post-op question

#1
Hi everyone. I've searched the forum but not managed to answer my question. Perhaps someone out there can? question is at the end in case this is too lengthy for some!

*Background*
I've suffered with my PS since I was about 14 (I'm now 24). I felt uncomfortable and pulled out a very long hair from what felt like a very strange place. I was freaked out but shy so didn't tell anyone. After that it continued to be mildly uncomfortable and drained for a few months but I ignored it.

I forgot about it until I started uni at 18, when I started sitting down in uncomfortable chairs a lot more and put on weight. I had what I now recognise as a "flare up" of the abcess. Basically it got very painful and eventually burst and drained. Again,I was embarrassed so I forgot about it.

I eventually plucked up the courage to see my GP (age 19), who basically said she couldn't see very much and they would give me antibiotics if I had a flare up.

Fast forward 5 years to 6 months ago. I developed terrible pain, wound up in A&E where they confirmed my PS and acute abcess. Although the nurse looked horrified at the sight of it, he said it wasn't big enough to lance. Although I was desperate for it to drain due to the pain, I was kinda glad since even the slightest touch to it was agony! I'm sure many of you suffer worse pain with your sinus and complications so my heart goes out to you. I'm usually ok with pain but this was something else, co-codamol plus ibuprofen barely took the edge off it.

Anyway, I am now on my 6th course of antibiotics in 6 months, having yet another flare up. I have to say that the pain is nowhere near what it was the first time and the thing seems to burst and drain more easily. I'm not sure if that's good or bad. Initially they had me on Flucloxacillin (given by the walk in centre) but the GP seems to think Augmentin is the right one and it certainly seems to clear up the infection faster.

I've seen the colo-rectal surgeon and am booked in for surgery next week. He says it will be a Karydakis procedure.

**
My main question is: will I be able to walk up stairs 1 day after my karydakis op? They want to keep me in overnight with the drain but home the next day. I have to walk up 2 flights of stairs to get into my flat so was wondering if this will be doable???

Thanks to anyone who can help and hope you all overcome your PS.

Pineapple.
 
#2
I think is doable as long as you don't stress it too much. One step every 10 seconds or so, but be aware that you will be on anaestethics for days (they often use long-term anaestethics) so you will feel no pain. But no pain does not mean that you are not stressing the wound! I do not know the karidakis surgery but I had a closed wound so I had to be very careful: stitches could break apart. I've walked for 200 metres in the ward of the hospital the day after surgery, entered in a tiny Daewoo Matiz and then done few stairs. IT was devastating, not for the pain but for the stress, the postsurgery and the fatigue. But your surgeon will give you better advises than me.
Good luck!! [:8)]
 
#4
Hi, I had a Karydakis, but no drain, and could walk ok, if a bit stiffly, the next day. I even went for a walk up to the shops and back, maybe 2km round trip. I was a bit sore after, but fine (probably a very silly thing to do)...But I am under the impression the drains are a bit more restrictive. Good luck!
 
#5
Hiya,

First off, very glad to hear it's finally getting sorted and I'm sure the op will be fine so don't stress too much about it.

I believe the Karydakis and the cleft lift are very similar. I had the latter, also with a drain. I also had my PS from 18-26 years.

They were going to discharge me the same day (had early morning op on Monday) but I left the next morning as the anesthetic had affected me badly. Even then, I did manage to get out of bed for the loo and stuff on the same day as my op - although I fainted coz of low b.p!

Anyhoo, you will need to take it veerrrrry slowly moving around, moreso coz it just feels weird with a huge wad of dressing on your butt and carrying around the drain. But you can still manage everything as long as you don't rush it. I had the drain removed a few days later which allowed me to be a lot more mobile. Regardless, I think I was sitting a for short periods by Thursday.

You can read about my surgery and progress here:
http://www.pilonidal.org/forums/showthread.php?t=11346&page=2


All the best :)
 
#6
Thanks everyone for your replies and kind words, it has made me feel a bit better about it! I think I was just freaking out because my surgeon said I should take 2 weeks of pretty much bed rest and I was worried about doing way too much too soon!

Stopit- after reading your story it sounds very similar to mine! Right down to the junior doctor in pre-op not even knowing what a pilonidal sinus was and telling me to phone the secretary or the registrar! Your surgery wasn't at the Royal London was it?
 
#7
Well I think your surgeon is being on the safe side. It is best to rest for about 2 weeks and take it as easy as you can; don't sit too much especially. After a few days you should feel pretty good so I can understand how many people would maybe over-exert themselves too early. I would take it easy after that too. Even though I returned to work after 3/4 weeks, I didn't go in everyday which was the right thing given that the stitch was causing me problems.

I was treated at Mayday in Croydon but I'm not surprised the junior doc didn't know, my GP called it an abscess until after the consult where the surgeon said it was PS.

Good luck for next week and do keep us updated.

