GetMeOuttaThisMess Posted February 3, 2018 Share Posted February 3, 2018 I have an elderly parent with a chalazion in a residential care facility and I'd love to be able to just I&D it, knowing that there's a possibility of it returning. At her age, and inability to get around, it would be so much easier to just open it, express it, and if necessary, put a stitch in it. I can easily order an I&D set, suture material, etc. through an online med supplier but what I can't apparently get is lidocaine to anesthetize it! The catch-22 is that we're able to order meds for others but we can't place an online order such as for clinical usage without the physician's license accompanying the order. No, we don't keep such agents in our clinic and since my docs are with a large network outfit I don't think (haven't asked) that they could just drop an ampule into their pocket and bring it to me at our monthly meets. Link to comment Share on other sites More sharing options...
Cideous Posted February 3, 2018 Share Posted February 3, 2018 It is strange and stupid but once again....see physician "ASSISTANT".... On a side note, be careful I&D'ing the Chalazion like a reg I&d. The Ophth plastics guys don't do it like one would think. They pull the eyelid down and perform the procedure from the inside of the eyelid. I'm not an expert on it, but my teenage son had it done, and I was surprised by the procedure. It was much more involved then I had anticipated. He was able to extract the entire thing from the inside of the eyelid. Anyway, just fyi. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 4, 2018 Author Share Posted February 4, 2018 Internal approach not an option. Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 4, 2018 Moderator Share Posted February 4, 2018 your idea is good excising this chalazion not a good one to start with...... I have my own account at Moore Medical and can buy anything..... Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 4, 2018 Author Share Posted February 4, 2018 Becoming a moot point. Started becoming discolored today and expanding outward so facility calls me. I get there to look and I’m able to express some purulent material (not what one typically finds in a chalazion) but most of the discoloration is blood right under the skin. Guess she’s going to force my hand and make me take time off work at the worst possible time to get this done by ophtho. at some point this week. Waiting at pharmacy now for systemic abx. from facility physician. Got her putting moist heat soaks on it for now to try to bring it to a head. You can palpate a deeper infuriated area. It’s now tender so lido would be a big help while pressing on it. I’ve got a Moore account as well and can buy all the supplies I want, except for dangerous drugs apparently. I had her scheduled a couple years back with ambulance transfer to ophtho and she backed out. Ugh... Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 5, 2018 Author Share Posted February 5, 2018 Today. Calling Ophtho in morning. Got some goo out. Link to comment Share on other sites More sharing options...
Joelseff Posted February 5, 2018 Share Posted February 5, 2018 Wow. I always refer to optho for these. Hope it gets better. Sent from my SAMSUNG-SM-G891A using Tapatalk Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 5, 2018 Author Share Posted February 5, 2018 For 99.9% of us it’s a no brainer to get there. Significant pre-existing condition that makes her absolute dead weight so multiple people would be needed to get her on a table. Link to comment Share on other sites More sharing options...
Cideous Posted February 5, 2018 Share Posted February 5, 2018 Jesh, that's an impressive one I must say! Link to comment Share on other sites More sharing options...
d2305 Posted February 5, 2018 Share Posted February 5, 2018 I got a couple of bottles of lidocaine at the local discount drug store. It's not expensive. Link to comment Share on other sites More sharing options...
Miaow Posted February 5, 2018 Share Posted February 5, 2018 That juicy thing would pop with just the touch of an 11 blade if the lid was everted and you got it from the inside (spoken like a true GYN provider who loves to pop and drain things). I imagine it would hurt and truly it needs an ophthalmic surgeon but it would be very satisfying to see it pop and drain, likely would also give significant relief. Going through the lid though ... that would be a mistake. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 5, 2018 Author Share Posted February 5, 2018 She’s already trying to go through the lid for us. I’m not sure you can "evert the kid" to get to it internally. I can't believe what autotext corrects to. It should have said evert the eyelid. It’s been interesting to watch because it’s been much smaller and flesh toned for a couple of years and decided to go volcano over the weekend. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 6, 2018 Author Share Posted February 6, 2018 Boo, hiss!!! Ophtho gave option of Kenalog/lido, warm compresses (not going to happen at her residence), or I&D. Gee, I wonder which one I would’ve chosen? Cut it! Wouldn’t you know that there was a modest amount of serosanguinous fluid and mostly tissue inflammation. Clue was the discomfort when just anesthetizing and fact that tissue was still tender. She has the pirate look going right now and I’ll take off her bandage tonight and squirt some emycin ointment on it. Looks like she degraded the capsule, liquified the wet newspaper, and caused a secondary inflammatory reaction. Better luck next time for goo. Link to comment Share on other sites More sharing options...
Cideous Posted February 10, 2018 Share Posted February 10, 2018 ^^^ good grief that is a sickening graphic description...LOL Bleh! Link to comment Share on other sites More sharing options...
Moderator ventana Posted February 10, 2018 Moderator Share Posted February 10, 2018 nope would not touch that unless I was in the ER to much liability "you made grandma go blind" on the stand i would not want to answer why I changed the standard of care for that.... Send to ER and talk to attending to get them to do it - I agree 11 blade and just single cut and it drains..... wondering about PATH too if it has been there a few years..... Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 10, 2018 Author Share Posted February 10, 2018 Sent from my iPad using Tapatalk This morning. BTW, Ophtho/Plastics didn’t even bother with the internal approach option. It isn’t as if she’s going to be doing eye makeup commercials. Just incise the darn thing. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 10, 2018 Author Share Posted February 10, 2018 nope would not touch that unless I was in the ER to much liability "you made grandma go blind" on the stand i would not want to answer why I changed the standard of care for that.... Send to ER and talk to attending to get them to do it - I agree 11 blade and just single cut and it drains..... wondering about PATH too if it has been there a few years..... It would be my own mother. There’s nothing I would’ve done that would’ve been any different that pothole (auto correct for ophtho) did, which I already knew going in. No other family to be upset aside from daughter-in-law, granddaughter who wanted to do it herself, and other son who stays in the background. Darn wheelchair van cost more than supplies and care combined! Sent from my iPad using Tapatalk Link to comment Share on other sites More sharing options...
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