PILONIDAL CYST – OVERALL GOOD STORY (SO FAR)
Hi all, My name is Bryan. As of this post, it is exactly three weeks after receiving a closed-stitched pilonidal cyst excision procedure (with an attached drainage tube). I’ve just had my stitches removed today and want to share my (overall good) experience throughout the surgery.
I will start by giving some background, but for those interested in the surgery and recovery, then skip ahead. Background: Overall, I am not sure when or how the cyst developed. During grad school, I would ride my bike and take various forms of public transportation throughout the busy South Bay streets and spent a lot of time commuting. I wear moderately tight clothing, but nothing too crazy. Anyways, I did occasionally notice some pain on my tailbone, but always attributed it to sitting incorrectly or pressing too hard up against it – as in, I always thought the tailbone was just sensitive.
However, for roughly the past 5 years of my life, I would get pink-eye VERY frequently (almost quarterly). I am extremely clean and when this started occurring, I would make sure that my hygiene was at tip-top shape. The cleanliness did nothing, and many doctors attributed the chronic pink-eye to allergies. I simply agreed (because, allergic pink eye is actually a thing) and went on with my life.
About a few months after noticing I had a cyst (but before the surgery), I would monitor the drainage and not let the wound get infected. I have yet to have an outbreak of pink-eye, and it’s been at least 9 months. I still am unsure, but I believe the pink-eye was being caused by the cyst getting (internally) infected, and my body would fight off these little infections. Now, when I first realized that I had an issue on my tailbone, it was because the thing had burst. I finished graduate school and began my first job in an office environment – commuting 2+ (total) hours a day, and sitting down for 8+.
One day, about a half-teaspoon size of bloody-pus was in my underwear, but this occurred after about a month of have some strange, odd smells come from me. Needless to say, the foul smell was the drainage, and boy did it smell. I googled around, saw that the pilonidal cyst is a common occurrence, and scheduled a doctor’s appointment. During the first doctor’s visit, I was told that the cyst bursting was a good thing, to take some epsom salt baths, and to see if the cyst drained naturally. If it ever reoccured, then reschedule another appointment. I did all of this. I soaked my “behind” with epsom salts, and tried to allow the cyst to naturally drain. It seemed to work, although I had to stuff my underwear with a layer of tissue to prevent any fluid from ruining my clothing.
After roughly two weeks, I was satisfied with the results and the cyst seemed to calm down. But then, a few months later, I felt it again. POP! Here’s where I probably made the wrong move. I was a frightened that it happened again, but held on to hope that it would just take the natural course, and clear on it’s own. Over the next 6 months, I wound place some tissue squares in my underwear to collect any drainage, but had to change this almost 3 times daily. Not too much would come out, but I could easily squeeze my tailbone to shoot out some of the grossest stuff I had ever seen/smelled before.
I finally set an appointment for a follow up; who immediately referred me to a proctologist/surgeon. (BTW, I go to Kaiser) The specialist was a true professional. From the moment I said “It won’t stop draining”, he immediately responded (as if he knew exactly what I was going through) “It won’t.” He took a look at it, and within 20 seconds, identified 3 pits that lead to the cyst, and estimated how large the cyst was. He said I needed to have surgery – I would have a 2 by 3 inch chunk of flesh removed from my rear end, meaning I would be out of work for 3 weeks, doing absolutely nothing!! The recommended surgery: closed-stitch excision, with a drainage tube attached. I was devastated.
Less than a year of beginning this job, and I already have to consider going on disability. Not to mention, I also teach a night-class every semester at the local university. A three week hiatus during the school semester is just not an option. I quickly scheduled a meeting with my supervisor and the director of human resources to explain my situation. I am so grateful that they understood and told me to get it taken care of right away. I gave them the option of the summer (now a few weeks away), or during the winter break (about 6 months from then) so that it would not interfere with my teaching. They didn’t hesitate – as soon as possible. They helped me with getting any necessary work done beforehand, and helped with any paperwork/forms that I might need regarding the disability. As a side fact: when I started telling people I needed surgery, not only did my father come out, but so did two of his brothers, and my grandfather. They all had the same exact issue (around my age, mid 20’s) and had to get it lanced and drained, twice!!
