Tuesday 22 July 2014

Lipoma (Skin Lumps)


In general, it is not absolutely necessary to remove a lipoma, provided that your doctor is pretty sure this is what it is. Of course, one cannot be absolutely certain with a naked eye until the lesion is removed and submitted for further testing.

What Is a Fat Deposit?

A lipoma or fat deposit is a slow-developing growth of fat this is found just under the skin, but they can develop anywhere in the body.  They typically appear on the neck, shoulders, back, abdomen, arms, and thighs.  It can occur at any age, but children rarely develop them. It is most common in people first appear between 40 and 60.

The typical lipoma is a small, soft, rubbery lump located just beneath the skin

No one knows why these lumps form but these tumours can occur as part of the inherited disease. My sister had her lipoma removed on her forehead many years ago and now its my turn, I had lipoma surgery on the palm of my hand.

I has had lipoma for about 3 years. After it got about 4.2(Ht) x 2.4(W) x 1.5(AP)cm- as recent report has shown, I had to have surgically removed.

A few days before surgery, I had initial consultation was with the primary care physician, and after a x-ray scan, I was then referred to an orthopaedic surgeon who diagnosed me.
X-ray: Looks like a ball-sized swollen lymph node.
Diagnosing a Lipoma
A lipoma may be diagnosed easily with a simple physical exam. This type of growth feels typically feel soft and can be felt to move slightly under your skin when you press on them. It isn’t painful since it is made up of fatty tissues.

A lipoma can’t be reduced size with self-care therapy. Ice and heat packs may work for certain types of skin lumps, but they are powerless against lipomas because they are fat-based. If you have any concerns about getting rid of a lipoma, see your doctor for surgery treatment.

A lipoma that is best left alone if doesn’t cause any problems. Your dermatologist or orthopaedic surgeon will make the best treatment recommendation based on a number of factors including: the size of lipoma and whether the lipoma is painful.

Images may be taken of your bodily structures to provide a much details picture. This can be done with an MRI, this scan is necessary to provide detail of the images or to give a three-dimensional picture of a structure within the body.
If the lipoma is large, has unusual features or appears to be deeper than the fatty tissue.

MRI provide clear images of body parts that can't be seen as well with an X-ray by using strong magnet.

There's a remote chance that a lump resembling a lipoma may actually be a form of cancer called liposarcoma.
The  the difference between a lipomas and liposarcomas is it grow rapidly, don't move under the skin and are usually painful. After surgery a tissue sample removal (biopsy) are send to modern pathology lab examination for confirmation.
 Phew! What a relief! Pathology result confirms the suspicion that the mass is a fatty one.


On the day of surgery, I have checked in at the registration desk, after paid an initial down payment of Rm 1k for minor surgery, I waited in the reception area.

As I stare at the television screens, a news flash caught me by surprise. Oh no! I'm going to the surgery  in another one hour's time and this breaking news makes my heart beat even faster.

Our thoughts n prayers for the families and friends of all on #MH17 and the
#MH 370 crash. It is 133 days from the start date to the end date.  I only hope that justice will be served.

I have to pause, take a deep breath..... Have mercy upon us, O LORD, have mercy upon us. This can't be true. I have a look at the screen again as I can't believe this is happening again. It's real, we are going to relives another tragic MAS plane crash nightmare. I'm lost for words.

 As I SMS to my friends, many doubt the text messages as it's still not in the local news since ABC and CNN are the first cable news networks to delivers the latest breaking news.

A nurse attended to me shortly. She kindly informed me that I needed to ride in the wheelchair, even I am perfectly able of walking yourself. I was shown to my hospital room as I was going to stay for a night, I opt for a private room.  I wanted the room to myself, since this is just a one day stay.

I was reminded by the nurse not to leave your purse or personal valuable items unattended in the room.The hospital is not responsible for lost or stolen. In-room food service, comprising 4 meals daily so no need fear of hunger unless you're the type of late night snack.

