So I had my first real medical intervention last week. I went in for an eye exam a few months ago, and they identified that the weird-looking skin on the inner margin of my eyelid (right up against my eye), which I had thought vaguely was some kind of combination of blepharitis, generally crappy skin, and just becoming an old lady,* was definitely not normal. The doctor did a biopsy on the spot, and that was very unpleasant - the local anesthetic hurt so much I actually shuddered involuntarily, and it turns out that having somebody cutting right next to your wide-open eye is psychologically pretty terrible. (Foreshadowing!) The biopsy indicated basal carcinoma, which is the "good" kind of skin cancer, but its location meant that I needed relatively complicated surgery.
On Thursday I went in for the removal, having followed the instructions to wear comfortable clothes and pack a lunch. This was Mohs surgery, which is used I guess in situations where they want to take the absolute smallest amount of tissue possible. They give you local anesthetic, cut the thing out, and cauterize the wound, and then send you back out to the waiting room to wait two hours until they get a chance to analyze the tissue and see if they got everything. If they didn't, they bring you back in, and repeat the whole process. This can be repeated multiple times, though 2-3 is the standard. I expected it would be pretty awful, but I hadn't realized how bad I would feel. A friend later identified the emotional awfulness of this sort of thing as your brain forcing your body to do something your body thinks is a terrible idea. This feels right to me - every bit of the surgery felt like danger, and my poor body wanted to run away all day. They put in numbing drops that felt like poison - bleach or something that should NOT go in your eye - and then stabbed me with about a pint's worth of lidocaine, and then they put a black plastic contact in my eye to protect it, and then they did a lot of cutting and snipping and tugging around my eye, and then they cauterized my eyelid, which makes a sizzling sound, and a terrible smell, and the whole time I practiced square breathing with all my might. And then they put an enormous bandage on my eye, and I propped my glasses over it as best I could, which meant I could see only mediocrely at best, and escorted me to the waiting room, where I sat and tried not to cry.
Cook was planning to come get me when I was done - he had offered to come wait with me, but I thought it would be silly for him to waste the workday that way, and it's not like he could help me with anything. I think of myself as a fairly resilient person with pretty good coping skills under duress, and I figured that I could manage this. Which I guess I could have, but I realized pretty quickly that I really didn't want to try- I felt so wobbly and vulnerable and miserably uncomfortable. (This was not improved by the elderly man with whom I was alone in this room. He very much wanted to talk at me about his opinions, many of which were stupid and some of which were racist in a crappy all-lives-matter kind of way and I felt filthy just from being in the same room. When they paged me back in for the second round of nightmare surgery, I actually felt relieved to escape him.) The second round of surgery - on my already-beaten-up eye - was even worse, and when I got back to the waiting room and Cook was there, I felt the most enormous wave of relief and safety. And then they paged me again, and I shuffled off to what I assumed would be a third round of cutting, but it wasn't - the second surgery had done the trick, and I could go home. So I went home, missing much of my lower eyelid, with antibiotics in hand, my eye bandaged shut and strict instructions to keep my head above my heart, to not do anything that raised my heart rate, to not bend over, to not lift anything, to not sleep flat.
The next day I had to go in for the plastic surgery to actually repair my eyelid. This was my first ever actual surgery*** - the kind where they make you take your clothes off and wear a gown (the nurse said I should probably take everything off, because "when you get really relaxed sometimes your bladder relaxes too, and it's a mess") and a comical hat for your hair, and you can't eat or drink anything after midnight the day before. I talked to a lot of medical staff, who were various combinations of extremely nice to me and extremely condescending.*** They gave me Versed, a sedative that immediately made me feel drunk, and wheeled me off to the operating room, where they shot me up with another pint of lidocaine and I spent an hour listening to 90s hip-hop and staring up at bright lights, watching them cut and tug and sew my eyelids. (Nightmare part 2 - I could not close that eye, even if I wanted to, I could only stare.) While the sedative (and the bed that actually had room for my arms, and the warmed blankets) made me feel somewhat more relaxed about this than the day before (though sadly not relaxed enough to pee myself), and it was physically less painful, it was a very emotionally draining morning. And then they took me off to recovery for a bit, and then I got to put my clothes on and go home, with the same strict instructions. I spent a lot of the afternoon napping, propped up on my bed. I'm not a napper, usually - it makes me groggy and nauseated - but I felt so tired and heavy, from some combination of exhaustion and sedative. Every time I moved my open eye, my other eye moved too, which tugged painfully on the stitches.
