Ganglion cysts

Posted by: wfaulk

Ganglion cysts - 03/02/2005 13:46

Apparently more people have these than I thought. I've got one on the back of thelower joint of my thumb. It's not gotten any bigger or smaller in several months. It's mostly innocuous, but occasionally I'll hit it the wrong way and it'll be really painful. I've thought about getting it removed surgically, but I'm a little worried about damage to the tendon, as I've been told that it's a growth on the tendon.

Does anyone have any knowledge to share?
Posted by: jimhogan

Re: Ganglion cysts - 03/02/2005 14:06

Quote:
Does anyone have any knowledge to share?

Nothing trustworthy. In another thread, though, when I referred to an "encapsulated whatyamacallit", this term is what was escaping me.

My Google on "ganglion cyst burst" turns up a page from handsurgery.org (whoever they may be) that notes "The old wives tale that the cyst is burst by hitting it with a bible is not performed". Maybe no longer. Around 1976 we whacked a couple in the ER, IIRC, and in 1985, I vividly remember wielding the treatment instrument as a co-worker, Carol (also a nurse) turned away and let me do the deed (she asked us to). Of course, being a bunch of east coast secular humanists, we did not have a Bible to hand so we employed an out-of-date edition of the Physician's Desk Reference (you hit it with the binding for maximal treatment efficacy).

Anyhow, I worked with Carol until 1988 and last I heard all was well. I wouldn't take this for too much other than a story, though. There could be other big reasons the Bible Technique fell out of favor. For one, it is probably hard to charge more than $30 for it!
Posted by: wfaulk

Re: Ganglion cysts - 03/02/2005 14:37

Yeah, give that mine is small and at the base of my thumb, I think the result of that therapy is more likely to be a thumb dislocation than a burst cyst.

It's looking like aspiration is a less invasive treatment option. At least one of the sites I saw referred to surgical removal involving removal of some of the tendon sheath, and I don't like the sound of that.
Posted by: jimhogan

Re: Ganglion cysts - 03/02/2005 14:39

A slightly better UK page here.
What they don't say is why the Bible method fell from favor. Many of these rupture and/or dissolve on their own, so the Bible just triggers that, but it may be that there are concerns about collateral damage. My coworker's was on the back of her hand (i n the area of the common flexor tendon sheath from that diagram) and it stood out like the Devil's Tower, so it was pretty easy to deliver a sharp, targeted blow that didn't whale on the entirety of her hand.
Posted by: jimhogan

Re: Ganglion cysts - 03/02/2005 14:41

Quote:
At least one of the sites I saw referred to surgical removal involving removal of some of the tendon sheath, and I don't like the sound of that.

Yeah, surgery = no going back. Surgeon's love it, and there ain't no substitute if there ain't no substitute, but always to be avoided if avoidable.
Posted by: Heather

Re: Ganglion cysts - 03/02/2005 15:02

Quote:

Does anyone have any knowledge to share?



Yes. I have one on the side of my wrist. I've had it for 3 years now, and it only bothered me once when I had tendonitis shortly after it first made it's appearance. The advice I got from 4 orthopedic surgeons since was "If it really doesn't bother you much, let sleeping dogs lie." None of them seemed to fond of surgery or aspiration for little ones like mine, so I've let it be. So far, no change in size or shape and no pain after that.
Posted by: jimhogan

Re: Ganglion cysts - 03/02/2005 15:12

Quote:
The advice I got from 4 orthopedic surgeons since was "If it really doesn't bother you much, let sleeping dogs lie."

Now those are 4 good surgeons. I shouldn't paint all surgeons with a broad brush. Many of them are objective. There are those, though, who can't see to consider anything but cutting. As Willie Sutton said "It's where the money is".
Posted by: Heather

Re: Ganglion cysts - 03/02/2005 16:09

Quote:
There are those, though, who can't see to consider anything but cutting.