Before you have your operation, you probably received the traditional pre-op order from the doctor: Don't eat or drink anything after midnight prior to the day of surgery. I had to get up early to eat very light meals, like toast and tea with milk, six hours before surgery.

It's a precautionary measure to prevent stomach contents enter the lungs, potentially blocking airflow and putting patients at risk for serious infections like pneumonia.

 When it came time for the surgery, It's Do or Die Time For Me!  The surgery has been delayed long enough. At this time, I will change into a patient gown for surgery. Before embarking I was reminded to make sure I do not wear underwear. She had a big grin on her face, "Wear Nothing Underneath".


People cannot wear any clothes expect for the hospital gown when having surgery. 

There is a sheer anxiety in surgical patient like me, it peaks when nurse crews move the trolleys along the corridors  before transferring patients from one trolley to another and lastly onto an operating table. Bring in more moments of high anxiety or panic to a patient. I imagine myself in situations like a cattle in a transport vehicle on the way to slaughter house! On the way to operating room, medical specialists use mild sedative (calming drugs) to calm and relax their patients.

A gas mask seal around my nose and mouth and doctor will ask me to count down from 10 (you never make it to two).  When you inhale the anaesthetic gas you feel really sleepy. You'll be put to sleep in no time.
After my operation the anaesthetic doctor will tell me where I am and that my surgery is over. I was shown the lipoma removed from my palm and keep in a small bottle. It will be sent to pathology laboratory elsewhere.

It takes a while for the brain to actually wake up, even after you are conscious. Most people don't remember much after the inhaled of anaesthetic gases. They will experience gas or wind pain following surgery.

Last thing I remember is the damn cold temperatures in operating room. ( kept cool to slow the rate of bacteria growth). A nurse double confirm as a witness by asking is this my name and my signature on my  written surgical consent.

You will have a health check before your operation. Nurses will monitor your blood pressure, temperature, and pulse, and give you medicine.When you return to your hospital room after surgery, you will be closely, again blood pressure, pulse, temperature will be recorded readings on clip board that hung off the bed for the doctor to read the patients chart in full.

After surgery, a small plastic tube is inserted into a vein on my arm using a needle. It was left there so that fluids and medicines can be put directly into the blood through the vein.

My left hand had this dressing on my hand after surgery, I feel like a Mummy on the loose

I was asked to drink sips of clear fluids water to determine whether I will vomit. When the nurse learn I do not throw up, lunch is serve as soon as I have no bad side affects. I was hungry as it's been about 12 hours since I was food deprived prior to surgery.

 The next morning I get a missed call from a friend. I got a strong gut feeling this is not going to be a good news. Shocking bad news, another friend confirmed my suspicions, Lam Chee Ming, my friend and former  colleague, passed away.

 You'll never be forgotten! R.I.P. buddy. Its a shame that our Kenyir Lake fishing trip revisit will never be fulfilled

He's an avid fan of Candy Crush and he constantly have been getting me to "give a life". Sorry pal I still haven't learn how to play the game but I can hear still feel the eerie echoes of your request playing faintly somewhere in the back of my mind.

Life Is So Short And Precious, you'll never know your number is up next. You can live in regret if you don't shower your feelings and love to those close to you  because it may happen that you never see tomorrow.

What You Should Do After Your Operation:

After your surgery, one of those most crucial things you can do is ward off an infection in your incision. An infection can reduce the pace of healing process, and can in some cases, may have unexpectedly serious complications.

Hallelujah! I do not have ugly surgical stitches and staples as the doctor practises of closing surgical incisions using modern marvel welds by cold plasma. I wouldn't want my incision looks like a centipede on my hand.
Thank you for being such a good and caring doctor.


My Aunt is a Matron for Surgery, she called my mother to remind me:

1. Don’t take soaking baths. Your doctor has stitched your incision to speed healing. You can take a shower instead of a bath if you have stitches or skin tape on your incision. The skin of your incision require time to rebuild its waterproof seal. Generally if you have a small cuts that are not gaping and may not require actual stitches,for 24 to 48 hours, do not allow it to get wet in the bath or shower. It has all the essential fats that are necessary for skin to regrow and self heal itself.

