Thing of (last) week: A hole in the head

Last week, I let a doctor cut a hole in the top of my head, rummage around for a bit, and pull out something nasty. Which was an interesting experience.

OK… maybe that makes it all sound a bit more dramatic than it actually was. I was having a sebaceous cyst removed from my scalp. However, since I’ve managed to spend pretty much 42 contiguous years on this planet without either (a) undergoing any kind of medical procedure that involved local anesthetic, or (b) ever having a wound big enough to be stitched, it was all a bit exciting at the time.

Of course, the one thing you should never, EVER do before having any kind of surgical procedure is this: look up its grizzly details on the internet.

Or seek out videos on YouTube.

Obviously, I did both of these things.


So why am I writing this? Well, largely because it turned out to be a fairly uncomplicated, painless process… but pretty much every blog-based account of scalp cyst removal that I found on the web prior to the operation made it seem like a journey into extreme pain and unavoidable discomfort awaited me. Maybe this post will help redress the balance. Or maybe google just prefers dishing up stories of pain, gore, and horror. Who knows 🙂

Anyway, here’s my (probably slightly dull) account of events:

I’ve had this little bump on top of my head for years, and I’d already been told it was a sebaceous cyst, and nothing to worry about. Unfortunately, around the start of this year, the bump started to grow, and start being a bit more noticable… it stopped being the size of a lentil, and started getting more towards marble-sized proportions… and it didn’t stop there. It became more visible… a bit of a nuisance when combing my hair etc… and, basically, just a little bit too big to easily ignore.

Of course, being a bloke, I thought I’d just leave it alone for a while, and see if it decided to go away by itself.

It didn’t go away by itself. Apparently they never go away by themselves.

So, early March, I decided to go to my GP and have it looked at. The GP referred me to the practice expert in lumps and bumps – though there was a week’s wait before I could see him. The practice expert decided the cyst might be infected, and put me on antibiotics… with instructions to take a 2 week course, then give the infection 2 more weeks to settle down a bit, then go back for another look.

The antibiotics were some odd variation of penicillin (I forget what they were called now) which required you to take 4 times a day, equally spaced, at least 1 hours before or 2 hours after a meal. When I looked them up on the web, I discovered I was taking the maximum recommended dosage… but I didn’t really have any bad side effects – other than an odd metallic taste in my mouth that appeared after a few days and didn’t go away for 2 weeks. However, scheduling the things around meals was pretty awkward and inconvenient. Nevertheless, I completed the course as instructed.

Unfortunately, this didn’t seem to make any difference to the lump… or not one that I really noticed anyway. When I returned to the doctor – a month after the first visit – he assured me that it had improved a lot. I wasn’t entirely convinced… but I’ll give his lump-examining expertise the benefit of the doubt.

At this point, I *finally* got put on a waiting list to have the thing removed… unfortunately, the earliest they could carry out the procedure was in 5 weeks time. Another wait. Great.

The day finally arrived. I was a bit nervous… one account I’d read on the net was from a lady who had spent the 24 hours following her cyst removal in pain so extreme that she couldn’t even sleep. I arrived 5 minutes before my appointment… and then found myself sitting in the waiting room for the best part of an hour, as they’d got a bit backlogged with work. And yes… that REALLY helped calm me down… *cough*

The operation was an odd experience. Aside from a couple of seconds of burning sensation when the first needle went in, it was pretty much pain free. I could feel the skin being tugged around, and the sensation of blood trickling down the back of my head… but all entirely painless. Yay for anaesthesia!

However, the procedure *did* seem to be taking an awfully long time – I’d been told it should only be about 10 to 15 minutes, depending on how easily the cyst came out. I didn’t have a clock in my field of vision, but I was sure it was taking a bit longer than that (later on, I discovered it was more in the region of 45 minutes). Eventually the doc admitted it was taking a little bit longer than usual, due to the fact that he’d “nicked a tiny artery”, and was having trouble getting it to stop bleeding.

He had a few sessions of pressing down on the top of my head, really hard – presumably to staunch the blood flow – (this was, actually, the only particularly uncomfortable part of the whole process)… and then I heard a strange sizzling noise … spookily similar to the sound that a soldering iron makes when it comes into contact with flux … and felt slight pinpricks of heat (the anaesthetic was maybe starting to wear off a touch by this time) … I guessed he must be using a cauterising iron to sort the bleeding out. Ewww!

Anyway, the wound got stitched up, and a nurse cleaned up the back of my head – “Just so you don’t look quite so much like you’ve just gone 10 rounds with Mike Tyson…”. At this point I got to look at the jar containing the removed cyst. It looked pretty gross… like a little white, pupil-less eyeball, with a small sliver of my scalp still attached. Apparently they cut out a small ellipse of skin when they do the removal, so that they can pull the edges of the incision together and you’re not left with any excess flesh where the lump used to be. Yay for geometry!

The cyst had come out in one piece… which is, apparently, the best possible outcome – if they break during removal, there’s a pretty high chance of re-growth.

As I left, the doctor said that *thought* he’d sorted all the bleeding out, and that I shouldn’t have any complications… but — if it did start bleeding again — try applying strong pressure, and if it didn’t stop, then “don’t mess about, go STRAIGHT to A&E at the local hospital”. Well… yes… that *really* filled me with confidence.

Oh, and “It would be best if you avoided washing your hair for a few days”. Lovely.

So I toddled off home, had a good look at my new battle scar (about an inch and a half, with 6 stitches), and prepared myself for the inevitable post-op pain.

I’d stocked up on max strength paracetamols… should I take them now, or wait until the pain kicked in? It would probably be more economical to wait for the pain to actually start. Hmmm. OK. I’ll wait.

I waited.

And waited.

After 4 or 5 hours of pain-free waiting, I was back on the internet to try to find out how long it actually takes for a local anaesthetic to wear off. The internet was surprisingly unhelpful; it seems to depend entirely on how much of the good stuff your doctor has injected.

So I waited some more…

Well, basically, the pain never came. I had no problems at all with the wound… and, a couple of days ago, the sutures came out. Head fixed. Bit anti-climatic really, isn’t it? Definitely a good thing to have that lump gone though!

Hooray for medical science! 🙂

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