The Down Range Forum
Member Section => Down Range Cafe => Topic started by: billt on February 16, 2011, 09:19:46 AM
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This isn't the most pleasant thing to discuss, but I don't know anyone else who has had it. Monday I went in for out patient surgery to have an infected Sebaceous Cyst removed on my back. I'm a little pissed about the whole thing because I've had this for a while, (over a year), and showed it to my doctor a long time ago. He said not to bother with it because they sometimes go away by themselves. It was then quite small and not a problem.
About 3 weeks ago it became very large, (about the size of half a golf ball), red and sore. I went back and he told me it was infected, and he was going to send me to a surgeon because he said it would be much too painful to remove in his office. A week ago Monday, (the 7th), I went to see him, (the surgeon), for the initial examination and he booked the surgery for this past Monday, (the 14th), in the hospital as an out patient procedure.
He told me because of the infection he would have to "remove some skin over the top of it". During the week that followed waiting for the surgery it really became inflamed, painful, and began to drain. I had the surgery done, and they kicked me to the curb with a prescription for 40 Vicodin, and said to leave the bandage on for 48 hours before taking a shower and changing it. Yesterday afternoon I took the bandage off and I have a 3" by 2" hole in my back close to a 1/2" DEEP! I was shocked. I had no idea he was going to remove so much tissue! I can't imagine how long this is going to take to heal? Has anyone ever had anything like this done? I could post a picture of it but it is a large wound and really graphic. They never even told me how to properly bandage this thing. I'm going to the pharmacy this morning to get some supplies. The last thing I need is to get this thing infected before it heals. Right now it feels like I've got a red hot branding iron sitting on my back. I just wish I was better prepared for what I was in for! Bill T.
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If you had it removed before it became infected it would have been much easier. My Dad had several removed years ago. The doctor slit the skin and popped it out. He looked like he lost a knife fight but was back to work in a couple of days.
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Tell me about it. Had I known this was going to happen, I would have insisted on having it removed back when I first discovered it. Now I'm in for a painful healing process that will most likely take months. Bill T.
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You will heal faster if you look at it this way, It's a small price to pay for not dieing from blood poisoning, it most likely doesn't hurt any worse than the infected cyst, but now you know there is light at the end of the tunnel. (not a train coming at you )
Depending on what other meds you may be on (blood thinners will mess you up ) a positive mindset will decrease pain and speed healing.
Another thought, this would be a good time to practice self defense drills as the pain in your back will act as a handicap similar to an injury. (Just be careful about breaking it open or popping stitches )
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Billt,
Ask your doctor or pharmacist about antibiotic packing. My mom had one removed two years ago right about now. It was larger than a golf ball. The made a two and a half inch incision and removed the cyst through that leaving a large hole in her side.
She was given antibiotic packing - gauze strip that is soaked with an antibiotic ointment. Everyday she had to go to the clinic and they would remove the bandages and packing, and then pack the wound full of new packing.
I would think that since yours is more of a crater than a hollow pocket you could apply this yourself. They did the packing for the first four weeks, and then just left it bandaged for the next month. She healed shut in about two months.
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It should smooth back over some as the fat grows back.
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Be nice RW, That's Muscle ! ;D
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The doctor was talking about a "wound pump" or vacuum. I've heard nothing but bad about these things. They can cause a lot of problems, and they are bulky and difficult to wear, not to mention they run about $100.00 a day, and insurance doesn't cover a dime of it. Melanie just talked to the doctors office and they said no antibiotics. Right now I have it covered with a 4" sterile gauze pad and tape.
It's not too bad when I sleep on my side, which I do normally anyway, but it is really sore if I lean back in a chair. I sit upright when I'm on my computer, so then it's not too bad. If I take the Vicodin I get an upset stomach, and a sore back. so it's easier to just suffer without it. I just wish I knew how long this was going to take to heal. I can't imagine what I'd do if I lived alone? Bill T.
