Kaiser surgeon says I am not eligible for cleft lift?

Discussion in 'Pilonidal Discussions' started by azurebarrage, Jan 12, 2016.

  1. azurebarrage

    azurebarrage New Member

    Joined:
    Sep 19, 2015
    Messages:
    21
    Helpfuls Received:
    4
    Hey everyone, I made a few posts on here a couple months back asking about the cleft lift. After jumping through hoops with kaiser, I got an appointment with the chair of the general surgery department who claimed and seemed to be knowledgeable about the disease and the bascom cleft lift.

    I've had my pilonidal disease for a long time, first 5 years ago at which point I had an open excision surgery that failed and resulted in 6-8 months of packing. The disease flared up again almost a year ago, and its only been getting worse ever since. I currently have two pilonidal sinuses, one at the very top of my cleft and one that is about 2-3 inches below the other or so(maybe halfway between the first sinus and my anus, a bit more?). I also have a recurrent cyst that keeps popping up on the right side of the top of my cleft(no matter how many times it runs it course it just comes back, luckily they aren't too bad). The sinuses drain constantly, even placing a gauze pad doesn't manage to stop all of it. It dries and is painful, the sinuses hurt and itch constantly...it's terrible.

    My surgeon says that I am not a good candidate for the cleft lift simply because my sinuses are too far apart. The wound will not seal properly, and the procedure will be ineffective.She also drew me some kind of diagram explaining that there is an infection looking to escape, so it makes these canals which lead to the sinuses, and that somehow the cleft lift wouldn't get it all? She says that another open excision is my only choice, and that my recovery will take about 6 months.

    I am 19 years old, and about to go into my second semester of college. I really, really, REALLY dont want to go through months of painful and uncomfortable packing at this point in my life, but I can't live like this anymore. I scheduled the open excision for 1/29/2016, and didn't even hesitate because at this point I believe an open wound will still be an improvement over what I am living with now.

    Is she right, or full of shit? Am I really completely ineligible for the cleft lift just because of where they are located? I am going to send some pictures to Dr. Bascom either tonight or tomorrow and get his opinion, but any advice you guys could offer would be great. Thank you!
     
    Last edited: Jan 12, 2016
  2. tyty501

    tyty501 Very Helpful

    Joined:
    Sep 13, 2015
    Messages:
    150
    Helpfuls Received:
    32
    Location (Country):
    USA
    Hate to hear that!
    I do know sometimes people aren't which sucks.
    I hate that you too like me have already death with an open excision that failed, I don't blame you at all for not wanting another.
    I actually am in college too and am taking the semester off to heal so I feel your pain on that.
    Def Check with bascom, then go from there with what he suggests.
    Best of luck
     
  3. Dr Immerman

    Dr Immerman Very Helpful

    Joined:
    Mar 17, 2014
    Messages:
    221
    Helpfuls Received:
    101
    Location (Country):
    Wisconsin
    Each surgeon has his or her own idea of how to perform a cleft lift, and exactly what the significance of the tissue rearrangement means for an individual patient. In my opinion, it is possible to perform a cleft lift even if there are sinus tract openings outside the usual area that would be removed. They can be cleaned out inside, and any skin openings outside the area of excision will just heal up on their own. I have successfully done this. The sinus tracts, cysts, and other nasty stuff under the skin is a result of the shape of the cleft. Once the cleft is flattened, and that stuff is cleaned out the disease process is eliminated.

    I would recommend getting other opinions.
     
    ellysparkles found this helpful.
  4. azurebarrage

    azurebarrage New Member

    Joined:
    Sep 19, 2015
    Messages:
    21
    Helpfuls Received:
    4
    Thank you so much! It really makes me feel better to get a Dr.'s opinion.

    I have another appointment to clear up some stuff with the surgeon today(I want her to explain exactly why she refuses to perform it, how deep the wound would be etc), and I'm also going to be sending pics to Dr. Sternberg and Bascom tonight. If I am eligible, I'll probably go with Dr. sternberg since I live in SoCal and SF is a lot closer than Oregon.

    after researching it and looking at some vids and pics, it seems like cleft lifts have been performed on as severe, if not worse cases than my own. Unless I am completely missing something about my case, I don't see any reason why I couldn't get one of these. I'll check back in after the appointment and I've heard back from Sternberg and Bascom, thanks!
     
  5. S2015

    S2015 New Member

    Joined:
    Dec 18, 2015
    Messages:
    11
    Helpfuls Received:
    0
    Location (Country):
    USA
    Yep, I totally agree that you should get a second opinion or as many opinions as you can until you are comfortable. I am from Cali too and with Kaiser too and I saw 3 surgeons before I felt comfortable with the 4th surgeons response and explanation. Wishing you the very best in everything!!!
     
