~URGENT ~ Pregnancy and Pilonidal Surgery

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Hi all... any comments / experience / advise on the following will be highly appreciated:

I am pregnant with due date in 7 weeks. I am a Canadian living in Toronto. I have had the cyst for a few months and was referred to a surgeon by my family doctor. I met with the surgeon today and the surgeon has scheduled me for a surgery for May 1. Initially, I had planned to consult the surgeon and have surgery scheduled till after the baby has arrived. However, the surgeon mentioned the following:

1. I should get the surgery done before I deliver, otherwise I will not be allowed to take Epidurel during birth as it could interject with the cyst.
2. The healing time will be 8 weeks, but I could go to work in 3-5 days.
3. I will need to take Tylenol 3 after surgery and Tylenol 3 and the surgery will have no affect on the baby in my womb.

After my appointment with the surgeon today, I started researching and came across this website. I see people going through a lot of pain and I get chills thinking what this process will do to me and my baby during pregnancy. I am really confused: 1) Trust the surgeon and get the surgery done, while risking extreme pain during pregnancy and any risks of taking medications such as tylenol 3 , or 2) Continue as is and go through birth without epidurel.

Any suggestions (especially for women who considered or got surgery done during pregnancy) will be highly appreciated. I do not have much time so I have to make my decision asap.

oh my goodness. this must be so confusing for you being pregnant and having to make such decisions right now.

i did get my first pilonidal cyst during my first pregnancy. right towards the end and it was misdiagnosed as a coccyx bone dislocation due to being pregnant. my doctor didn't even look at the spot. he just had me point to where it hurt and diagnosed me with that.

i had no trouble delivering with my cyst and getting my pain meds during delivery. it was never even discussed and i'm very confused as to why that has any bearing on your cyst.

if it were me i would wait till after delivery and i would get a second opinion on the epidural. that sounds a little fishy to me and i wouldn't settle for one surgeons opinion.

anyways, i wish u the best of luck and i hope someone here can offer u better advice than i have for u.
Hi Cricket1.... Thank you for responding so quickly. The surgeon said that epidurel is injected through the back and they won't do it given the cyst is close to the epidurel space.

I am also afraid that my cyst may baloon and it could then become hard for me with the baby. In Canada, the wait times for such operations can be up to three months! I got lucky with the appointment.

I am not sure what to do!!
another thing to possibly consider is that by the time u give birth, you'd be only six weeks post op and could already cause failure of surgery due to the pressure there is in pushing out a baby.

its hard enough to keep these wounds intact thru activity, bowel movements, etc. i would definitly ask your surgeon what the chances are of a successful outcome after trying to deliver a baby with a fresh surgical site.

it was weird because that had never even occured to me until my husband was reading over my shoulder and was worried about it. hes wandering if u couldn't try to find an alternate pain med for delivering. i get something called an intrathecal moriphine. it works beautifully and allows full mobility during laber but none of the pain.

is this your first pregnancy?
Wow, what a difficult situation! I would be really careful with this one and get a second opinion if you can (though also being from Canada, I know how hard it is to get an appointment with anyone). My concerns are:

- 3-5 days back to work afterwards? It sound like you're having an open excision. Two weeks is more realistic for this (you will have a draining wound that although packed, does not make things comfortable).

- It took me about 3 months heal and I wasn't several months pregnant. Your body uses a ton of energy to heal these open wounds. My concern would be what this would take away from the baby. Also, with the extra pregnancy weight, there will be more pressure on that area and it will be harder to heal.

- Tylenol 3s during a pregnancy? I would definitely research that one carefully. They have codeine and that's powerful stuff.

If your big concern is the epidural, then it may pay to meet with a person who actually administers epidurals. They are pretty creative and can often work around things like herniated discs, for example, so the cyst may not be as big a problem as it sounds.

Good luck with all of this.
My pilonidal arrived during my second pregnancy and I was advised to have surgery after I had given birth. It didn't interfere with my having a spinal block (I had a caesarean section).

I really feel for you hun xx[o+o]
I can't think of a way that a pilonidal could be part of the epidural space and keep you from having an epidural during labor/delivery. The spinal cord itself ends at L1-2 in the lumbar spine. There are still nerves that run down, but the epidural, by definition, goes into the epidural space. Get another opinion on this. There is about 4 inches difference in location of L1-2 and the coccyx.

I don't think I'd want the surgery before giving birth, though.
I have a lot of sympathy for you. For some reason pilonidal cysts seem to commonly first appear when a woman is pregnant and it's so unfair! Must have something to do with the hormones. Yet another reason why pregnancy is hard on the body, as if you need something else now. [:^]
I would lay off on the surgery though. that's just me, but I imagine that all the medications that go into your system for the surgery, not to mention the T3 will not be good for the baby.

As for not getting the epidural, don't count on that as being the best thing anyways, not all women can even get an epidural, depending on how fast your labor is. Also sometimes it doesn't work as well as they say it will and youre still in pain. Also (this agin is my own personal opinion) epidurals are scary, playing around with your spinal nerves. I know it's rare, but it can happen that a person can become paralyzed either temporarily or permanently from this. It happenned to a woman in my city (Winnipeg, Manitoba) in 2006. 5 weeks after giving birth, she became paralyzed. I would say be grateful that you can't have an epidural. If all those drugs to have surgery on the cyst are safe, then use those drugs up for when youre in labor.

If your cyst is active now, have it lanced/drained, and sit in sitz baths (epsom salts) and then when youre finished breastfeeding, look into getting the surgery.

I wish you all the best in this situation. This is something that the obstetricians never tell you. (This happenned to me too, I had the pilonidal cyst all my life, but it only flared up for the first time when I was pregnant, I had to get it lanced (sans pain meds OUCH!) and I just recently had the surgery.[oyo]
Dear all ....

Thank you so much for such valuable information. I now have a better perspective on things and your opinions help me ask the right questions when I go to get a second opinion.

I have taken your advise and am getting second opinions (can't get from another surgeon) from my family doctor, my mid wife, and the Ontario Health help line. I will keep you posted.

This forum is a blessing!!!
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