From: sbharris@ix.netcom.com(Steven B. Harris)
Subject: Re: Self-surgery (not for the squeamish)
Date: 26 Jun 1997
Newsgroups: sci.med

In <33b168e3.76541246@news.thegrid.net> nospam@this.address (wink ;o))
writes:

>OK folks, this is pretty gross.  Skip down if you have a strong
>stomach.
>
>G
>R
>O
>S
>S
>
>
>S
>P
>A
>C
>E
>
>The problem is a sebaceous cyst on my head that became so painful I
>took matters into my own hands 2 days ago with an Exacto knife.
>(can't afford a doctor)
>
>I got a lot of stuff out of it, consistency of peanut butter, and some
>stuff that looked like skin you peel off yourself when you have a
>sunburn  (I warned you this was gross).
>
>I'm keeping Neosporin on it, keeping it covered, and once or twice a
>day using hot, wet compresses for 15-20 minutes.  It seems to fill up
>a little overnight, but I get that stuff out of it at the time of the
>hot soaks.
>
>The only problem so far is that it hurts like a @#$%#!!.  I'm taking
>ibuprofen for that and it helps a little.
>
>Is there anything else I need to know or do?  Will this get better?
>I'm not a doctor (I don't even play one on TV).
>
>Thank you.
>wink
>
>(e-mail:  wink at thegrid dot net)
>
>P.S.  Regarding not seeing a doctor -- I've been trying for months now
>to get attention to this thing.  I make too much money to get any help
>from "the system" but too little to afford a doctor or health
>insurance.  Trust me, if there were any way  I would have done it --
>especially AFTER my little adventure in self-surgery as this pain is
>unbelievable.




   Well, you'll probably be okay (scalps are resistant to infection,
though not perfectly), but the worst problem is that you may get
recurrance of the cyst if you haven't gotten all of the sac out.  A
doctor would perhaps inject steroids at this point.  If you're going to
do medicine, you're going to have to learn to do that, too <g>.

   Meanwhile, I recommend as much hotpacking as you can stand.  And
neosporin.

                                        Steve Harris, M.D.

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.med
Subject: Re: Sebacious Cyst on Scrotum
Date: Fri, 21 Mar 2003 17:51:28 -0800
Message-ID: <b5gfit$8ta$1@slb1.atl.mindspring.net>

"jr data dctr" <jrdatadctr@yahoo.com> wrote in message
news:2047b302.0303211729.2185eb95@posting.google.com...
> I'm looking for advice from a medical professional or an individual with
> common experience.  Please be civil about this since it is a health
> concern and a relevant topic for many guys -- not just me.
> 
> I have a sebacious cyst on my scrotum.  Its been stable for at least a
> year -- it has not changed in size, has not become infected, and has
> never emitted any liquid.  I've shown it to 2 primary care physicians
> who've assured me that it is not a problem.  I previously had a cyst on
> my scrotum which disappeared after about 1.5 years without any
> intervention.
> 
> What kind of doctor has expertise on this subject?  Are there any risks
> to either letting this take its couse or pursuing treatment? What sort
> of treatment is available?  What risks are involved?  Is recovery --
> from an incision in the scrotum to remove this cyst -- lengthy or
> painful?
> 
> I also want to ask about what I suspect to be the underlying cause of
> the cyst -- and maybe the reason it hasn't yet cured itself as well --
> perspiration.  I have a high metabolism and tend to perspire a lot, even
> in cool temperatures.  What can I do to keep this area dry from
> perspiration?  Old Spice is only indicated for armpit use.
>
> Thanks in advance.


Castration always works....

Seriously, sebacious cysts sometimes take a shot of steroid
into them to keep them from coming back. Or a really good
excision. See a dermatologist-- they aren't afraid of them.
And they'll remove anything you don't like, without an
argument.

Of course, you'll have to pay quite a fee plus often
pathology charges to look at the tissue. Get prices before
you say cut.

--
Spammers are not welcome. I welcome email
from all non-advertisers who can fix my email
address (it's open book).

