Cleft Lift Recovery Log

Discussion in 'Pilonidal Discussions' started by john matrix, Feb 24, 2016.

  1. john matrix

    john matrix Very Helpful

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    This is my first post in this forum. This website has proved to be a wonderful resource for understanding this condition, so I thought I would chronicle my days following cleft lift surgery as the recovery logs were most helpful as I considered how I wanted to treat this disease. I'm due to go under the knife on Monday, Feb 29. I was lucky—one of the surgeons listed in the table of cleft lift specialists on this website practices in my city in Virginia, and he is an in-network provider on my health insurance plan. I met him last week, and after he looked at my pilonidal troubles, he decided I would be a good candidate for the cleft lift surgery.

    Some background:

    I'm a tall, 27-year-old man with a hairy buttocks. At present, I'm aware of one pit and one drainage point. The pit is located midway between my anus and the top of my natal cleft. It is rather large compared to many of the pits I've seen in pictures on this website and others. The drainage point is located below the pit, about one inch above my anus. I was concerned about the proximity of the drainage point to my anus, but the surgeon doesn't think it will be a problem.

    I've had the pit for several years. I can remember seeing it in my early 20s, but I was unaware of what it meant, so I paid little attention as the drainage point had not yet appeared. The area began to itch as I passed into my mid 20s, and then came tiny spots of bright blood on toilet paper after I would wipe. I ignored the situation as it did not seem to pose any immediate risks. In retrospect I realize how silly it sounds to ignore those symptoms, but I had never suffered from any health problems so my sense of youthful invulnerability prevailed.

    I began a new job last summer requiring me to spend long hours outside in hot weather. I believe this is what exacerbated the problem—it went from little bits of blood and itching to heavy discharge, with foul-smelling fluid tinged green and yellow. There was also more blood. I saw a doctor at an urgent care clinic in November, and he recognized the pit as pilonidal disease, but he called the drainage point a granuloma. He prescribed antibiotics and referred me to a general surgeon, who agreed the pit was pilonidal disease. She felt unable to diagnose the drainage point, so I was referred to a colorectal suregon. That surgeon—whom I saw in mid December—ran a probe through the pit, and since it came out at the drainage point, he felt confident declaring both anomalies to be related to pilonidal disease. He suggested a closed excision with a midline suture.

    By this point the antibiotics from the first doctor had dramatically cut down on the discharge. I decided to wait and see how long it would take for another flare up. I lasted until the beginning of February. This next flare up went from no symptoms to full-blown discharge within 48 hours, and unlike my painless past experience with the disease, I felt some discomfort. Excisions and their lengthy recovery time are of no interest to me. The consensus among medical professionals fluent in this condition seems to be that the cleft lift procedure is the best solution. Many of the stories on this website with positive outcomes seem to be from those who have had the cleft lift. With all of this in mind I scheduled an appointment with the local surgeon who performs the cleft lift.

    What I'm Aiming For:

    My purpose with this log is to share my cleft lift recovery in detail. I suspect anyone considering their options for treating this disease is obsessing over it as I did, so I would like to contribute my story to the forum. Please feel free to ask any questions you may have as I work through my recovery. I plan to write my first entry sometime on Feb. 30.
     
    Last edited: Feb 24, 2016
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  2. Noble1

    Noble1 New Member

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    Thanks for posting this. Did you get the closed excision then have another flare up, or were you just taking antibiotics and waiting for the closed excision surgery? I had a flare up in January this year, and I have been lurking in these forums trying to find the best solution. I found a surgeon that performs the cleft lift, and I hope that I can go right into this option instead of wasting time with open, closed, pit picking, and other procedures that don't really solve anything. I look forward to hearing about your recovery, and best of luck!
     
  3. john matrix

    john matrix Very Helpful

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    I haven't yet had any surgical procedure. The antibiotics are the only treatment I've received. The surgery is scheduled for tomorrow morning, but I've been told the surgeon intends to keep me overnight for observation. I plan to post again when I've returned home.
     
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  4. Noble1

    Noble1 New Member

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    Sounds good. My first appointment with my surgeon is at 1:30 tomorrow. I wish you the best, man. Let us know how it goes!
     
  5. john matrix

    john matrix Very Helpful

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    Day Two

    24 hours post-procedure

    The cleft lift surgery is done. I was put to sleep before the procedure, and when I woke up, it was over and there wasn't any pain. I had a smooth experience from the moment I arrived at the hospital until I was wheeled into the recovery room. No nausea or vomiting to report.

    I'm at home resting now after being kept overnight at the hospital for observation. I rode home on my side in the backseat of a small SUV, and it wasn't too uncomfortable aside from when we had to brake suddenly at a stoplight.

    Considering I just had a surgery—my first ever major medical experience—I feel good. There is soreness and some slight pain in the area of the surgery, but it has not been anything unbearable. The worst physical experience has been bursts of dizziness when I'm on my feet for more than 15 or 20 minutes, and this is likely from the narcotic pain medication I've been prescribed.

    The surgeon told me I had a small sinus and cyst, so he didn't need to remove much tissue. He stitched it shut and left a drain in overnight, but the drainage was minimal, so it was removed this morning. Since the cyst was draining about an inch from my anus, the doctor used glue to shut that portion of the incision and hopefully protect it from any fecal material in the area.

    In addition to minor pain there was also some slight itching from the gauze left over the wound post-procedure. It was nothing unbearable, and certainly not as bad as when my pilonidal cyst was in flare up mode. That gauze has since been removed, taking the itchiness with it.

    Here's a breakdown on where I am with specific activities:

    1. Sitting — I haven't tried this yet. I was on my back without pain when I woke up in the recovery room, but I haven't tried it since.
    2. Walking — I can walk slowly without trouble. I walked across the entire hospital to fill my painkiller prescription at the pharmacy onsite without pain.
    3. Stairs — I can take these slowly.
    4. Getting up and down — I can get up and down from the bed and couch without any problems. It's an awkward series of movements, but nothing too bad.
    5. Bowel Movements — I haven't had one yet. I'm nervous as my bowel movements tend to be large and messy. I'm taking Doc-Q-Lace to soften my stools for when the time arrives.
    6. Food — I've resumed my normal diet. I just had a sandwich for lunch.


    I'm happy to answer any questions you have.
     
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  6. Jeffrey Jones

    Jeffrey Jones New Member

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    Thanks for all of this, and hopefully you recover fast. Quick and silly question (to be answered whenever it is nature does call): Can you update this with your experience of, uh, going #2? I'm wondering if there's a risk of the wound opening upon sitting on a toilet (since the body slumps and puts pressure on the tail bone area) and giving pressure in order to remove waste.

    -Thanks
     
  7. kittygirl

    kittygirl Very Helpful

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    #2 is going to take a few days, you're going to feel like you need to go but don't force it, it'll come out easy when it's ready, I think I didn't go for 3-4 days but my memory is getting hazier as time goes on.....
     
  8. john matrix

    john matrix Very Helpful

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    Day Three

    48 hours post-procedure

    Still no sitting or bowel movements. I've spent the time since my last entry either in bed or on the couch. There has been some pain, but it is nothing I can't manage with the aid of the narcotic pain medication I've been prescribed. The worst part has been the stress on my legs and lower back from so much time on my sides and stomach.

    I changed the dressing this morning on the small wound from where my drain was removed. There was a little blood. I haven't otherwise had any drainage. I can walk a little faster than I could yesterday, but I'm still taking it as slow as I can to avoid aggravating the incision site. Climbing up and down from the couch and bed is easier than it was yesterday.

    It is still quite early in my recovery, but so far, so good. I'm right where I wanted to be at this point. I realize I have a long road ahead of me before I'm 100 percent, but I'm committed to seeing this through the right way.

    Despite not showering since Monday morning, I feel cleaner than I did when I was showering twice a day before the procedure. That foul pilonidal stew is no longer draining out of my backside, and while there is a long journey ahead for the wound to heal, that little change has done much to bolster my spirits.

    I will update this log when I've had a bowel movement. It still has not yet come. In my case, the wound is a few inches away from my tailbone. My cyst was located close to my anus instead of above the anal cleft like it is for so many others.
     
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  9. john matrix

    john matrix Very Helpful

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    Day Four

    72 hours post-procedure

    Still no sitting or bowel movements. I tried lying down on my back earlier, but it was uncomfortable so I changed position. I may try sitting on my coccyx pillow later today. I'm in less pain today than I was the past few days. I haven't had any meaningful discharge—only a tiny amount of blood at the site where the drainage tube was removed two days ago.

    I feel more limber when I get up and down from the couch and walk around the apartment. I have a two-story apartment, but the stairs have not been any trouble for me. I continue to eat a normal diet.

    I plan to take my first post-surgery shower later today. I'm nervous the shower will aggravate the incision, so I'm going to be careful to prevent any direct hits from the water stream in that area.
     
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  10. john matrix

    john matrix Very Helpful

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    Day Five

    96 hours post-procedure

    I had my first bowel movement this morning. It was a nerve-racking experience. My bowel movements tend to be soft and messy, and this one was no exception. I used an entire roll of toilet paper along with several wet wipes. Then I climbed in the shower and let hot, soapy water run over the area for a couple of minutes. After all of this, I still found little bits of fecal matter on toilet paper I ran through the area. This has left me nervous of an infection taking hold. I inspected the area with a mirror attached to a long rod—the kind of mirror bomb squad guys use—and there does not appear to be any openings along my incision after this episode.

    Otherwise, I'm progressing well. I had my last narcotic painkiller at about 4:15 p.m. yesterday. It's now 11:20 a.m. the next day, and I'm not in any pain besides the general soreness which has been present since I woke up after the procedure. I'm able to lie on my back comfortably, but I have not tried to sit. I think I will leave that for another day—I had enough excitement with the bowel movement. I'm moving around better today than I have been, a positive trend that has continued since day two. I feel alert, healthy, and increasingly limber. Hopefully the bowel movement won't set me back.
     
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  11. ellysparkles

    ellysparkles Very Helpful

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    This might be TMI but I bought a full/long door mirror and set it up in my bathroom. I, too, had a low incision and was paranoid about getting the area dirty when wiping. I just wiped using the mirror and never had any problems. I also found Charmin brand wet wipes were the best and pretty gentle/soft.

    Wishing you a speedy and easy recovery!
     
  12. john matrix

    john matrix Very Helpful

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    Day Six

    120 hours post-procedure

    I had another bowel movement this morning. This one was especially frustrating—I believe I'm constipated, so a tiny little piece did not want to come out. I hovered over the toilet for 20 minutes trying to get it to come out without exerting myself, but I had no luck. I cleaned diligently with toilet paper and wet wipes, and then I took a shower and let a lot of antibacterial soap clean the area.

    I continue to abstain from narcotic painkillers as I am not in any pain. There is a general soreness to the area, but it is nothing worse than the feeling you get from a bruise.

    I'm now able to sit for short periods of time using a coccyx pillow. I sat on a chair in my living room for a couple of minutes earlier, and I plan to do so again later this afternoon. There was not any pain or discomfort during or after sitting. Today was the first time I've tried sitting.

    The wound continues to look better. There is much less redness than there was immediately following surgery. Some of the steri-strips are starting to fall off. I'm excited to see the wound unobscured.

    I've been using a hand mirror like the kind you see bomb disposal guys use in the movies. I feel like I've been cleaning the area the best I can with toilet paper and Costco brand wet wipes (also nice and gentle) right after a bowel movement. I shower after using those products. So far there is no evidence of an infection, but what would recovery from surgery around your anus be like if you didn't have at least one paranoia? The only comfort I have is that I'm doing the best I can to clean the area.
     
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  13. john matrix

    john matrix Very Helpful

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    Day Seven

    144 hours post-procedure

    I'm now sitting for each meal. I have my coccyx pillow on a dining room chair. I'm also able to lie on my back comfortably. There is a tiny amount of pain that comes and goes, but it's nothing debilitating. I can walk almost as I did before the procedure. Yesterday afternoon I walked to a supermarket four blocks away from my apartment without trouble. It was nice to get out in the world for a little while.

    I had an end-of-days bowel movement yesterday afternoon. The floodgates opened and my constipated bowels erupted like a full-open dump truck. This brought with it the worst pain I've felt since going under the knife. My wound held despite this gruesome episode. I cleaned the area with toilet paper and wet wipes, and then I took my customary shower.

    I plan to take it easy today after yesterday's trip to the supermarket and the industrial-grade bowel movement. I don't have any reason to believe I've opened the wound or infected it.
     
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  14. john matrix

    john matrix Very Helpful

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    Day Eight

    172 hours post-procedure

    I had another bowel movement this morning. I dread going to the bathroom for a bowel movement. The pain is excruciating, but I consider myself fortunate as these movements have not opened my wound. I continue to vigorously sanitize the surgical area after each of these unpleasant episodes. I've stepped up my stool softener dosages in hopes of mitigating the agony. I should add a caveat here—like I said before, my bowel movements are traditionally large and unpleasant. I usually unleash a colossal load every 36 to 48 hours in what is a grim ritual when I'm not recovering from surgery.

    The sani-strips are beginning to fall off the top of my anal cleft. The incision is dark red, but the skin around it looks healthy aside from some light bruising. I'm excited for more of them to fall off so I can inspect the rest of the incision.

