Dr. Gilmore provides a masterclass in clinical patience, effectively illustrating why secondary intention healing remains a cornerstone of effective wound management. This content bridges the gap between textbook theory and practical patient care with remarkable clarity.
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Moose and Cherub Cyst Follow UpsAjouté :
Before we get started on this video, remember there are hundreds of archived and new videos under the members section of the John Gilmore page. Please check it out.
All right, we're back with Mr. Moose.
You're live, buddy. How are you? I'm doing okay. You made a lot of noise the other day. A lot of people commented that you were kind of loud. I I it hurt.
>> It hurt, didn't it? Heck, yeah. Worst pain I ever felt.
>> Really? Was it really? Absolutely. Well, you didn't like that needle a bit, did you? And you know, I had several people that asked me if you were a redhead, and I said, "Yeah, you had kind of a, you know, red tint to your hair." Seems like people with red hair need a little bit more anesthesia. Although, the biggest part of your pain was while I was actually administering the anesthesia itself.
>> That's correct.
>> All right, so you went home 2 days ago.
Here's the dressing. Has this drained through? Is this the original dressing or did you replace it?
>> I've replaced it.
>> You've replaced it.
>> Yeah, yeah. That one was just soaked soaking red.
>> Okay, so you don't mind if we video your follow-up here today.
>> No, sir.
>> Got Gonzo right over here. So, let's go ahead and remove this and tell me about your pain control the last couple of days.
How'd you do at home? Uh I did okay at home. It's just driving, you know, at work. You know, I wasn't on no medication [clears throat] or nothing while I was at work.
>> Right, you can't take pain pills at work, can't you?
>> That's good.
>> So, it kind of hurt a little bit.
Uh But not too bad?
>> No, not too bad.
>> Did you need any nausea medicine? No, none at all. Did you uh take your antibiotics? I did, yes. Actually, this looks pretty good, little Gonzo. Yeah, I think so, too.
Is that sore over in here? Mm, no, sir. How about there? Up in this area. No, sir.
Forceps.
All right.
Little sore in there? Mm. Got a couple of swollen lymph nodes.
>> bit. All right. Take a deep breath.
Ready?
All right, that wasn't so bad, was it?
Oh, no. Nothing like the other day.
Golly, that's great.
Oh, man, this is in good shape, Gonzo. I don't think we have to repack you at all, bud.
That looks great. Yeah, that looks pretty good. I think we can just go ahead and put a dressing over this for you and not have you come back next week. Okay.
>> You like that? Yeah.
>> You just have to be sure that you take the dressing off once a day and do some warm compresses. In other words, this is going to continue to drain. Okay.
>> All right? Cuz we want this to heal from the inside out. Because not only did you have a cyst, you also had an infection.
Okay. All right, so we want this to heal from the inside out. We call that granulating in. So, we want you to remove the dressing once a day, put a warm compress under there, and you know, make sure that it stays open and drains.
Okay.
>> All right? Um finish your antibiotics.
If you run into any trouble along the way, just call or come back in. Okay.
Okay? Will do.
>> All right, man, you're a sport, Mr. Moose. Thanks for letting us record your axillary axillary abscess and cyst adventure. Okay. Cool.
>> Hey, let's get going. We're back here with Cherub. Cherub, how'd you do last night?
Uh I slept good. I felt no pain because of the anesthesia. Thanks.
But then this morning it started hurting. Did it? Okay.
>> Did you take a pain pill this morning?
>> Yes, I did. It helped? It helped. Okay, good. Okay, so I'm going to take the packing and Dr. Gilmore's going to do the re- unless he lets me do it.
>> No, you can go ahead and take the packing out. That sounds good.
>> Take a deep breath in.
And you're going to I'm sorry about this. 1 2 3.
You okay? Uh-huh. Hot dog, don't trip me. You stepped on my foot. Was it right behind me? No, but Yeah. All right, so now we're going to squirt a little lidocaine in here.
>> Okay.
And this is plain lidocaine?
