Can I still go back and ask questions?

sunnygirl · Regular Joined: 26 Dec 2009 Posts: 22

I had Mohs surgery last week, had part of my cartlage taken out, it was deep but the margins are clean I was told. They could not find anymore lesions. I was ask if I had more questions but I couldn't think of any. They always come later. 2 days later reconstructive surgery and now over 12 stitches in my nose. How can I go back and ask for more questions? What should I ask? I'm having anxiety attackes.

Also what happens if the stitches get removed a day or two later because I don't have a car and need to find a ride first?

HaoleBoy · Senior User Joined: 19 Aug 2008 Posts: 135

Sunnygirl, As I recall, you had a combination of BCC and squamous ......I am not a doctor and did not have BCC or squamous (or both) -- unfortunately -- I have melanoma.... so things are NOT as bad as they may seem to you; it could be far worse... but to answer your questions:

1. Why don't you write down your questions and call the Mohs surgeon's office and ask the nurse (or if you have access to a fax or can get the doctor's email address, send him a written copy)... most doctors will respond back to you.... and FYI -- ALWAYS a good idea to write down your questions in a notebook or a medical journal before you go to a doctor's appointment (any doctor) and go right on down the list of your questions and take notes on what they tell you .....This is what I do....

2. As far as a car goes, I'm not sure what you're getting at but how did you get to the Mohs surgeon's office in the first place ?

3. Some questions to ask:

- Chance that the BCC or squamous will return at the same place (both are known for doing this, but Mohs surgery has the best track record I believe in mitigating this)....

- Ask whether any recurrence of the BCC or Squamous cell tumor presents like the original primary tumor (i.e. will look the same, is it on the surface, or could it present as a bump/lump)... does it always present in the same location in the same locations as the surgical site or could it be elsewhere in the same proximity of the original tumor?

- Was there any evidence of perineural invasion by Squamous cancer cells (i.e., invade a nerve pathway which is a potential route for metastases)...

- -Was their any evidence of any invasion into the lymphatics or vascular system ? Not likely for BCC since it grows so slowly and rarely metastizes but Squamous -- which also grows slowly -- does have metastic potential in SOME cases....

- What should I do and not do in terms of washing/cleaning the surgical area after the stitches come out ?

- What is my follow-up plan with you "Doctor Mohs Surgeon"

- For your derm, how often should I see you given that I now have history of skin cancer...

- Does this incidence of BCC/squamous put me at any higher risk for melanoma...

- Ask the nurse to mail you the normal melanoma patient handout with the some pics of TYPICAL (but by no means ALL) melanoma and the ABCDs (but note that the variable which should be there -- CHANGE -- is not in the ABCDs, but if something changes on your skin and doesn't clear up in 2 weeks , that should be your cue to see the derm)...

- This will likely have to wait until you visit your derm, but ask the derm to demonstrate how to conduct a thorough self skim examination ... and do these monthly and write down the results by body part....

- If you have alot of moles, ask the doctor about mole mapping so they can keep a record of your moles and any changes in them....

3. I know it is hard to be positive when you have had your face carved on (particularly for a woman), but take some comfort in the fact that this is BCC and squamous and not melanoma. BCC is not lethal except in a very few cases (i.e, someone ignores it for years and it invades a blood vessel or an artery) and squamous, which can metastize, only does so in about 2 - 6 % of all squamous cell cases according to Emedicine (http://emedicine.medscape.com/article/1101535-overview)

Regards and prayers for a speedy recovery....

Haole Boy (aka Hawaii Bob elsewhere)

sunnygirl · Regular Joined: 26 Dec 2009 Posts: 22

HaoleBoy, thank you so very, very much for your many answers. i'm so sorry to hear you have melanoma. i hope your're going to be alright. i'm sending many prayers and blessings for you. i have 3 girls with alot of very dark moles and they have no insurance to see a md. i know they need to have some removed. i'm so worried.

i copied down all of the info you have for me and i call the office back on monday. my mohs doctor said i should only come once a year for follow up. i don't know much about skin cancer. my family is oversea, my mother died of cancer, my grandfather died of cancer, my sister has cancer, my brother inlaw had skin cancer, my niece had cancer when she was in her 20s. i have noone to talk to. i'm so grateful for your answers. God bless.

[quote="HaoleBoy"]Sunnygirl, As I recall, you had a combination of BCC and squamous ......I am not a doctor and did not have BCC or squamous (or both) -- unfortunately -- I have melanoma.... so things are NOT as bad as they may seem to you; it could be far worse... but to answer your questions:

1. Why don't you write down your questions and call the Mohs surgeon's office and ask the nurse (or if you have access to a fax or can get the doctor's email address, send him a written copy)... most doctors will respond back to you.... and FYI -- ALWAYS a good idea to write down your questions in a notebook or a medical journal before you go to a doctor's appointment (any doctor) and go right on down the list of your questions and take notes on what they tell you .....This is what I do....

2. As far as a car goes, I'm not sure what you're getting at but how did you get to the Mohs surgeon's office in the first place ?

3. Some questions to ask:

- Chance that the BCC or squamous will return at the same place (both are known for doing this, but Mohs surgery has the best track record I believe in mitigating this)....

- Ask whether any recurrence of the BCC or Squamous cell tumor presents like the original primary tumor (i.e. will look the same, is it on the surface, or could it present as a bump/lump)... does it always present in the same location in the same locations as the surgical site or could it be elsewhere in the same proximity of the original tumor?

- Was there any evidence of perineural invasion by Squamous cancer cells (i.e., invade a nerve pathway which is a potential route for metastases)...

- -Was their any evidence of any invasion into the lymphatics or vascular system ? Not likely for BCC since it grows so slowly and rarely metastizes but Squamous -- which also grows slowly -- does have metastic potential in SOME cases....

- What should I do and not do in terms of washing/cleaning the surgical area after the stitches come out ?

- What is my follow-up plan with you "Doctor Mohs Surgeon"

- For your derm, how often should I see you given that I now have history of skin cancer...

- Does this incidence of BCC/squamous put me at any higher risk for melanoma...

- Ask the nurse to mail you the normal melanoma patient handout with the some pics of TYPICAL (but by no means ALL) melanoma and the ABCDs (but note that the variable which should be there -- CHANGE -- is not in the ABCDs, but if something changes on your skin and doesn't clear up in 2 weeks , that should be your cue to see the derm)...

- This will likely have to wait until you visit your derm, but ask the derm to demonstrate how to conduct a thorough self skim examination ... and do these monthly and write down the results by body part....

- If you have alot of moles, ask the doctor about mole mapping so they can keep a record of your moles and any changes in them....

3. I know it is hard to be positive when you have had your face carved on (particularly for a woman), but take some comfort in the fact that this is BCC and squamous and not melanoma. BCC is not lethal except in a very few cases (i.e, someone ignores it for years and it invades a blood vessel or an artery) and squamous, which can metastize, only does so in about 2 - 6 % of all squamous cell cases according to Emedicine (http://emedicine.medscape.com/article/1101535-overview)

Regards and prayers for a speedy recovery....

Haole Boy (aka Hawaii Bob elsewhere)[/quote]

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