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Why do we always end up with this crap on our ass or back :'(
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Vicodin seems to effect most people that way, See if they can give you something else, like Percocet.
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a positive mindset will decrease pain and speed healing.
Another thought, this would be a good time to practice self defense drills as the pain in your back will act as a handicap similar to an injury. (Just be careful about breaking it open or popping stitches )
Isn't that what John Rambo does.....Ignore pain? ;D No stiches, just a big hole. Right now I'll take a pass on running from room to room, "slicing the pie". ;D Bill T.
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Why do we always end up with this crap on our ass or back :'(
I'm just glad it's not on my face, or you know what! :o Bill T.
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Isn't that what John Rambo does.....Ignore pain? ;D No stiches, just a big hole. Right now I'll take a pass on running from room to room, "slicing the pie". ;D Bill T.
At least in #3 he reminded Col. Trautman that that is what the Col. had taught them. However, when the Col. asked if it worked Rambo said "not really" :'( Speaking of which - You might want to consider the burning gunpowder trick. On a wound that size I would suggest a .50 BMG ;D
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Not so much "ignoring it" but distract yourself from it.
Last summer, before they got my Heart meds right, I was having a lot of trouble with chest pains, and stomache upset.
One night at work everything I touched either went wrong or broke, I got so PO'ed that I fired a (small ) allen wrench (bent ) across the shop, and was cussing a blue streak. I realized later that it was the best I had felt in a month. ;D
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Not so much "ignoring it" but distract yourself from it.
I know what your saying. Even BS'ing with you guys keeps my mind off of it. I got a new movie to watch today, "Unstoppable", so that will keep me occupied for a while. Then there's the 2,500, .223 cases I've got that need prepping. But I'm not in that much pain! ;D Bill T.
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I know I haven't been posting, but dang, you guys are falling apart.
Don't dismiss the wound vac therapy. They work great. They provide much faster healing time. We use them all the time at work with great success. Since you are an active guy I'm not sure lugging a vac pump around would be a good option for you but there are portable versions.
It sucks that you have a hole in your back but it will heal. It will take time. The doctors and nurses should have done a better job explaining the procedure and reviewing your discharge instructions. They forgot the "informed" part of "informed consent".
Since you had an infection the wound was left open. The source of the infection is gone so you shouldn't need antibiotics. If they had closed the wound there could have been some residual infection trapped in the wound and that would make things much worse. The best advice I have is to not overdo it with dressings. Stay away from antibiotic creams or anything else. For a dressing you can do a wet to dry dressing. Get some kerlex or other type of gauze, moisten it with normal saline, gently pack it in the wound, cover with dry 4x4 gauze and tape it in place. Change it 2-3 times/day. Keeping the wound bed moist (not soaked) will help it heal. It will heal from the inside out. You will notice granulation tissue forming in the wound bed and the wound edges healing in. You will probably have a big dimple and a nasty scar, but hey, you're old and married, no chicks are going to be checking you out anyway. ;)
Good luck.
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Thanks 1911. How long before you think it will dry up enough so it won't require a bandage? I'm surprised it isn't leaking more than it is, considering how large of a wound it is. Bill T.
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Everyone heals at their own rate. It is going to take a while, maybe a month, maybe longer. No good answer on that. Nutrition plays a big part in wound healing. Just eat healthy, it shouldn't be a problem for you.
You shouldn't have a lot of drainage either. When you change the dressing you may notice some serous drainage (pale yellow) or a little bit of blood on the packing that you take out. That is ok and should decrease over time. If the gauze sticks when you are taking it out, just moisten it with some more saline and let sit for a few minutes before taking the packing out. Should help decrease any bleeding also. Let the doctor know if there is a lot of drainage, the drainage is foul smelling or purulent, or if the skin around the wound becomes red or inflamed. That could mean that the wound is becoming infected.
Keep doing the wet to dry dressings until a good bed of granulation tissue develops. You will notice the change. After that just cover with some dry gauze until you feel comfortable going without anything.
