Large pilonidal sinus. :(

Hi everyone. I'm a 24-year-old guy who might have a big problem looming, and I'm so anxious about it.

For the past year or so, I've been dealing with what appears to be a large pilonidal sinus. It's a slit at the top of my butt-crack. It looks kind of like my ass crack just stretched apart, as though someone grabbed my butt cheeks and pulled until a seam opened in my gluteal cleft. Sorry for that mental image but it's all that I could think of.

There doesn't appear to be any sort of cyst or swelling, at least not yet, and it drains fairly regularly. Sometimes the sinus gets very itchy. Occasionally, it goes through a phase where it drains very little, and I start getting a dull pain in my lower back. It feels like it's deep below where the cyst is. It's very worrying, especially since I have anxiety disorder, and I'm a terrible hypochondriac who fears for the worst case scenario in every situation. Right now, I can't stop worrying that it will get worse and worse to the point where the pain is worse than childbirth - which is something I've read on these forums. I have a very low tolerance for pain - the dull pain I'm feeling now drives me to nearly panic at times! To boot, I have a very important trip in 12 days. I'm going to Disneyland with my significant other and I plan on proposing to her. Everything is already booked solid. I hope I can make it to the trip, and survive its five day duration, without falling into that worst-case scenario and ruining the whole vacation. Up until yesterday, I wasn't worried for my trip because I thought 17 days wasn't a long enough time for it to escalate to a point where the pain would be debilitating, but now I've seen several threads where people have gone from painless to completely disabled from the pain in less than a week.

From what I've read and seen on the interwebs, I don't have a 'classic case' of Pilonidal Disease. It seems most people develop one small pit that doesn't drain very much, and then a bump begins to swell on their tailbone, and the terrible pain comes with it. I don't have a bump, nor any intense pain, but I have had this gash in my butt-crack for months now. I do want to get surgery for it ASAP after the trip, even though I hear it often doesn't work and followup procedures are necessary. I figure it's just plain unnatural to have a second big hole in my bum, so I should do something about it even though the recovery will be rough.

I'm wondering if anyone has any experience with a large sinus opening that drains on its own, and also if anyone has any advice on what I can do to improve my odds of making it through the next 17 days. I'm taking two warm baths every day, which feel great because my discomfort vanishes as long as I'm in the warm water, but unfortunately returns as soon as I get out. I'm also putting Neosporin on the area and powdering my butt with Gold Bond to keep it dry. I often get sweaty, since I'm 220 pounds, hairy, spend a lot of time sitting at the computer, and live in a hot climate where the temperatures in the summer can exceed 95 degrees Fahrenheit.

Thank you so much for your time!

I'm no doctor but I think you will be ok. When people get extreme pain from their Pilonidal it is because it will not drain and it builds up under the skin. I had that type for several years and it was painful until it drained. You said you have had it about a year and there is a big hole that drains so I doubt you will have that problem. Although I'm sure your anxious about it considering your big trip coming up. I remember never wanting to book a trip in advance and worrying for weeks before the trip if this damn problem would ruin it.

Again I'm no doctor but it would be my advise that sitting in the bath tub is not a good idea. Sitting in dirty water with an open wound can cause infection. Typically people who have cysts that wont drain either sit in a hot tub or use a heat pack to bring it to the surface.

Try to relax, enjoy your trip and when you get back find a cleft lift surgeon. The recovery is not very painful and fairly quick. Good luck to you

Know the feeling soldano- mine's pretty similar in that it's open, drains regularly but is just a pain in the.... I can't always predict what will trigger the times when it's worse, but even when it is- it's not paralysing, just painful. Sit properly, eat as healthy as you can, drink plenty, shower morning & night -and if you can keep product away from it then clean & dry is probably the best thing. Try letting the air get to it once a day (lie on your front or side) and keep the monster rollercoasters for another trip! Oh, and spend time obsessing over your proposal, not over your pilo- that's not what you want to remember!

You sound like one of the (relatively) luckier ones! You know you're in more trouble when it gets extremely painful. Also, if you were in any immediate danger, you would know all about it. I've never lasted longer than a fortnight with a cyst that has caused trouble. They tend to burst and become a problem within a short period of time. At least in my experience!
Use lots of heat on the area (hot baths, showers, a heat pack, etc.) This will draw the infection (if any) to the surface and make life awhole lot easier. You shhould really go to your doctor and see what they say. It could just be as simple as a course of antibiotics, or a simple drainage that they can do under local anaesthetic. Unfortunately, I had to have major surgery because I was mis-diagnosed as having a fractured tailbone (I had a bad fall, this is what triggered the cyst!) YOU CAN AVOID ALL OF THIS by simply visiting your doctor. PEASE trust me on this one. Any time I feel that something is not right with my wound, i go straight to my doctor. I will no take any risks when it comes to this. Luckily, my doctors are always so helpful and are happy that I insist on having it checked. They'd rather deal with a little bump than a massive cyst, I suppose!

