Monday, Feb 25, 2013 was
an eventful day for me. I
had a facial lump of
1x0.5x0.5 cm cut off by
Prof Foo C L from the
Singapore General
Hospital. He thought it
was just a scratch tumour
as I scratched it to try
to get rid of it but it
persisted. Sometimes,
scratching causes a
reaction and the pimple or
inflammatory lump
disappears. But this lump
persisted and increased in
size.
"How long has it been
present?" he asked as I
was on the operating
table. "Months," I
replied. After seeing this
good-natured Syrian
hamster with a malignant
tumour excised at Toa
Payoh Vets recently, I
decided to get my skin
lump on my face excised
and checked for cancer.
"Will local anaesthesia be
painful?" I asked Dr Foo.
"Only during injection,"
he said. He injected 3
areas but the pain was
only a small ant bite. I
guessed he had perfused
the skin immediately on
injection and the
anaesthetic had numbed the
area. He made a blue
elliptical
marker
pen area and
excised it. Marking the
area to be excised is a
good practice even for
vets but not all vets do
it.
The SGH also has a good
practice of verifying the
patient's identity and
operation site. I was
asked my name and identity
card number at various
points of admission on the
day of surgery, outside
the operating room and
inside the operating room.
This practice ensures that
the right patient is being
operated on. I got asked
which area was to be
operated. This ensured
that no mistakes will be
made, e.g. operating on
the wrong side of the
face. Such mistakes have
been made in human surgery
with horror stories of the
wrong foot amputated.
For veterinary surgery,
the patient can't
communicate with us. The
owner sometimes give
incorrect information. For
example, a rabbit or cat
may be male but the owner
says it is female.
Trusting the owner who
says her pet is female
means just spaying the
pet. The abdominal area
will be shaved and the
incision made. No uterus
will be found after some
time. The vet thinks that
the pet had been spayed or
worst of all, discovers it
is a male.
It is the responsibility
of the operating vet to do
a full examination
including the gender of
the pet to be sterilised.
Owners are trusted
implicitly but some of
them don't really know.
Pets don't talk to vets
and so mistakes have been
and can be made by vets in
operating on the wrong
site.
As for my surgery, Dr Foo
said general anaesthesia
was unnecessary to remove
my facial skin lump.
"There is always a risk of
death," he said. "You may
be the unlucky millionth
person to die under
anaesthesia. Local
anaesthesia will do. It
takes around one hour in
all."
So, I was strapped on the
narrow operating table to
prevent me falling off.
Swabs covered my eyes to
shield them from the 3
bright operating lights. I
could not feel the cutting
as the area was numbed by
the local. Dr Foo had
asked whether I felt any
pain before excising. This
is one part which vet
surgeons can't get
feedback from the animal
patient under local
anaesthesia. "6/0 vicryl
and 4/0 ethicon," he said
to the nurse. The wound
was closed well
subcuticularly by 6/0 but
he stitched up the skin
with 4/0 in case of stitch
breakdown. This 2-row
stitching could be the
secret of success in a
plastic surgeon in getting
a small scar. I got some
antibiotic ointment which
I didn't use. I asked for
plaster to cover my facial
wound with a few stitches
so that crowds would not
stare at me when I
attended Cliff Richard's
concert in the evening at
Marina Bay Sands Grand
Theatre.
In any case, Cliff Richard
who is 72 years old, gave
such an energetic
3-hour-long performance
that would put a younger
singer to shame. His jokes
were appreciated and the
audience left much
satisfied. One commented
that he did not sing
"Bachelor's Boy." I was
waiting for him to sing
"Fall In Love With You",
but was disappointed. This
was a song I heard at the
25th Baba & Nonya
Anniversary in Malacca
last year. I got a short
video done. See:
https://www.youtube.com/watch?v=-G48MbWTu8c
Cliff Richard's "Fall In
Love With you" song when
he was very young is at:
https://www.youtube.com/watch?v=T0EHxaVJ0ok
Dr Foo sent my facial lump
was sent for histology. It
looked white and
elliptical in the formalin
bottle. There were some
fine hairs of around 3 mm
long on the skin of this
lump as commented by Dr
Foo. "Don't read too much
into it," he said to me. I
do not know why he
commented on the presence
of these fine hairs.
As for the Syrian hamster
operated on Valentine's
day, the fair lady owner
brought the 2-year-old
hamster to consult me 11
days after surgery. There
were large reddish skin
nodules on the body, under
the armpits and on the
left thigh. They were
around 4 mm x 4 mm raised
skin rashes. Could they be
due to the "anti-mite"
spray the young lady was
spraying to "kill the skin
mites"? She had diagnosed
hair loss and brought the
spray from the pet shop.
"Your hamster has a
malignant skin tumour," I
showed her the histology
report which I had paid
for since she did not want
histology. "It is possible
that these red lumps are
the spread of the skin
cancer which was 2.5 cm in
diameter. I gave her the
photo of the lump sent by
the laboratory.
"Should I continue the
spraying of the skin?" she
asked me. "No," I said.
"This hair loss of the
hamster could be due to
other reasons and not
mites." A hamster with a
large skin tumour could be
scratching himself a lot
and hair loss would be
expected due to trauma.
"Let the Syrian hamster
enjoy his life since he is
2 years old and their
lifespan around 3 years,"
I told her that the rashes
could be either irritation
of the spray or spread of
the cancer. She was to
give medication for 7 days
and if he nodules
disappear, it would be due
to irritation.
"I adopted him from the
SPCA," she said to me. "He
is such a gentle hamster
and does not bite me
unlike some hamsters."
"Yes, he is very
good-natured," I said. "He
does not bite me too." Dr
Daniel who had operated on
him came by and had the
stitches taken out.
Stitches can be taken out
on the 11th day with no
problem of the skin
breaking down. The wound
had healed. Time will tell
whether the skin cancer
had spread. There was a
black pigmented spot on
the further back before
the left hip area. It was
not present before. So it
is hard to say whether
this was cancerous. I did
not advise removal as
there was not much skin
and there was economics to
consider.
Updates will be on this
webpage:
http://www.asiahomes.com/petshotline/20130228syrian_tumour_follow_up_toapayohvets.htm
TOA
PAYOH VETS
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