My Pilonidal Cyst which I have had for a week has just ruptured and I have some questions and concerns. It is a bit long but I am just going to start from the beginning with everything that I have done the past week. I felt a small lump at the top of my cleft a few days before the pain started and ironically the only reason I even checked the area was because my boyfriend complained of a lump himself and I also had a few years ago found a small lump the size of a pea not at all visible but felt during a sit up. So I didn't think much of it as I figured it was just something I have always had under the skin there. At some point on Saturday(Mar 16) I started to notice pain and began doing hot compresses to the area hoping to help it along. I can’t remember size or anything about what it looked like at this point. By Monday it was the size of a quarter and was red, swollen and obviously infected. I did a small internet search and came up with pilonidal cyst but stopped reading as soon as I saw lancing and surgery. The pain was so bad I went to the clinic Monday and the doctor confirmed pilonidal and prescribed antibiotics (cephalexin) and said fingers crossed this works because the surgery is not pleasant. He also said to go to ER and get it lanced if it gets any worse. So I go home and find this website and basically the surgery he described was excision. I live in Canada, Alberta to be specific and have no intention of having an excision ever. So I am going to have to look into getting something done privately if I need surgery. I also became very concerned about the lancing after reading horror stories on this site. The recovery time and seemingly botched jobs really concerned me and also the fact that mine felt so swollen and infected I was worried that the local freezing would have no effect. The night of the doctor visit I also started to have chills, muscle aches, headaches and a hot feeling on my face. I never did take a temperature but I suppose I had a bit of a fever from the infection. On Tuesday I make an appointment with my family doctor so I can talk about this with someone but he is on holidays so unfortunately it is with a stranger and over a week away. Wednesday the cyst has continued to grow and I call the doctor again and get an early appointment for Thursday now and hope to be able to get a lancing there instead of the ER. I find out she won’t do it but decide to go there first and expect to probably get sent to ER after my appointment. Wednesday I decide to try going to work. I don’t sit at all at work I am at a bookstore so on my feet walking and occasionally light loads to carry. I take Advil and feel great for 4 hours can feel the pressure of the cyst but the pain and all my fever symptoms are gone. Then with 3 1/2 hours left the Advil wears off and I feel like crap and shuffle along for the rest of the shift. That night was very bad usually I don’t feel much pain lying on my stomach and that is how I sleep normally but the pain kept me from sleeping. So work not such a good idea certainly aggravated it badly. Thursday I am feeling ready for a lancing to make the pain go away. The cyst is about 1.5” long and a little less wide and very swollen but still does feel firm. I have been doing 3 hot compresses a day followed by a warm Epsom bath because frankly although the hot compress feels fine while I am doing it I often find it leaves the area feeling angry and unbearably painful (there is not a position that I can lay or stand in) for the next 1 or 2 hours without horrible pain. The bath helps relieve this so I am going to stick to baths only at this point. Thursday is the first day I have really been able and needed to do nothing but lay on my stomach and do the bath soaks. I head to the doctor and she thinks it has been long enough that the antibiotic I was prescribed should have taken effect by now. She definitely considered prescribing a second but didn’t. Not sure how I feel about that. I don’t like taking drugs in general especially antibiotics if they aren’t going to do anything and I have never taken 2 at once. Does anyone have any experience with this? Then she tells me the cyst still feels firm and is not ready to be lanced. At this point I am disappointed I want some of the pain relieved. So I now have an appointment for Monday. I go home and in the evening after my bath my cyst has ruptured. I am so happy I really thought it would never happen and that lancing was going be the only way. So I decide to do a warm wash cloth with a compress since now that it can leak I figure I won’t get the pain like I did before. Leave it on for 15min and look at the wash cloth and there is nothing on it. Check it out and realize it really hadn’t ruptured yet but it is desperately trying just a tiny layer of skin in the way. So back in the bath and this time it does actually rupture. I let it drain as much as I can then go to bed. At 2 am the pain is not letting me sleep so back in the bath and more fluid comes out. The fluid is yellowish in color with some blood in it. It does not smell at all. Not really what I was expecting. Anyone know what this means with regard to infection etc.? I am a bit disappointed I thought I would have more pain relief once it ruptured. It is Saturday right now and last night I again woke up in the middle of the night in horrible pain and had a bath to get more drained out. I am doing 3 bath soaks a day and use warm wash cloth compresses also to keep it draining. Any idea why it gets so painful in the middle of the night. My only theory is during the day with my moving around a little the draining is fairly constant but at night while I sleep it stops and the pressure builds up again. I shouldn’t say stops because there is discharge on the gauze when I wake up. Any ideas? I am very disappointed it ruptured a day and a half ago and not much in the way of pain reduction. I got the impression that some people had much relief. At least with it draining I feel I will be ok to wait till my appointment Monday. Any ideas what draining will mean with regards to beating the infection? Or where I will go from here if the draining has no effect on the infection? The hole is so small I worry not enough is coming out. Oh and about 12 hours after it ruptured all my fever like symptoms have gone away so far. So it has now been one week since this started any suggestions or advice is very much needed please.