Posts Tagged ‘cyst’

Lipoma and cyst removal surgery

Monday, August 3rd, 2009

About 5 years ago I started developing a lump on my leg – on my thigh. It grew to the size of a small marble. It was below the surface of the skin and seemed fairly firm and quite spherical.

lipoma cyst on leg

Lumps growing under your skin can be bad news so I went to see my doctor. He told me it was a lipoma – a harmless build up of fat under the skin. He said I could have it removed if I wanted to but that it would do no harm if I left it.

I lived with this odd lump for 5 years and it didn’t cause me any trouble. A year ago I spotted that it had grown larger. It had now reached the size of a large marble under my skin. I went back to the doctor and this time we decided to get it removed. He wrote me a referral and told me that I should expect an appointment letter from the St. Mary’s hospital in about 6 weeks.

My appointment letter arrived. It told me that I would be a day patient – i.e. no need for an overnight stay – and that the surgery would be carried out under local anaesthetic. I was told the date and time to report to the small surgery unit. Apart from that there were no special instructions.

The surgery

On the day I reported to the St. Mary’s Hospital small surgery unit’s reception and had a simple form to fill in. A little later a nurse came in and told me to change into the hospital robes. I did this and waited some more.

Another nurse arrived and took me upstairs to another waiting area. This waiting area was full of other people in surgical robes – either waiting for their surgery to begin, or sitting there under observation after their surgery was complete.

More waiting was involved, until the surgeon appeared and lead me to another room. This room was like a doctor’s room. It had a movable bed (plastic, not fabric covered), and lots of cupboards. Another nurse was in the room as well preparing some equipment.

The surgeon asked some questions and took a look at my lump. She explained what she was going to do. Seemed simple enough, give me the aesthetic, cut a slit in the leg, remove the lipoma and then stitch the leg back up.

I had to sign a form saying that I understood what was going to happen and that I understood that I would be left with a scar.

She had me lie on the bed and positioned my leg. She shaved the area and then using a marker pen drew a few lines onto the lump where she was going to cut. She then swabbed some liquid (I’m guessing it was iodine) onto the area to sterilise it.

Next was the anaesthetic. I had assumed that this would involve a single injection to the area – wrong! She told me that the injections were usually the worst bit of the surgery. She would inject into the surrounding area multiple times. She warned that the injections would feel like bee stings.

The injections did definitely sting. She started out with about 4-5 injections around where the lump was. She then poked the area and asked if I could feel anything. I could. She then gave me another 4-5 injections – I wasn’t watching but I think that as well as them being around the lump they were also at different depths into the skin. Clearly each injection only numbs a very small area. More injections followed until finally she was satisfied that the area of my leg would not feel anything.

As I was lying down I fortunately couldn’t see exactly what she was doing. I saw her holding a scalpel blade. I don’t know exactly when she started cutting into my leg. This is obviously a good thing and meant that the injections were working!

She spent some time doing what I assume was cutting. It is a very odd feeling to be lying down whilst someone uses a scalpel and surgical scissors to cut into your skin. Every so often she’d ask the nurse for some help of a new piece of equipment. A few times she needed a new scalpel.

After what was about 10 minutes she told me that she could see the lump and said that it wasn’t actually a lipoma which is what my doctor had diagnosed it as. It was a harmless benign cyst. The surgeon said that this made it a bit more tricky as she needed to remove it in one piece. If she couldn’t get it out intact then there was a risk that a piece could get left behind which would start growing again.

She also told me that it was quite firmly attached at the bottom so it would require a lot of cutting to remove. She continued cutting and snipping for another 15 minutes. I didn’t feel any of it. All I could feel from my leg was a numb feeling caused by the anaesthetic. Similar to the numb feeling you might get from a dentist anaesthetic.

Finally she announced that it had been removed!

She checked that there were no pieces left and then got ready to sew me back up. Doing the stitches (or sutures as medical people call them) seemed to be straightforward. She used 6 stitches in the area. She told me that they usually have the ends cut short but in my case she’d leave them long so they didn’t come undone. There was a risk as the incision was in a mobile part of my leg.

On top of the main stitches she stuck some paper stitches down – so the main stitches wouldn’t move about. I had a look at the wound at this point and the sight was not great. It was as if someone had cut a one inch hole into my leg and then sewn it back up – which of course is what had happened.

She then put a giant plaster over the stitches and finally wrapped a bandage tightly round my leg.

She told me that I should take it easy today, and warned that my leg could be very painful once the anaesthetic wore off. I could take some standard pain killers if I needed them. I was to take it easy for the next few weeks but there was no need for me to avoid walking. No running, sports or anything stressful for my leg, but normal walking would be fine. In two weeks I should go to a nurse at my doctor’s practice to get the stitches removed. I was also told not to get the wound wet. I could shower if I kept my leg away from the water, but definitely no baths.

It all sounded like it had gone very smoothly. Little did I know that the surgery was only the start!

Before I left the operating room she showed me the cyst in a bottle. It was white, quite spherical and the size of a large marble. It looked a bit like an eyeball!

Afternoon recovery

After the surgery I was told to sit down in the waiting area and have a drink and a biscuit. 10 minutes later I was allowed to leave.

It was quickly apparent that walking with an anaesthetised, stitched up leg was to be a slow affair. I made it to be bus and managed to get home.