And remember, the best way to prevent the spread of infection is through proper hand washing. ;D
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Couple of things.
1. My Dad had a melanoma removed from his back, the wound was the size of your fist - deep as well as tall and wide. It did heal over, but that was a LONG time ago and I have no idea what he did - different medicine back then too.
2. That big of an open wound will probably drain for a few days, maybe a week? I however am not a doctor, although I did play one with Suzie when I was a kid! ;)
3. Get a second - or third - opinion, get your personal physician involved. The "no antibiotics" thing on an open wound bothers me a bit, that doesn't sound normal. However, now that the cutter has had his say, most other doctors probably won't interfere. But I would ask why no antibiotics and demand an reasonable answer.
4. Always always always!!!!! take control of your medical procedures. To the doctors, you are another stat to be dealt with clinically and efficiently. NO one - and I mean no one - will be looking out for you but you (OK, and Melanie in this case). Ask questions, probe the answers, look online, get the facts, regardless of how minor or trivial the procedure looks. Be a pest to the doctors so they will answer you just to get rid of you.
It is a proven fact that people who approach medicine as I suggested in #4 do far better than those who put their lives in their doctor's hands.
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Just asked the wife, she says its no big deal, its often done by GP, in the office.
She said some stuff about how if its infected prior to removal it can be very bad and can often end in removing alot more of the surround tissues.
I'm sure there are lots of videos on youtube.
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They haven't said anything about "packing" the wound with gauze. It had some in with the original bandage I had on it from the hospital, but I changed that yesterday, and again this morning with just a gauze covering and some tape. I've got a bunch of surgical dressings and gauze bandages. The doctor is supposed to call today with more "instructions". I'm not holding my breath. I just hope the thing doesn't start itching and driving me nuts. Bill T.
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You want to keep the wound bed moist to promote growth of granulation tissue. We usually just do wet to dry dressing. There are a lot of fancy gauzes and dressings out there that may work but I don't think you need to worry about it in your case.
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Just for fun, this is some of the goop I squeezed out of someones back. This doesn't include what squirted on the wall and floor. I can't even begin to describe the smell. I need a raise. ;D
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+1 on what Junkie said about the wound-vac. I don't know if it is a viable option regarding the size of your wound, but it kept me from being an above-the-knee amputee and kept me away from many of the usual bouts of infection (and resultant tissue removal) usually associated with the type of dirty wounds (lots of trash, dirt, and debris) I had. My doctors were amazed that I never experienced any type of infections after all the severe trauma to the tissue and 15 surgeries. I credit the wound-vac, the tediousness of care of the nursing staff, and how well they trained my wife for the after-care at home.
Also, ask about the non-stick wet-style gauze pads. They don't stick to the wound and make bandage changes easier. I think they are coated with an anti-bacterial vaseline based ointment, but still allow the wound to breathe.
Junkie pretty much nailed it, though......wash hands and clean, clean, clean.
Either way, good luck on the healing and I hope you mend well.
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I had two 4-inch fatty tumors removed from my back. One side was bleeding really bad internally. They cut me open and shoved a few wet sponges in the hole and dry gauze over top of that. A visiting nurse came by every day to change the dressings. After a month or so the hole was small enough not to put any sponges in so the nurse quit coming. I had to bandage it myself from then on. The doctor told me to let water blow in there when I take a shower. He sent me back to work with a hole still in my back. I didn't take any antibiotics and didn't need any.
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Thanks 1911. How long before you think it will dry up enough so it won't require a bandage? I'm surprised it isn't leaking more than it is, considering how large of a wound it is. Bill T.
Drying it up is all you are worried about? A gauze pad soaked in Viscerol 30 placed on the wound for two hours and then twelve hours in open air will be dried up for good. If you want I can PM you a funeral home that will soak the gauze for you at no cost, or for $3.50 + UPS I'll send you a pint ;)
Sorry, but between the problems of many friends and a couple major pot holes here at home I needed to just be me for a minute.
