Do you know of any east coast doctors with facilities to also stain

They probably do the staged Mohs for a reason.  Melanoma is easier seen under a microscope when the pathology uses paraffin and stains.  Mohs, itself, typically uses frozen sections techniques for squamous and basal cell — much quicker.  So while you say it is barbaric, it is probably the safest method if they indeed are doing actual pathology and that is the cause of the staged delay.

They probably do the staged Mohs for a reason.  Melanoma is easier seen under a microscope when the pathology uses paraffin and stains.  Mohs, itself, typically uses frozen sections techniques for squamous and basal cell — much quicker.  So while you say it is barbaric, it is probably the safest method if they indeed are doing actual pathology and that is the cause of the staged delay.

They probably do the staged Mohs for a reason.  Melanoma is easier seen under a microscope when the pathology uses paraffin and stains.  Mohs, itself, typically uses frozen sections techniques for squamous and basal cell — much quicker.  So while you say it is barbaric, it is probably the safest method if they indeed are doing actual pathology and that is the cause of the staged delay.

I've had a couple MOHS procedures to remove basal cell from my face.  The facility I had it done did it all at once.  Thery'd remove some, look at it, then come back and take more and repeat until they got it all.  It was done at Coastal Dermatology in New Bern NC.  I just figured that's how everyone did it.  I think if you call around it shouldn't be too hard to find someone capable of doing it all in one visit.

I've had a couple MOHS procedures to remove basal cell from my face.  The facility I had it done did it all at once.  Thery'd remove some, look at it, then come back and take more and repeat until they got it all.  It was done at Coastal Dermatology in New Bern NC.  I just figured that's how everyone did it.  I think if you call around it shouldn't be too hard to find someone capable of doing it all in one visit.

I've had a couple MOHS procedures to remove basal cell from my face.  The facility I had it done did it all at once.  Thery'd remove some, look at it, then come back and take more and repeat until they got it all.  It was done at Coastal Dermatology in New Bern NC.  I just figured that's how everyone did it.  I think if you call around it shouldn't be too hard to find someone capable of doing it all in one visit.

As I understand it, they are recommending the slow MOHs because with melanoma it is impossible to read the pathology of the excised specimen quickly as it does not freeze well.  So in order to get clear margins they will need to cut away until they reach the no-melanoma zone +5cm.

You could try to get a second, or third opinion at Moffat in FL, or Sloan Kettering in NY, but I'm guessing that you'd get the same answers your Dr is giving you now: fast WLE or slow MOHs.

I'm really sorry you are going through this,

Shalom,

Julie

As I understand it, they are recommending the slow MOHs because with melanoma it is impossible to read the pathology of the excised specimen quickly as it does not freeze well.  So in order to get clear margins they will need to cut away until they reach the no-melanoma zone +5cm.

You could try to get a second, or third opinion at Moffat in FL, or Sloan Kettering in NY, but I'm guessing that you'd get the same answers your Dr is giving you now: fast WLE or slow MOHs.

I'm really sorry you are going through this,

Shalom,

Julie

As I understand it, they are recommending the slow MOHs because with melanoma it is impossible to read the pathology of the excised specimen quickly as it does not freeze well.  So in order to get clear margins they will need to cut away until they reach the no-melanoma zone +5cm.

You could try to get a second, or third opinion at Moffat in FL, or Sloan Kettering in NY, but I'm guessing that you'd get the same answers your Dr is giving you now: fast WLE or slow MOHs.

I'm really sorry you are going through this,

Shalom,

Julie

Duke is a very good place to be!  Local to Virginia, depending on your part of Virginia, is Dr. Brian Johnson in Norfolk and Newport News.  He's an excellent MOHS surgeon who has achieved astonishingly good cosmetic results on a couple of neighbors of ours.  My understanding is that they read biopsies the same day and keep nibbling until all is clear, but you would need to confirm with him  I don't know whether he handles melanomas.  ET's melanoma was a bit more advanced than anything addressable with MOHS, so we were referred to a general surgeon (Elizabeth O'Neil — also quite good) for the WAE and SLNB.  Even after all the nibbling, the tissues would need more careful confirmation, and it's possible you would need to come back in to nibble more.  This was true even with ET's WAE and SLNB.  It was a few days before we got the "all clear" confirmation from the lab for the surgery that was done.  We were prepared for the possibility ET would have to go back under the knife, which thankfully she didn't.

Duke is a very good place to be!  Local to Virginia, depending on your part of Virginia, is Dr. Brian Johnson in Norfolk and Newport News.  He's an excellent MOHS surgeon who has achieved astonishingly good cosmetic results on a couple of neighbors of ours.  My understanding is that they read biopsies the same day and keep nibbling until all is clear, but you would need to confirm with him  I don't know whether he handles melanomas.  ET's melanoma was a bit more advanced than anything addressable with MOHS, so we were referred to a general surgeon (Elizabeth O'Neil — also quite good) for the WAE and SLNB.  Even after all the nibbling, the tissues would need more careful confirmation, and it's possible you would need to come back in to nibble more.  This was true even with ET's WAE and SLNB.  It was a few days before we got the "all clear" confirmation from the lab for the surgery that was done.  We were prepared for the possibility ET would have to go back under the knife, which thankfully she didn't.

Duke is a very good place to be!  Local to Virginia, depending on your part of Virginia, is Dr. Brian Johnson in Norfolk and Newport News.  He's an excellent MOHS surgeon who has achieved astonishingly good cosmetic results on a couple of neighbors of ours.  My understanding is that they read biopsies the same day and keep nibbling until all is clear, but you would need to confirm with him  I don't know whether he handles melanomas.  ET's melanoma was a bit more advanced than anything addressable with MOHS, so we were referred to a general surgeon (Elizabeth O'Neil — also quite good) for the WAE and SLNB.  Even after all the nibbling, the tissues would need more careful confirmation, and it's possible you would need to come back in to nibble more.  This was true even with ET's WAE and SLNB.  It was a few days before we got the "all clear" confirmation from the lab for the surgery that was done.  We were prepared for the possibility ET would have to go back under the knife, which thankfully she didn't.