My Lovely Little Lump

I had a minor surgery three days ago to remove a pesky gummy lump on the back of my left wrist. When I first noticed a pea-sized bump on my left hand some two years ago, I just ignored it thinking it would go away on its own. And it did. But it came back and never went away and eventually limited my hand movement, especially during exercise. Push-ups were doubly hard and some yoga poses became too difficult to maintain like those that require pushing your hands against the floor such as the upward-facing dog. I only decided to see the doctor when even the slightest flex caused discomfort and when people started noticing it. One time someone reached for my hand then he felt the lump and started playing with and asking endlessly about it. I mean, it was fine he asked but I didn’t know how or what to answer him.

Okay, so what I actually have, errrr, had was a ganglion cyst. This type of cyst rises out of any joint, most commonly the [back of the] wrist, and grows out of the tissues surrounding the joint like ligaments, tendon sheaths and joint linings. Why a ganglion forms is still a mystery but it frequently affects women between the ages of 20 to 40, individuals with prior tendon or joint injury and gymnasts and other athletes who repeatedly put their wrists under stress.

The ganglion’s balloon-like structure is filled with fluid similar to the fluid lubricating the joints. Its size changes from time to time and may even disappear only to reappear days or weeks later. Usually it gets bigger with increased wrist activity then it becomes smaller with rest. Mine was roughly 1.5cm in diameter on my first visit to the orthopedic surgeon but during its early stages, it’s sometimes not visible. But even if I couldn’t see it then or it was just the size of a whole black pepper, I could still feel pain when I move my left hand.

Since ganglion cysts are almost always harmless and benign, treatment may not even be necessary. But if the cyst grows and increases pressure on the nerves, causing more pain, and limits the joint’s range of motion then it calls for medical attention. In most cases, surgery is the only option to treat a ganglion cyst. But there are also conservative treatment options that include draining of fluid from the cyst (aspiration) or immobilization of the affected joint until the cyst decreases in size and the pain subsides. My doctor and I agreed to surgically remove my ganglion to lessen its chance of recurrence. A ganglion cyst can be pretty persistent as recurrence rate can be as high as 40% following its excision.

The surgery (a ganglionectomy) was an outpatient procedure, meaning I didn’t have to be confined in the hospital overnight, and it only took a little over an hour to complete. I was awake and chatting about the Miss Universe pageant with my doctor and nurse during the surgery because only a local anesthetic was used; only my left hand was numb to all the dissecting and stitching during the surgery. It was disturbing to hear the clinking of surgical instruments and how several times it felt like these metal implements seem to come in contact with my bone. Twice the nurse asked if I wanted to see the cyst and how they were trying to excise it. I was curious, of course, and for a split-second thought of turning my head towards the surgical table where my hand was being probed. But, no, I didn’t want to see my hand cut open, blood oozing and flesh and bones exposed.

I didn’t look at the cyst even after it was excised. I only had the guts to examine the fluid aspirated from the sac inside a syringe—it was super viscous and looked like a clear gummy candy.

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My swollen and sewn-up hand on its second day.

There will be no badminton and upper body workouts for me for at least a week or until the stitch had been removed. And for the next three weeks, at the least, even with the incision healed, my left hand must have a reduced range of motion. So no lifting heavy items, no hard gripping on objects, no strangling irritating humans until it feels as strong as the uninjured wrist. After all, healing cannot be rushed as deep wounds take longer time to heal.

Three days after the surgery and my left hand is still semi-functional. Of course I couldn’t flex it, I cant even turn a door knob with my left hand, but swelling has already subsided and it looks like it’s about to heal without getting infected or bruised. The scar left by the 1-inch incision is a different story, though.

Other sources:

http://orthoinfo.aaos.org/topic.cfm?topic=a00006

http://www.nyboneandjoint.com/conditions-treatments/ganglion-cyst-of-the-hand-wrist

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