So this will be long, but I really encourage you to read this. I want to share my experience here in the hopes that some of you will find some comfort or understanding in what you are going through by reading about my experience.
First off, you came to a good site. I am really grateful to those who put this site together because it has been a great resource for me throughout the entire process. It also answered a lot of the major questions I had. One recommendation – add Dr. Marshall Cross as a doctor for the Hampton Roads area of Virginia. He is an excellent surgeon and you will see in the rest of my story why his expertise and knowledge made such a huge difference in my experience.
That being said, I’ve read so many horror stories. Not just on this site, but on others. While I understand that each person’s experience can be different and that some people have been through a lot, I wanted to share a positive story because I think those are lacking. If you read no further, just take these few words of advice if considering surgery. I wish someone had told me this:
1. Choose the BEST doctor. And I mean the best. My doctor truly made a world of difference.
2. Consider choosing a doctor that is expertly skilled and confident in performing flap procedures. This was the best option for me as I did not want to have an open wound, and it might be a good option for you.
3. Embrace the drain. If your surgeon wants to put in a drain (and if they are doing a closed incision, they really should) then LET THEM! The drain may seem scary, but it is what pulls the blood from your incision and ensures that you do not bleed at your incision site. I’m pretty sure it also reduced the chance of infection.
4. If you do have a closed incision and a drain, don’t be afraid when they have to be removed after 2 weeks. I was terrified, but believe it or not it did not hurt at all. I wish I had known that and I would have been so much more relaxed.
5. If you do get a flap procedure, keep it clean, clean, clean. I showered every day after my surgery and after about 3 weeks, I started taking a washcloth in the shower, putting Dial antibacterial soap on it, and softly washing the incision. This really helped ensure I did not get any kind of infection. It also helped reduce a slight rash that had appeared. Finally,
6. Stay calm and positive throughout your experience. This will help you heal faster because you are allowing your body to completely focus on healing and not wasting time by becoming overwhelmed with stress and worry.
If you choose to read further, which I hope you will, here is my story – I’m 26 now, but I first noticed that something was wrong about a year and half ago. One day I just started feeling extreme discomfort when I sat. The pain eventually went away. A few months later, I noticed it again. This time it got worse and eventually when I wiped the area, it was oozing and bloody. It must have abscessed, but at this point I had no idea what it was. It healed and the pain again went away.
Finally, the last time it started hurting, about 3 months ago, my husband encouraged me to go to the doctor, which I should have done sooner. So not knowing where to start, I decided to see my dermatologist first. My dermatologist took a look and remembered learning about pilonidal cysts. She saw two holes the size of pin pricks at the top of my butt crack and thought that it could be the sinus of a pilonidal cyst. She did not want to mess with the area until I consulted a surgeon to make sure that’s not what it was. So she referred me to a general surgeon in my area. Little did I know this was hugely important to my experience.
My surgeon was not just any surgeon, but truly the best in the area. You will see why – I immediately went to see the surgeon. He instantly knew it was a pilonidal cyst and told me that the decision was truly mine. He said he could not guarantee that the cyst would ever return, but it likely would unless I had surgery. I didn’t have to have it right away, and I could even wait until next year. He said that when he did perform the surgery, his patients have a less than 5% chance of a reoccurrence. He also said that if he did perform the surgery he preferred to do a flap procedure on me. Unlike an open wound, the flap procedure would allow him to use extra skin from my butt cheek to close the incision.
The great thing about this is that the wound care is a lot less involved and from what I heard from others, it is less painful. I also feel that it is less prone to infection because everything is closed. I was shocked. How could this happen to me? I had been in perfectly good health and didn’t understand what could have caused this. The surgeon assured me that there really is no known cause and it is one of those things that can just happen.
For those of you that feel this way, know that it is not the end of the world. It is much easier to make the best decision for you when you are relaxed and calm. After I calmed down, I discussed my options with my husband. We both decided that surgery was the best course of action, because I wanted to solve the problem and I felt that surgery was the best guarantee that I would not have to deal with the pain any longer. Lancing it or waiting until the next flare up just sounded like I was prolonging the inevitable. We also decided to schedule the surgery in the next coming weeks and get it over with. I worked out a schedule with work where I could work from home during my recovery.
