323 - DFSP (6) : Surgery etc

6th chapter of the DFSP (Dermatofibrosarcoma protuberans), a form of skin cancer, that was found after 2 biopsies of a "mole" that was for a while suspected as something not so dangerous, called Dermatofibroma, but which turned this rather aggressive form of cancer, that tends to come back at least 50% of the cases, so I must have surgery to reduce recurrence to 10%. 

I explained the diagnosis in post 307. 


Today, I saw the dermatology specialist to fix the date of this surgery. It'll be Thursday 25/01/2018, in just a week!  (at 9:15 AM...)

For it, I explained to the surgeon that I'm an extremely sensitive and anxious person, and that even stitch retrieval had been tough for me the first time around (in October), ad so, I asked if my wife could be there to help distract me - as she was allowed for the biopsies and stitch retrievals before (at the other doctor). 

He said he was okay with that, but that he'd allow her only to the point of my local anaesthesia, after which she'll have to leave the room and he'll perform the surgery, which should require ... not 2 but a 6 or 7 (!) point anaesthesia (meaning that he'd put the needle in the large area 6-7 times), to make sure it all falls asleep.

I'll be able to bring my headphones and listen to music (I plan to disinfect them to reduce any risks). 

The doctor said it wasn't an issue if I take an anxiolytic beforehand, to help me deal with the anxiety levels that I can foresee even now as I right. I'll ask my psychotherapist this upcoming Monday if he can prescribe the one he had told me I can take in extreme cases and that isn't addictive nor mandatory daily treatment. 

The entire surgery should last 15 or so minutes. Beforehand, I'll have to take that very morning, and previous night, full showers, and treat my skin with a special gel that he prescribed. That one and the post-surgery treatment solution aren't financially taken in charge by my medical insurance, so I had to pay a total of 18,80 €.


The good news is that the rest of it is taken in charge by the insurance. 

The day of surgery shall be tough. I'll have to get up at 6AM so I can take my shower, dry my hair, treat my skin during shower, and also apply an anesthetic cream one hour before surgery, and eat breakfast... (until then, I must go to bed earlier and earlier every night, so getting up so early won't be a shock, so I apologize in advance that I won't be able to chat late evenings).  

I'll also have to cut and shave the hair around the area, to help save time in surgery and post-surgery treatment and stitch retrieval. 

Surgery is set at 9:15 AM. (Why do all these doctors set such early appointments ?! I wish I could be in bed till 8 🤣😢)

A nurse will come to our apartment every other day for 2 weeks after surgery, even on weekends, to treat my wound, and then, I'll have my stitches retrieved. 

The doctor explained that my skin should take ... 3-4 MONTHS to heal after that, but that in view of my particular sensitivities, he thinks this is the best option - leaving a special bandage on the area, and NOT doing a skin graft. This is good news for me, because after we left, I told this to my wife and she said it'd be otherwise extremely painful and uncomfortable to have the graft, so I'm glad that the doctor doesn't wish to do it. 

My regular dermatologist had said that the Slow Mohs surgery was going to be a rather long one, as a person from the lab would be present to check my cells in the microscope, before closing my skin, but the specialist explained this won't be the case. It'd lengthen the procedure and raise risks of infections. 
Instead, the doctor shall note sections of the area, and send samples to the lab, who will check the cells and if all is well, I'll have only this one surgery. 

There is, however, a most likely scenario that some cells would remain. In that case, and the specialist considered my particular sensitivity once more, and said that to avoid my going back too often, he'd call me for a second surgery, with a fuller anaesthesia, but not the kind that is risky for my health, and perform normally only this second operation, taking everything that the lab would have seen prior. At least, this is what he'd try to do, but since there remains a 10% chance of recurrence, we cannot know in advance if I'll need 1, 2 or even 3 operations in the next few months. 

2017 was tough, and I hoped 2018 would be easier, but it turns out that I'v had a bad cold for 19 days now, and shall have at least 1 surgery, 2 weeks of treatments, and 3-4 months recovery, in the MINIMAL case. 

This means that I'll need you my friends to make sure to keep me busy, distracted and supported at least until April ! I thank here every single one of you who can and shall do that in that lapse of time - but I totally understand if you are unable to do so - after all, many of you study, have jobs,  and lives of your own. I won't be mad if you're not there for me daily, rest assured. I will thank everyone who will be able to help and support me. 

I'm so anxious about this entire upcoming series of surgery, stitches, treatment, recovery!

At least, I am glad to report that the specialist had good, clear replies to my questions, and seemed very understanding and considerate of my anxiety and fragility. He seems to be kind and have good bedside manners.