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The doctor told me to let water blow in there when I take a shower. He sent me back to work with a hole still in my back. I didn't take any antibiotics and didn't need any.
That's exactly what my doctor just told me. Hard to believe they want all that meat exposed to the Shower-Massage? Melanie just repacked it with wet gauze per his instructions. Bill T.
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That's exactly what my doctor just told me. Hard to believe they want all that meat exposed to the Shower-Massage? Melanie just repacked it with wet gauze per his instructions. Bill T.
Now where did you hear that before? :P
The water from the shower will help keep it clean and can also stimulate tissue growth.
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Junkie describes exactly what they did for me when I had my accident. I ended up with a three inch diagonal crater in my chest/sternum below my throat from something I hit or hit me.
It was devoid of any skin, about 3/4" deep and nasty looking. I have some pics here somewhere. It took daily dressing changes while I was in the hospital. Usually by the most beautiful girl I think I've ever seen who was the third shift RN fresh out of Baylor. It was always a pleasure to see her......really sweet Texas beauty! I fell in love every day...
Anyway, it healed, looks nasty and doesn't bother me..
Good luck!
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Nurse wife totally agreed with wet/dry rotation. It will be a slow pot hole to fill, and Vicodin is a weird drug. It is the only thing I ever tell doctors I can't take.
Stock up on dressings, tape, etc,... All previous postings are spot on.
Except the one where,....we tell you to suck it up, and walk it off..... ;D
Don't let it stay too wet or too dry for too long. Eat well, lots of Vitamin E, zinc, and C.
Watch the PSI of the shower, the new tissue can easily be flushed/blasted out, and extend the heal time.
All the best. Get the wife to dress up in one of those nurse uniforms with the white stockings,.... ;)
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Dilaudid is great for pain but I doubt you'll get any. Yummy!
I'm having flashbacks.
;D ;D
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Drying it up is all you are worried about? A gauze pad soaked in Viscerol 30 placed on the wound for two hours and then twelve hours in open air will be dried up for good. If you want I can PM you a funeral home that will soak the gauze for you at no cost, or for $3.50 + UPS I'll send you a pint ;)
Does it smell as nice as Hoppe's #9? ;D
Good luck Bill, those things seem to take forever to heal but you'll be up and at 'em soon.
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Does it smell as nice as Hoppe's #9? ;D
Good luck Bill, those things seem to take forever to heal but you'll be up and at 'em soon.
I don't remember. After twenty years of working with the stuff the olfactory units are pretty well shot. It is a carcinogen though, but in all my years of testing I always passed the exposure tests.
The 30% formaldehyde and high alcohol content make it popular with potheads 8)
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(http://i812.photobucket.com/albums/zz50/billt460/CystSurgeryAfter48Hours001.jpg)
There it is, in all it's glory. 3.1" X 2" X about 1/2" deep. Bill T.
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In the world I work in that is called a "full depth tissue donation." We developed my prescription for that exact procedure only it is usually much larger.
I have often wondered as I worked on those what the pain would be like ::)
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Hey, that bear in the picture has a hole in it just like the one you were talking about. Talk about coincidence. ;D
It looks good (probably doesn't feel like it). Just do the dressings, keep it clean, give it time, and all should be well.
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I hope they shaved you first ;D, if not I bet it hurt when the tape pulled all your man sweater off ;D
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I hope they shaved you first ;D, if not I bet it hurt when the tape pulled all your man sweater off ;D
Yea, looks like you got a moth problem Bill!
;D
kidding....heal up. I have one a bit smaller on my back from a cancer excision some years back. It will get smaller over time.
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Dilaudid is great for pain but I doubt you'll get any. Yummy!
I'm having flashbacks.
;D ;D
I found out the hard way that I'm allergic to that stuff. They tried to switch me off morphine after so many weeks and gave me shot of it and liked to have killed me. BP dropped off the scale and on top of that I was hallucinating and tried to fight the nurses who were trying to stabilize me...I thought they were trying to smother me.
