Cleft Lift Recovery Log

Discussion in 'Pilonidal Discussions' started by BrianS, Nov 5, 2014.

  1. BrianS

    BrianS Helpful

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    Day Zero

    This site has been a huge resource for me and I couldn't be more thankful to the site, Sasha (for running everything), and the people on here that I've been in contact with who helped guide my decision. I am still nervous as HELL heading into surgery, and I am hoping for the best, but I decided to give back by posting a recovery log. My hope is that by me posting this, someone who is in my position, even if it's years down the road, can read this and get hope for beating this disease, or be better informed when it comes to choosing how to manage their cyst. (Also feel free to message me, even if it's years down the road, and I will try my best to get back to you).

    Pain/previous surgeries: I have had zero pain and what I would consider zero discomfort. My cyst has never abscessed, I've had no prior surgeries, no lancings, nothing. I've been lucky compared to several others stories on here.

    Type of surgery: Cleft Lift (Bascom procedure)

    Date of surgery: Friday, November 7, 2014

    Surgeon: Dr. Marc Brand with Rush University in Chicago, IL (1725 West Harrison Street)

    Pictures: I probably won't post them directly in this thread unless I'm comfortable sharing, but if you would like to see before/after, etc. feel free to message me and I can share them if you'd like.

    Cost: I will have to update this as time goes by, just recently switched insurance companies. So far I am at $1,200 for the cost of the hotel for a week (until drain removal)

    Travel time: 5 hour drive from where I live to Chicago, will be staying in a hotel until drain removal

    My story: I will try to make a long story short. I am a male in my early twenties. I work a very physical and active job (sitting in a car for 10+ hours a day), and sometime around May (this year, 2014) as I was using the restroom, I noticed a decent amount of blood in the toilet. Naturally, I freaked out and found the source of the problem, which was a small hole (pilonidal sinus) almost at the very top of my cleft, draining blood. I wiped up the blood and checked it again in the morning, to find nothing. I eventually went to the dermatologist and he diagnosed it as a pilonidal cyst. He shot it with cortisone and gave me a prescription for antibiotics and told me to come back if it got worse. He also told me that usually, the only way these things go away is with surgery, so I immediately Googled "pilonidal cyst surgery," (MISTAKE #1). I was horrified by the pictures and spent several days practically unable to sleep, not wanting to eat much, and non-stop thinking about surgery. Around the same time, I also found this forum. I continued to read about open excisions and look at pictures. Everyone I knew told me to stop looking at the pictures and quit reading on the internet and that the surgery couldn't possibly be "as bad as the pictures." I should have listened to them, but in a way, I'm glad I didn't.

    Thanks to my continued reading, I discovered pit picking and the cleft lift. As soon as I started reading about this, I went from being on the verge of what felt like depression to something I can't describe. I finally had hope that there was an alternative to the barbaric pictures I found on the internet, and that I could get through this with less pain than I expected. I began researching and found a doctor locally that does pit picking, and talked to one of his former patients on here. I went to see him, and he suggested pit picking, but told me I should finish the antibiotics and wait to see what happens. The following day after the appointment, I checked again in the mirror and noticed a small pit forming lower in the cleft. I started to worry just a little bit again about what was going on, so I got back on this site and went to the Surgeon Hall of Fame. I had nothing against the doctor I saw locally, but he didn't seem very versed in the cleft lift, and I wanted another opinion. The Surgeon Hall of Fame is where I found Dr. Brand. I was looking for someone close who had good reviews, and there were several positive posts praising Dr. Brand under the "Illinois Surgeons" thread. I can post some of the "testimonials" here for those of you that live in the Midwest, or you can go read them for yourself at the link below;

    Illinois Surgeons

    I scheduled a consultation with Dr. Brand for November, but eventually bumped it up. By the time I got in to see Dr. Brand, he told me I had about 5 pits in my midline underneath the sinus, which was more than the one pit I found weeks earlier. Dr. Brand outlined my options, from open excision, to pit picking, to cleft lift. I had a million questions and Dr. Brand spent time answering each and every single question. He didn't rush me, or tell me he needed to see other patients, he simply sat there while I asked any and all questions, even some of the stupid ones, or questions he's heard thousands of times before. And to be honest, several of them were related to pain post-op after reading the stories of excruciating pain from others on this site. Dr. Brand had excellent bed-side manner and treated me like an intelligent human being and didn't force me into anything. I've also been in touch with some of his former patients. Finally, Dr. Brand recommended the cleft lift due to the amount of pits I had and the success that he's had with cleft lift versus pit picking. (When I asked, Dr. Brand said he had done around 200 cleft lifts with a 99% success rate. I believe he's also done at least 4-5 more cleft lifts in the time since I had my consultation).

