Need advice about surgery

Discussion in 'Pilonidal Discussions' started by beechcott, Oct 19, 2011.

  1. beechcott

    beechcott New Member

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    I have had a pilonidal cyst for a few months, but didn't figure out what it was until recently. It isn't really a very serious one, it's fairly small. Still, it was quite a nuisance and painful at times. I went to my doctor, who said (without examining me) that these cyst always come back if you just lance them, and that I should have it removed. He gave me a regimen of antibiotics and scheduled me an appointment with a surgeon, who inspected the cyst (now noninfected and painless, due to the antibiotics), and scheduled me a surgery. He said they will remove the cyst, and leave the wound open, and I will have to pack it with saline-moistened gauze twice a day. He says the incision will probably be about an inch and a half. He said that this is the best surgery available for a pilonidal cyst, and that he expects me to heal in about six weeks.

    But since then, I have done a little Internet research, and it appears that the surgery he has scheduled for me is actually an outdated, poor surgery. It is a case of the cure being much worse than the problem. Instead of six weeks, the average healing time is eight to ten months, and sometimes the wound never closes at all. Not only that, it will not be a small incision as I was lead to believe, but a hole big enough to fit a golf-ball into. "Packing" does not mean just putting a small crease of the gauze into the incision, but the whole piece of gauze. Plus, there is a high rate of infection. It turns out, the only good surgery for a pilonidal cyst is called cleft lift surgery, but my surgeon doesn't even seem to know what that is, as he didn't mention it. However, I am on Medicaid, and he is the only surgeon I can get. Also, my Medicaid goes out when I turn 18, which is December 28, this year (only about a month away). The surgery is scheduled for November the 1st.

    So what should I do?
  2. maynergator

    maynergator Helpful

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    I had an open excision, and while it is not the most recent, updated procedure out there, it worked for me. You can't really give the healing time an exact count. Everyone heals differently. My excision was several inches long and went clear to my tailbone and it was healed within 2-3 months. Also, the size of your cyst will determine the size of the excision necessary to remove it completely. This factor also will determine how much gauze is needed. Also, there are different ways to make sure that your wound closes by stimulating growth.

    The reason your doctor has probably never heard of the cleft lift is because not many doctors practice it. While it is the best procedure out there, it's not the only good procedure offered and it's pricey. If you can't get the cleft lift, don't worry about this procedure not working because it has worked for people. It doesn't sound like your cyst is very large. :) If this is all that is available, go for it with an optimistic outlook. Best of luck!
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  3. fearful

    fearful Very Helpful

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    Welcome to the boards

    You have to remeber that a lot of stories on the net are from people with failed surgerys. Personally I wouldn't have a open excision if I have anything to do with it mainly because I don't like the idea of having a hole in my bum. But that surgery has a success rate of 85/90% which is a good result. And the other thing is the surgeon can't promise you a wound size until he's in there and finds all the tracts and pits that need to be removed also healing time some people heal within months and some take longer.
    If you feel you would prefer a closed procesure like the cleft lift and think you can wait till next year untill you have insurance to cover it I would wait for it. But if you can't then that's okay too, there is a pretty good chance of healing with a open excision too
    beechcott found this helpful.
  4. beechcott

    beechcott New Member

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    So, you don't think it should be too bad? How painful is gauze packing? Is it possible to do it by yourself? And you mentioned stimulating growth. How to go about that? It is eating certain foods or something? I also always find it hard to keep lint from somehow getting into the area of the cyst. Will that cause any risk of infection? How much saline should be put on the gauze? And how long should I avoid movement and sitting after the surgery?
  5. collegemel84

