Tag Archives: excision

Letter from my consultant

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Friday 28th June

Fantastic news!

This morning I received a letter from my consultant dermatologist, (the one I saw right back at the beginning), who has carried out the two excisions on my lower back. The first time round the results came back inconclusive, so a Wider Local Excision was done, twelve days ago.

“I am writing to confirm that the re-excision of the scar site on your right lower back did not show any residual pigment cells, only scar tissue was identified. Please be reassured by this.”

Yay!! A great relief! An unbelievable weight has been lifted. The dark clouds have dissipated somewhat.

The next step will be the lymph node procedure, to be carried out at Exeter ~ still haven’t heard any news of an appointment, yet.

Thinking lots of positive thoughts, as always.

My stitches were not removed!

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Wednesday 26th June

Scheduled for a visit to the practice nurse this morning, I managed to convince her that I wasn’t ready for the stitches to be removed from my lower back. Yay! Since the wider local excision ten days ago, I had been in a fair amount of discomfort: a dull, throbbing, bruised sensation, making it difficult to sit or sleep properly.

I had this awful fear that, because it was a much bigger wound than before, the scar hadn’t knitted together properly, and if the sutures were removed, the whole thing would open up! Silly thoughts I know, but I was really concerned. The nurse, sensing my uncertainty and trepidation, agreed to leave the procedure until Monday; exactly two weeks since the operation. Big sigh of relief!

She commented that my left foot was healing well, despite a small area of raw skin, but it did however, appear to be quite swollen still, but that was to be expected, after two bouts of major surgery. I told her I was trying to take short walks, but on returning home, and later on in the evenings, my toes look like a pack of pork sausages! She said I must continue to elevate my foot whenever possible, and also to massage it, to try and reduce pressure.

Returning from a slow, gentle walk around the town, this afternoon, I sit down in the garden, and my husband turns the hose on, cooling and massaging my aching foot! Perfect hydrotherapy!

Back op #2

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Monday 17th June

It was way back, on 16th April that I first visited the dermatology department of my local hospital. On that day I had a dodgy looking mole on my right lower back removed under local anaesthetic. The results came back as inconclusive, so erring on the side of caution, the surgeon decided I should have a wider local excision. So here I am: not the most awesome way to start your week, but needs must when the professionals make that decision based upon your best interests.

I was first in at 9am; introduced to two nurses, asked whether I minded a student being present, whether I was taking warfarin and if I had pacemaker. The surgeon then arrived and began to put me at ease. I signed the consent forms, and we were good to go.

Having stripped off and climbed aboard the gurney, I could not see what was happening, but I could certainly feel the many sharp jabs of local anaesthetic, (the surgeon had to inject more halfway through as I could feel a little bit too much for my liking!) I was cut open, the scar tissue and surrounds dug out, deep stitches and surface stitches applied, and finally a  dressing gently positioned over the area.

And breathe . . . . And so to the recovery room for a welcome, wobbly-held, cup of tea.

Had a long chat with the ‘nice’ Macmillan nurse, about my left foot ~ I need to be taking it slow, with little bits of exercise and short walks, to help reduce the swelling, and also massaging in Bio Oil or Vaseline, to break down the fibrous collagen in the wound site (really doesn’t feel pleasant doing that at all!) Then she spoke about the possible sequence of events, going to Exeter for the lymph node biopsy procedure. Not pleasant either, but really is the best, and only course of action to take.

Am now in bed, heart is racing from the anaesthetic and tummy wobbly because it was uncomfortable, but thankful another procedure has been given a tick in the box.

Onwards and upwards towards a steady and comfortable recuperation.

My GP called

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Wednesday 12th June

Lying in bed, on a dreary, grey June afternoon, I am roused from a nap by the telephone ringing. It is my doctor whom I originally saw back at Easter time, about my foot.

He wanted a quick catch-up, as he had been absent from the surgery for a while. He understood that I had been through a lot since he last saw me (understatement!!!), and wanted to know how I was doing. As he had the scan results infront of him, he was so pleased that they had come back clear. We talked of my upcoming appointments and surgery, the infections and antibiotics, and also of the lymph node biopsy procedure. He would try to see me tomorrow, when I go to have the wound dressed. He was also concerned that I wasn’t at work, standing up, teaching all day, and would write me out my fourth sick note, for collection tomorrow.

It was great to speak with him, knowing he had taken time out to enquire about my health and well-being. A super caring and concerned GP: so lucky to have him as my doctor.

The day the cast came off

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Wednesday 22nd May

Again we arrive at the hospital in Plymouth way to early, but it gives us a chance to locate the correct ward, and on the way, requisition a wheel chair, to speed up my movement!

Handbag on lap, crutches clenched between my knees; this is the new, smooth way to travel!

The ‘Peel and Reveal’ session was carried out very expertly, and almost painfree, by a wonderful nurse. What my eyes were presented with at the completion was amazingly fascinating, and yet shockingly gruesome! The size of the excision was unbelievable; there was a great dented crater, my fourth toe looked as though it was standing on a stalk, and where was the skin graft skin? I think I was expecting normal flesh colour, but maybe a bit pink and puckered! The split skin graft had been turned into a mesh and stretched over the wound, with a number of stitches to keep it in place. Wow!

