*Alarm blaring at 5am* – That is how I started my morning. Dr. Ingraffea normally starts his day at 7:30, but on Fridays he starts at 6:30, which unfortunately for my sleep pattern, means I too had to start at 6:30. He starts early on Fridays because that is the day he does surgery on melanomas. He told me I could come in at 7:30 if I wanted, but I figured I should go through what an actual doctor does on a regular basis, and besides, I would never pass up the opportunity to see surgery on a melanoma!
For basal and squamous cell carcinomas, it takes the lab about 30 minutes to stain the mohs layers, but for a melanoma, the layers go through a specific staining process to contrast the melanocytes from the background tissue. This process takes an extra 45 minutes, so Dr. Ingraffea really hopes he can get out the melanoma in one layer, or at the most two. Thankfully both melanomas were cleared in 2 layers at the most.
One of the patients was quite the bleeder, due to a specific known medical reason, so we were expecting it and had extra gauze ready. This patient’s reconstruction took much longer than others because we had to continue cauterizing the blood vessels to minimize bleeding. Dr. Ingraffea let me put on some surgical gloves and retract the skin as he cauterized the bleeders. It was so cool to be up close and actually getting to be a part of the surgical process!
Most cases were finished fairly quickly, which is exactly what I liked to hear on a half day! We did have one case that seemed like nothing but ended up taking 6 layers to clear and that is why mohs surgery is so important and useful!!
After work was done, I was able to make it to Cary Dermatology again and hang out with Hannah and Oyinlola for a drug rep hosted lunch. (We had Boston Market and it was delicious!!)