    Fast forward to now, and the surgery is scheduled for Friday, November 7th. I will be staying in a hotel that is a straight shot from the hospital on the highway, but about a 15-30 minute drive outside of Chicago and the hospital. The travel will be worth it, to have a $150/night hotel versus a $350/night hotel closer to the hospital. $$$$$$$$$

    In all this time, the cyst has still drained blood maybe 4-5 times total since May, and it regularly drained pus, but that was controlled with antibiotics. I've been on antibiotics since May, which is a long time, but it's helped control the drainage. As I mentioned above, my cyst has never abscessed and I have never had any pain, and I would rate discomfort maybe a 0.5 or a 1 at the most on a scale of 0-10. The cleft lift will be my first surgery of any kind for the cyst, I have not even had any lancings, so I'm hoping that will speed my recovery and help keep the pain and discomfort to a minimum. I know there have been debates on here as to whether cleft lift is a good first option for surgery, and others suggest pit picking before cleft lift, but given that I have a somewhat deep cleft, I'd rather make sure this thing never comes back. I don't want to ramble on, so I'll leave it at that. If anyone has any other questions, feel free to ask.

    The bottom line: Still worried and nervous for surgery, and probably will be until it's over. I know I've had zero pain, zero discomfort, and have only had the cyst for 5 months, so a lot of people would say to just live with it, but I want to do something before it flares up and I'm rushed to the emergency room in screaming pain. And more than anything, like the rest of us, I want to get on with my life.

    Here goes nothing......(as long as I don't hop off the operating table and run out of the hospital before the IV goes in :eek:)
     
    Last edited: Nov 5, 2014
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  2. dsimms

    dsimms New Member

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    I assure you....
    pictures are not needed :)

    I am curious for the 5hr drive to the surgeon.
    I live near a big city, so in the event that I need
    a 3rd operation, then I do not think I will have any issues.

    I just have to hurry up and make sure if i need that operation
    as of right now or before the end of the year, I am at 100% on insurance.
     
  3. InkSlinger

    InkSlinger Helpful

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    Glad to hear you're getting the cleft lift! Sounds like you're in good hands. I'm getting mine with Dr. Reinhorn in Massachusetts in January 2015. I've learned so much and gained so much from this site as well, and I plan on posting my full story and recovery log as I near the time of my surgery.

    Good luck tomorrow, and we'll all be here to support you as you recover!
     
  4. stokliner

    stokliner Helpful

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    Congrats, man. I have my cleft lift scheduled with Dr. Brand November 21st, and there's another member on this forum who has one with him early November too! I couldn't be more confident in a surgeon doing this procedure. I am also in my early twenties and have had no prior operations, other than a lancing and draining a little under 1 year ago, when I first discovered this annoying condition. I've also lost about 20 lbs in the past few months from exercising and eating MUCH healthier. Between that new confidence and my confidence in Dr. Brand, I am feeling good vibes for all of us going through this in November under his care. While no procedure is easy, I just feel such positive energy towards all of us going through this, especially since we can relate through the same surgeon. You're definitely making the right decision getting it now and with this doctor, so fear nothing!

    I wish you all the best and look forward to your log, especially since I will be going through the same thing so soon. Make sure you get a good night's rest, and eat a healthy dinner with lots of water. And stock up on those healthy groceries and movies!
     
  5. LILLY

    LILLY Very Helpful

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    I believe all three of you are in good hands. Dr. Brand and Dr. Reinhorn both have very good reputations. They are among just a handful of surgeons in the country that I considered.

    Good luck tomorrow Brian!
     
  6. BrianS

    BrianS Helpful

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    Thank you all for the good luck! I am settled into the hotel and have everything unpacked. Lots of jello, 7-Up, and water for my liquid-only diet.

    Got the call during the drive up that surgery is scheduled for 7:15 AM tomorrow morning and I have to be there by 5:45 AM. I am trying to remain positive and I know I am doing the right thing with the right surgeon, but the nerves are getting to me right now. Still very nervous/scared.
     
  7. wa2124

    wa2124 New Member

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    Good luck Brian!
     
  8. Girlbooty

    Girlbooty Very Helpful

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    Best of wishes and a speedy recovery!!
     
