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Been at outpatient dermatologist surgery. Mohs surgery.

8 years ago

Had a basal cell carcinoma on my nose. Treated it for over a year as a large blackhead by another skin clinic. (not a dermatologist) I have had every kind of treatment known to man. LOL EXCEPT the right diagnosis. About a month ago I was tired of fooling around with this thing and went to my home town dermatologist. He took a biopsy and it was a basal cell carcinoma. He took as much as he could out, but said he just could not get it all so he made an appointment in Atlanta to a dermatology clinic there. This Dr. had to do the Mohs surgery as it was so deep. He had to keep digging and digging..I was wondering in there was gold in that dang hill. LOL. Finally! He got it all. He did a little patch up job, sewed me up. Left office and could not feel any part of nose or part of face. Now I am in pain!! He did not write anything for pain. Is this unusual and how long will this pain last? My nose and eyes are swollen now. Keeping ice on it on and off like he said. Ugh. Wonder if I will have to have plastic surgery? He did not say, and I did not ask.

Comments (25)

  • 8 years ago

    Can't believe he didn't discuss aftercare and pain meds. They should have done an evaluation on you and gone over expectations before doing the surgery. I would call his office now (they usually have an afterhours service) and see if they can't get you something for the pain or at least advise you what to take. Also, call the office tomorrow and get answers to your questions.

    Personally, I would take any Rx pain meds I had around the house or OTC pain meds.

    You may not need any plastic surgery since Mohs Drs are facial surgery experts and should be able to do simple surgery without the need for plastic surgery. More complex surgeries will require follow up cosmetic surgery.

    Info you should have gotten.

    User thanked annztoo
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  • 8 years ago

    Agree with annztoo, very much beneath the post-op standard of care.

    Pain meds are most effective when you are not "chasing the pain"--make an "urgent" call to the surgeon.

    I would be careful re: unprescribed pain rx, though. Only your physician could advise you regarding any possible contraindications.

    Hoping you get some much-needed relief pronto!

    User thanked nannygoat18
  • 8 years ago

    I did ask about plastic surgery, and he said he was taking care of that today. I did not understand, because he sewed it up and I have a follow up in three weeks. I thought plastic surgery was more involved than that. Am I right or wrong? I am taking tylenol as that is all I have in the house. He told me not to take any aspirin products until I see him in three weeks. Good, as I do not have any. LOL Totally stumped here as He had to go into the cartilage in my nose. They had to keep going in as they kept finding more and more. Total of 5 times. I was so sick of being there I was just ready to leave. Got out at 4:37 p.m. They did give me a paper on when to take bandages off and how to clean site. That is all. I should have asked as like I mentioned, now I am soooo darn confused! I hope everything turns out good. I am not a very nice looking person but dang I need all the help I can get!

  • 8 years ago

    Write a list of questions before you call. Hope things are better in the morning,

    User thanked lisa_fla
  • 8 years ago
    last modified: 8 years ago

    I had MOHs surgery done on my nose as well and I thought they were going to go right through the nose into the nostril. They didn't however. I do hope you were told no exercise for 2 or 3 weeks before the surgery started. I was told after the surgery and I had a race in 3 days which I couldn't do. I was furious and would have changed the date of surgery when it was first scheduled had I known. I shouldn't be so immature because I am lucky that the surgery was readily available to me.

    I don't remember the pain but I didn't need plastic surgery. It is something that those trained in MOHS know so that step shouldn't be required if they are talented at their jobs.

    I hope you're feeling better soon and are happy with the results.

    User thanked blfenton
  • 8 years ago
    last modified: 8 years ago

    I had it in early May. was there about 5 hrs. about killed me (the waiting part). my nephew drove me 'cause they had told me I might be there up to 8 hrs and by then it would have been dark and add into that my condition after it all and the continual construction and detours to get home, I didn't want to be driving!

    I went thru 2 times of them stabbing me to death to numb the area and then the final one before the actual incision. the first wait was about an hour, the 2nd was about 2 hrs. That was HLL on my back and behind. I was in bad shape after it all and super glad my nephew was there to get me home.