Just to let you know. It's been 5 months since my op now and everything seems to have healed up nicely, no problems... it's a good feeling!
 
#8
I just had to ask- everything seemed so strangely similar! Perhaps our experiences are just typical? Although I have seen 2 GPs at my surgery and they both seem quite knowledgable about it and were quick to refer me on. So there is hope out there for some sufferers!

I'm glad to hear you're doing well, it gives me hope. Just one question (if you don't mind). Does it all look almost normal "back there" (except for the scar of course). I know it's the least of my worries, as I want rid but I don't want to feel self conscious. My boyfriend promises he won't mind but my bum has always been his fave thing about me!

Will keep you all posted on my progress.
 
#9
same with my husband :). the first time i saw my scar, i will be honest, i felt sick and was depressed for a while. i won't lie, it's not the same but you get used to it. i compare it the weirdness of, for example, if someone didn't having a belly button because you basically don't have a cleft anymore - it's all sewn up... all the way down to where the two cheeks part properly. basically the bumline starts lower down? from far away it still looks normal as the scarline give the impression of the cleft, lol.

i've heard it may become different over time and a depression will form, so let's see.

if you're anything like me/us, you will get used to it and it won't even be something you think about after a while. it's a small price to pay for being free of PS especially if it goes as smoothly as mine has gone so far.
 
#10
Thanks for your honesty, it helps to prepare me!

As long as I'm free of this thing I'll be happy, I'm tired of constant pain and flare upsand fear of sitting down!
 
#11
Just to update- I had my op on Thursday and got home from hospital today (sunday). I ended up staying 3 nights in the end, which was not what I expected. Basically the drain wasn't ready to come out until today and I chose not to come home with the drain. The main reason is that getting to and from hospital is not that easy for me, we don't have a car and have the stairs to contend with.

Things have been quite smooth so far in general. I haven't really had much pain, just a bit of discomfort. Even the drain coming out today was fine. I'm taking paracetamol and diclofenac regularly. I had my op around 10:30, was back on the ward by 1pm and managed a short walk to the loo by 5pm. I felt nauseous on the hot ward but that settled eventually.

The worst thing about it has actually been the back and hip pain I'm getting from lying on ym side so much! I've also been bored and frustrated with extra time in hospital, but my lovely boyfriend has been visiting diligently every day. I guess what has really shocked me has been how shoddy the NHS care has been at times. There were some genuinely skilled nurses on the ward, but also some downright shocking things. I don't know if it was due to it being weekend, or staff shortages (there were a lot of agency staff)

One nursing assistant (agency) kept insisting that I turn onto my back for my blood pressure measurement. I kept refusing as i wasn't inclined to lie on my wound and fortunately I was assertive enough to say no. Another nurse last night (also agency) came to empty my drain but said she didn't know how to do it. She came back hours later after my boyfriend went to see if anyone was actually going to do it. I had to explain to her how it worked and she ended up unclamping it too early and blowing air UP the drain into the wound (which did not feel nice!!!)

I ended up in floods of tears, mostly freaking out because I was convinced the air was going to damage it and turn it into an open wound. It took 2 different experienced nurses to convince me it would be ok. It was ok and I later realised i had felt the air rush back out fairly soon, it just felt so wrong! It just seemed to me that an experienced nurse should have been changing the drain or at least showing the new nurse how to do it! would've saved times anyway.

I think I've been quite negative about it all so I'm working hard to stay positive from now on. The boyfriend pointed out that I've tended to latch on to anything bad like it's inevitable things will go wrong. So i've managed to blow things way out of proportion at times (although some of the NHS care is truly shocking!!!)

Anyway, all is well with the wound so far, going to be doing daily dressings and back to clinic in a week for a check up. Fingers crossed, will keep you posted.
 
#12
awww hun, i'm glad it the op went well but i totally sympathise with you on the aftercare. it's pretty shocking.

it's like the nurses didn't even know what i had done or why i had a drain. every time one came over i begged to see a doc but never saw one until i was discharged. one stupid nurse made me get up to answer a call, not even 3hrs after i was bought upto the ward. i was like 'i really don't think i can get up yet' and she was all 'nonsense, just get up'. i made it to the phone area, finished speaking to my mum and passed out in front of them all, followed by being sick all over the reception area floor. well, she did get told off from all angles for having got me up so soon.

one of the nursers who started later was a star though. but it's very disturbing that a lot of them just go 'eh? pilonidal sinus?' when they look at your chart, wonder what your drain is for and generally have no idea how to provide the appropriate aftercare.

but the worst is over, i hope the rest of your recovery goes smoothly. just a tip, try to keep a dressing on as long you can, even if it's not completely covering. for me, it protected the area from rubbing against clothing etc. my GP nurse agreed with that and i went back for quite a while for dressing changes until i could do it myself.
 