  9. ellysparkles

    ellysparkles Very Helpful

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    Praying for an easy and speedy recovery Brian! Good luck!
     
  10. BrianS

    BrianS Helpful

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    Thank you all so much! I owe it to you guys that I'm here right now. Trying to stay positive, reading some of your posts on your experiences, it helps. I will try to update you all as soon as I am able tomorrow.
     
  11. dsimms

    dsimms New Member

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    cyst operations are very common....If ever come a day that you come up with a triple hernia
    and your colon pushing through your stomach, that is something to be nervous about, and
    even hernia operations are fairly common these days, but a triple hernia makes you think
    about how common it is just a bit more, and you worry about the operation 10x more then needed.....

    There should be very little to worry about, its not brain surgery, they will put you to
    sleep; 10-9-8, your out, they roll you over, then operate on your backside, but if
    you should pass away, then there is a very good chance your doctor screwed up...
    :(

    and to be honest with you, if you die, then I highly doubt it would
    be cyst related, regardless, when it is time to go, then it is time, nothing
    in the world you can ever do to change that option, but you are not having
    brain, or heart surgery, and my guess will be that you will be just fine....
     
    Last edited: Nov 6, 2014
  12. stokliner

    stokliner Helpful

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    LOL, you guys, dsimms seen some sh*t.
     
  13. dsimms

    dsimms New Member

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    wife is currently recovering from triple hernia surgery....
    and they could not just poke a couple holes and do their
    work, she had to have open stomach surgery, so they split
    her open like a water-melon, then stitched her back up...
    talk about having that Frankenstein look....
     
  14. dsimms

    dsimms New Member

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    and let me tell you another procedure that I consider worse then a cyst is
    having your intestines tangle up for no real reason, your stomach bloats up,
    you can not pass gas, burp, crap, or anything, and when that is no longer tolerated,
    then your body forces you to vomit which relives some pressure just to start
    all over again until your body says time to vomit again, then go to the hosp for
    them to run 10 different tests on you, then hook up this tube like device, then
    they say open wide, and I am like wtf are you going to do with that? Well, we
    are going to shove this tube up your nose, down your throat, and down into your stomach in
    order to prevent the gas build up and discharge unwanted stomach fluids.
    Im like Ok, hell no, it took almost an hr for them to convince me to do
    this before they could transport me to another hosp more then 1 1/2hrs away.
    I went in around 9pm, and did not get to the other hosp until 5am that morning...
    and from there spent the next 5 days in the hosp. They put 3 small holes
    in my stomach, they went ahead and removed my appendix, did the
    surgery, and I was pretty much off my feet for the next 2-3 months.....

    and yes, this is much more life threatening then a cyst operation....
    When your stomach stops working properly, then that will hold
    up the process for other things in your body that needs to work...
    If i had decided not to have gone to the hosp, then I probably would
    have died of bloat, and if not, would have lost my smaller intestines
    from being cut off due to no blood flow in the intestines....
     
    Last edited: Nov 6, 2014
  15. Brandonw

    Brandonw Very Helpful

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    Best of luck Brian! Things will go very well. Keep us posted!
     
  16. stokliner

    stokliner Helpful

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    Dsimms,

    I meant no negativity from my comment, if that's what you're getting at... Your last comment makes me feel better about how minor this procedure is in the grand scheme of things, but it is still a surgical operation and many of us have not had many procedures like you. I am sorry you've dealt with so much, but let's keep the vibe positive and focused on the OP of this thread and his swift recovery. On a separate note, any health complications are why I recommend a proper diet, exercise, and general healthy decisions in life. The body is complex, and it's better to prevent any health issues than to change once they've started.

    Brian, hope everything went well! I'm guessing you're getting out or already out by now and feeling like a champ already ;)
     
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  17. BrianS

    BrianS Helpful

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    Surgery is complete. Laying on my stomach in the recovery room getting ready to leave. Will update back at the hotel.
     