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.med
Subject: Re: Sebacious Cyst on Scrotum
Date: Mon, 24 Mar 2003 20:33:11 -0800
Message-ID: <b5oma2$ekl$1@slb9.atl.mindspring.net>

Dermatologists are not only adequate surgeons when it comes
to sebacious cysts, but will no doubt be a good deal better
at removing them and giving a small scar with no recurance,
than somebody who's used to chopping out prostates or
kidneys for a living. As you said, if you need a surgeon,
see the kind of surgeon who does the surgery you need every
week, if not every day.

SBH



"Howard McCollister" <nospam@nospam.net> wrote in message
news:3e7fc9c7$0$2732$45beb828@newscene.com...
> Kent, the age of medical specialization has even reached the hinterlands
> of Minnesota. You can fight it if you want to, but people will generally
> prefer to see a surgeon for their surgery, and with good reason. Even
> minor surgery is best done by someone who does it every day. Sorry. It's
> a fact of life in 21st century America. I don't treat runny noses, you
> don't do surgery. It's the way it is, and the way it should be.
>
> HMc
>
>
> "Kent H." <kh6444@attbi.com> wrote in message
> news:3E7FB51D.DDD13ED@attbi.com...
> > Come on Robert, you could do it! You don't have to see a Uro for
> > something that omnipresent in the skin throughout the body! I didn't
> > mean to imply that it shouldn't be removed under any circumstance that
> > makes the patient unhappy. Maybe his girlfriend doesn't like it.
> > Go for it!
> > Kent
>
>
--
Spammers are not welcome. I welcome email
from all non-advertisers who can fix my email
address (it's open book).

From: "Howard McCollister" <nospam@nospam.net>
Newsgroups: sci.med
Subject: Re: Sebacious Cyst on Scrotum
Date: 26 Mar 2003 07:11:03 -0600
Message-ID: <3e81a672$0$83723$45beb828@newscene.com>

Well, to be honest, I also know where Waseca is. At least I'm pretty sure I
could find it.

In some universes, Steve is probably right. Dermatologists are highly
skilled at all forms of skin surgery, and general surgeons have absolutely
no clue about the scrotum and it's contents. In other universes, which I am
more familiar with, general surgeons know their way around the scrotum, do
testicular surgery routinely, perform vasovasostomies, and address a wide
range of other surgical problems that would definitely perplex the
inhabitants of universes like Steve's.

There are indeed multiple universes in medicine. Practices, skill sets, and
referral patterns evolve to reflect the needs, interests, and capabilities
of the medical community and the people that make up their patients. This
evolution varies widely from place to place, and is generally most
observable in the differences between urban and rural practices. The fact
that a doctor does a gyn residency absolutely does not universally mean that
he/she is more skilled at pelvic surgery, for example, than one of the local
general surgeons; something I have observed MANY times over the last 20
years (as recently as yesterday, in fact, as I was called in to repair a
damaged ureter -- again). In some universes, like mine, the surgeons do more
EGDs and colonoscopies, and with equal or greater skill, than the typical
urban gastroenterologist. A universe gone crazy, eh?

Thank you for your kind words, Kent. Truthfully, I don't perceive a flame
war of any kind here. It feels more like the kind of prickly give-and-take
that goes on in doctor's lounges around the world.

