Probable forehead flap in a week’s time, how to prepare?

Glad that part is done. Thinking of you with the graft surgery. Once it's done you can concentrate on getting better.

Let us know how you're getting on when you feel up to it 

Solihull hospital 

My neck of the woods.  If you feel in need of reassurance / coffee after the op, just let me know

where did you have yours done Lizch xx

Birmingham QE.   What about you?

I had it done at Nuffield Derby but my plastic surgeon was from Queens hospital Nottingham.  I was offered MOHS but he was convinced he coud do it with normal surgery which he did.  The worst one just at top of my nose right near my tear duct was a small scab.  I had to order some prescription glasses on line during Covid and thought they had rubbed me.  When I went to see him about the other one I asked if he would look at that one. He said it was inconclusive on his dermascope and did a biopsy when operating on the first one and came back as a bcc. I had skin graft from down the side of my ear for that one. These things are nasty little beasts arent they and people dont realise and think oh its only a small skin cancer, but they are not.  Keep in touch xx

I had scratched my nose with a hawthorn the previous summer and got a scab which healed.  The BCC was in the same place so I thought it just had not healed property.  I was also on an anticoagulant for a DVT and when it just kept scabbing and falling off I blamed the medication.  Also in COVID. 

Is your donor site fully healed? 

Yes donor site was no problem at all just a very fine line right down the side of my ear. It was strange having that done as I could hear him stitching it.  The site of the bcc was awful as it scabbed and apparently it shouldnt have done. I had 50 stitches in it mainly internal and then he stitches the dressing to it and then on top stiches like a scouring pad on it. I looked like I had a blue bee on my face. The stitches were so hard for the Nurse to get out.  I was so upset I sent him a picture of it and he told me to vaseline the scab off before I saw him, which I did but it took a long time to heal.  It is nearly a year now and it looks fine. I can see the scars but people say they can't.  It was all done with just locals in a treatment room, very relaxed atmosphere and he was so kind and caring.  Was yours done like that.  Nice to chat to you as sometimes people dont understand.  How long ago did you have yours done xx

Mine was 2 years ago in January.  Weird having your dressing stitched to you.  I don’t think I had nearly that many stitches. With a forehead flap you have to have it separated after 4-6 weeks and then stitches around the nose and forehead - I did get a big scab on my nose at that point.  The flap was under GA but the separation was done under local as there was a covid surge and they were stopping admissions.  The forehead injections were horrible but yes, the surgeon / nurses were all lovely.  

Lizch it would be lovely to meet up some time down the line.

It’s good to read your stories.  I am sitting here in the private hospital, better not name them as I have been critical, and I am about to be more critical), awaiting surgery.  

My story so far:  I got confirmation of the surgery dates, 21 and 23 Feb, on the afternoon of Wednesday 15 Feb, and I was emailed a link to a health questionnaire with instructions to complete within 48 hours.  I did it right away and got advice that afternoon that my pre op assessment would be done by phone at 4 pm on Monday 20.  I thought to myself that they were cutting it fine, but feeling confident that I would pass all checks I just waited.  I recalled that at my surgery a year ago for hip replacement I had a face to face assessment and had to go in twice, once for blood sample and once for ECG and MRSA swab.  But the info with the questionnaire said  tests MIGHT be required, so I thought, maybe because it’s face surgery it’s not as big a deal as a hip replacement.  

I had my phone assessment on Monday, and we got to the bit about mental conditions. There was a box to tick for anxiety.   I thought I might as well lay it out, although normally I would put my bravest face on, frankly I am a very anxious person, and I felt that a bit of TLC wouldn’t go amiss.  The nurse said, oh of course, having a diagnosis of cancer …. I said it’s not that, it is going under GA, I am scared.  She asked if there was anything the hospital could do to help.  I said if I could possibly have minimum time on the day waiting for my surgery.  She said she would make a note of that and they would try to take me in first, though any diabetics would have to go before.  Fine.  Then when we got to the end, the nurse said, right, someone will be in touch to arrange tests.  I said WHAT?  You know I have MOHS surgery tomorrow?  She said, no, you are booked in for a skin graft on 23rd, though you are right, that isn’t long now is it, I’ll let them know to get on with the test appointments.  I spent a few minutes explaining to her that I did indeed have surgery the next day, to make the hole that the graft would repair.  She didn’t have any record of it, which I found out later was because the dermatologist had arranged the MOHs at the NHS hospital.  But anyway, I needed the tests for 23rd.  I said when exactly will that be because that’s only a couple of days away and she finally woke up and said she would speak to her manager as soon as she got off the phone.  So I got off the phone pretty darn quick.  By then it was 4.30 and I suspected I wouldn’t hear back that day, and I was right.

