Lumps, Bumps & Lidocaine

[http://health4men.info/] This video started as a lecture for student nurse practitioners. Featured subjects include common "lumps and bumps" (epidermoid inclusion cyst, lipoma, abscess) and finally a debate on the "myth" prohibiting the use of lidocaine and epinephrine for digital ring blocks. It all started in 1903 when Braun, the man who first used procaine (progenitor to lidocaine) with 'suparenin' (epinephrine), immediately declared—based on sheer conjecture—"if the action of suprarenin (epinephrine) be too intense or long continued, gangrene of the tissues can occur, particularly if the nutrition of the part is already interfered with, as, for instance in arteriosclerosis of the extremities, wounds, or plastic flaps."
Please post comments and questions and I will answer back. Keith Seidel, NP

Category:

Education

Tags:

• Abscess
• incision and drainage
• boil
• epidermoid inclusion cyst
• sebaceous cyst
• lipoma
• epinephrine
• lidocaine
• procaine
• local anesthesia
• digital ring block
• Apple Keynote
• Keynote presentation

[verywest]

"Fibroma(s)" are benign tumors (they do not necessarily need surgery or treatment). Irritation, inflammation, trauma, are the top suspected causes but some people do have a genetic predisposition, just like lipomas and people who suffer adipose dolorosa. As to fibroma, first thing is to make a definitive diagnosis and for that you should see your primary care provider. Make sure that's what you have. veryWest

[HusbandandWifeShow]

Ok, but what causes it?

[verywest]

@HusbandandWifeShow — Not sure which issue your are referring to. Abscesses are almost always due to staph aureus (MRSA or MSSA); epidermoid inclusion cysts (the name itself tells the story) a small piece of the epidermis becomes included inside the body. Thus dead epithelial cells have no where to go other than to form a cyst. Lipomas are benign fat tumors. The man with the large mass under his left breast has "adipose dolorosa" (meaning: "sad fat")—various causes here. veryWest

[HusbandandWifeShow]

So I'm guessing 'necrosis' means the finger looses it's function?

[verywest]

@HusbandandWifeShow — Yep, 'neco' prefix implies something dead, and there is a very long list of words beginning with NECRO. A great application for word association is "VISUAL THESAURUS", it displays words in word-maps, so you can actually see how words are related. veryWest

[HusbandandWifeShow]

@verywest ... fibroma was what I'm speaking about. I did a search and I found that it could be due to trauma or exercise. I need to study this much more because I think I know how I got it. I have another question once I get more info on this. Thanks!

[verywest]

@HusbandandWifeShow — Well, I use lidocaine with epinephrine for digital ring blocks exclusively, except for patients with impaired circulation. The irony of it all is that not doing so actually put the patient at higher risk due to the need for tourniquets. Yeah, they can do damage to tendons and nerves—permanent damage. So, the irony of it all. veryWest

[verywest]

@HusbandandWifeShow — Yes, the "Hippocratic Oath" dates back to 2400 BCE, and although doctors are said to take this oath during graduation they actually recite one of the many modern versions of this ancient oat—the essence of which is "to do no harm." We all know that part but what is important is that Hippocrates was the first to pen the ethics and moral conduct that in a large part has shaped our modern world. veryWest

[verywest]

@HusbandandWifeShow — You are describing a "fibroma" and yes, I have removed these but would suggest you go to a podiatrist. Doing surgery on the hands and feet can be tricky and dangerous so I usually refer more advanced cases such as these. Massaging it will not help but then, hay, I doubt that it will hurt either. If it is real "hard" to the touch then you should have it surgically removed. veryWest

[verywest]

@HusbandandWifeShow — I use to carry small digital Canon camera with me everyday until a year or so before I retired. Just like everything else, the prison system became more restrictive—pat-down body searches, no this, no that. But, it was a lot of fun while it lasted. Now what? veryWest

[HusbandandWifeShow]

@carmy60...I knew I heard that 'Hippocrates' term before. The oath...