Dengue Fever

Sigh.

Sigh.

Sigh.

It's not just a sorethroat. It's dengue! Rashes came out after the fever subsided. Hauled ass to the polyclinic and got a few tests done (Hemoglobin, white blood cells, hematocrit and platelets). Needless to say my poor white cells are sorely depleted. Platelet count is still within the normal range but seems to be on a down-going trend. Which means, another round of blood-test is in order (my poor veins). I feel fine otherwise. No overt bleeding but damn my throat is killing me. More to report tomorrow.

I do not recall being bitten by any mosquito, but apparently I am very sweet  :)  Or the mozzies were sweet on me.

p/s Beautiful picture of me covered in spots. While more accurately described as peticheal rash (pin-point bruising), a more confluent pattern would be called Islets of White in a Sea of Red. Doesn't it sound poetic?

Pharyngitis

I gazed into the mirror
And found these staring back at me
Fever, chills and pain of disproportionate suffering
Caused by two little dots petite and 'cute
Much aggrieved I am

Mucocele

A swelling in the lower lip.

A mucocle is not to be confused with a cold sore from herpes simplex (Type 2) infection. The former is benign and painless while the latter implies that you've been naughty and have been putting things in your mouth that you should not.

A mucocele is a collection of saliva trapped within the soft tissue due to a ruptured minor salivary gland. If you run your tongue along the inner lining of your lips, you will feel small bumpy lumps that are meaty and nodular (that's the minor salivary gland). Do NOT under any circumstances bite or suck at it. Apparently, that's how I got this swelling (from chewing my lower lip) The end result is a round fluctuating nodule with a bluish tinge at the surface. You can't pop it like a pimple and it grows bigger if you keep worrying it.

If the darn thing grows bigger it is likely to be due to a blocked salivary duct and it's time to go for surgery. The procedure is to excise the salivary gland involved and send for biopsy (to rule out oral cancer). This costs RM400-450 done by an oral/dental surgeon. The minor operation takes less than 1/2 hour and recovery is expected within two days. However, a mucocele should be able to resolve spontaneously without intervention. Just leave it alone and it should  disappear by its own little self after 3-6 weeks.... which was what happened to mine after some reassurance from the good doctor.

Anyways, surgery is an invasive procedure and a mucocele is likely to recur after the initial surgery so it's best to adopt the wait and see approach. I couldn't live with it at first and wanted it out immediately. I'm glad the doctor advised against it - see now, that's why physicians can't heal themselves (plus they make the worst patients). Being in the sick role messes with objectivity and judgement.

Removed My Own Stitches

without Lidocaine
and almost passed out in the process.

I had five effing knots to remove altogether, which was imo five too many. Looked for "how to remove surgical stitches" on Youtube but had no luck. Used google and came up with some instructions on WikiHow. A much better reference would have been this one, which I stumbled upon only after the whole bloody ordeal.

Using a pair of scissors and a tweezer cleaned with alcohol, I snipped off the head of the knots as close to the skin as possible. The first one was difficult, it being anchored at two places. Was horrified to find that the scissors were blunt, so had to sorta saw my way through along the blades. Fresh blood oozed from a little gape. Felt sick.

Second one was a piece of cake. The thread came off easily, but I was beginning to feel pain and faint-hearted. Went to take Ponstan and took a break by lying flat on the bed to wait for the lightheadedness to pass. The pain-killer was taking effect, which was good. Went to clean up the bloody smear from the first knot coz I think it was getting gruesome. Crawled back to bed.

A minute later I was back at it, this time I decided to start from the other end. That end was well crusted - scabs are a good sign of healing. Indeed, the third one came out beautifully at one gentle tug. Fourth one I almost lost the suture after cutting off its head. Had to dig around the flesh a bit, trying to catch the stray strand while muttering "shit oh shit how am I gonna explain this to my doctor". Of course I got it out in the end.

Okay last one... I just went for it. Snip snip... pull. DONE!!! I go to the bathroom, irrigate the site with lots of saline water and hope that it won't get infected. Dried it with cotton and sealed it with a surgical plaster. Heaved a great sigh of relief then proceeded to retch into the toilet bowl. Cat was concerned, stood on hindlegs and peered into the toilet bowl. The nausea passed after a few dry heaves. Felt like a complete wuss. It's confirmed then... I would have made a lousy clinician.