Bill, that don't look too bad.....hell, as long as you can't see bone........ ;)
And like others have mentioned, the water therapy does help stimulate new growth.
I had to go through that for 2nd degree electrical burns on my arm years ago. Only difference was they had to scrub my raw arm with what amounted to a Brillo pad with some kind of red soap in it. After they scrubbed it, I had to let warm water spray all over it before drying off and coating with Silvadine.........I was not happy.
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I have often wondered as I worked on those what the pain would be like.
Let's just say I've felt better! Bill T.
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I found out the hard way that I'm allergic to that stuff. They tried to switch me off morphine after so many weeks and gave me shot of it and liked to have killed me. BP dropped off the scale and on top of that I was hallucinating and tried to fight the nurses who were trying to stabilize me...I thought they were trying to smother me.
it before drying off and coating with Silvadine.........I was not happy.
Heck Chuck, for a while they were giving me BOTH on an IV drip! Morphine alone wasn't getting the job done and one reason it took me another 6 months to kick the drugs altogether. Couldn't take it by mouth though, made me sick as a dog.
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I think I'll stick with red wine. ;D Bill T.
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I think I'll stick with red wine. ;D Bill T.
It will certainly improve the effects of the vicodin!
:D
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Heck Chuck, for a while they were giving me BOTH on an IV drip! Morphine alone wasn't getting the job done and one reason it took me another 6 months to kick the drugs altogether. Couldn't take it by mouth though, made me sick as a dog.
Yikes! Dilaudid is a derivative of morphine. The 2 shouldn't be given together. Dilaudid is about 10 times as potent as morphine so the dosages are lower. The benefit comes in that when high doses are needed the dilaudid doesn't have all the metabolites that can cause more problems like morphine can. No wonder it took you a while to get off the stuff.
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Yikes! Dilaudid is a derivative of morphine. The 2 shouldn't be given together. Dilaudid is about 10 times as potent as morphine so the dosages are lower. The benefit comes in that when high doses are needed the dilaudid doesn't have all the metabolites that can cause more problems like morphine can. No wonder it took you a while to get off the stuff.
It was only a few days. My wife stepped in when I started talking gibberish like I just stroked out or something. Scared her to death! My advice to anyone traveling in the Northeast! STAY AWAY FROM RHODE ISLAND HOSPITAL!
They dropped the morphine and kept me on dilaudid for the duration. First with IV pump and then sub-Q injections till I was home. Like I said, I couldn't take it orally. Had to switch to hydrocodone at home. Been through a lot of crap over my lifetime but that was definitely not a fun time.
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Before they pulled out the I.V. and kicked me to the curb, they gave me a shot of Demerol. The ride home was nice! The car seemed to just float along. Good shocks I guess. Bill T.
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I got no advice for you. I'm just glad my back doesn't look like the one you have. Do what the doc says, and also eat some extra fats and proteins as well as taking a good multi-vitamin.
And for gosh sakes, don't show that to people.
Get well, buddy.
Crusader
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You didn't say they installed a coin slot. :o
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Yikes! Dilaudid is a derivative of morphine. The 2 shouldn't be given together. Dilaudid is about 10 times as potent as morphine so the dosages are lower. The benefit comes in that when high doses are needed the dilaudid doesn't have all the metabolites that can cause more problems like morphine can. No wonder it took you a while to get off the stuff.
Might be why it done me so bad....too much, instead of allergic to it......what ever the case, it was a bad ride for a little while.....scared hell out of the ICU staff...... ;D
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Bill, you have received a lot of good info on this thread, take it, I am not a medical professional, but have had some training, your wound looks good actually, just follow the advice, you and Melanie, inspect it daily, just as noted, look for redness, excessive drainage, bad odor etc... if any of that shows up, go directly to the DR. don't wait to see if it gets better on its own.
