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so this patient has had a evolving inflamed epidermal cyst over the course at last how long now since its been in flames yeah month a month day the problem she had is nobody wanted to open it up and the plastic surgeon want to see this too either directly and the problem is we cant remove this because its infected so were going to have to just see if we can get it to drain so were going to put some anaesthetic in the problem with this is lidocaine works on an acid base mechanism so the anesthetic is a little bit acidic and the basic tissues usually convert that to more of a neutral substance which is then soluble into the actual tissues when theres an infection like this its also acidic so the anaesthetic doesnt work as well so were going to inject some deep and see if itll take a little bit and feel poke here poke your little pressure now I try to get behind this cyst but if Im into it youll see that pressure starts with dirt and assists and those will start to pressure f