The next day I was due for MOHs at 5 pm .  I waited till 9.30 then phoned the hospital to ask about the tests.  Oh yes, now that she looked, there was something about this.  The appointments team would be in touch.  I had a little meltdown at that point.  They asked whether I could come in on the way to the MOHs and I said no, I had a sick puppy (with impeccable timing, my darling girl had failed to sleep through the night for the first time since her first night home, and had trips to the garden with terrible diarrhoea, she would have to come with us to wait at Solihull so I wanted to minimise the time she was out in the car) but I could be there in an hour if needed.  They rang back fairly soon and I got my tests booked for 11.30.  On the way driving myself  to the tests the phone rang and I could tell it was the hospital company.  I thought, I hope they aren’t cancelling the tests now I am nearly there.  I got parked with time spare and phoned them back.  An officious voice told me they were calling from the accounts department , their terms were strictly payment 10 days in advance and if they didn’t get  cleared funds today they would cancel the procedure  … I had another little meltdown at that point, and told them I was at the hospital and wanted to talk to a person, which they couldn’t do because they were off at a call centre somewhere, but I said they could find a manager to meet me after the tests.

Deep breath.  I went in for my tests.  Nurse was lovely, fortunately, asked after the puppy!  I explained that I have crummy veins and it often takes several goes for people to get blood.  She was sympathetic and after trying and failing on one arm, called in a doctor who was also lovely and did get the blood from the second arm without too much trouble.  It’s sometimes a good thing that I have low BP ( usually 100/70) because it came up as 144/120, even though I was trying to stay calm.

I came out and asked receptionist and they got me two ladies to whinge to, a clinical experience manager and someone from the business side.  I blurted it all out, about the offhand consultant and the lack of forethought which meant I had to come in for tests when I should have been relaxing ahead of surgery that was actually a very big deal to me, and that I had been so shocked by the size of the quote that I hadn’t read the fine print about how to pay, I had been waiting for an invoice and I hadn’t even received a quote for the MOHS.  I had the funds but sometimes Santander takes its own sweet time to transfer payment and I was now scared that they were going to cancel and leave me with an open wound after today’s surgery.  I had been waiting months with them while my nose got worse even though I was paying a fortune to get on with it.  I had to chase them for everything including the tests, but when it came to money they were right on the job.  I said they were treating me like a piece of damaged flesh with a bank account attached.  The clinical lady looked very sorry, oh no, they really care … The business lady looked at me with a “Yes.  And your point is ? “ expression.  She repeated that there policy was strictly cleared funds in advance.

I pulled myself together as I was only wasting good puppy cuddling time, went home and dusted off my emergency credit cards and called and paid as I should have done in the first place instead of having the whinge session.  I tried to pay for the MOHS but they knew nothing of it, suggested I contact the dermatologist.  His secretary went to voicemail so I texted him and he kindly replied and said invoices for his procedures come after the surgery,  It felt nice to be trusted by somebody!

Today my husband dropped me off for 7.30.  I saw nurse, anaesthetist and consultant.  I have time to write this long whinge because they haven’t got my MRSA results back from the swab two days ago.  So I am moved to the end of the list.  It’s now 10.30.  A different but also lovely nurse has just topped up my water glass and went off to check on MRSA.  Results won’t be back until this afternoon, but the consultant has said he will go ahead anyway.  I asked her if they knew when it was likely, she has just returned to say no info yet.  It’s now 10.36.

I told the anaesthetist about my veins, because after my first hip replacement, when they stabbed me in both hands before putting the cannula in my arm, I told the anaesthetist at my second hip replacement about it, and he was very sympathetic and gentle and got it in first time.  This bearded birdy looked offended that I should dare to tell him his job, said if he sees a vein he goes for it, if it doesn’t work they have to try other sites, he appreciates that it can be painful but. ..(shrug).

 I tried  to put on a cheery face with the consultant who has clearly decided that a breezy offhand manner is what people want when contemplating surgery.  He expects a forehead flap will be required, but not any cartilage from the ear.  He will tuck the end of the flap inside the nose.  I ask if that means the hair from my low hairline will actually be growing inside my nostril.  Well yes, it will be a bit fiddly to trim, but ( shrug).  Trying to get a bit of reassurance, I stupidly ask “So, have you done many of these surgeries?”  “No, you’re my first, just kidding “ (chortle).

Fortunately the nurses are lovely.  As is the catering guy, who has taken my order for a meal I may well get to enjoy in two directions, if past experience is any guide.  A prawn salad sandwich l. I could murder it right now, I can tell you!

 Thanks for a place to vent.  I feel fine now.  Next post will be a happy one from the other side.