  18. BrianS

    BrianS Helpful

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    Day 1 (Surgery Day)

    Surgery and pre-op: As I mentioned before, got the call on Thursday afternoon while driving up to Chicago that surgery was scheduled for 7:15 AM on Friday, I was to be at the hospital by 5:45 AM. I woke up for 2 hours in the middle of the night around midnight and had trouble falling back asleep, stayed up until around 2:00 AM. Got 2 more hours of sleep and was up by 4:30 AM, out the door by 5:20 AM, so I got maybe 5 1/2 to 6 hours sleep total. It was about a 20 minute drive from the hotel to the hospital, 11 or so miles and a straight shot down the highway. All we had to was get on the highway a block from the hotel, then get off the highway a block from the hospital, made for easy travels. I got there, signed a bunch of paperwork, was admitted, and sent up the 5th floor to wait. (I got a little worried when I found out what was going on with my insurance, but I'll address that later). They had a great waiting room, along with even more private waiting rooms for family members. They also had a status board that would allow any family members to see where you were, such as the operating room, recovery, etc. I got called into the operating room, changed out of my clothes and put on the gown. I met with the anesthesiologist' team, and they discussed how things would go. I have never had a breathing tube before, and was a just little unnerved at the thought of something being in my throat. Looking back though, I don't ever remember it going in or coming out. My throat is just a little sore, but not that bad.

    One of the nurses eventually asked me, probably per whatever paperwork she was doing, "So in your own words, what is Dr. Brand going to do for you today?" I told her, "He's going to give me a new a**?" We all got a little laugh out of that, and it gave me a brief moment of ease.

    One of Dr. Brand's assistants came in with what looked like a Sharpie. It was just a simple felt marker, and she marked my butt since, as she put it, "everyone's butt is shaped differently." She told me not to worry, that it wasn't permanent, but that was the least of my worries heading surgery, naturally. I'm sure she was just trying to put me at ease.

    I went out, got the surgery, and was in the recovery room by about 9:30 AM I believe. Unfortunately, I never did get to see Dr. Brand, so that will have to wait until my first follow-up next week when I hopefully see him then.

    Trying to think of what else to tell you guys. If you have any questions, as always, feel free to ask. Dr. Brand did say my cyst wasn't too bad, I'll mention that later.

    Anesthesia: Prior to receiving the anesthesia, I began to dry heave after the IV went in before they actually hooked up the line for anesthesia. I was also shaking pretty bad, like a "cold shake." I wasn't nauseous, and I don't have a fear of needles. I think the nerves were just REALLY getting to me. I asked one of Dr. Brand's assistants if I could try and go to the bathroom real quick (#2) before they put me under just so that I could clear out my system since I hadn't gone since about 6:00 PM the night before, and avoid having it all backed up by the time I had my first BM post-op. She said it was okay, and I tried, but nothing happened. I'm almost glad I didn't because I feared spreading bacteria around back there prior to surgery. Still shaking and nervous a little bit, I came back from the bathroom and got the IV. They started to say how the view I would see out of the window as they wheeled me to the operating room was the best view of the Chicago skyline I'd ever see. Long story short, I never got to see the skyline. I was out.

    Recovery: I woke up somewhat on my back, with my left leg straight out and my right leg bent up a little bit at the knee. Didn't really worry me that I was on my back, I still felt comfortable. I eventually got a little uncomfortable and asked if I could switch to my side. They helped me roll to my side, and I did that for a while before that became really uncomfortable just because all of weight being focused on my hip. I eventually made it to my stomach and that was great, I stayed in that position for the rest of the time, because it felt much more comfortable. I have also been sleeping on my stomach and sides for the past several months in preparation for surgery, so it's not an entirely uncomfortable position for me.

    One of the things that Dr. Brand does differently than other cleft lift surgeons, as mentioned by some of his former patients on here, is that he uses a tight, ACE bandage, essentially a pressure wrap. I believe they said this is to encourage the incision to heal. It's not as tight as I thought it would be, other than when I was laying on my hips for a long time. I'm fairly comfortable, I just waddle and take very short strides when I walk around. I am not allowed to touch the dressing, and I am not allowed to shower either until my first follow-up. I will then have the drain removed and begin daily dressing changes. Then I will have a 2 week follow up, and if things look good, I should be able to stop the daily dressing changes.

    They eventually brought me some food, I asked for Jello and crackers. They wanted me to eat something before I left. The first scoop of Jello didn't really stay down. I more spit it up than I threw it up. I had a little bit of some Ritz crackers soon after the Jello and they stayed down just fine. I should also mention that I have a nausea patch behind my ear that will stay on for about 72 hours, and I haven't felt much nausea at all anymore, so it must be doing its job.