  6. dks64

    dks64 New Member

    Joined:
    Nov 6, 2016
    Messages:
    2
    Helpfuls Received:
    0
    Heya, SoCal Kaiser peeps,

    Would anyone mind sharing the names of any of these Kaiser doctors who at least claim to know of or utilize the Bascom cleft lift? And do you happen to know anything about their success rates, or experience with performing it correctly? If not, even just their names would be more than appreciated.

    I finally created an account here because I need to start treatment asap, and I would really just like to get it right and find a doctor in the SoCal/Los Angeles area who practices the Bascom cleft lift. I've looked up some doctors that were "recommended" in other posts for the area, but I haven't found any helpful follow-up info or search results that confirm any of them utilize the method successfully (some of the post-treatment patient updates I followed seemed to indicate they actually received really invasive procedures with poor recovery, and some doctors' websites only promote major excisions and flap techniques, even doctors listed on the PDF sheet as supposedly performing cleft lifts).

    With open enrollment underway, and without seeing any particularly-recommended doctors in the area to follow, I'm thinking I'll just sign up with Kaiser and hope for the best. I have some hesitations, and pretty extensive personal and family history of pros and cons with them. But Kaiser may be my best option overall for care that I can actually afford (cost of premiums + cost of treatment). And I figure at least they have a large in-house network, so if there is a good pilonidal specialist among them somewhere, it might be easier to press and plead to get to them once I'm inside.

    I did consider getting a Blue Shield CA PPO so I could just see Dr. Sternberg himself. But I'm short on finances, and I'm afraid even with the best plan, the cost of the premiums+surgery on a PPO plan is still way out of my price range. :( So, without another highly-recommended doctor to follow, Kaiser seems like the next-best option, based on the affordability factor alone. And seeing the mention here that there might actually be some Kaiser doctors who might know the Bascom technique gives me hope!

    So, aside from issues with getting approval, would anyone mind sharing the name of any Kaiser doctor(s) you saw or know of, who at least are considering this as a treatment option? I would like to be able to research them further, and at least know who to look into. And if you have any other advice or recommendations for pilonidal treatment in the SoCal/Los Angeles area, I'd be glad to hear it!

    Many thanks,

    dks
     
  7. azurebarrage

    azurebarrage New Member

    Joined:
    Sep 19, 2015
    Messages:
    21
    Helpfuls Received:
    4
    Dr. Stephen Yoo at Kaiser Permanente, Harbor City. He is very kind, patient, and answers all your questions with a thorough and sensible answer. He doesn't rush you in the slightest or act like he doesnt have time for you. He sat with my father and I for over 20 minutes just going over all our concerns after he had already spent 10 looking at my pilonidal.

    When you mention the cleft lift to him, he won't look at you with confused eyes. He will know exactly what you are talking about, what it entails, and will then check to see if you are qualified. He has done work with Dr. Bascom(the father of the cleft lift procedure) in the past so he certainly know what he is doing in regards to this procedure. Absolute least intimidating doctor I've ever been to.

    Now you're probably wondering "so...how did the procedure go?" It was FANTASTIC. I had to wait for like 6 fucking hours to get into surgery but but it only took a couple hours and he came to check with me personally afterwards to see how I was doing. My Post op was a little bit rough but he gave me very simple and painless instructions to clear up any complications I was having, and responded to all my crazy emails full of concern.

    Cannot begin to tell you how happy I was to find Dr. Yoo. This is starting to sound like a shill post but this man seriously changed my life. I searched for someone within SoCal and within my insurance that could perform the cleft lift so I wouldnit have to experience(for the second time) the butchery that is open exccision. I highly, highly recommend at least looking into him.

    The only catch is that it is NOT easy to get an appointment with him. Sometimes you get lucky and get one within a week, but I've had to wait over a month just for a post-op. Completely and absolutely worth it though. Good luck with your surgery man!(or woman)


    Lastly thank you to the people who posted in this thread I made all these months ago telling me to get a second opinion. I was just days away from going through with another open excision but instead emailed bascom some pictures and he told me I was a perfect candidate. Thank you, all of you, seriously. This is such an awful and embarrassing disease but this forum gives people a ray of hope.
     
    Last edited: Nov 7, 2016
    ellysparkles and Dr Immerman found this helpful.
  8. sam314

    sam314 New Member

    Joined:
    Aug 29, 2016
    Messages:
    7
    Helpfuls Received:
    1
    I have Kaiser in San Diego and my surgeon is Dr. Exume. He seemed very knowledgeable about pilonidal cysts and from what I know, he has been practicing the cleft lift procedure for a long time. All my appointments with him were in Chula Vista so it might be out of your way but I think traveling to see him is worth it. Now, I am scheduled to have a cleft lift surgery with him on December 5th.
     
    Last edited: Nov 7, 2016

Share This Page