How I Found Out That I Had Melanoma On My Nose

1991 through 2003: I worked road construction anywhere from 8 to 14 hours a day. In the summer of 2001, I burnt my nose really bad. It took weeks to heal.

2012: Friends, family, and coworkers kept coming up to me to let me know I had grease or dirt on my nose. As the year went on the frequency of those mentioning it to me was increasing.

August 2012: I went to the family Doctor. He recommended I see a specialist since it was not symetric.

November 3, 2012: The specialist took a sample from my nose. He said it was either nothing or Melanoma.

November 14, 2012: The phone rang. "I am sorry to tell you this but you have Melanoma. We need to schedule an appointment soon." The doctor called me and explained I could have him perform the removal but he didn't do repairs. The repair would need to be done elsewhere. A mile down the road was a plastic surgeon whom many of his patients went to.

November 21, 2012: I met with the plastic surgeon. He indicated he could remove the area based on a visual procedure. I mentioned the other doctor said he used Mohs for removal. Mohs is a process where the area is removed and then tested immediately to minimize the area removed. We agreed to have Doctor #1 perform the removal using Mohs and Doctor #2 perform the repair. Based on his observations, we anticipated the areas the size of a nickel to be removed. The repair option was to take skin from adjacent to the area and stretch it to cover. Other options included making an incision in the forehead and bringing down that flap while leaving it attached to the forehead to maintain blood flow. The final option we discussed was taking a graft from another area but that was not preferred because it would only be a very thin graft to ensure the skin lived.

December 4, 2012: I had the area removed. After the removal, the nurse indicated the area was larger than anticipated. She thought it was the size of a 50 cent piece. I almost threw up when she said that.  I felt so sick knowing I had this hole in my face that huge.  A friend then drove me to the plastic surgeon. The surgeon confirmed it was too large for a flap and he recommended I have a graft done. I had two options of being awake or asleep during the operation. I chose to be awake however the anesthetic did put me into a light sleep and the next thing I woke up. The doctor had slit behind my ear from top to bottom for the donor area. I had a large yellow piece of gauze stitched to my nose which held the skin in place.

December 11, 2012: My check up visit went as well as hoped. The doctor removed the gauze which was stitched and holding the skin in place.  The margins were healing and there was no infection. The doctor did let me know that since it was December in Minnesota, that I should not blow snow, shovel snow, or spend any amount of time outside other than walking to my vehicle. He said the skin could freeze and die.  If it did we would have to redo the graft.

December 18, 2012: My week 2 check up visit was good.  Now I only needed to make sure I didn't rub my nose when I was sleeping. I did have it covered all of the time, even when I showered and used a fresh dressing each day.

 

January 8, 2013: The stitches from behind my ear were removed. The doctor now recommended that I leave the dressing off as much as possible for air to get to the graft. It was healing well but along one side the skin had died. He said that would fill in over time which is did.

This photo shows the dressing used.  I would use a QTip to place triple antibiotic over the graft, then cut a portion of this yellow dressing to just barely cover the graft, then place Medipore over the entire area. 

This photo shows the graft as well as the Medipore tape I used as a bandage over the gauze. The areas on the left is from January of 2012.  After dressing the area, I would cut a piece of Medipore and cover the entire area.  I tried of a number of medical tapes until I found Medipore.  It was the most comfortable, didn't irritate my skin, and stayed in place all day long. 















August 9, 2013:  The area has healed well.  The doctor tells me it will continue to "fill in" for another 8 months.  There was quite a deep depression at first.  There is still a little depression but it isn't that bad.  The surface appearance is noticeable as it is scarred but it isn't noticeable unless you are within a few feet.  Even at that, sitting at a table with people who don't know me, they don't immediately notice. 

August 9, 2013 Photo:  The scar is a little more noticeable in person but not bad. 

Summary:  Lesson learned, I should have had it checked right away and the area would have been smaller.  Although I am lucky that it wasn't further along, it could have been much worse.


Also: I found this blog which ended up being very similar to what I went through.
http://quietchi.blogspot.com/2010/01/my-melanoma-in-situ-and-skin-graft.html