HMc


"Kent H." <kh6444@attbi.com> wrote in message
news:3E812DBF.304A6EBE@attbi.com...
> BP 15 = Bard Parker # 15 Scapel:
> You obviously know all about that, even in your sleep.
> If you're chasing a sebaceous cyst on the scrotum you shouldn't get
> anywhere near the epididymis. If you did get near or onto the epididymis
> you would be in pretty much the same trouble as would the dermatologist
> in the same situation. You would be screaming to the urologist for help,
> wondering how to preserve the integrity of the testicular "vas deferens"
> seminal route. However, both of you in almost all circumstances are
> gifted enough to stay out of that type of trouble.
> Howie, this isn't and shouldn't become a flame war. This NG represents
> different things for different posters. It is helping some poor patient
> on the one hand, illuminating a colleague on another, and occasionally
> just chuckling amongst us.
> You are obviously a great doctor; the town of Crosby is honored and
> lucky to have you.
> Cheers,
> Kent
>
> Howard McCollister wrote:
> >
> > Not sure what a BP15 is, nor where Waseca is, but the difference
> > between me and the dermatologist is that I can fix any damage to the
> > epididymus, whereas the dermatologist is pretty much screwed. At least
> > in MY universe...
> >
> > HMc
> >
> > "Kent H." <kh6444@attbi.com> wrote in message
> > news:3E80F505.B54D2F98@attbi.com...
> > > Howie, just don't hit his epididymis with your BP 15.
> > > Cheers,
> > > Kent
> > >
> > > Howard McCollister wrote:
> > > >
> > > > Me. Surgery on the scrotum is part of the scope of training of a
> > > > general surgeon, and I do more of that kind of excision than
> > > > either of our urologists. And the last sebaceous cyst of the
> > > > scrotum I removed was referred to my by a dermatologist.
> > > >
> > > > HMc
> > > >
> > > > "Kent H." <kh6444@attbi.com> wrote in message
> > > > news:3E7FEDA5.5976B35@attbi.com...
> > > > > Howie does that mean the uro in Crosby is going to take the cyst
> > > > > off the nut, or are you???
> > > > >
> > > > > Howard McCollister wrote:
> > > > > >
> > > > > > Kent, the age of medical specialization has even reached the
> > > > > > hinterlands of Minnesota. You can fight it if you want to, but
> > > > > > people will generally prefer to see a surgeon for their
> > > > > > surgery, and with good reason. Even minor surgery is best done
> > > > > > by someone who does it every day. Sorry. It's a fact of life
> > > > > > in 21st century America. I don't treat runny noses, you don't
> > > > > > do surgery. It's the way it is, and the way it should be.
> > > > > >
> > > > > > HMc
> > > > > >
> > > > > > "Kent H." <kh6444@attbi.com> wrote in message
> > > > > > news:3E7FB51D.DDD13ED@attbi.com...
> > > > > > > Come on Robert, you could do it! You don't have to see a Uro
> > > > > > > for something that omnipresent in the skin throughout the
> > > > > > > body! I didn't mean to imply that it shouldn't be removed
> > > > > > > under any circumstance that makes the patient unhappy. Maybe
> > > > > > > his girlfriend doesn't like it.
> > > > > > > Go for it!
> > > > > > > Kent

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.med
Subject: Re: Sebacious Cyst on Scrotum
Date: Wed, 26 Mar 2003 20:02:33 -0800
Message-ID: <b5tt8j$1u$1@slb9.atl.mindspring.net>

"Howard McCollister" <nospam@nospam.net> wrote in message
news:3e8111d1$0$6076$45beb828@newscene.com...
> Not sure what a BP15 is, nor where Waseca is, but the difference between
> me and the dermatologist is that I can fix any damage to the epididymus,
> whereas the dermatologist is pretty much screwed. At least in MY
> universe...



COMMENT:


And why in God's name would anybody be cutting anybody's
epididymus while going after a lesion of the skin of the
scrotum? Testicles and associated structures are mobile; not
only can they be moved, but they actually move by themselves
out of the way of a needle or blade, and it's quite a lot of
work to immobilize one even if you WANT to cut or stick it.

Following this logic you dare not get rhinoplasty by anybody
who isn't also trained as an ophthalmologist, due to the
fact that in case they slip around your nose and hit your
*eye*, you're screwed....

SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.med
Subject: Re: Sebacious Cyst on Scrotum
Date: Thu, 27 Mar 2003 13:08:34 -0800
Message-ID: <b5vpcc$otj$1@slb6.atl.mindspring.net>

"Kent H." <kh6444@attbi.com> wrote in message
news:3E827A88.E69A73B6@attbi.com...
> Place your hand on your scrotal sac, "your nuts", and ascertain the
> proximity of the surface of the skin to the epididymal structure, and
> then imagine yourself with a BP 15 in hand, and try to remember what you
> learned while you were being trained.
> Cheers,
> Kent


COMMENT

Place your hand on your "scrotal sac" and pull a piece of
skin through two closely opposing fingers. Wow, did you get
a testicle going through?  You must have nuts the size of
peas. No? Try again. Still did it?  You must have the hand
coordination of a chimpanzee.  Try again?  *Still* can't get
a nut-free pinch of scrotum?  Wow, time to switch to
psychiatry.