>> Yes, sir. Good. All right, here we go.
This is just a little bit of fluid.
It'll be cold.
But it shouldn't hurt very much.
So, you kind of have a little pouch here. Okay.
So, yeah, we were able to put the whole CC right in there.
So, let's wait just a moment for that to work. So, you slept okay, but you woke up having some pain, did you?
>> Right.
Did you have much nausea? No. No. Okay.
How'd you do with the the new antibiotic I put you on?
>> Uh it's so far it's agreeing so.
>> Okay, good. This actually is looking really really good today. I'm really pleased with how this looks. Thanks for letting us do the update video for everybody, too.
>> Oh, thank you for doing this for me.
Okay, we're going to start putting the packing in.
Nice and easy.
It's going right in.
>> You're blocking. Am I blocking the video?
Shame on me. How's that? Is that better?
That's better. All right. I'm going to shrink yourself sorry. I'm going to have to get small for this job. So, this is iodoform gauze. It has a a Betadine or an iodine-like product in it to help prevent infection and help this wound stay open. Like we talked about yesterday, remember we want this to heal from the inside out, right? Okay.
So, nice and gentle, we're just going to replace the packing. And this is just so everybody knows, this doesn't have to be an extremely painful experience to have packing replaced. If you just pour a little bit of It squirted >> little lidocaine right in there. It's not that bad, right?
There you go. It's all in. Oh, no. So, we're going to have Gonzo come put a dressing on that for you.
>> Okay. And we're going to leave this in place over the weekend. Okay. All right?
And have you come back on Monday, and we'll do this again. And depending on how things look Monday, we may or may not need to pack it again then.
>> Okay.
All right?
>> Should I change the pack just leave the padding out?
>> change the gauze that's outside. Just leave the packing inside.
>> Okay. Yeah, if you need to change it out, that's fine. Okay. It will continue to bleed like this? It It's going to ooze, yes. And that's fine. That's normal. Okay. All right?
All right, Miss Cherub, thank you.
>> Thank you. All right, bye-bye. Bye-bye.
Ready to go? Mhm. All right, we've got Miss Cherub. How'd your night How'd your weekend go?
>> Good, very good. Good. Is your pain a lot better now?
>> Much better. Oh, good. All right. And this is the same dressing that we put on it? Uh no, I've changed it both days over there.
>> All right.
Good. Has it had a lot of goop coming out of it?
>> Uh the first time it did. The second one was half and half, and then this is So, it's getting better, huh?
>> I'll take a deep breath in. Yeah, deep breath.
Oh, that looks so good.
That is really nice and clean in there.
See that, little Gonzo? You're blocking.
Hold on.
I think you were blocking it.
>> blocking? It's better now? Yeah. Looks nice and clean. Um I don't think we have to to pack this again. Okay. So, we're just going to put a dressing on this, but you do have to do some warm soaks on it. We want to make sure that stays open and drains from the inside out or heals from the inside out.
>> Okay.
Um If at any point it does look like it's closed off and the abscess is coming back or anything, just call me or come in, let us know. So, I'm going to say unless something unusual happens, this is probably going to be your last visit for this particular problem. This skin is all feeling so much better now.
>> Mhm. Really is. I'm so pleased with that. And that's not hurting now when we touch that, is it?
>> Okay. So, you know, a warm compress on it a couple of times a day would be a good idea.
Make sure that somebody can look at it for you. Miss Mr. Cherub can look at it for you and be sure that it's staying open so it can heal from the inside out.
>> Okay. Finish your antibiotics. How's your pain control? Good?
>> Mhm. Yeah. All right. Well, you're awesome. Thanks for letting us video this for all our YouTube fans. You And you saw the first video, didn't you?
>> Yes, I did. What'd you think of it?
>> I was impressed with it.
>> Did you like it?
>> Pretty cool to see that Yeah, very cool to see it. That was all right.
Well, thanks for letting us video this, and if you have any problems along the way, just holler. Okay. Okay. Thank you. Bye.
>> Bye.
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