    I had to keep bandage on for a week and went back in for them to remove the bandage and stitches. My eye was swollen into a slit and was black, purple and red. It looked like I'd been slugged. It was tender but not really any pain. It did itch a lot that week as it was healing.

    They had given me a prescript for pain meds and antibiotic (I think that was the other one). We picked those up on the way home, just in case I needed them when the numbness wore off later that evening. I didn't.

    My incision went from the outer corner of the right eye to just a bit above the right nostril. It was longer than I expected it to be. I go in next week for a check up.

    Then they want to do a whole body scan for other possibilities.

    oh, I do remember that the person on my left used my nose like a handle... I thought it might break off with her death grip. She did that (I assume) to hold my head in position for the doctor slicing into me. That part was painful. they didn't numb my nose!


    User thanked desertsteph
  • 8 years ago

    OOh, I am making my appointment in the AM! I won't go into it, but I am thinking this situation will apply to me also. Thanks for the heads-up. I learn so much here!

    User thanked lovemrmewey
  • 8 years ago

    Several years ago, I had Mohs surgery for a basal cell carcinoma located next to the tear duct on my right eye (inside corner of the eye). You'd be hard pressed to find the scar. No, I did not have any plastic or reconstructive surgery.

    It is important that your surgeon is fully and properly trained in Mohs surgery. The American College of Mohs Surgery has lots of great information, and there is also a search function to find a fully qualified Mohs surgeon near you.

    User thanked Lindsey_CA
  • 8 years ago

    desertsteph, wow! That sounds a lot like what I went through! I wish I had caught it earlier! It is the a.m. now and yep, I am in pain! Actually my nose feels like it has been broken. I am sure it will feel better soon. Hopefully real soon! Thank you all for your great info! Love to you all!

  • 8 years ago

    Thistledew, I hope you feel better soon. I would start investigating reconstructive (plastic) surgeons now on my own. Just in case you need it. I wouldn’t be comfortable with just a referral from the dermatologist at this point. My friend has one removed, and due to her chosen surgeon being ill, she went to another and wasn’t near as happy. In retrospect, she said she should have waited the few weeks for another appointment. The thing is, usually the surgery and reconstructive part can be done all at once, and I am surprised that wasn’t suggested.

    Anyway, there are reasons for certain pain killers. Excessive bleeding is one. I know there is much being said and done now to avoid pain killer addiction, but your doctor can prescribe only a few days of something for you. And I am surprised you weren’t given an antibiotic. But all of this should have been discussed with you.

  • 8 years ago
    last modified: 8 years ago

    Yes, I was wondering why I did not get any pain med. or an antibiotic, Outside playing. When I was in waiting room there were others who had had the surgery waiting to see if the results were clear and no cancer was detected anymore and the nurse came out and gave them a written prescription for an antibiotic and pain prescription. I heard her telling them that. She then told them they were clear to go. Ugh. Hope they did not mess up on me.

  • 8 years ago
    last modified: 8 years ago

    CALL NOW and get pain meds prescribed. I'd think you should also have antibiotics.

    DH and I have had Moh's procedures for small basal cell lesions, but never for anything this extensive. I didn't think it was used on anything as deep and extensive as what you describe.

    User thanked chisue
  • 8 years ago

    chisue, when the Dr. had to come in for the 4th or 5th time he told me I was his "hard case" today. I do not know. But at last it was over and no cancer was detected anymore. Even though they were numbing it I still felt pain where they were having to go so far in my nose. I kept hearing scraping sounds. I guess that is normal. I was kinda freaking out when I started feeling the pain during procedure, but I kept my cool and said nothing. At the end of the session he did tell me that I had to be the most patient person he had ever worked on. I do not consider myself a patient person. I may have been in shock LOL as when I got out and into the car I was so cold I would not let hubby turn on air conditioner and it was over 90 plus degrees in Atlanta. I was shaking with cold and he got a blanket he keeps in back of car for me. About an hour I got fine, though. I did call the Dr. and he phone in antibiotics. Suggested extra strength tylenol. I am taking that. Not much relief though. I guess with this pain med. scare and people suing Drs., they are afraid of being sued. Another example of some of the people ruining help for others.