If you had any surgical training yourself you'd realize that
"proximity" has absolutely nothing to do with it. Any
scalpel will be used to cut the skin surface only, not make
a blind stab at your "nuts."  Then the cyst is removed with
standard blunt disection with atraumatic forceps and Metz,
just as you'd do any subcutaneous procedure. Again no danger
of harming the epididymus or anything else in the area.

If you're going to be a suspenders and belt kind of person,
you can always isolate the area of the scrotal skin being
worked on with a padded clamp (any sponge forceps), or even
your favorite long curved atraumatic forceps, so long as you
don't crunch them down all the way. There are a million
varieties of long curved atraumatic forceps. But you know
that, right?

SBH

From: "Howard McCollister" <nospam@nospam.net>
Newsgroups: sci.med
Subject: Re: Difference between sebaceous cyst and a zit?
Date: 18 Jun 2004 23:23:04 -0500
Message-ID: <40d3bf06$0$70079$45beb828@newscene.com>

"plabord" <plabord@lycos.com> wrote in message
news:e9ad97d1.0406182013.3244025e@posting.google.com...
> For about two months now I've had what I think is a sebaceous cyst on
> my scalp, and while I'm waiting for my appointment with the surgeon,
> I've decided to  read up on the topic. So far I get the impression
> that a sebaceous cyst is similar to a big zit. But from what I
> understand, a sebaceous cyst can't be popped like a zit, because there
> is a "sac" that needs to be removed or the whole thing will grow back.
> However I remember as a teenager popping my zits away, even huge ones
> (once ripe, of course), and most of the time they didn't return at
> all. Why is there a sac in the cyst but not in the zit?
>

Sebum vs. pus.

HMc

From: "Howard McCollister" <nospam@nospam.net>
Newsgroups: sci.med
Subject: Re: Difference between sebaceous cyst and a zit?
Date: 19 Jun 2004 15:15:10 -0500
Message-ID: <40d49e29$0$58658$45beb828@newscene.com>

"plabord" <plabord@lycos.com> wrote in message
news:e9ad97d1.0406191023.3287ae4e@posting.google.com...
> > >
> >
> > Sebum vs. pus.
> >
> > HMc
>
> So then it's no riskier to pop a cyst that a zit? Then why all the
> warnings everywhere about a sac that has to be removed?
>
> PL

No risk at all. It's the difference between a cyst and an abscess. If you
"pop a zit", you are, in essence draining an abscess and it heals once
drained. If you pop a sebaceous cyst, you will empty the cyst capsule but as
long as the cyst wall remains, the cyst will just reform. The cyst wall
("sac") has to be removed.

Most sebaceous cysts will eventually become infected. It REALLY sucks when
that happens.

HMc

From: "Howard McCollister" <nospam@nospam.net>
Newsgroups: sci.med
Subject: Re: Difference between sebaceous cyst and a zit?
Date: 20 Jun 2004 07:42:13 -0500
Message-ID: <40d585c7$0$17189$45beb828@newscene.com>

"plabord" <plabord@lycos.com> wrote in message
news:e9ad97d1.0406191849.720a9b0f@posting.google.com...
> > Most sebaceous cysts will eventually become infected. It REALLY sucks
> > when that happens.
> >
> > HMc
>
> Thanks for the responses.
>
> My appointment with the surgeon is two weeks from now, and I'm really
> tempted to lance the thing. I know there are no guarantees, but if I
> sterilize the needle and wipe the area with alcohol, etc., would
> lancing it decrease the chances of infection, since these cysts seem
> to get infected on their own anyway, or increase them? Again, I know
> there are no guarantees, but just in general in your experience.
>

"Lancing" it will accomplish nothing except possibly get it infected and
certainly making the surgeon's job harder. If a patient came to me wanting
their sebaceous, and they had just "lanced" it, I would tell the patient we
had to wait until it healed before we would try to excise it.

HMc