thanks for responses. currently had to start a course of anti biotics again to hopefully prevent current recurrence by noticing it before it makes it to severity level where anti biotics have very little effect, and requires medical proffessionals to get it to come out. I hate having to decide whether to take anti biotics or not... knowing all the problems they can cause. Sleeping so little lately just from the anxiety increase... guess I'm doing better than I could be though. Responses made me feel somewhat less scared with the responses about how it open excision doesn't always turn into a nightmare. I'm without the money to travel and get a cleft lift done elsewhere. It sucks cause I'd prolly go get a cleft lift, but the financial burden it'd put on my family would be upsetting as I do not have anywhere near the kind of money to pay for it. Also have a opioid painkiller dependancy already, which is one of those things that worries me for surgery since I already do not have that same natural endorphin production most users go into pilonidal surgery with, will likely be at much higher painkiller dose than most pilonidal surgery recovery patients are due to the tolerance that I already have, which in turn will be that much harder to get myself off it when alls said and done.. Its about 10months since that first flare up so I guess im still within the "new-comer to pilonidal disease" stage where it probably effects you more psychologically than after having dealt with this (pain in the a**) for a longer period. Probably(hopefully) gets easier over time. Still waiting on surgery date, surgeon said "in the fall" but he doesn't seem to care as much as I feel like he should, especially with all the potential complications of living with a pilonidal (increase in potential for squamous cell carcinoma, potential for infection that can make it to the stage of sepsis, etc). A lot of the time honestly I feel like I'm going to die.. but I think its the result of having like somewhat severe health anxiety.