Day 173: Cut It Out!

One of the difficulties of this deployment is the inability to maintain my medical skills. It has been months since I have delivered a baby, performed any suturing, or provided care for a hospital-bound patient. Seeing active duty folks with back pain, ankle pain, and shoulder pain day in and day out gets old after a while. Well, today I had my chance to spice it up!

Patient Case: An Afghan Army soldier wanted to get this lump taken out near his right ear. He reported no significant pain or drainage, but it had been increasing in size over the past several months. He mentioned that it had been cut open in the past, but it has recurred multiple times. He desires to have the lump removed. The lump is soft in consistency and non-tender.

Diagnosis: Sebaceous Cyst or Epidermal Inclusion Cyst

This was not only a valuable mentoring opportunity, but also a chance for me to reacquaint myself with certain medical skills such as minor skin procedures & suturing. From the mentoring side of things it gave me a chance to teach the Afghans the concept of "sterile technique" since their concept of "sterile" is washing their instruments in the sink like last night's dishes.

Back to the cyst...Epidermal Inclusion Cysts or "EICs" commonly occur on the face, back, or chest. They are walled off capsules that are filled with a substance called keratin. The reason for their recurrence is the failure to remove the cyst wall after draining out the keratin build up (another mentoring point).

After prepping the room and going over some sterile technique pointers, we were ready to go! Here are some pictures of our cyst removal party.

My medic, Ayub (scrubs)...my interpreter, Latif (the hard core shades), and myself working on removing an EIC

A shot of the cyst wall being removed. I hope I don't gross anyone out!

Look at the pretty sutures!

The procedure went extremely well and the patient was very grateful. I was able to mentor the ANA medical staff on minor procedures, improve the ANA medic's suturing skills, and address a medical issue other than low back pain or a cold. It was a win-win for everyone!