How I+Ds work
Posted for a friend who's about to undergo something similar to the Incision and Drainages (I+D) that I have to do frequently for my skin condition.
Medical details herein
They always start with a history, weight, blood pressure, pulse, temperature, etc. During this I always make sure to tell the doctor that before the local anesthetic (lidocaine) injection I want them to use cold canned air on the site first. The injection of the anesthetic itself typically hurts me a lot - seriously, like ten times worse than for say, a tooth filling, because just touching the cyst with a finger is already more painful than drilling without anesthetic, so of course injecting a needle into it will hurt. However, if they used cold canned air (there's a medical version of this, it's not the same as what's used to clean keyboards, though it's not too different) then that cold may hurt a tiny bit, but I don't feel the injection at all. Many doctors I've seen don't think to use this first, so now that I know about it myself I always request it explicitly and 9 times out of 10 they have it (the other time the doctor didn't know what I was talking about, but when I described it after the procedure to the nurse she did know, so if I ever get told they don't have it again, I will ask the nurse).
Depending on the location of my cyst, I do not need to completely disrobe, just enough to expose that part of my body and have my clothes far away. I did have one on my back once and I took of my shirt, possibly my bra, and put on a gown with the opening facing back, and laid on my front. They clean the area with an iodine swab (which is cold and squishy) or three, then used the cold canned air. They'll poke a few times and ask if I feel it, and when I say no, they do the anesthetic injection, which I also don't feel. Sometimes they wait a while for it to take effect, and depending on how much fluid is in the cyst they may have to repeat the injection either immediately or later (for a lipoma, which is a denser fatty material I believe, I doubt they'll have to repeat).
During the procedure you will not feel much pain, but you will feel some - I'd say between a 2 and a 4 on this comparative pain scale, and it lasts only around 15 minutes total. (Considering that I get an I+D when my pain is at a 4-6 for a week, for me that's not that bad.) You may feel pressure from them having to squeeze to get material out - anesthetic does not get rid of the feeling of pressure, only of pain, it's kinda weird.
Once the procedure is over, the pain is completely over. (Unless they use tape to hold on the bandage for me, as tape rips my skin when I remove it.) I've twice had them give me a drain for a larger cyst, it's basically a small bit of cotton that looks like a shoelace but only like an inch long total, with one end under your skin, and the other end sticking out from the incision. If they do this (but it's really rare, twice out of dozens of or a hundred times I've had an I+D), they may have you come back in a day or two to remove the drain or to replace it - but I told the doc last time that that wasn't really possible on my schedule, so she told me how to remove it myself.
They typically tell you to change the bandage/dressing every 24 hours, or more frequently if it's soaking through. The main purpose of the dressing is to protect your clothes.
So, hope that helps someone!
Originally posted on Dreamwidth.
comments there. Comment here or there.
Medical details herein
They always start with a history, weight, blood pressure, pulse, temperature, etc. During this I always make sure to tell the doctor that before the local anesthetic (lidocaine) injection I want them to use cold canned air on the site first. The injection of the anesthetic itself typically hurts me a lot - seriously, like ten times worse than for say, a tooth filling, because just touching the cyst with a finger is already more painful than drilling without anesthetic, so of course injecting a needle into it will hurt. However, if they used cold canned air (there's a medical version of this, it's not the same as what's used to clean keyboards, though it's not too different) then that cold may hurt a tiny bit, but I don't feel the injection at all. Many doctors I've seen don't think to use this first, so now that I know about it myself I always request it explicitly and 9 times out of 10 they have it (the other time the doctor didn't know what I was talking about, but when I described it after the procedure to the nurse she did know, so if I ever get told they don't have it again, I will ask the nurse).
Depending on the location of my cyst, I do not need to completely disrobe, just enough to expose that part of my body and have my clothes far away. I did have one on my back once and I took of my shirt, possibly my bra, and put on a gown with the opening facing back, and laid on my front. They clean the area with an iodine swab (which is cold and squishy) or three, then used the cold canned air. They'll poke a few times and ask if I feel it, and when I say no, they do the anesthetic injection, which I also don't feel. Sometimes they wait a while for it to take effect, and depending on how much fluid is in the cyst they may have to repeat the injection either immediately or later (for a lipoma, which is a denser fatty material I believe, I doubt they'll have to repeat).
During the procedure you will not feel much pain, but you will feel some - I'd say between a 2 and a 4 on this comparative pain scale, and it lasts only around 15 minutes total. (Considering that I get an I+D when my pain is at a 4-6 for a week, for me that's not that bad.) You may feel pressure from them having to squeeze to get material out - anesthetic does not get rid of the feeling of pressure, only of pain, it's kinda weird.
Once the procedure is over, the pain is completely over. (Unless they use tape to hold on the bandage for me, as tape rips my skin when I remove it.) I've twice had them give me a drain for a larger cyst, it's basically a small bit of cotton that looks like a shoelace but only like an inch long total, with one end under your skin, and the other end sticking out from the incision. If they do this (but it's really rare, twice out of dozens of or a hundred times I've had an I+D), they may have you come back in a day or two to remove the drain or to replace it - but I told the doc last time that that wasn't really possible on my schedule, so she told me how to remove it myself.
They typically tell you to change the bandage/dressing every 24 hours, or more frequently if it's soaking through. The main purpose of the dressing is to protect your clothes.
So, hope that helps someone!
Originally posted on Dreamwidth.
comments there. Comment here or there.