#13
I'm glad everything is fine for you now, but I do agree the NHS system (at least the post-operation part) can be truly shocking. I had experience with some continental national health systems and compared to the NHS sometimes it looks like third world country. I mean, there is a lot of money going on, good equipment and buildings but nurses and docs sometimes look like they are out of the world. They don't know what to do, they don't have experience, sometimes they just repeat the same movement infinite times like machines without thinking!! [8)]
 
#14
Pilonidalslaughter, IAgree it seems third world and since the royal london is a listed building parts of it do look third world too!

My main concern now is when do these stitches come out? I have 3 different answers: ward nurse said 7 days (which will be weds/ thurs, so to see practice nurse), registrar said in clinic a week on mon (10 days) and my discharge letter says 14 days by practice nurse... just left me confused!

7 days seems soon to me. But I may see if I can hobble down to the GP on thursday and have the nurse take a look. The hospital only gave us 3 days of dressings which my boyfriend has been doing for me (although not very confidently after not really being properly shown how!)

Stopit, thanks for the advice about the dressings, will keep doing daily dressings for now at least. Fongers crossed for no problems!
 
#15
pineapple;72790 said:
Pilonidalslaughter, IAgree it seems third world and since the royal london is a listed building parts of it do look third world too!

My main concern now is when do these stitches come out? I have 3 different answers: ward nurse said 7 days (which will be weds/ thurs, so to see practice nurse), registrar said in clinic a week on mon (10 days) and my discharge letter says 14 days by practice nurse... just left me confused!

7 days seems soon to me. But I may see if I can hobble down to the GP on thursday and have the nurse take a look. The hospital only gave us 3 days of dressings which my boyfriend has been doing for me (although not very confidently after not really being properly shown how!)

Stopit, thanks for the advice about the dressings, will keep doing daily dressings for now at least. Fongers crossed for no problems!
I don't know for your case but 2 weeks seems ok for me (for me was like this). Seven days is too early!
This is another big problem of the british NHS: to split tasks between different buildings, teams and people. And so, each one has a different opinion on the matter. Informations are not sent to other people as well. In other countries if you have a surgery in the hospital, these post-surgery tasks are done by the nurses of that hospital and it's the same doctor the operated you that check your conditions afterwards. Here in UK one surgeon operates you, than some stupid nurses take care of you for one day; then you are sent to another center to take care of the wound; and then to a center to take out your stitches. It's a nightmare!!
 
#16
hey pineapple, do you know what kind of stitches you have?

i had dissolvable with steri strips laid across the wound. in the first week to two, i had those waterproof dressings that I kept on for three days, then would have them changed by my practice nurse. it would also give her an opportunity to assess the wound. in addition, i think in the early days, it's not a good idea to change it everyday if you can avoid it - it should be clean even when it comes off and it's best not to disturb the wound.

after about week 2, the nurse said it could come off but beacuase i was going back to work with a long train commute, i said i'd rather keep a dressing. so i got a prescription for a bunch and would put on one every morning myself (it didn't cover the lowest part) and would let it breathe at night.

i would still see the nurse once or twice a week. she only took off the steri strips when they were starting to peel a bit themselves.

i think a lot of this is down to waiting and seeing how you're healing.

i would advise building a relationship with your practice nurse/s. mine were great after the first time i went in with my drain. if i needed an appointment at short notice or anything they were very accommodating. the receptionists were aware that i had surgery and needed aftercare too.
 
#17
I'm not sure the exact type of stitches I have, just that they have to be cut off.

I wasn't planning on daily dressings but today the wound was oozing quite a lot and needed a change. I was a bit freaked out but my bf and flatmate said it doesnt look infected, just oozing. It is also much more painful since last night but I think that might be the local wearing off???

I'm seeing the practice nurse on thurs afternoon so unless things get worse I'll try to hold on unti then... bit scared though, but hopefully just pilo pananoia?
 
#18
Turns out I have an infection. Yesterday the oozing continued and by the evening I felt feverish. I took a taxi to A&E where they cut a couple of stitches from the bottom of the wound to allow the infection to drain properly.

They took swabs and bloods and sent me home with lots of gauze and tape. I'm waiting to hear from the team to see if I need to go in for IV antibiotics. Not keen to go back in but gotta do what needs to be done!

I'm a bit scared now but feeling better, I knew something wasnt quite right. It seems beter today, I'm just worried about the open bit and longer healing.
 
#20
Thanks Stopit. I saw the practice nurse today because I've given up on hearing from my team. She is optimistic that the infection will clear over the weekend so we will see. I'm going back daily for dressing changes. She was surprised that we were doing the dressing ourselves and after reading posts on here I've started to feel that the aftercare advice I have received is very bad.

I want to complain but I'm not sure if it will make any difference or get anywhere. It may make me feel better. I'm seeing my surgeon in clinic on monday so I'll mention it to him...
 
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