The picture accompanying this story was taken on one of my many winter trips to the High Sierra, near Kit Carson Pass, a favorite place to go backcountry skiing. A friend I’ve known since college has joined me for backcountry trips like this for most of the last twenty or more seasons. We started out going to huts, but then transitioned into tent camping so we could take advantage of the best times and locales to catch the best snow. It’s been one of the greatest treasures of my life.
Unfortunately, it’s not without some risks. We’ve faced some tough blizzards on occasion, one winter having our tent destroyed by high winds and waking up with it flipped inside out and huddled inside what remained until morning. Another recent winter we both got COVID, probably from a pizza vendor in our base hotel. The biggest risk, however, is one that can show up much later, especially if not enough sunblock was applied. Usually I’m pretty good about this, but apparently it only takes one good roasting to get a bad sunburn. My most exposed area is my rather large nose, and more than once I’ve come home to face a rosie proboscis worthy of Rudoph, much to my wife’s annoyance. I thought I’d learned my lesson long ago and lathered up with a high SPF sunblock, but apparently not in time to face the bitter consequences.
I first got Basal Cell Carcinoma (BCC) a half dozen years ago, a small lesion just above my nose, and had to have it removed using a technique known as Mohs surgery. The doctor basically cuts around it and then verifies they got it all while you wait, then sews you back up. If all goes well, which it did that time, you’re good to go and the consequences are minimal (in this way it’s much preferred to melanoma, the kind of skin cancer that took John McCaine’s life). In fact, it almost worked like a small face lift. My wife commented that I looked younger due to some of the brow furrows decreasing. I don’t recommend this as a cosmetic strategy however!
A couple years ago I noticed a new lesion on the side of my nose that wouldn’t go away. I had it biopsied and it came back negative. I wish I’d gotten a second opinion, because apparently they missed it. A second biopsy a month or so ago revealed it to be BCC again. I got my Mohs appt and went to the very same surgeon I’d seen six years ago. This time I didn’t get nearly as lucky. She carved it out and took it to the lab, but didn’t get clean margins. I went in again for another bit of carving, but cancer remained. Finally, on the third try, she got it all. Very unfortunately, there remained a rather large oval wound where the skin on the left side of my nose used to be, extending very close to the nostril opening. She referred me to a plastic surgeon for consultation. That’s when my nightmare really began. It turns out that this is a pretty big deal. They can do a skin graft, but it will likely result in some disfigurement and possibly breathing issues. The only real permanent solution is something nearly unthinkably horrific called a forehead flap. The surgeon cuts an incision in the skin of your forehead and pulls it down to the nose so there is blood supply while they do a full reconstruction. It requires three major operations over the course of a couple of months, with another month or two to heal. That will very likely be the way I’ll be spending the rest of this year.
Today I go in for my skin graft and there’s a sliver of hope that it will be good enough. I’m hoping this surgeon is really, really good. It’s been a very hard summer with a close friend’s heart attack* and another dear friend stricken with a much scarier kind of cancer, so I’m counting my blessings that this is at least curable. Still, I wouldn’t wish this experience on anyone, so please, please, put on plenty of good sunblock when you venture outdoors. If one person reads this and saves themselves what I’m going through I’ll be really glad I wrote this diary.
* BTW, my friend Byron just had quadrupal bypass heart surgery last week and is expected to make a full recovery. Thanks again to all of those dear Kossacks who expressed their well wishes.