On the other hand for those who undergo surgery, wound can break down your healing incision and let bacteria in. So stop yourself from Indulging shower and bath foam for the next two weeks after your operation.

2. You may be tempted to quit taking medicine of post operation if they upset your stomach, but finishing the entire prescription is essential to staying infection free. If you stop taking your antibiotic too soon, you may be at risk for developing some bacteria survive and re-infect.

Again she emphasised that I must finished the antibiotic treatment. Even  this information will be printed on the label of the pack to remind you to complete the full course, even if you feel your infection has cleared up.

What You Should not Eat to Avoid Infection After Surgery?
Not conducive to wound healing food such as deer meat, bean curd, onions, peppers, leeks, and because they can easily cause infection is not conducive to wound healing.

The elders would advised me to refrain from eating:

Eggs-  A bacterium, Salmonella enteritidis, can be inside perfectly normal-appearing eggs, infection include painful abdominal cramps, diarrhoea, and often fever.

Ducks and chicken - because the fact still remains that it  is one of the worst offenders when it comes to food poisoning.

Sea foods and fish- It is poisonous, arsenic in fish and seafood may be high, because fish absorb arsenic from the water. Theoretically possible that chemicals, metals, marine toxins, and infectious agents have been found in seafood would risk internal infection.

Food that can cause serious allergic reaction such as peanuts, wheat, tree nuts (such as walnut, cashew, Brazil nut), shellfish(including shrimps, mussels, and crab), fish, milk, eggs and preservatives.

Black soya sauce-The idea is that the dark pigmentation will somehow seep into one's skin and will result in dark spots or scars.

What to Eat After Surgery?
If you have had surgery, the food you eat can make a great impact on your recovery and on how quickly your wound heals. Eating the right foods can provide the necessary building blocks your skin needs to heal quickly.

Vitamin A can promote wound healing. It is mainly found in fish oil, carrots, tomatoes and other foods.

Vitamin C also can promote wound healing. Exist in a variety of vegetables, fruit, jujube(better known as red dates), chili is a treasure house of vitamin C but don't overdo it.

The elders would advised : Snakehead fish, also known as Haruan, is widely recognised in Asia Pacific countries as a healing remedy. The fish promotes dermal wound repair and reduces post-operative pain and discomfort.

 In China, pearl powder is sprinkled into wound to heal wounds because of its antiseptic properties. It enhances tissue growth and accelerate healing with minimal scarring.

After recover fully from surgery I will start  drinking apple cider vinegar, it can bind to toxins and help to cleanse the body and kill bacteria. A healthy lymphatic system can remove toxins from the cells in the body while improving immune by take apple cider vinegar in small doses throughout the day.



Wescobee Apple Cider Vinegar & Honey I recommended! Other brand it gives sour taste and pungent smell. 
Now that the lipoma has been removed, here comes the insurance claim headache. I was warned that Great Eastern Insurance has a bad reputation due to past history of claims unsettled.  Soon I will find out the whether what I read or heard is or isn't? I hope not.

I can't believe a company did not want to emphasize on customer service which in this case is the Claim department? If a  disgruntled customer did not feel satisfaction with the service rendered, they will not only  discontinue their Insurance policies but also make sure their friends and relatives did not buy them.

If worse comes to worst, I'll will definitely switch to another company upon reaching Maturity Age.   I've been thinking to get my medical card, is it worth it?

Hey guys, I know that life sometimes really sucks with endless problems, but I have to  look on the bright side of life....I'm still alive. What more can I ask? A lottery strike perhaps?

O my God, because You are so good, I am very sorry that I have sinned against You. For being greedy, forgive me Lord.

Money is one of the most important subjects of your entire life but don't you ever neglect your health while accumulate your health.  All the money in the world couldn't save you when you have a critical illness.

As the saying goes 'Health is wealth' and nothing rings more true!





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