And then it occured to me that today was only Day 9 since the biopsy. Doc had said to wait for 10 days before removing the stitches coz the wound was deep and she wanted to make sure it had time to close. So. Hm. It seems that I jumped the gun a bit. This experience was interesting and loads of fun though (in retrospect). My only regret was that I did not have antibiotic cream to cover the suture holes. Will let you know if I turn septic in a few days.

p/s Am too physically and mentally drained to post pictures. Not that I have any to show anyway.... I had both hands full during the entire time.

p/p/s OF COURSE you should NOT try this at home. I am a deviant patient, please don't follow my example.

Mole Removal

For those with morbid fascination of gross medical pictures, I got something different than the usual recipe/cat/food/emo posts. So here is the photo of the offending mole as promised, which gave me great worry over the past one week. There is such a thing called too much knowledge - and too much of any good thing is no good. The most concerned issue on top of the list was: "is this malignant melanoma?" So I decided to get it checked out.

Okay, so I know that I come from a moley family, and I myself have multiple moles scattered here and there but this is by far the largest I owned. Located on the right hand side my soft round belly, slightly above the umbilical line sits a raisin like protuberance which has been with me since childhood. I am pretty sure I was not born with it so it can't be a birthmark (checked my naked baby photos).

Isn't this the cutest thing ever?

Biopsy sample sent to path lab (marked Urgent).

99% of the time, moles are benign. But if the mole shows signs of ABCDE you should seek medical advice.

A- Asymmetry

B- Borders which are ill-circumscribed

C- Color of different shades

D- Diameter more than 6mm

E- Erosion, crusting, itching, ulceration and bleeding.

An elliptical incision is made to remove the mole, and to provide better apposition during wound closure. You will be injected with local anesthetic to numb the area. My procedure took a while longer than anticipated because it ran deeper than usual into the skin. Which got me agitated and thinking about worst-case scenarios.

It didn't help that there was a new albeit smaller mole adjacent to the mother of all moles. Knowing words like satellite lesions, metastases, dissemination etc does not help with peace of mind. Believe me when I say that I have read up on malignant melanoma of all sorts of research papers to learn more about it. You know, just in case.

When the results came back a week later, it was almost an anticlimax. Turned out that this fugly bugger was nothing but a simple mole called benign melanocytic nevus. So, life is back to normal. My concern is shifted to caring for the surgical site to ensure minimal scarring. I come from a family "gifted" with keloid scars. But that's another story for another day.

I'm In Stitches

It was not a laughing matter. Went for a skin biopsy to check out a mole which has been with me since childhood. Only recently, it turned crusty and started to bleed when I scraped it. Nasty fellow.

So to the doctor it is! Cautherize? No way. I recommend the old-school slice and dice method ie. excisional biopsy. That is the correct way of doing a skin biopsy.

Will show you the offending mole in my next post..... If you show me yours ;)

Bloody ooze: clotting and crusting over the sutures

After cleaning - looks more presentable now.

Dr: Ooh... it's healing very well.

Kutucat: It is? Seems to me like there's a lot of stuff going on out there.

After one week, I went back to the clinic for follow-up. The doctor said that my wound was healing well and praised me for being such a good girl (What am I.... 5 years old?). But I did feel proud lah - I was very diligent in cleaning and dressing my wound daily okay.

RM4.90 per box of 20 strips

Am allergic to plasters hence the rashes and broken skin (erosion) which gave me two days of crazy intense itch, I could let it hang lose without bandages on except I'm afraid the suture migh get caught in the fabric and get yanked out accidentally... with little pieces of my flesh trailing behind the string. And my guts leaking out the gapping wound. No thank you. I have Handsaplast Sensitive! A hypoallergenic plaster with soft flexible material which allows skin to breathe. The adhesive is kind on the kind too.

Ahhh... nice...

More to come in the next installment. You will never look at another raisin the same way again.