I've spent the weekend in a weird useless state, napping and sitting and listening to podcasts, feeling uncomfortable and nauseated. Occasionally I get up and wander around, but moving around too much feels bad and woozy. My vision is weird, too - my right eye is struggling to figure out what its job is now, and what I'm seeing with that eye right now is like grey static on an old TV, which then underlies my left eye's view of the actual world, so that everything I look at is weirdly static-y looking, alarmingly similar to the way my vision darkens and fragments when I pass out. And it's oddly difficult to understand that for my right eye, there's no difference between closed and open. When I blink my left eye, my right eye sort of squeezes too, and it hurts.
I have another surgery scheduled a month away to "open up the eye." (As best I can tell, the surgeon took the inner layer of my upper eyelid, flapped it down over the hole in my lower eyelid, and stitched everything up. The stitches will dissolve in a few weeks, leaving me with a fused-shut eyelid. In July, he'll more or less just cut across the flap. This seems like magic, and I'm very dubious about it - how does the cut surface figure out that it's a mucus membrane now? - but apparently surgeons have been doing it for a hundred years.)
I took off the bandage today to reveal my sad swollen shut eyelids. I have a couple of piratical patches to cover, for use in public and on work video calls, but for now, the stitches are covered by my upper eyelashes, and the eye just looks closed, like I'm constantly winking. (Cook occasionally does finger guns at me and winks back.)
This has been a really difficult experience to calibrate. On the one hand, it is a tiny bit of skin, and the prognosis is very good - the carcinoma is very unlikely to recur, and the repaired eyelid should be entirely functional (if eyelash-less). Really not a big deal at all. On the other hand, the physical, emotional and logistical impacts of it are substantial, and it all has kind of a horror movie feeling, so it feels like a big deal. I suspect it'll feel like much less of a big deal in a week or so.
Anyway, two takeaways:
1) I really appreciate my family, especially Cook, who is taking care of all of his usual housework plus all of mine, taking care of me, and handling most of the parenting (including navigating Skipper's panic about all her end-of-year schoolwork). The kids are stepping up to pick up some of my housework and to bring me things and read to me. (Skipper is reading me an Agatha Christie book, and has taken a strong position that the British spelling of "moustache" must be pronounced "MOOstash" which makes me giggle every time.) I am really lucky to have a family that can hold me up at home, and also bring a feeling of home to me when I need it.
2) The doctor told me this kind of eyelid cancer is likely the result of childhood sun exposure. Wear sunglasses. Put sunglasses on your kids.
*In retrospect this seems crazy - obviously irregular skin is something to worry about. But every previous time I thought something was wrong with me, it turns out to be either a) me getting old or b) me being anxious. I've never thought something was wrong with me and had it actually turn out to be something that was both wrong and actually fixable.
**I mean, I gave birth in a hospital once, but that was a fairly high-speed event, and I was too busy to pay much attention to things like wearing a hat (or, say, shucking off all my clothes in a room crowded with, I think, about a hundred people).
*** My surgeon has the classic surgeon's bedside manner. When I had my pre-op meeting with him, he told me brusquely that I'd probably have my eyelids sewn shut for a month and that I would never have eyelashes on my lower eyelid again. This was all news to me, and I said cautiously "I'll never have eyelashes?" and he said "Well, would you rather have eyelashes OR WOULD YOU RATHER NOT HAVE SKIN CANCER?!" And when he came to see me right before the operation, he didn't greet me at all, just walked up to me and said "You're going to have your eyelids sewn shut for a month" and I said "Hi."