  • 8 years ago

    I take Tylenol #3 for spinal stenosis. I have taken two pills at night as needed for many years. I have taken a pill after oral surgery two times. I have never become addicted. Get some relief!

    User thanked chisue
  • 8 years ago
    last modified: 8 years ago

    "I kept my cool and said nothing. At the end of the session he did tell me that I had to be the most patient person he had ever worked on. I do not consider myself a patient person."

    Same here. I swear I kept waiting to hear a snap or crunch of my nose from the pressure the person on my left put on my nose. I kept thinking 'does she think my nose is a handle to move my head around?' I'm surprised I didn't end up with a headache just from that!

    I only got 6 pain pills I think. the 2 types together were only 10.00. I told them at my check up that I'd keep them in case I break a leg or something, ya never know. that could be a time that I couldn't get out to the pharmacy. Haven't even looked to see what they actually are! I'm very careful taking things like that. I seldom even take Tylenol anymore. I think I'm always in enough pain that I think it is normal - lol! I was on tramadol for yrs (for fibro) but stopped those last fall. that was really bad - mostly because of the restless leg syndrome that came with the withdrawal. I survived that and don't want to depend on anything like it again.

    I do hope you get those pain pills and antibiotics into you for this healing process. And do take some 'friendly flora ' type stuff after the antibiotics are done to get your intestine tract back in order. Antibiotics will throw it off and cause many other problems for you. I take a capsule will each meal.

    They did tell me to keep the incision moist, to coat it with Vaseline or some such type thing. they gave me some samples of a dermo recommended ointment. It's about 30$, so I've used Vaseline so far (after samples ran out), but think I will be buying it because it didn't have the greasy feel that Vaseline does.

    My surgery was very, very close to the tear duct - and that worried me. I go in next week for another check up and then in mid Aug I go in for a check up on my right eye cataract surgery (that was done at the end of January).

    I hope you get pain free quickly!


    User thanked desertsteph
  • 8 years ago

    They prescribed Tramadol. (hope spelling is right) as they could phone that in to pharmacist. The nurse said that they forgot to give me as prescription for Tylenol 3. If I wanted the tylenol 3 I would have to pick it up at their office as here in Ga. those kinds of drugs cannot be phoned in to pharmacy. I do not know if it is a state or federal law. Anyway, the surgeon I saw is 55 miles away so I chose the Tramadol. I have never taken tramadol, but it is doing o.k. but still having some pain, but not quite as bad. Not sleepy so I like that! I am experiencing some itchiness this a.m. Not bad, though.

  • 8 years ago

    That doesn't sound like a very good experience, but I am happy for you that the growth has been finally taken care of. Best wishes to you during your recovery.

    User thanked Rosie
  • 8 years ago

    DawninCal, thank you. You are very kind person!

  • 8 years ago

    Wow, I'm sorry they forgot to give you a script for pain meds! That was a pretty big boo-boo, imo, especially since you were shocky when you left. It's best to say what you are feeling, no matter how busy the staff seems to be. Be very watchful about the itchiness as it may be an indication you are allergic to the tramadol. Do call if it worsens! Very glad to know your surgery was otherwise successful.

  • 8 years ago

    I always get an itchy scalp with Tramadol.

  • 8 years ago

    did the 'itchy' start after taking Tramadol or before? I had 'itchy' - but assumed it was from the stitches. wasn't on tramadol or other new meds. the 'itchy' was the worst part of the after of it... plus my eye 'leaked'. well, something did. might have been drainage from the incision - I don't know. that lasted for weeks.

    I was on tramadol for many yrs and never had itching I associated with it.

    It's been 2 months now and the 'leaking' has stopped. the itching too.


  • 8 years ago

    Glad you finally got your pain meds. Your post reminded me that I'm overdue for a check up. I have two new moles on my face that look like the basel cell cancer I had years ago, when it first appeared. I also have some other issues I want to ask about.

  • 8 years ago

    I had this surgery done a few years ago and had no need for plastic surgery. I have no visible scar.

  • 8 years ago

    I had this surgery too. Next to my nose. I can see my nose isn’t like it use to be but after the local doc sent me to local surgeon (twice) I’m just grateful to have found the mohs surgeon. no real scars and some pain just glad to be rid of cancer.

    hope you are better now.