My Flap Procedure Surgery The day of the surgery quickly arrived. I thought it would be a very long process, but I was truly only in the hospital for maybe 4 hours. I get motion sickness easily so the prep nurse asked if I wanted a patch to help me from throwing up from the anesthesia. I took it and was glad I did! After a few words from my doctor, I was ready to head into the OR. I was curious as to whether they first put you in position before you go under, but they did not. They simply let me lay on my back in the bed and then gave me the anesthesia. They said they would put me in position once I was out.
Next thing I know -waking up. I felt some discomfort and pain when waking up, but they quickly gave me some pain medicine through the IV. Problem solved. Before closing, my surgeon also put a liquid over the area numbs any pain for about 8-10 hours. I had dissolvable stitches under my skin and then 21 stitches on the outside, including two stitches that held the drain in place. The drain worked to suction the blood away from my incision site. And no, you do not feel the suction of the drain. One of the things that really made me appreciate how good my surgeon was is that he did not hesitate to really clean the area that he removed. After opening me up, he put a dye in to see where the roots were. This is what he had to remove to ensure that I do not have a reoccurrence. He ended up taking out more than planned, but this was to ensure that he got all of the roots and left a clean margin.
My Recovery After a Flap Procedure The recovery is truly the important part. The surgery is the breeze. The recovery is where you have to do everything right. This means following the doctor’s orders, listening to your body, and keeping the incision clean. My surgeon told me to expect needing a recovery time of 4-6 weeks. He was so right. It was not until after 6 weeks that I truly felt that it was time to return to work. I had an interesting experience with pain medicine. Oxycodone and Vicodin both caused side effects for me that I was not worth the pain it took away, so I decided to just take aspirin. This worked for me the best. I took it about every 6 hours for pain. I also showered every single day. Just to avoid getting any hair stuck in the incision, I made sure to flip my hair over and wash and rinse it in that position to avoid that problem. You might also be curious as to how to shower with the drain. The best solution for me was to remove the belt from my shower robe and use that to tie around my waist. Then I could hang the drain from that when I showered. Just be sure to wash the belt every day. I was worried about whether or not showering would be painful, but it truly did not hurt. I simply let the water fall over my incision and allowed the soap from when I washed my back to wash over my incision.
After 3 weeks, I was able to directly clean the area using a washcloth. After two weeks, the drain and stitches came out. I did not feel a thing during the drain removal and only felt slight discomfort when my surgeon took the stitches out. He walked me through the entire process and even told me some jokes to calm me down. He had to remind me to breathe and it was easy to see that he really cares for his patients, not just when he performs the procedure, but in each follow up appointment. One of the major questions I had was: how do I go to the bathroom after surgery???
The advice on this site is simply spot on: you just do it. It’s true. Somehow you just do it. The first week or so I had someone help me get to the bathroom and let me hold onto them for support. This is where mothers, fathers, husbands, wives, girlfriends, boyfriends, and friends come in – they will truly be your support group. I know my family was. But back to the bathroom – go to your local pharmacy and invest in a toilet seat cushion. This was helpful at first, but after a short time, you won’t even need it. I think I sat on it a few times and then after that I used it as a prop behind my back to hold me forward which was more comfortable.
As far as sitting goes. I didn’t truly sit until 5 weeks after surgery. Don’t be concerned because my body may be different from yours. I heard stories of people sitting within a week or two after surgery. Bottom line is that you need to listen to your body and do what is right for you. I was either laying on my sides or on my stomach. I did have some bad hip pain and back pain for about a week or two, but after awhile you learn how to cope.
My husband bought me a body pillow that was a great investment. I had my last check up about two weeks ago. It’s been a little over 2 months since my surgery. The doctor gave me a clean bill of health and I am still healing. A few weeks ago I noticed a black area on a small part of my incision. Not worried, I went to see my surgeon. He said that is likely an internal stitch that my body rejected. The stitch is probably gone, but what happens is the body forms a pool of blood at the surface as it tries to reject it. He had to make a very small cut to alleviate the area and then put silver nitrate on it. I won’t lie that it did hurt, but now I am back on track with my healing. The few seconds of discomfort was worth it.
So there you have it – my experience. It was truly an experience, but not a horror story. It’s possible to go through something like this and find the positive in it. And I will tell you that after you experience something like this you are not worried about a scar, all you want to do is heal. That’s what I’m doing now, and I know that within a few months I will be completely healed. I can put a check in the pilonidal cyst block 🙂