Once home I sat with my leg up and tried to rest it as much as I could manage. For several hours the area of my leg that had been operated on remained very numb. Slowly the numbness started wearing off, to be replaced with a sharp painful stinging sensation.

I’d been told that I could take painkillers if I needed them. The problem is that you don’t know how much the pain is going to increase by. I decided not to take any pain killers unless the pain got really bad.

For another few hours the anaesthetic wore off. The pain did increase but it was manageable. It was most noticeable when trying to move or walk.

I had to sleep on my back that night as my leg was too painful (and too fragile given that it had new stitches in it) for me to put any pressure on that leg.

The next day

The next morning the pain had died down considerably. I was able to hobble around, but my limp was obvious.

I continued to rest my leg as much as possible as I knew that I needed to give my wound a chance to heal.

Recovering

Over the next two weeks the pain reduced more. I was able to take the bandage off in the first week but the large plaster remained covering my wound. I had no idea what was happening underneath, but I was hoping that the hole was closing up.

after cyst lipoma removal surgery

It was no longer painful when sitting or walking, but the pain was there if any pressure was applied to the area. I still couldn’t sleep on my side.

As the days wore on I could walk more and more normally. I thought it must be getting better.

Visit to to the nurse

Two weeks after my surgery I visited the nurse to have the stitches removed. I couldn’t visit the nurse at my doctor’s practice as they were dealing with a mice infestation, so I went to the Soho Walk-In Centre. You don’t need an appointment to go here, but you do have to be prepared to wait. On this visit I arrived after work and after filling in the form they gave me, I had to wait nearly two hours before I was seen.

The nurse was very friendly and after questioning me asked me to sit on the bed. First she removed the giant plaster and then started removing the paper stitches. I was watching as she did this.

The paper stitches are stuck onto the skin (like match stick wide pieces of masking tape). The adhesion is fairly strong so a bit of ‘pull’ is needed to remove them. As she took them off it became very obvious that my wound was still completely open. Only the main stitches were holding each side of my skin together.

She spotted that one of the longs ends of one of the stitches was sticking inside my leg. Perhaps this was making it harder for the wound to heal. She re-positioned the end part of the stitch and told me that it was clearly too early for the stitches to be taken out. She put some new paper stitches in place, and put another giant plaster over the wound. She told me to come back in a week.

Before I left I did find out that in order to avoid a two hour wait it would be a good idea to get there just before 8am when it opened.

A week later

A week later I went back to the Soho Walk-In Centre. As suggested I got there before 8am. There were already a few people waiting. At 8am the door was opened and we were let in. I filled in the form and after about 10 minutes was collected by another nurse.

She removed the giant plaster, and then the paper stitches. The wound looked pretty similar to a week ago. It still wasn’t closing up.

The nurse told me that she would have to remove the stitches anyway. She said that there was a limit to how long they could be left in. She removed the stitches – which is very quick and painless by the way – and then cleaned up the wound.

She put new paper stitches on to try to hold the two edges of skin together and then put another giant plaster over the top. She gave me some giant plasters so I could replace the plaster a few times and told me to come back a week later.

lipoma cyst removal scar 2

The next two weeks

Over the next two weeks I visited the Soho Walk-In Centre three more times. Each time my wound would be examined, cleaned and be re-dressed. Each time when I saw the wound again it didn’t appear to be much better. Each time I was told to come back in 3-5 days.

One one occasion to save me a visit one of the nurses gave me a dressing kit so that I could re-dress the wound myself the next time. And I was given a supply of the Mepore giant plasters so I could change them every few days.

dressing pack

mepore giant plaster

On another of the visits a gel was squeezed into the wound which was supposed to encourage the healing process.

intrasite gel

A breakthrough

It was now four weeks since my surgery and the wound was still not closing. I was wondering if the wound could be infected. In fact one of the nurses had wondered this but after getting a second opinion had decided it wasn’t.

On visit number 6 to the Walk-In Centre the nurse I saw told me she believed the wound was infected. She explained that this was why it wasn’t healing up. She cleaned and re-dressed the wound. Over the actual wound she put an inadine sheet. This is a small piece of fabric which is soaked in iodine. Iodine helps to kill bacteria. She also gave me a prescription for Flucloxacillin – an anti-biotic which is similar to penicillin. I was to take this three times a day for the next week.

inadine

The Flucloxacillin caused me no problems apart from one day when I had a lot of chest tightness. On my 7th visit to the nurse I mentioned this side-effect but was just told to keep taking it.

On my 8th visit I saw real improvement to the wound. It looked like the anti-biotic had killed the infection and allowed my wound to heal. The wound had almost closed up. Rather than putting a giant plaster over the wound the nurse put a thin see-though skin-like layer over the top of it. She said this would help the scab that was over the wound to break down and would speed up the healing process.

duoderm layer

The end

Six weeks after my surgery I made my 9th visit to the Soho Walk-In Centre. My wound was now fully closed up. The nurse took off the skin-like layer, cleaned the wound and put another one of the skin-like layers over the top. She told me to leave this layer on for another week. She told me that there should be no need to come back!

Indeed this was my last visit to the nurse, after taking the final skin-like layer off I was able to leave the wound exposed. It still had a large scar over the area, and there was a indent where the cyst had been but at least I could have normal baths, and showers again.

Over the next 6 months the scar did reduce. It still hasn’t disappeared and the indentation is still there but it is good to have got rid of the lump – even though the whole experience was a lot more hassle than it should have been.

lipoma cyst removal scar 3