Unexpected Consequences

fels

As background - after COVID, virtually all of my playing opportunities ceased. I continued practicing a general program every day, even working on specific literature pieces. Nothing that was over taxing. Continued to play in our Brass Quintet and a Community Chamber Music program.

About a month ago I underwent a MOHS surgery for Base Cell Carcinoma on the back of my neck (left side - midway between the ear alignment and the cervical spine). The surgery went down four levels and left a golf ball size divit that was stitched up. At the first post surgery check, I noted numbness radiating up from the surgery site to the back of my ear (mastoid). Repeated observation and post ops 2 and 3. Stitches removed etc.

I followed my basic maintenance practice,

After a rehearsal for an All Saints Day Mass, I noticed my lower left lip swelling and increased numbness in the left cheek - radiating up into the left eye orbit.

For a brass player this is: WTF!

I changed my practice routine and monitored the numbness.

Basically - numbness has continued up the neck - and the left cheek feels like i just left the dentist office after a crown. I feel the lack of responsiveness when practicing. I was concerned for the Mass gigi - but all went well.

I played yesterday at ensemble group and felt not quite in control but managed. Practiced today and feel the left side not responding like i want.

My research suggests that the MOHS surgery could have impacted the lower occipital nerve resulting in neuralgia. The facility numbness is more problematic (trigeminal nerve) since that nerve does not normally interact with the lower occipital nerve.

The Mohs surgeon's office responds that numbness may last up to 12 months, otherwise no instruction.

On my own, I am pursuing treatment with acupuncture and homeopathy.

Overall, not a happy experience. All advice welcome - mostly daily practice management is on my mind.

Dr GO

I had Mohs surgery for a basal cell cancer in the fold of my nose near my left eye. Left a divot and a half centimeter hole in my face. They gave me an option to close the hole by making a triangular flap of tissue from under my left eye, and stretched it to attach to the bridge of my nose. Damndest thing happened. Felt like I had an itch under my eye and when I scratched it... missed the damned itch. But when I played in the mirror to find the itch, it was actually on my nose, but I felt like I was scratching my eye. This feeling went away and the nose itch became a nose itch after about 2 months. I hope for you the nerve changes comeback within this time as it did for me.

fels

@Dr-GO Yes, as with yours, my Mohs hole was large -- the surgeon had to excise up and down in order to suture the main hole. -- Looked like a Frankenstein stitch. I also am hopeful that the two month window will hold true. Your nerve issue sounds
more localized whereas mine is directly involving the Lower Occipital Nerve path. In the meantime I will continue with acupuncture and homeopathy.

fels

@fels
three months from my initial post - four months from the MOHS.

Numbness continues at the back of the ear and along the left cheek; sometimes swelling of left lower lip. Fortunately, heat packs and slow warm ups allow me to play as before. Sooooo , I guess as long as I'm careful I can proceed to play as adjusted.

fels

@fels
Update February

I was playing a long tone exercise (Stamp) this evening on my flugelhorn. I noticed (perhaps it was there before but I just noticed it) that the left cheek and lip corner was very stiff and "condensed", the right was very relaxed. Just another symptom waiting for a diagnosis. I still think it is related to the MOHS surgery on the back of my neck.

GeorgeB

@fels

So sorry to hear that. I hope things improve for you quickly.

George

adc

@fels Funny (not really). I had Mohs surgery on the rear of my scalp for basel cell. I have had two others. So jfar so good. In that location I will be ik.

I wish you well my friend!!

GeorgeB

@fels
I had surgery for basel cell near the tip of my left ear. That ear looks like Spock's from Star Trek. But I guess I caught it early enough because no problems since the surgery five years ago.
Growing old isn't for sissies.