Hats Are Hot on Chicks—Little & Big
As described in the January 1 and January 2, 2014 posts, two weeks ago, on December 30, 2013, the basal cell carcinoma in the part line of my scalp was excised using Mohs micrographic surgery (see the November 21, 2013 post). Yes, what I said before is true: after having a total robot-assisted laparoscopic hysterectomy for uterine (endometrial) cancer, I can honestly say that removal of this little pink spot on my scalp caused me very much more pain than having my reproductive organs yanked out through six tiny incisions. I told my gynecologic oncologist that I’d have a hysterectomy again any day before I’d have another scalp lesion removed because of the different in post-op pain. He just sort of stared at me. But I meant it.
Today, I returned to have the stitches removed. The dermatologic surgeon had originally said he would use royal-blue suture material to be sure the stitches would stand out at the time of removal, but for some reason he changed his mind and used black Ethilon. I was braced for more pain in this super-tender area, which still had some scabbing. But when the nurse took the stitches out (five–I counted), I am happy to report that it wasn’t bad at all–very quick and easy. At the time of surgery, the nurse said I would feel “a pinch and a tug” when the stitches came out, which was pretty much true, with only a small twinge or two. She had also said they don’t give numbing injections for suture removal because the lidocaine hurts more than taking the stitches out. That is definitely the case–lidocaine injected into the skin burns like hellfire, although for some reason it doesn’t burn like that when it is injected into your mouth before a dental procedure.
The image on the left shows the area where the basal cell carcinoma was removed from my left frontal scalp; the image on the right (which I do not think is me–it’s probably a generic photo) shows the surgical area after it was sutured crosswise. It’s a little hard even for me to orient myself in the photos, but if you looked at me in person, you’d see a horizontal scab crossing my high-left-sided part line at the very front of my scalp, almost touching my forehead. Now that the stitches are out, I’m looking forward to using regular shampoo–and conditioner!–again. And, of course, I’ll be using sunscreen in my part line, which may be a bit wider than usual while a few hairs grow back.
Looking back on it, I believe I had a reaction to the lidocaine at the time of surgery. I fell asleep when I got home, which I hadn’t expected, and my laparoscopic incisions itched. These symptoms wore off by the next day, but that’s when the burning, pulling pain started in earnest as the anesthetic started to wear off. This burning pain lasted for about four days. I told the surgeon about it today, and also told him that I had taken narcotic pain meds that hadn’t helped. He said hot burning pain like that indicates nerve involvement and that a nerve could have been caught in a stitch. Had I called him, which I hadn’t because it was New Year’s Eve and New Year’s Day when I was in the most pain, he would have prescribed a pain medication used for seizures, such as Neurontin (gabapentin), because typical narcotic analgesics don’t work for nerve pain. He also said I was fortunate that the pain wore off in a few days–sometimes it lasts two to three weeks! Now, just before bedtime, I can say that although the previous burning nerve pain is almost gone, the nerves must have been disrupted by the suture removal this morning, and I have some sensitivity–especially when I touch the area. So I guess it will be a while before I can get my very graying hair colored–the skin is just not ready for anything that irritating.
So although I didn’t start the new year feeling very good, I did start it cancer free. And I have learned my lesson about letting things go–I first noticed this pink spot two or three years ago and didn’t have it checked. It didn’t start to bother me until this past summer, when it started to itch and deepened in color a bit. In retrospect, I should have gone to the dermatologist within weeks of first noticing it. And despite the fact that I have never liked wearing things on my head or in my hair, I will now learn to love hats–and I have a newfound respect for sunscreen.
Because we were so focused on discussing my pain today, the doctor and I never got around to talking about sun protection. But common sense will prevail, and I will start using my facial moisturizer with sunscreen in the area of my part line as soon as the skin is less tender. Here are three “drug-store” facial moisturizers in descending SPF (sunprotection factor) value that you may wish to try:
- Neutrogena® Healthy Defense® Broad Spectrum Daily Moisturizer – SPF 50 with Helioplex®: I believe this is the highest SPF available in a moisturizer and is, according to the ad, the #1 dermatologist recommended daily moisturizing product. I have a friend who uses it, and she loves it.
- Aveeno® Positively Radiant® Daily Moisturizer Broad Spectrum SPF 30: Here’s a mid-range SPF moisturizer, which the ad says is “award winning.” My previous experience with this product was that it was drying–this moisturizer is oil free, which may appeal to those who have oily skin.
- Olay® Total Effects® Fragrance-Free Moisturizer with Sunscreen – Broad Spectrum SPF 15: I’ve used this product for years on my face, but never thought to use it on my part line. The SPF is “low” at 15, but I’ve never developed any facial cancers. Also, I have often been complimented on my youthful-looking skin (despite, or maybe because of, the freckles).
You can find many more products on the web for different skin types, and some are tinted so you wouldn’t have to use foundation (if you do).
But whatever you do, please take a word to the wise and protect your delicate skin from the sun–especially on your head. You really don’t want to know what it feels like to be scalped.