    The cyst itself: So glad to have it gone. Dr. Brand said my cyst was not that bad. He said that it was fairly high up (assuming that means in comparison to the rectum) and there was a small abscess, however there wasn't much pus, just a little bit of hair that he got out of there. I'm not 100% sure how long the incision is. I think the fact I attacked this so early, only 5 months after it started, with no previous surgeries or lancings, and before it had a chance to become painful, has really helped make my turn-around so quick, at least on day 1. I also think it's a good thing I got this taken care of while the cyst was still fairly small.

    The drain:
    It is a suction drain, "the grenade," as many people refer to it. It doesn't really bother me, it's just kind of there. It hasn't drained anything yet though, so I'm a little concerned. (Actually just realized it the drain popped open somehow, or was "unsuctioned." Fixed that problem, so hopefully it should start to drain now, just have to be careful about that). The drain will get milked every 8 hours.

    Going home: This wasn't too bad. Dr. Brand told them I could sit on the way home, but I felt more comfortable laying in the backseat on my side (we have an SUV). I put a pillow behind my back to keep the incision from hitting the seat. The 11 mile drive that took 15-20 minutes on the way into the city in the morning took closer to 30-45 minutes on the way out of the city. It was just a little annoying, but nothing too bad. Chicago traffic has been this way every time I've come up here to see Dr. Brand.
     
    Last edited: Nov 11, 2014
  19. BrianS

    BrianS Helpful

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    Day 1 Continued (Surgery Day)

    Sitting:
    Dr. Brand said that I can sit right away, or at least that's what he told them before I woke up from surgery. I'm kind of surprised by this, given that I've heard from his previous patients he told them not to sit for about a week. Maybe it's because of the location of my cyst, the fact I have no previous surgeries/lancings? I'm not sure. I still have not sat, not so much because there's any pain, I'm just kind of paranoid. I don't know what to do, wondering if maybe I should start sitting right now for a couple minutes at a time. I do have a brand new, very firm coccyx cushion that I can use. (Thanks Connie777 for the recommendation on the exact pillow)

    Diet:
    Here is another thing that surprised me. Dr. Brand said I can eat whatever I want. With other previous patients of Dr. Brand's that I talked to, they were mostly all on an imodium/liquid-only diet until their first BM. I believe Dr. Brand said that due to the location of the cyst I shouldn't really have any problems going to the restroom.

    Medication:
    Right now, taking a stool softener, an antibiotic, and a third one I can't think of right now, I believe it's an anti-fungal. Still going to hold off on the Norco for a bit and stick to Tylenol. They gave me one Norco at the hospital shortly after surgery, then I had the Tylenol 4 hours later. I may take a Norco tonight before bed in preparation for the morning in case there's any more soreness.

    Using the restroom:
    Have only stood up so far, no problems in that department. Still worried about sitting down to use the restroom, especially given that Dr. Brand said my diet is unrestricted.

    Cost (Insurance):
    Now, here is the great part. I was a little disappointed during check-in once I got to the hospital when the woman admitting me told me I was out-of-network. When I had talked to Dr. Brand's office in the previous days/weeks, I was told that due to the fact the procedure was outpatient, they didn't need authorization, so I thought I was good. I was told after surgery that my deductible was about $1,100 and I may have to pay 50% of the surgery that insurance won't cover. Fast forward to the drive home, and we get a phone call from someone at Dr. Brand's office or the hospital (can't remember which). We are told that they had just received a letter from my insurance provider informing them that my employer will be covered by their national network, that I had met my deductible (not sure how, since we just switched to them on October 1st, so I think they're helping me out for some reason), and that everything will be taken care of, 100%. So, as it stands right now, all I'm responsible for is my hotel bill! $1,200, that's it!


    So...what can I expect in the next few days since Day 1 has really been fairly smooth? An increase in pain or soreness tomorrow? I will probably take one of the Norco painkillers prescribed before I go to bed just in case.

    Should I also try to sit now since he said I can sit if I want? I'm worried about doing damage. I've tried the process of sitting down, sort of a squat position, and haven't really felt anything.
     
    Last edited: Nov 11, 2014
  20. Connie777

    Connie777 Very Helpful

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    Congratulations Brian! Sounds like you're doing great!

    Go at your own pace. Let your body tell you what's ok and what's not. If your feel pain or discomfort, stop that and try again later. If you're not feeling pain or discomfort, it's probably ok! Try doing whatever you want (sitting, etc) and see how it goes. Take it slow, and you'll do fine!

    I'm so pleased your surgery is over! I agree that your surgery and recovery are likely to be easier because you dealt with it early in the game.

    Looking forward to reading how your recovery is going!

    Keep up the good work!
     

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