The Nose Thing

I noticed a little white spot on my nose, it didn’t look like it should be there. But, it was small, about the size of a pin head, and not noticeable at all. I’ll mention this next time I see the doctor, I thought.

And, I did. It might not have been the next visit, but one day I was in for something else. I remembered the little spot as I was going out the door. “Oh, I said, what’s this?” and I pointed to my nose.

He looked and frowned. Ran his finger across it. “That’s a Basal Cell Carcinoma.”

And I frowned!

“I’ll make you an appointment with a dermatologist for a biopsy.”

Thank goodness, we were living in Arizona, probably the skin cancer capitol of the world. If we’d been here in Oklahoma, my doctor might have been the one who carried a bottle of freezing-stuff from room to room. He might have made one of his on-the-spot diagnosis and froze that little  spot until it sizzled.

Fortunately, I was in Arizona and when the biopsy came back in agreement with my family doctor’s diagnosis. He gave me a choice. “You can go to a plastic surgeon. Or, you can have radiation, Or you can have Mohs surgery.”

I frowned. “But this is such a little spot… plastic surgery, radiation! What’s Mohs surgery?”

And then he told me that Mohs surgery takes the least amount of tissue with the most certainty of “getting it all.” The surgeon marks the suspicions spot, dividing it in sections, before removing the afflicted tissue. The segments are examined under under the microscope. If any cancer is left, the surgeon knows the exact location and removes another small amount of tissue. This is repeated until the microscopic examination shows that the edges and bottom of the removed tissue are clear of cancer. Sometimes only one slice is necessary. “This is what we recommend and we have an excellent surgeon in mind.”

This all seemed so unreal! And way too much excitement for such a tiny spot. Did I mention that it was about the size of a pin head? I mentioned that to the Mohs surgeon when I asked her how much of my nose she expected to remove.

“This may only be the tip of the ice berg,” she said. I don’t know what I’ll find until we have a look under the microscope.” And then she started talking about the repair and a plan to remove tissue in front of my ear for a skin graft on my nose.”

I blinked and shook my head. “A skin graft for this tiny spot? Let’s wait and see if I really need a skin graft.”

She nodded and patted my arm. I felt I still had a little control over the situation.

“After the skin graft, we’ll stitch a yellow pressure bandage to you’re nose.”

I laughed and rolled my eyes. This had to be a joke. Who ever heard of stitching a bandage anywhere. Weird! I shook my head.

She humored me. “We’ll schedule the surgery and you can decide about the repair after we’ve removed your cancer.”

And, I left the office wanting to believe little spot would not require a skin graft… And a yellow bandage sewed to my nose! Well, she did make me laugh when I was feeling pretty glum. Although basal cell is not a life threatening cancer, the thought of removing part of my nose was very disturbing. How much were they going to remove? There was no answer and my imagination took flight. Our granddaughter had a jewel in her nose (I hated it) but, maybe that’s what I would do if I needed to hide the scar/hole. Maybe I would need a jewel encrusted gold nose…

A couple of weeks later, I sat in the waiting room of the mohs surgeon’s office with a large white bandage taped to my nose waiting for the results of the microscopic exam. I prayed they wouldn’t have to take more tissue… no more cutting. Although I had experienced no pain, cutting on the nose makes a lot of unpleasant noise.

Good news. They got it all. No more cutting. Now, “Did I want a skin graft to repair the wound?” She handed me a mirror.

After a quick glance I knew the answer. “Yes. I believe I do want a skin graft.” And an hour or so later I left with a yellow bandage sewed on my nose. Medical professionals don’t do much joking about serious matters.

It took about a year for the skin graft to become almost unnoticable and during that time, I did some fretting that wasn’t warrented considering that I had cancer; it was a nonthreatening cancer and it was gone.

That was eight years ago and this is how my nose looks today, much closer than most people see it.


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