None of them had mentioned this to me before, although to be clear, I never even asked. Surgery: My surgery was scheduled for July 14 (Thursday). It was very interesting, because I didn’t talk with my surgeon at all for about a month (the time from me scheduling it, until the day of the surgery). I spoke on the phone with various medical assistants, and had a lengthy interview with the anesthesiologist, to make sure I would be healthy enough to receive the drugs. I had to get some blood work done, but all of this was protocol.
I had planned to stay at my parents – house (about 2 and 1/2 hours away from the medical center) and my mom would drive me to surgery, then home. On the day of the surgery, I arrived around 9:00 am. By 9:45, I was in a bed with a tube in my arm, watching CNN. About 5 different nurses came in, introduced themselves, and did whatever they needed to do to prep me. I get a bit squeamish, so I tried to focus more on the TV to detract from everything else. By 10:45, I was being wheeled into the surgery room and had been administered some preliminary drugs. I met the entire team that would be in on the surgery( about 4 to 5, plus 2 (cute) medical students – accidentally checked the wrong box! ). That’s the last thing I remember. I woke up about two hours later and immediately blurted out: “Did I snore”? The nurse who was attending to me, said “Shh I won’t tell anyone,” checked my vitals, and gave me some apple juice and crackers.
My mother ran to the pharmacy to get my prescriptions and about 20 minutes after I woke up, she arrived at my bedside. I was prescribed a week’s worth of Vicodin and some stool softener pills. After the drugs subsided, I was wheeled-chaired out and picked up by my mother. I sat in the passenger seat, with the back tilted nearly all the way back, and had two pillows underneath me. Kaiser graciously gave me the pillows. The 2 and 1/2 hour drive wasn’t too painful, mainly because I still had drugs flowing through my body. With that being said, it definitely was uncomfortable, but nothing unbearable. Post-Surgery: During the surgery, I received 5 stitches and a tube that ran through the cavity to allow for drainage. The tube was wrapped around a gauze roll (probably 2 inches in diameter), which was then stapled (?? or stitched) to my butt cheeks. Over this “bolster” was about a 6×6 inch square medical pad that was taped on.
I was told to come back for two follow ups: a 1-week follow up to get the bolster removed, and a 3-week follow up to get the stitches removed. Yes, this means I had a 2 inch diameter, 5 inch height gauze tube “roll” stapled into me, located at the crevice of my rear end, going down the crack. It was hard to walk. I could only lay on my stomach. And it was quite painful. I took a Vicodin pill every four hours – not because that’s what was recommended, but because the pain would come back as soon as the meds wore off, and I needed them. The bolster being stapled to me was by far the worst part. I could change the dressing (the pad) over the top of the bolster, but was told not to touch the gauze roll or tube. I could shower, but had to (this sucked) put saran-wrap around my private parts to prevent the bolster from being completely immersed with water. The bolster looked disgusting, and had some blood, pus, and other fluids soaked into it, but this is all natural and nothing out of the ordinary. Oh, and bowel movements. The Vicodin had me plugged up for the first 80 hours. I didn’t eat much anyways, but I was really regretting this part of the ordeal.
When I had my first bowel movement, it was hell – and maybe the stool softener worked, but I couldn’t tell. For starters, during bowl movements (I think?) blood rushes to your muscles and organs in that area, which cause some things to move around – in a very uncomfortable way. Additionally, the fact that I was constipated meant that I had to force a â”soda can” out. That wasn’t fun. To be clear, the anus was still about 3-5 inches away from the end of the bolster, so I was not worried about interference from the tube, the gauze, or the stitches. The main source of pain was from the fact that I was sitting and defecating for the first time. Bowel movements after that didn’t seem to be too much of a problem, minus the occasional pain here and there. To sum up the first week: A lot of Netflix (tangent: check out Stranger Things), I was drugged up, and basically laid on my stomach the entire time. Walking and pooping were about the only activities I could do, and neither were pleasant.
My parents were extremely helpful. They cooked and made sure I got everything I needed, but they didn’t have to do anything gross or invasive. I was ready to get the damn thing off of me and couldn’t wait until then! A week later, we had to make the 2 and 1/2 hour trek once again. This was definitely worse than the initial surgery-day-ride-home. I had to lay in the back seat, which was very uncomfortable, and the swelling of the wound was painful. When we arrived, the doctor removed the (four) staples that attached the bolster to me. This was extremely painful. The gauze portion was removed and he showed it to me. It didn’t smell good. He threw it away and proceeded to remove the tube. Now, I have to admit, I have never felt anything like this before – it was definitely painful, but probably more uncomfortable than anything else. It was over in less than 10 seconds, and WHAT A RELIEF!
