Well, to my eye (and my husband’s) there was no real change in the wound, except that it did feel like it was separating around the edges. I was extremely worried about what the doctor would say when I went in to see her that day. My understanding was that the next line of defense would be to go into the hospital with IV antibiotics. My anxiety level was at about a million.
I called the doctor who did the Moh’s procedure to schedule an appointment that day so she could see the wound and give me her opinion too. I was very unsettled at this point that the plastics doctor did not have a firm handle on exactly what was going on, especially since I did not think it was looking as if it was responding to the antibiotics.
The only change I had noticed since my last visit was not in my wound, but in my energy level. I felt great on Friday night, Saturday and Sunday (basically 24 hours after I started the new antibiotic). I felt like I was back to my old self for the first time since the surgery instead of sitting on the couch all day. I hung out with my closest friends and family, and cooked up a double batch of beef stew so we’d have something to eat over the weekend and on Halloween, which was Monday. I had good energy and didn’t get tired even after cooking for 2 hours.
I was prepared (almost) for the worst when I saw the doctor on Monday. She told us that the culture had indeed come back negative for MRSA, so that didn’t give us any clues.
However, when she took off the bandages to examine it, we were shocked that she said it looked better! She was able to cut off about 1/3rd of the scab, and there was viable skin tissue underneath!!! We had thought that the whole flap died from the infection, so this was wonderful news. There is still at least 2/3rds of the wound that is still scabbed, but she is optimistic that it may heal similarly. She wants to wait at least a month before doing any more surgery to give it a chance to heal on its own.
I practically jumped for joy when I saw the new skin. I was sent home with instructions to continue the antibiotics, ointment, and wet-to-dry bandages.
I kept my appointment with the Moh’s doctor because I still wanted her opinion and I also wanted to make sure that she was fully in the loop about what was going on (especially if it turned out I had MRSA). She was actually relieved when she saw the wound! She said that when she heard I had a possible MRSA infection in my nose that she assumed the worst, and that this looked great in comparison. I told her how we were treating it, and she said that it was the exact right thing to do, so that was reassuring. She also said that my plastics doctor does amazing work and that she won’t give up until I am totally satisfied. This was also super-reassuring. She said she would call the plastics doctor to circle back with her on this.
I also told her about a fairly new study that had come out on Moh’s and MRSA (which I found when I googled “Moh’s MRSA”)
This study has shown that pre-operative screening for MRSA can drastically reduce post-surgical MRSA infections. She asked me to forward it along to her. It is not current protocol to screen 100% of patients for MRSA, and I was not in one of the high-risk groups that she would normally screen (I don’t work in an institutional setting like a hospital or school, am not elderly, etc). I don’t blame anyone for my developing a post-surgical infection – the doctors did their jobs right and these things can still happen. And we still don't even know if it was MRSA or not. But if there are ways to make improvements so that other patients can avoid it, I want to make that happen. It’s all about continual improvement.
This is a picture before the doctor took some of the scab off.
This is what she considers “great”! So I guess I do too.
Sorry for the color cast on the photo. I am not jaundiced in real life.
This is a picture the day after she took some of the scab off. There is still about half the scab left.
Notice the notch in the rim of my nostril. This was caused totally by the infection and was not from the Mohs surgery.
(it is essentially the path that the bacteria traveled out of my nose and into my wound).
The plastic surgeon will correct this once I am fully healed.
Or maybe I’ll just get a nose ring to camouflage it ;0
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