Axillary Cyst

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M

mommywri

My daughter has a mechanical aortic valve and has been on multiple courses of Augmentin this year for sinus infections and is again on Augmentin for this cyst. The cyst is about 1 com in diameter and doesn't seem to want to go away--but hasn't gotten larger on the abx. Has anyone who has a mechanical valve ever had an axillary cyst? What did their doctors do (or not do) to treat this? Does anyone know if this significantly increases the likelihood of bacterial endocarditis if she goes off the antibiotics?

Thanks so much for any advice or experience you can offer.


Martha (worried mom to Christina St Jude Mechanical Aortic Valve 2002)
 
I had trouble with some cysts about 15 years ago, and they went dormant for a while. Since surgery, however, they became active again, and I had them surgically removed. So far, I've had a total of four cysts cut out in three separate surgeries.
Mine were called subaceous cysts. The antibiotic keeps the swelling down so they can be removed. My cyst surgeon has explained to me that these cysts can occur anywhere, that there is no known cause, nothing to do to prevent them. I've had some become so infected that they broke open and oozed, so I have mine cut out as soon as I can arrange it.
I searched long and hard to find a surgeon who would remove mine while I stayed on coumadin. He cuts out the cyst, and then cauterizes everything abundantly, before stitching things closed. I haven't had any problems.
 
mommywri said:
My daughter has a mechanical aortic valve and has been on multiple courses of Augmentin this year for sinus infections and is again on Augmentin for this cyst. The cyst is about 1 com in diameter and doesn't seem to want to go away--but hasn't gotten larger on the abx. Has anyone who has a mechanical valve ever had an axillary cyst? What did their doctors do (or not do) to treat this? Does anyone know if this significantly increases the likelihood of bacterial endocarditis if she goes off the antibiotics?

Thanks so much for any advice or experience you can offer.


Martha (worried mom to Christina St Jude Mechanical Aortic Valve 2002)


Hi, Do you by any chance mean MAXILLARY cyst?(axillary is armpit). The maxillary sinuses are those just above the upper teeth on each side. Cysts are very common in this location and usually resolve when the infection is controlled. Steroid nasal sprays like Beconase or Flonase are usually prescribed. Surgery is almost never necessary. As far as I know these cysts have no relation to valve surgery or endocarditis.Recommend a CT sinus scan and then consultation with a good coservative ENT specialist. Marty
 
Thank you Marty and Jim

Thank you Marty and Jim

Thank you for your responses Marty and Jim--I really appreciate you sharing your knowledge/experience with me. The cyst is located underneath the arm and is currently a little over 1 cm in diameter--at least what we could feel. It probably is an infected sweat gland according to her pediatrician. (I am assuming sebaceous gland and sweat gland are the same thing?) It may go deeper and there is some pain. The surgeon that we went to wants to put her on abx for 14 days and then take her off. If the cyst grows more he will remove it. The cardiologist and pediatrician thought that they should come out sooner rather than later and appeared to be uncomfortable with taking her off abx with the cyst probably because she has already had bacterial endocarditis twice. Did you remain on abx until you had the cysts removed?

We can't communicate with the surgeon we saw one week ago and are trying to make an appointment with a different one who can see her soon, but all of them seem to be on holiday and are seeing people in the second week of January. I appreciate you letting me know to ask about doing the surgery while still on coumadin. --That seems to be very good advice! Any other suggestions would be most welcome.

--Martha
 
AXILLARY= armpit!

AXILLARY= armpit!

Oh,Martha, you did mean AXILLARY! As far as I know this has no relation to heart surgery and in no way should cause endocarditis. Just get a good general surgeon you can trust. He/she can decide how the antibiotics are handled and advise whether you should "hold" warfarin or bridge with Lovenox. Most of us on this panel favor bridging.I doubt the surgeon would like to operate with full warfarin anticoagulation.
 
The surgeon I have been using for these cysts has learned with me. He now recommends that I start antibiotics as soon as one develops. That may be only to keep the swelling down so he can see what he is removing.

I first went to a surgeon who is close (15 minute drive) and he refused to do the surgery while I was on coumadin. That (having him do the surgery) meant a week-long stay in the hospital on heparin, since at that time lovenox was under suspicion. I searched further, contacted a hospital that does doctor referrals, but without success. I finally asked a doctor friend who checked around and eventually found the surgeon I'm using. I'll gladly give you contact information on him, if you'd like. He may be able to recommend someone similar in Massachusetts. PM or email me.
 
Thank you for your advice

Thank you for your advice

Thanks so much for your advice--it seems a shame to spend a week in the hospital if it is unnecessary. I did try to call some local doctors' offices in Boston to ask whether they operate on patients on Coumadin. However, the offices couldn't tell me--they just mentioned that there would be a plan for going off and on Coumadin.

-M
 
mommywri said:
Thanks so much for your advice--it seems a shame to spend a week in the hospital if it is unnecessary. I did try to call some local doctors' offices in Boston to ask whether they operate on patients on Coumadin. However, the offices couldn't tell me--they just mentioned that there would be a plan for going off and on Coumadin.

-M
Please please please educate yourself and don't rely on their opinions. Talk with a few before settling on going off anticoag and be sure a bridge is going to be used.
 
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