And they are plentiful. My sister dealt with many of them during her surgical residency.
Posted by: pca

Re: Ganglion cysts - 03/02/2005 16:18

I have had a couple of these, most recently at the base of my right ring finger, just at the point where if I picked something up the pressure was greatest and the pain worst. My GP advised that the best treatment, unless the thing was really causing problems, was to apply steady pressure for a few minutes a day. Just press reasonably hard on it for ten to fifteen minutes, not quite to the point of pain. After a week or so it would deflate, and eventually go and probably not come back.

He was completely correct. It took about ten days, and I've had no trouble since.

His opinion was that surgical intervention with these things was almost never warranted, and usually too dangerous. If it went wrong the cure caused a lot more problems than the disease.

pca
Posted by: jimhogan

Re: Ganglion cysts - 03/02/2005 16:20

Quote:
He was completely correct. It took about ten days, and I've had no trouble since.

Ah, Bitt, now *this* looks like what you were looking for!

(Not as much fun as whacking you with a Bible, mind you!)
Posted by: wfaulk

Re: Ganglion cysts - 03/02/2005 17:50

I'll give it a shot. Yours sounds quite like mine, even. Pressing on it for ten to fifteen minutes, though -- that's a lot of pressing. It's going to cut into my two-fisted activities. It may be time to invest in a C-clamp.
Posted by: muzza

Re: Ganglion cysts - 03/02/2005 18:22

I had a ganglion cut out of my wrist several years back. It was affecting my training and surgery was the only option. I haven't had any problems since, not that i'm still training tho.
The steady pressure remedy sounds fine if it works for you
Posted by: jimhogan

Re: Ganglion cysts - 03/02/2005 22:14

Quote:
Pressing on it for ten to fifteen minutes, though -- that's a lot of pressing.

Why anytime I have to apply steady pressure for 15 minutes or more, I just dig out my VHS tapes of the Joy of Painting with Bob Ross and put one on. Hypnotic. With Bob, I can get through *anything*.
Posted by: Dignan

Re: Ganglion cysts - 04/02/2005 01:04

Quote:
but always to be avoided if avoidable

Sometimes, though, it's a 50/50 decision. I'm comfortable with you folks here, so I'm not too shy to say that I had a much less desirable cyst. I had to have that one drained, and let me tell you that it is neither fun, nor comfortable, and it's a tad bit embarrassing. Afterwards, it was left up to me as to whether or not I wanted to have it removed, because they told me it could come back. I decided not to, and thank goodness it hasn't come back yet, but if it does I'll definitely have it removed.
Posted by: DWallach

Re: Ganglion cysts - 04/02/2005 01:25

Those pictures... at that site... were awful. It's a good thing I'm not a medical doctor.
Posted by: jimhogan

Re: Ganglion cysts - 04/02/2005 02:02

Quote:
Those pictures... at that site...

I hovered...I did not click....

Been there, watched that. Dignan, take heart, it says incidence decreases with age, and I think many don't come back. You have taken this thread to a whole different plane, though...a dark, scary place Bitt never thought he'd be going!

Seriously, I worked as a night-shift ER orderly for 2+ years when I was in school, often working with a nice guy named Al (now Al, MD somewhere in Florida). Among ~15 other rooms, in the back corner was a shared clinic room where we'd set up to do minor -- dare I say freelance? -- surgical procedures. Another room was a big tiled shower room that you could roll a whole gurney into. Yeah, like a carwash.

On a given Friday night, it was not unheard of to get a comatose street person with 2-3 weeks of crap in their pants (I shit you not) and we would roll them to the car wash after an initial exam.

At the same time, a surgical intern would exam somebody with a pilonidal/perianal cyst/abcess. We'd have to go back and prep a tray, drape the (usually young) person and stand to through the procedure with the requisite doo-dads.

When we came to the occasional friendly impass, Al and I would flip a coin or play rock-paper-scissors. In a matchup like this, if I drew the carwash I considered myself the big winner.