I was told to keep resting and have very limited activity, and to expect drainage from the wound for the next few weeks. I felt so good that my mother and I went down to the cafe and ordered a sandwich and coffee. I was able to sit in the front (passenger) seat on the way home, with a little bit of pain and a small amount of drainage. The next follow-up would be in two more weeks. During the next two weeks, I saw great deal of improvement. I did not need the pain meds anymore, I was able to take my parents’ pugs on walks (only around the block) and was able to transition back into sitting (for short periods of time). I was also able to finally sleep on my sides, however for the most part, I played it safe and continued to watch Netflix and vegged out, mainly on my stomach. I mean, I was getting paid for this.
About 4 days after getting the bolster removed, a bowel movement occurred and when I went to sit down, a red-yellow-clear watery fluid drained out from the wound area. I was quite frightened because it was about a tablespoons worth, but I quickly remember the doctor’s advice. It happened again while I was sleeping, ruining a pair of basketball shorts and continued leaking for the next few days. I could “press” on the spot above where the wound cavity was, to get this “squish” noise and the fluid would squeeze out from further down. I was worried and e-mailed the doctor, but he said this was completely normal. Expect the drainage, and don’t be afraid if it looks like a lot. Just monitor the colors – if the fluid ever gets greenish or thick, then you may have an infection, which is extremely serious and needs to be taken care of immediately. I had my mom buy some feminine hygiene pads and would wear those in my underwear (I guess I’m a heavy flow). I also purchased some Tucks hemorrhoid pads (with Witch Hazel) to help keep the area clean and safe from infection.
About 16 days after the surgery, I was able to drive for my first time around the block, but I probably could’ve done it a few days sooner. The next day I went for a 20 minute drive on the freeway, without any problems (but a bit of the expected drainage). To sum up the second and third week: A ton of progress. A few of my friends came up to visit and we barbecued and I was able to walk around and even have a couple of beers. I helped my dad change the oil on the car (although, I didn’t do a whole lot), and I was able to run errands with my mom.
Much more Netflix and a ton of sleep. The day before my follow-up, I was able to drive back to my apartment so that I could easily commute in the next day. As a side note, I was able to get all of my upcoming semester notes/quizzes/homeworks finished, so I am all ready for the next semester! They don’t stand a chance. Which brings me to today. I woke up and drove to the doctor’s office for my second follow-up. There was very minimal drainage at this point, and almost no pain. The stitches were always a bit uncomfortable, but nothing I couldn’t handle. Upon arriving at the doctors, he checked everything out and said it looked fine and the healing process was normal. The stitches were removed, with surprisingly little pain. He told me to monitor it and refrain from exercise for another week or so. After that, slowly begin stretching and working out at a limited pace, until I feel comfortable getting back into things.
I love to play ultimate and run, but will probably lay off that for another month or so, and will continue to have a gingerly approach to movement. Soon enough, though.
Summary: I wanted to post this to show that there are some good experiences with the surgery. That being said, this is only day 21. The doctor said that there is a 3-5% chance of reoccurrence, however I know there are many of you out there who have had horrible, chronic issues. Each of my family members had the cyst lanced and drained (twice, each) and the cyst never reoccured. I am crossing my fingers (and praying) that it will not reoccur on me as well.
As a side note: I often said things like “bit uncomfortable” and “not too bad”, but I have to admit I do have a high pain tolerance. At the dentist, I do not get numbed prior to having a cavity filled, as I am more afraid of passing out from seeing a needle than having to deal with the pain of a filling. But the pain really wasn’t too bad, other than the first week. I hope that nobody has to deal with this, but if you do – stay optimistic. Don’t be embarrassed by your condition, because honestly, it can’t really be prevented. It just happens. People will try to feel sorry for you, but if you just joke around and act normal, people will know you’re just doing what needs to be done.
I can’t wait to use it as an excuse next semester to try to get sympathy points when I make my classes – test too hard! Haha just kidding.