Speedy recovery my friend.
Side note: You would think since it was VDay, the surgeon could have cut it in a heart shape. ;)
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I haven't been here as much as usual, so I missed this thread until now. I am currently hooked up to a wound vac following surgery to remove an abscess. Woohoo! Talk about fun! ::) Bill, your current wound may not require a vac, but I wouldn't hesitate to use one in the future. They decrease healing time by about half, as well as providing the benefits of less frequent dressing changes (every 2-4 days) and no drainage issues.
I somehow missed out on the dilaudid all the way around. It seemed like it had little effect on me, other than making me feel flushed and a little light headed. I've received maybe 3 or 4 injections and also had a pump loaded with the stuff... no gibberish nor REAL pain relief.
Get well soon, Bill!
Swoop
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Hey, how's the back doing?
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Hey, how's the back doing?
Thanks for asking. So far, so good. No redness, soreness, or infection. It's closing up and is much narrower than it was a month ago today when I had the surgery. I keep a 4" square Gauze on it and change it twice a day, and soap and rinse it in the shower daily. Believe it or not it actually feels good to get it wet. There is less and less drainage every day coming from it, but it still looks nasty. It still has a long way to go before it's completely healed. There is much less pain, stinging, and burning.
It is closing in from the sides, as well as up from the bottom, which now has the texture of sliced Corned Beef with about the same redness to the new tissue. It's really amazing how your body can repair itself after losing that much hide. Bill T.
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Glad to hear the healing is on track, Bill......much luck and best wishes for continued healing.
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(http://i812.photobucket.com/albums/zz50/billt460/CystSurgery002.jpg)
Saturday will be 3 months since the surgery, (February 14th). As you can see it has healed up quite well. I never would have guessed that much hide would have grown back that quickly. Anyway it's nice to not have to screw around with bandages anymore! I'm sure in another few months a lot of the redness will disappear and the color won't be as noticeable. Bill T.
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Actually, from this angle, and this is just my opinion now, it looks, kind of, like Mel reamed you a new . . . . .
;D
Congrats on the healing, good news!
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I never thought it would heal like that. Especially after 2 weeks when the surgeon started right away talking about skin grafts and the like. It grew in from the sides, and up from the bottom. Amazing how the body takes care of itself like that after such trauma. Bill T.
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Actually, from this angle, and this is just my opinion now, it looks, kind of, like Mel reamed you a new . . . . .
;D
Congrats on the healing, good news!
glad you posted that first....
yes I did think the same thing..
glad it is all going well,
the medical insurance would be loving you recently mate
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The medical insurance would be loving you recently mate.
Especially after they got the $4,500.00 bill from the Mayo Clinic for my Prostrate Biopsy. I didn't have to pay a cent. It made up for the $7,200.00 A/C System I did have to pay for! Bill T.
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I never thought it would heal like that. Especially after 2 weeks when the surgeon started right away talking about skin grafts and the like. It grew in from the sides, and up from the bottom. Amazing how the body takes care of itself like that after such trauma. Bill T.
+1
Glad the healing process has gone well, Bill.
**My brother had an abscessed cyst removed from his thigh (up near the groin) a month ago and the healing has played the devil with him due to the location. He had a smaller one removed from his neck area last week. He asked the doctor why all of a sudden he has had such a problem with cysts, and the doc said his is a form of staph infection. The doc said it could be from either contact in the workplace, wal-mart carts, or such....or it can be inhaled. He told my brother to take a Q-tip every morning and coat it with a thin coating of Neosporin and gently coat just inside his nostrils and that would help with the inhaled form of staph. I have never heard of that, but I told my brother it would be worth a try.
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Another thing is to check places on your body for deep blackheads. Your back, underarms, or the back of your legs, anywhere you can't see, or pay attention to. These can and do turn into cysts that can grow and become infected. Most can be removed before they do. It's a hell of a lot better than what I went through! The older you get, the more prevalent this becomes. Bill T.