Grapefruit-sized Growth, Part 1: The Punch

ENGLISH He actually saw someone else who had this procedure you know so (unintelligible) Dr. Lee – Have you ever seen anybody for this? Patient – No. Dr. Lee – No? Dr. Lee – Have you ever seen anybody for this? Patient – No. Dr. Lee – No? Dr. Lee – Because it’s something that you know um (put on mute) Dr. Lee – It started very little and then just right in the middle of it and then it just started growing and growing huh? It’s pretty firm. I don’t if it’s a lipoma or a cyst. And I feel a little depression right here. So what I think we will do, thank you, Is…I think what we should do first is (put on mute) You ok? Patient – um hmm. Dr. Lee – Good That should hopefully be all the kind of pinch you feel, alright? That’s the goal here. So what I’m gonna try to do first is just kind of actually see if I can pull anything out of this. We can figure out what it is first. So, I’m gonna put a little more numbing right here, and put a little alcohol Ok. You shouldn’t feel anything ok except my touching you. Are you ok? Patient – um hmm. Dr. Lee – Good Just trying to put some pressure and pull Ah, nothing’s pulling out You still ok, right? I’m going to ask you that a million times. Patient – I’m fine. Dr. Lee – That’s what I do. He’s so calm. I think your wife is more stressed out for you. She’s so sweet. I’m just gonna do what we call a punch, this is what we normally do in the office here just for a biopsy Just make sure I’m never hurting you. I’m gonna grab that stuff and pause it for a minute Ok. Again, you just make sure you’re ok. Let me see if we can see what’s underneath here Let me numb it here a little bit more This is what you can do even if you’re taking a biopsy of something It looks solid. Wife: It’s gonna be a big (unintelligible) Dr. Lee: No. Don’t say that. Ready? You’re gonna know right now that… You mean you wished it was a cyst. Wife- no. You ok right? Patient – um hm Dr Lee – ok It’s moving all around underneath there you see? Detached. This one might truly pop out… this thing is like a… It’s actually (unintelligible) I’m going to keep that on the side just in case But I’m sure we’ll have more tissue. See that underneath there? Yeah. So… So what I’m gonna do, let me put a little more numbing right there and I’m just gonna buzz that just to buzz it and then we’re gonna numb up around here, ok? We know what it is now. That’s good. Ok. I’m gonna put like a little numbing under the skin ok So you just might feel a little tightness here. It might spray me. You ok? Patient – um hm. Dr. Lee – ok If you can handle this, this is easy. This is a little numbing to put underneath the skin so it will be all numb Feeling ok right? It’s just gonna feel tight. Patient – I’m ok. Dr. Lee – Ok. Good. This is where it’s gonna feel kind of wet. You know, I might need your assistance here too. You wanna put on some sterile gloves for me here too It will help me to hold this I’m gonna put a little baby pinch on the outside. Pinch. This is an eighteen Assistant: There should be an added element I’m just gonna hold this under mainly Make sure it doesn’t get wet on me Ok. I’m just going to put some numbing under your skin here. Again a little tightness I guess hold that one like almost plug it So it won’t…I don’t want it to ge soaked, you know, the wall of fluid to just come out You ok huh? Patient – um hm. Dr. Lee -Ok. You can handle this, this is it. You know, actually right after this, we should put him in a cap too Can you bend your head down a little bit? It’s gonna make this bigger here for a minute yeah. thank you. It’s going to get in the way of your cap…your head (Assistant laughs) What? I was just wasn’t trying to get you. I was just trying to check. You ok? Patient – um hm. Good. Oh. I like him. He’s not nervous He’s doing just great. And I’m happy that this looks like. I think it’s going to look like Do you remember the one patient we did for um… it was on her upper back and it was (muted) Almost like a solid mass? I think it’s gonna be like that. I’ll just get under it. Pop it out. It’s gonna feel tight cause we’re just putting a lot of numbing fluid under there. I wanna make sure it’s not coming out of there I wonder if I should sew that shut here. You have to put pressure cause it’s gonna soak up the gauze. It’s just gonna soak this up. You know what I mean You wanna actually push it so it doesn’t soak just take up the volume of that towel and just make it wet. It’s still coming out. You ok? Your hands falling asleep? A little bit? Patient – A little bit. Dr. Lee – You need to move it? Patient – I’m ok. Dr. Lee – Ok. In a few minutes, I’ll let you move it though. You gotta sit in a position you can sit in well. I’m sure One finger just push there. Cause it’s gonna wanna come out Cause I’m putting a lot of fluid under pressure here Can you hold that for me? Ok let me see this side for just a second… There

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