Macmillan nurse phones again

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Tuesday 21st May, late afternoon

I’m on my way to the loo, hopping and shuffling, when the phone rings. The nurse wants to touch base, and see how Friday went with my trip to the hospital, what happened, what was said.

When I told her that the operation had gone ahead, I’d had a wider excision and skin graft, she was really taken aback. Oh, but, but, but . . . My case had only been discussed that morning, in the weekly meeting, by the Multi Disciplinary Team. They/she assumed I hadn’t had the operation, that I had just gone to Plymouth for a quick chat, and then come home.

I felt I was being told off for having the skin graft. I recounted to the nurse that my consultant said I could always have a delayed sentinel lymph node biopsy at that hospital, as they carry out the procedure there. No they don’t, she snapped. And then ended the conversation saying she had a number of calls to make further enquiries.

I felt as if I had done something wrong. It was quite upsetting.

It feels l am in a power struggle; my treatment action plan seems to be part of a game. Who is better qualified? Who has the greater clinical knowledge? I trust my consultant, and will listen to his expertise and advice. I really want my glass to be half full, rather than half empty. I think that there should be greater communication between the two hospitals. I would like continuity of care from supportive professionals. It’s not too much to ask?

Operation two

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It’s Friday 17th May, and the alarm goes off at 4:10am. We are out of the house and on the way to Plymouth a little after five. The sunrise is beautiful; colouring the sky in pink, yellow and orange.

Due to the lack of traffic on the roads, we arrive at the hospital car park at 6:35am, far too early! The appointment was set at seven thirty. Twiddles thumbs.

Upon arrival  I didn’t know what to expect. I half imagined we’d be back on the road soon, after a quick chat. But it became clear that surgery was going ahead, and I was first in the queue. I spoke with nurses, the skin graft registrar, a fabulously jolly anaesthetist, and of course the wonderful plastic surgeon.

He really wasn’t happy that the Macmillan nurse had told me my results over the phone, and had also confused me with the order of events. My surgeon had wanted to speak to me himself about the melanoma. He asked how I felt, and there was genuine care and concern in his eyes.

He explained that the plan was to cut away a lot more tissue around the original wound site, slice a sliver of skin from my thigh, and magically affix it into place. I would then have a plaster cast set around my leg.

I went down to theatre soon after, monitors were placed here and there, bleeping that all was normal, an oxygen mask went over my face, and a thin needle introduced the anaesthesia into my system. I remember the eight, bright lights above me. zzzzzzzzz

Coming round, I couldn’t feel a thing, but I could see a fat, bandaged leg poking out from the covers. The nurses and doctors in recovery were amazing, so attentive, cheerful and professional. I was treated like a star!

About an hour and a half after coming round, I was discharged, and we began the drive home. Just before we left though, the anaesthetist popped her head around the curtain to see how I was doing, and to make sure everything was OK. She made a shape with her thumb and forefinger, to show the size of the new wound ~ it appears to be mahoosive!!

I spend a dopey afternoon in bed, taking the super strong painkillers at regular intervals. I now know I have to time it right to make a trip to the loo, ha ha.

Post-op #1 ~ wound dressing

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Monday 6th May

Three days after the operation I had an appointment to visit the nurse in our local surgery. My wonderful next door neighbours had borrowed a pair of crutches for me, making it easier to cross the road to get to the car.

If I thought it was painful before, I wasn’t prepared for this!

Upon unwrapping the bandages, the wound, actually more like a crater, was filled with gauze. The wound had to be kept open, in preparation for a skin graft, two weeks hence.

Using saline solution and plastic tweezers, the nurse, as gently as possible, began to prise the dressing away from my skin. Forty five minutes of crying, hyperventilating, hanging on to my husband’s shoulders, and finally the wound was clear.

It did look quite scary and very deep. Having cleaned and re-bandaged my foot I felt a lot more comfortable, plus I was armed with a box of much stronger painkillers!

And they worked! If I timed it right, taking two, 40 minutes ahead of time, I could hop-hobble to the bathroom in a little less pain!

A much better sleep was had that night.

Operation One

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Thursday 2nd May.

OK, so the day looms; overnight bag packed (just incase), phone plus charger, trusty Kindle, all ready to go. I’ve had nothing to eat since yesterday dinner time, not even a cup of tea this morning!

Soon after arriving at the hospital, we go for form filling, blood pressure and MRSA swabs. I have a name tag bracelet and a great big black arrow pointing to the offending blob; as if it needs an arrow!

Going into theatre is a breeze, anaesthesia takes over, and when I come round I don’t realise it’s all over.

Water, cups of tea and a ham salad sandwich are brought to me. Wonderful, wonderful after-care.

I finally hobbled out mid-afternoon, no pain, no ill effects. We stopped briefly for a cappuccino, and drove back home, whereupon I went straight to bed, feeling a bit groggy.

I was told to keep my leg elevated for at least 48 hours. Sleeping with my leg outside of the duvet is a little tricky, but I managed it.

On my discharge notes it said I’d had an excision of a lesion dorsum, left foot with dressing. Recommend rest and elevation and off duties.

In the first 24 hours I mustn’t cook, use electrical equipment or tools, not to drink alcohol nor to sign any legal documents, ie cheques. Any of the above may endanger you or others!