flesh colored bump on the side of my nose for years. It turned out to be BCC too.

I went to Stanford University Medical Center for my MOHS. At Stanford you are not put under. You go into the surgery room where they use shots to numb the area. The doctor takes a slice off and then analyzes it under the microscope until he gets clear margins. Meanwhile you go back into the waiting area to find out if you need to have more removed. Once he has clear margins the cutting stops and reconstruction begins. I had to go in four times before he reached clear margins. There are several other people there too all getting their skin cancers removed.

I had to have a skin graft put on the site. All the while everytime I came back in the room for another slice or for the skin graft I was given numbing shots. The skin graft came from below the back of my ear. When the graft was done I was sent home with a large ball of bandage on my nose.

I am surprised that your hospital requires you to be put under. If you find this not to your liking, I would call other MOHS centers and ask what their procedure is.

I was very fortunate in that my same MOHS doctor did my reconstruction and it was all included in the price of the operation. I ended up needing two different kinds of laser treatment. One to smooth out the scar and another to remove the redness in the scar. If I was not happy with the redness he would zap it on another visit until the scar was the same color as the rest of my nose.

Of course I still have a small scar, but I am able to cover it up with foundation. When I look at it now, it is hard to believe how awful it looked right after the operation and even a few weeks after. It took a good three months for it to heal before the doctor was able to do the finishing touches with the laser. Then after each laser treatment it takes a couple of weeks to heal.

Since I was embarrassed by having a large scab, and black & blue from the lasers, etc on my nose I covered it up a bandaid. I did this so people would have to use their imaginations on how bad it looked underneath. My family thought I was silly, but I thought that people would stare more at the black and blue skin and scab then at a bandaid.

If you are concerned about the cost of the MOHS try to find a doctor who does not put you under needing an anestesiologist and one who also does the reconstruction.

Good luck with your MOHS. Let us know how you are doing.

InnocentCat
10-21-2005, 07:42 AM
I wanted to thank everyone for your repsonses...it it greatly appreciated !! :)

I too had a flesh colored bump on the side of my nose for years. It turned out to be BCC too.

I went to Stanford University Medical Center for my MOHS. At Stanford you are not put under.

Let me clarify...they are not putting me under for the MOHS....that will only be a local....it is for the reconstruction that they said that they will put me under....and I should say that it is the Mohs surgeon that said that they will put me under for the reconstruction....not the reconstruction surgeon himself....I don't even get a consult with him. I am thinking seriouosly of contacting them to see if that is at all possible....or any options that may be available. Although I know of course there can be nothing definate until the MOHS surgery is complete....

You go into the surgery room where they use shots to numb the area. The doctor takes a slice off and then analyzes it under the microscope until he gets clear margins. Meanwhile you go back into the waiting area to find out if you need to have more removed. Once he has clear margins the cutting stops and reconstruction begins. I had to go in four times before he reached clear margins. There are several other people there too all getting their skin cancers removed.

They did say that I would have a long boring day with all the waiting.

I had to have a skin graft put on the site. All the while everytime I came back in the room for another slice or for the skin graft I was given numbing shots. The skin graft came from below the back of my ear. When the graft was done I was sent home with a large ball of bandage on my nose.

I am surprised that your hospital requires you to be put under. If you find this not to your liking, I would call other MOHS centers and ask what their procedure is.

I was very fortunate in that my same MOHS doctor did my reconstruction and it was all included in the price of the operation. I ended up needing two different kinds of laser treatment. One to smooth out the scar and another to remove the redness in the scar. If I was not happy with the redness he would zap it on another visit until the scar was the same color as the rest of my nose.

Of course I still have a small scar, but I am able to cover it up with foundation. When I look at it now, it is hard to believe how awful it looked right after the operation and even a few weeks after. It took a good three months for it to heal before the doctor was able to do the finishing touches with the laser. Then after each laser treatment it takes a couple of weeks to heal.

Since I was embarrassed by having a large scab, and black & blue from the lasers, etc on my nose I covered it up a bandaid. I did this so people would have to use their imaginations on how bad it looked underneath. My family thought I was silly, but I thought that people would stare more at the black and blue skin and scab then at a bandaid.

If you are concerned about the cost of the MOHS try to find a doctor who does not put you under needing an anestesiologist and one who also does the reconstruction.

Good luck with your MOHS. Let us know how you are doing.

I am going to contact the reconstruction/plastic surgeon and get some more information

KNOWLEDGE IS POWER !!!

InnocentCat
10-31-2005, 04:57 AM
Just to follow up on what's going on. I have been able to communicate with the reconstruction surgeon...and it seems that some of the things that the Mohs surgeon told me were not entirely correct. For one thing I was told on at least two occasions by the Mohs surgeon insurance person that they believe that they (the reconstruction surgeon) bills. When I called the recon surgeon office regarding my insurance pre-cert I found that was not correct. Also when I mentioned some questions to the recon surgeon's assistant, who was very helpful, I was given the recon surgeon's email address. I emailed him and got a response alomost immediately....even though it was on a Sunday! I was told that I would be able to have a consult before hand, something that I was told by the Mohs surgeon that I would not be able to do, and also that they rarely use general anestesia. So I am going to call this morning to set up a consult.

Bottom line.....if you are like me and are using two different doctors to have everything done...make sure that what one doctor is telling you about the other doctors procedures are correct. Looks like sometimes that one hand doesnt know what the other is doing !!

InnocentCat
11-27-2005, 09:07 AM
Tomorrow is the day.....I will have my Mohs surgery in the morning followed by the reconstruction. I will check back in tomorrow and let you know how it went..that is if I feel up to it. I understand that it will be long boring day of 'hurry up and wait'. But I have been waiting a long time to get this taken care of. I will be glad when it's done.

:wave:

InnocentCat
12-03-2005, 10:23 AM
Here I am !! Cancer Free !!! I actaully went through 2 long days rather than just one. Monday morning I had the Mohs surgery...which only took about 15-20 mins. They got it all in the first session which I thought was wonderful...and somewhat rare.

After that I went down to the reconstruction surgeon down the street for a 1pm appointment. He was on a surgery that kept him longer than he thought so I was offered to wait until 6pm when he would be free...or going home and coming back the next morning....which I did. It was sorta funny how one minute I was looking around the operating room and I saw my doctor come in. The next thing I knew I was in the recovery room with the nurses tryig to wake me up. They took a skin flap from my forehead and attached it to make it the new left side of my nose. So now I am covered with bandages. That's not all that bad...except I wear glasses and right now I can't wear them because of the bandages and the swelling. No driving for awhile...and watching tv is abit limited. They even have a home health care nurse that is coming by 2 - 3 times a week to change my bandages. Plus they taught me how to do it too....so today will be my first attempt on my own. Next week I go to have some of the stiches taken out...and a couple of weeks down the line I have a second surgery to adjust and fine tune what was done earlier this week.

:jester: Glad to be here !!

Belle2003
12-04-2005, 12:12 AM
Glad to hear all went well. Where do you live where you get a nurse to come to your home and change your bandages? Two or three times at that!!?! Happy healing!

InnocentCat
12-04-2005, 03:13 AM
Thanks Belle !! I live in the Dallas TX area...I would mention where I had it done but I am not sure if we are allowed to do that here...so I will hold off on that ....if we are allowed to mention it just let me know and I will post it


:jester: