DD going for surgery in a few weeks then starting freshman year!

Discussion in 'Pilonidal Discussions' started by Anonymouse1, Jul 14, 2013.

  1. Robert Eden

    Robert Eden Very Helpful

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    If your Doc says you're not a candidate for the procedure, consider getting an opinion from another cleft lift doc (unless there are tons of cleft lift success stories from him/her in the forum). Maybe even call Dr. Bascom's office and ask. I've read on the forum that they can do phone consults... give them a call and email pics (and then probably call again). You certainly could say you exhausted all other options.

    I remember one post from a guy who's doc said "Cleft lift, no problem", but when he was under the knife the doc got over his head and switched to an open excision because it was "too big". I remember another case of someone who had a "modified Bascom procedure" and had a recurrence (descriptions of the procedure in the post didn't sound like a cleft lift.)

    Here in the U.S. docs are business people, sometimes they'll say anything to keep a customer. :( I don't remember any post from a popular/experienced cleft lift doc who said he couldn't perform the operation.

    Robert
     
  2. Anonymouse1

    Anonymouse1 Helpful

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    Connie, confused is my permanent state of mind! ;)
     
  3. Robert Eden

    Robert Eden Very Helpful

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    Sonspilon: I would say starting High School 6 days after a cleft lift is taking a chance, but the alternative could be pain, drainage, and not being able to participate in things for a good part of the semester. If he has to miss a little of the start (and that's not assured) it's better than suffering for months.

    Talk it over with your doc (and try and get an earlier date of course). If it's a first surgery and relatively minor case, it may be fine. I had surgery on Thursday and was able to do things over the weekend and return to work (sitting) Monday. I took a few breaks to lie face down the first week though (I work from home).

    Connie: I wouldn't worry too much about traveling a bit to see a doc. At least first surgery and/or simple case that isn't very likely to cause problems. If you're concerned about later complications, you may be able to have a local doc work with the surgeon w/o traveling back. Talk to your surgeon about it. I think it's better to travel to a good doc, than stay local for a bad procedure.

    Robert
     
  4. Connie777

    Connie777 Helpful

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    Thank you so much for the reassurances, Robert! That sounds very reasonable. That was my thinking too, but I'm so grateful to have a person with experience with the procedure to back up my opinions with a factual experience. I know that all cases are different, but there must be a lot of similarities too, and it still helps to hear you say it! Thanks!

    Although I have no experience, my instinct is to agree with Robert's advice for you, Sonspilon. I also worried that if I waited, we would take the risk of flare-ups, drainage, and other complications. Timing is bad, but we have to do what we can. (Imagine how embarrassed he would be if he had a drainage issue and had "leakage" on the back of his pants in school! First few days of high school! That would be totally humiliating for anyone, let alone a teenaged boy (or girl, for that matter!) I'd discuss it with your doctor. They will have a good idea about what's possible.

    We'll all go through this together, Anonymouse1 and Sonspilon! We can share experiences and help support each other!
     
  5. Connie777

    Connie777 Helpful

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    We saw the surgeon today! He looked and said the wound is still open and "wet" (oozing), but it needs to be completely healed and dry before he can do the surgery, but he said the tissue involvement was fairly extensive and the cleft lift was definitely the best option for my son. He said we don't have to do surgery, but his experience has been every one that came to him, returned with at least one recurrence. He said it's kind of a crap-shoot, leaving it. We discussed timing and he scheduled us for a follow-up check on Aug 5th, and surgery is scheduled for Aug 6th, but will be cancelled if the wound is still not "dry", so we're working hard to get it all healed up! Good news is NO MORE PACKING! Yay! We are to keep the area shaved (once a week) and liberally apply this antibiotic powder twice a day. MUCH easier than packing the sinus tract! He felt we were rushing it a bit, but he understood us not wanting to wait until Xmas break. He did say, he would not compromise if the wound was not ready -- not willing to take ANY chances! That's a good thing!

    So, all in all, a good visit. Worth the 6 hours round-trip! (At least 4 more round trips to go! Ugh! But will be worth every bit of it!)

    He did say that Dr. John Bascom (the elder, the one who developed the cleft lift procedure) died fairly recently. I was very sorry to hear that! That man helped SO MANY people!

    So now, I'm eager to hear about doctor's visits from Anonymouse1 and Sonspilon!
     
  6. Anonymouse1

    Anonymouse1 Helpful

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    That's great news Connie! Fingers crossed that the wound heals up nicely so that you can proceed. DD's wound from her lancing healed up except for weird pink tissue tags at the top and bottom ( I have no idea what exactly these are). She took her last antibiotic yesterday, so I'm hoping that there is not a bunch of gunk and pus underneath! We're anxious to get this thing resolved!
     
  7. Connie777

    Connie777 Helpful

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    How long did it take your daughter's wound to heal? My son had his lanced on 7/7, so it's been over 2 weeks, and still open and draining! He took 10 days of antibiotics after it was lanced.

    Anyone here know how long this crazy wound will take to heal?

    I'm eager for it to close and heal so we can get on with it! I'm becoming a little testy and impatient! I very much empathize with you! Can't wait to hear what your doctor says on Wednesday, Anonymouse1!
     
  8. Anonymouse1

    Anonymouse1 Helpful

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    She had hers lanced on July 1st, but with no antibiotics given at the time which was the mistake, as it got infected about 5 days after that. It's not draining anymore, but those skin tags are peculiar, it's almost as though the wound closed too fast for the top and bottom to catch up. The skin tags are a lovely healthy pink color though! ;)
    High protein diet and plenty of fluids should aid the healing process Connie.
     
  9. Connie777

    Connie777 Helpful

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    Thanks so much for the information! So your daughter is about a week ahead of my son. That's good to know, as a benchmark.

    The nurse also told us to push protein! She didn't mention fluids, but that makes a lot of sense! Thanks for the tip!

    I wouldn't worry about the tags -- I suspect they will be removed when the surgery is done. Nice that infection is gone though. I suspect your daughter is ready to have the surgery now. I'm envious! We still have to wait. I don't wait well. : ( Just want to get it done and over with forever!

    I really appreciate the information!
     
  10. LILLY

    LILLY Very Helpful

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    One of the main reasons cleft lift was developed was to correct open wounds that would not heal. Just thinking back on all of the cleft lifts I know about almost all were performed while there was an unhealed wound or draining in some fashion. I don't mean to rain on anyone's parade but I am wondering why you were told the wound needed to heal first.
     
  11. kittygirl

    kittygirl Very Helpful

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    my doctor had me wait about a month since he wanted to make sure all the infection was gone....
     
  12. LILLY

    LILLY Very Helpful

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    Yes, I have heard of people waiting until the infection was cleared but not having to be fully healed with no drainage.
     
  13. Connie777

    Connie777 Helpful

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    Doctor said he felt infection was a risk when wound was draining. I think he still suspects an infection, but didn't prescribe antibiotics. We did a 10-day round when it was lanced, and home health nurse said it did not look infected any more. I suppose it's hard to tell what's going on in those sinus tracts. He did prescribe an antibiotic powder (BFI powder) to be applied LIBERALLY twice a day. Read up on it and it's said to help dry up wounds.

    Now I'm worried he doesn't know as much about this surgery as I had hoped! : (

    I guess I can only hope that the wound is healed by Aug 5th!
     
  14. LILLY

    LILLY Very Helpful

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    Believe me I hesitated to say anything because I don't want to worry you any further. Under those criteria though my son never would have qualified for the cleft lift. He had a large draining sinus that was connected to a large deep cyst with significant fluid. There was no way that sinus could heal or even dry up. I just don't want you to be turned away for reasons that maybe you shouldn't be.
     
  15. Connie777

    Connie777 Helpful

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    My choices are limited. I had to travel over 100 miles to get to this surgeon. There are 2 other surgeons listed in the Miami area, but I researched them and both are very poorly rated -- both are about 2 out of 5 stars. This surgeon gets 4.8 out of 5 stars! BUT the people doing the reviews are just regular patients, and sadly, most patients are pretty ignorant about their health and available and appropriate treatments. To most, the doctor is "god".

    Perhaps I could contact Dr. Tom Bascom? I hear he does take calls. But I'd have to see if he could put it in writing so I could show my surgeon, and as we all know, surgeons don't usually like to be "corrected".

    I guess I will give it a week or so. If it's still draining, perhaps I'll try to call Dr. Bascom's office.

    Nothing's ever easy.
     
  16. LILLY

    LILLY Very Helpful

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    You took the words right out of my mouth! I thought to myself what would I do in that situation and I would call Dr. Bascom. He seems to be very generous with his time.

    I also understand about the distance. We did bypass several surgeons that were closer and drove 4 hours each way for our surgeon. It's not ideal (the distance) but we were happy with the result.
     
  17. Sonspilon

    Sonspilon Helpful

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    Connie, our doctor too said he needed to wait until my sons wounds were healed a bit before doing surgery. He also said my son has "extensive" pilonidal disease and I guess he wants to do the least amount of cutting necessary (he does cleft lift only). He was on antibiotics a few months ago and now we only shave once a week and pack his crack with hydrofera blue which may be similar to the powder you are talking about.
    My only concern is he has this almost perfectly circular opening above his crack that looks really gross. He didn't have it a couple weeks ago. It looks pink at least and it's not draining per se, just a tad bloody and overall disturbing looking!
    It sounds like your surgeon is doing the right thing though. Good luck to all of us!
     
  18. Connie777

    Connie777 Helpful

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    My son has the gross-looking circular opening too, but it is IN the cleft, and that was the opening to the sinus tracts where I was inserting the gauze packing. You say this is new? I think that would concern me. At what point does he plan to do surgery? You said he was on antibiotics a few months ago? Does this mean he has been waiting for healing for several months? Wow! What does the doctor say about new openings? When does he plan to do the surgery, under what conditions? How horrible that you BOTH have to go through this, and for so long!

    Thinking back, I will say the doctor said the drainage was "foul smelling", which I never noticed, so it's not overwhelming, but he must feel that indicates some infection is still present.

    I think the advice here is sound. I will give it a week or so, and if it still hasn't closed, I will try to call Dr. Bascom. I have read that he is very generous with his time and often will speak with a patient at length, even when there is no chance this patient will become HIS patient. There's a special place in heaven for people like this!
     
  19. Linda2

    Linda2 Very Helpful

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    HI - like Lilly, I hesitated to come in on this, but my son had an unhealed wound from an earlier open excision, and a sinus stretching way down in the cleft which was draining, and at no time did our cleft lift surgeon want, or mention, putting off surgery because of this. I also understood, like Lilly, that this procedure was particularly good for those with unhealed wounds and difficult (infected) sinuses. I think that there will always be some infection in the sinus - even if it is not draining. I would at least talk to another surgeon just to be certain - and check that it is Bascom's cleft lift. That sounds stupid but you would not believe how many surgeons throw the term about without it being Bascom's. The doctor who did Razzyirt also sounds good for taking phone calls, and he has a lot of stuff available on the internet - I think it is Rosenburg? It would just be a precaution to talk to someone else. It is just that it can take a long time to close - and may never close - so you need to know what he is going to do as a backup.
    Good luck.
     
  20. Connie777

    Connie777 Helpful

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    Thanks for the advice! I think I will call either Bascom or Sternberg. I also worried that perhaps he was not actually doing the cleft lift, because I read on this forum of someone who said they saw a doctor on the list and they said they did it, but was actually doing excision with closure. So I called to confirm, and also asked at the appointment yesterday. I do know for certain that it is the cleft lift procedure because the surgeon specifically said he went to Oregon to train with Dr. Bascom. He said he called and asked if he could come and train with them, and was told he was welcome to come and train there, but there is a video on youtube he could use to watch the procedure. He replied that he didn't want to learn from a youtube video! So he went there to learn the procedure. So I am positive he is doing the Bascom procedure. Perhaps for this reason, he would be willing to listen if I called Bascom about this? Hmmmmm. Gonna call today!
     

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