    collegemel84 Helpful

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    Hello there. first off im so sorry to hear youre going thru all this..like the rest of us. my surgeon does the same open excision surgery..i just had it almost a month ago. my cyst was good size but not huge. the incision was 3 inchez long, 2 inches wide and went all the wayto the bone. i do wet to dry packing twice a day..well my mom does i should say. Theres no way i could properly pack it on my own. theres a considerable amount of gauze in there...less now since im about 50% healed. we use 3 inch rolled gauze and honestly at the beginning there was between 2 &3 feet of it in there.but it gets waded up so its not that much. the gauze just has to be wet, mom just wrings it out a bit. i wont lie the first two weeks were incredibly painful..just keep up withte pain meds and take them as prescribed..dont wait until ur in pain. i shower each time my mom changes the gauze. i found its easier n less painful to pull the gauze out myself in the shower, a lil at a time n letting it get wet again before i pull it out more. after about 2weeks i didnt need the vicodin as much and went back to work. i waitress ans bartend so im always running around. each of us is different..depending on age,health,size of the cyst etc... but mine is healing great. Im almost a month in and prob more than 50% filled in. the pains still there but not nearly as bad as it was. ibuprofen does the trick most of the time...doc said my mom is doing the BEST job hes ever seen a family member caregiver give. so just make sure u can take 2 or 3 weeks off fromwok or school or whatever is on your schedule..have someone who can pack it for u. keep it packed tight and deep to keep from getting infection stuck in there again. i put maxi pads..overnight long super absorbent...in the back of my underwear to keep from ruining my clothes cuz it does drain fluid n blood as it heals. (Dont worry the blood means the tissues are filling in like theyre supposed to..the blood is what we want to see the doc told me). Get urself prepared mentally and just know its what u have to do to have a chance at being healed. my surgeons had good luck with open excision..hence tbe reason he still does it. igood luck with eveything...im here if u have any questions..just ask!!!! :)
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  6. beechcott

    beechcott New Member

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    Another poster mentioned stimulating tissue growth. How to do that?

    I also always find it hard to keep lint from somehow getting into the area of the cyst. Will that be a problem? And should I avoid sitting for a few weeks or more after the surgery?
  7. maynergator

    maynergator Helpful

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    It really isn't that bad. Packing isn't painful, but can sometimes stick when you remove it. To avoid this, make sure completely moisten the gauze and ring it out a little. Some people can pack it on their own, but I have no idea how they are able to. It was impossible for me. It's a lot better to have someone help you. As for the lint, you can't prevent that but you can flush the wound by buying a can of spray saline, or just standing in the shower letting water run into the wound. Have someone inspect it for you looking for lint. It's not good to let it stay in there. As for sitting, I didn't start sitting until it was comfortable for me, and that's all you have to do for that. To stimulate wound growth, you're right, a good diet, and LOTS of protein stimulate growth. I drank protein shakes. Also, if your wound ever comes to a standstill, there's a more uncomfortable way to stimulate growth. My surgeon took a q-tip and rubbed inside the wound vigorously until it started to bleed. As bad as that sounds, it stimulated the wound and the blood acts as a natural cleanser. Hopefully you won't come to a standstill though, haha. If you need any more tips, let me know!
  8. collegemel84

    collegemel84 Helpful

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    Like i said everyone is different...depends on how big it is and how well u tolerate pain. Packing at first is very painful.. for me and lots of others ive talked to. (I dont want to scare u but dont want u to think its pain free and easy) but gets easier everyday. i cover my packing with a 4 by 4 gauze pad to keep it covered and clean. havent had a problem w.lint or anything getting in it. Showering twice a day and rinsing it out in the shower im sure helps w.that. and i agree about the protein... fruits. veggies and lots of protein. i must say the qtip rubbing to make it bleed is something ive never heard of and honestly not something i could handle. its painful enough without someone doing that!!!!!!!
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  9. collegemel84

    collegemel84 Helpful

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    As for sitting... i couldnt for the first 2 weeks...the 23rd it will be a month and its still uncomfortable at times. its an open wound on ur tailbone so sitting at first is a no-no...u wont be able to. lay down on ur side or ur stomach. sleeping on my back is sill not something i can do. Too painful.
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