I had my first cyst removed in Oct 2010. I was initially diagnosed as having a fractured tailbone (big mistake!) So, the cyst went untreated and got more and more infected and more and more painful, to the point of major surgery. The doctors and surgeons couldn't believe how huge it was. Took five months packing about about seven months to be mostly healed. The wound had to be healed from the inside out (this is better than having it stitched post-surgery!) so it took a long long time.
Unfortunately, I've just had a recurrence. I quite often get little bumps near my wound, but they generally come to nothing. Now today, I find out I have a brand new cyst growing from my wound but in a different direction. On a course of two penicillins for the next two weeks and have to keep a keen eye on it. It's quite sore and I have cold symptoms with it (swollen tonsils, blocked nose, fatigue, raised temperature, [although no fever!] etc.)

HOWEVER. I would just like to say that I am a rare case with regards to how ridiculously bad my whole experience has been. Every doctor, nurse, consultant and surgeon I have talked to has commented on how bad mine has been and how they've rarely seen them as bad. BUT I am also out the other side, and do not fear it happening. I don't enjoy it, but I don't fear it!
To anyone worried about it all, yes it is a hard time when you get them and it can hurt, you just need to stay positive because the end is nigh and it could be worse! <3

Hi again, everyone. Thank you all for your advice.

It's been 10 days since my pilonidal started getting uncomfortable. I ended up going to the doctor and describing my pain. When I told him it often radiated down my buttocks to my upper legs, he said that it was impossible that a pilonidal was at fault. Instead, he thought it was an orthopedic issue caused by all the sitting around I did plus the saggy eight-year-old mattress I slept on.

He gave me some painkillers which helped with the general back pain, and I felt better and better every day. I got a new memory foam mattress four days ago and slept very well for the first two nights. On the third night, my cyst drained a lot and I developed a bad itch. I had to take a bath to feel clean again - wiping at the sinus hole with toilet paper is painful. Yesterday, my bum hurt quite a bit, and for the first time in my life my pilonidal discomfort woke me up. I only got four hours of sleep.

Today is going okay so far but I'm just annoyed that this trip which should have been very cheery and relaxing is going to be a race against time. I am just about exactly 7 days away from the end of the trip and I'm hoping I can make it to the end without having to stumble into an Orlando emergency room to deal with a major infection that would ruin the entire trip.

A few months ago, the thought of having surgery on this thing was still scary, but now I'm actually kind of looking forward to it. Even if it weren't for the discomfort and pain, just knowing that the ticking time bomb in my buttcrack is gone makes it all seem worth it. I just hope I can make it another week!

You poor thing. It really is so crap. I do find that mine can get quite itchy, even if there's no pain or anything. Must be quite a normal thing.
I'm still on antibiotics for my latest recurrence. Eight a day and it's taking its toll - I am SO TIRED. It's still a bit sore whichis unusual seeing as I've been on the antibiotics for a week and a half now... If it persists within the next two days, I'll be going straight back to my doctor, no questions asked. I ain't takin' no chances! But, it'll be worth it. Damn things!!
Hopefully it'll be just a minor thing but I can't stress enough hwo you should keep on top of it and not let it get infected/larger than it might already be. So important. Regular and quick doctor visits are much better than a long and painful recovery from major surgery.
Hope all is well and you're enjoying your trip

I'm back from the trip. Some very interesting things happened.

The very first day, on the long car ride to Disney, my cyst went berserk. I couldn't sit. I nearly cried. The pain was so intense and debilitating that I couldn't think of anything else. We ended up going to the hospital in Celebration, which is a Disney-built town next to Walt Disney World. The hospital was gorgeous and world-class. I was expecting a bill in the thousands, but I only ended up paying $100 since I had no insurance. Gosh. I had an amazing experience there. I even watched The Lion King while lying on my stomach in the emergency room. The doctor prodded my sinus and caused it to drain, which was a relief. He also gave me some morphine and an I.V. full of antibiotics. I was given a prescription for oxycodone and two antibiotics, and was told I could hit the parks as planned.

Well, it was very rough. I had an on-and-off fever, headaches, nausea and drowsiness from the medication. I also still have occasional pain caused by my sinus. It feels as though sitting or being jostled around cause it to swell up or fill with fluid or something. I was hoping after the doctor drained it, it would calm down for at least a few weeks but the very next day it felt almost as bad. My anxiety also kicked in and I had a couple of panic attacks when the crowds started swarming. Still, I managed to hit all the major attractions and had a lovely time with my fiance, who said yes! That distracted me from my discomfort for a good hour. Ouch.

We're now back home and I feel okay. My sinus is still draining, it hurts to sit for longer than 30 minutes, and the medicine is still making me queasy. On monday, I have a visit to the surgeon, who will probably refer me to another surgeon who specializes in these things. Maybe by the end of July I'll be on the path to recovery. I'm a huge computer geek so I really miss being able to play games and surf the web comfortably.

Mine is there it is right in the middle, about the size of a Q-Tip. My 1 Dr recommended said the cleft is what I need but said I won't have a but crack. Any thoughts on this, is this what you have? Is yours in the middle where your cheeks rub?

I had the cyst removed which was painful and required long recovery time but I was one of the unluckier ones... If you can hav a drainage done before a removal, I'd recommend it!