    I can now comfortably walk at the same speed as I did before the surgery. Each day I climb off the couch and bed a little faster.

    There is still a general soreness around the surgical area. I have not taken any narcotic painkillers in four days, and I haven't had any Aleve in two days. The pain is minimal and easy to handle.
     
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  15. kelseyb123

    kelseyb123 New Member

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    Your updates are awesome, looking into going to the doc soon for my problem. It's weird cAuse I'm not even hairy in my natal cleft ? Anyways - looking forward to your continued successful healing
     
  16. john matrix

    john matrix Very Helpful

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    Day Ten

    224 hours post-procedure

    Apologies for skipping a post yesterday. I'm working from home now, and I was caught up in a couple of projects. My recovery continues to go well. I've been taking stool softeners three times per day since my terrible bowel movement on day six—my bowel movement this morning was easy and painless, a welcome relief after all the stress and pain my previous movements caused. I encourage anyone recovering from pilonidal surgery to use stool softeners if his or her doctor approves.

    I've felt quite limber over the past 48 hours. I'm walking like I did before the surgery, and I can lie on my back for extended periods without any pain. I sat on my coccyx pillow for more than 10 minutes yesterday without any pain. There is still soreness in the area, but it's not any trouble. I haven't had pain medication (narcotic or over-the-counter) since day five.

    My incision looks quite nice considering how little time has passed since the surgery. I'm looking forward to my followup appointment next Tuesday, March 15. I haven't yet driven in a car or rode in one as a passenger. I'm not sure when that time will come, but I do plan to drive to my followup appointment.

    No more steri-strips have fallen. There are some that look close to ready to go, so when they do, I'll provide an update on how the incision looks in that area.
     
    Last edited: Mar 10, 2016
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  17. john matrix

    john matrix Very Helpful

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    Day Twelve

    All of the steri-strips have fallen off. The wound looks good. The skin surrounding the incision is red, but otherwise the area appears healthy. The incision does not appear to have opened anywhere. This is the first complete look I've had at my new cleft—it is pretty wide open, so that should hopefully prevent any recurrences.

    I'm still getting a little bit of pain, but it's nothing too bad. I haven't taken any pain medication in a week. I can now sit for up to 15 minutes at a time before it gets too uncomfortable. I'm trying to ratchet the time up a little bit each day. I hope to drive a car in the next few days to get in a practice run ahead of my followup appointment with the surgeon.
     
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  18. john matrix

    john matrix Very Helpful

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    Day Fifteen

    I took a 40-minute aimless drive today. When I left I had no destination or amount of time I wanted to spend in the car, but I thought it was important to give driving a shot. I'm happy to report there was no pain or discomfort during what was the longest time I've spent sitting since the surgery. I used my coccyx pillow for the drive. Returning to driving was a real spirit booster.

    My wound is scabbing over nicely. Tomorrow I will see my surgeon to receive what I hope is his blessing that all is well. I don't feel like I'm having any trouble with my recovery. I'm back to 100 percent mobility other than the luxury of using my rear end when I'm rising from a seat or from bed. Sitting without the coccyx pillow is my next hurdle.

    I'm hesitant to declare my experience a success so close to the surgery, but my body is reacting exactly as I hoped it would prior to going under the knife. Before surgery I read all the accounts I could find of the cleft lift and the other available procedures, and I am, so far, convinced now as I was then that the cleft lift is the optimal approach to treating pilonidal disease. I say this with the caveat that I still have a long way to go before my body is back to where it was before the surgery.
     
  19. john matrix

    john matrix Very Helpful

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    Day Sixteen

    Today I visited my surgeon for a followup appointment. I was told my wound appears to be healing exactly as it should and there are no apparent complications. I was cleared to begin walking at a brisk pace on the treadmill, but I cannot return to running and weight lifting for another couple weeks. Despite this approval, I plan to continue to take it easy until more time has passed. There is what I hope to be a pilonidal-free life ahead of me to exercise after I have fully emerged from the recovery period.

    I also tried sitting for the first time without a coccyx pillow. This was on the advice of my surgeon, who said I should start trying to sit without its help. My car has comfortable leather seats, so I used those as my first test without the pillow. I managed the 25-minute drive home without any significant pain or discomfort. I plan to start sitting daily without the pillow.
     
  20. Cleft in Loo

    Cleft in Loo New Member

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    Being three days out from my cleft lift, I must say I wholeheartedly agree with you on this point. The lack of putrid drainage emanating from my backside makes every bit of pain, discomfort, and inconvenience completely worth it.
     

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