My Journey to Freedom from Pilonidal via Pit Picking
I’ve logged in after over a year of my treatment (can’t believe its been a year already) and been completely disease free (can’t believe that either – but happy). It has been such a huge stress in my life and right now, as I write this, looking back at the hours and hours that I wasted hiding in the bathroom waiting for drainage to end, the pain, the constant threat that it can show up at anytime, anyday. I’m ecstatic to be free from that finally – actually for over a year now!
This forum had been really crucial for me in understanding the disease and some members were really helpful in providing their feedback/surgical experience. It’s only fair that I contribute back and hopefully, someone can benefit from this.
My Story: Like most people here, it started with what seemed like a pimple on the butt and, in my case, since I did have face and back acne, I just chalked it up to another one just showing up at the wrong place. The first time I noticed one was back in 2010, then about a year later. Both of these were just like another pimple on my body i.e. inflammed bump that relased pus when it drained and done. 2012 is when I got the real shocker, it got real big, about the size of a quarter and when it popped, it drained for almost an hour. That’s when I suspected, something isn’t right and hit the internet. After about a couple of hours, it was pretty clear that this is case of Pilonidal cyst. Although, fortunately, I never had to go to an ER – like many people on this site. It started to get worse, every month it would inflame to a quarter sized pimple and then drain for several days.
Too embarrassed to go to a doc and too scared by the horror stories online. I decided to do nothing and just stick with cleaning the area everyday. Luckily, for the most part of 2013 and 2014 that worked very well. I maybe had 7-8 flare-ups in those two years. My only concern back then used to be that hopefully, it won’t flare up while I’m on vacation. Guess what happened in 2015?
By Spring 2015, I had two flare-ups already (which was unusual) but just when I was getting ready to book a flight out of the country, I felt that familiar sensation of an oncoming flare-up and I knew that for the next 7 days its going to flare-up, burst, and drain – which is going to be an issue since I’ll be outdoors most of the time. Leaving me with the only option of cancelling my trip. I was infuriated with myself for not taking care of this sooner and being able to lead a normal life. That’s when I started researching this disease again and scheduling a treatment.
Ouch! In my search for The Cure, the first thing that became apparent was how uninformed most doctors are about this disease and some medieval procedures with high recurrence are still the norm. Since, I’m a single working guy. Being able to take months off of work just wasn’t an option for me, not to mention no body to help with changing wound packing etc. So I decided to start off by getting in touch with surgeons on the list. I live in SF Bay area and I called a local surgeon who seems to have quite a few positive reviews here. I won’t name the surgeon, but my first and only visit with him was horrible. The clinic was not as nice as I would expect it to be (kinda shoddy). The doc came in half an hour late, looked at my butt for 5 seconds and then spent next 10 mins explaining to me why cleft lift is the right procedure for me. When I asked him about the Pit Picking procedure he got agitated for some reason and said that for me Cleft lift is a good option and told me he had to go see other patients. This for me was a huge red flag and I felt very uncomfortable, so decided not to see that surgeon anymore. I know some people here also recommend cleft lift, so you can just be done with it, but after having seen pics of it, I personally would rather try Pit Picking first.
Unfortunately, that meant I had to look outside the area, which meant travel expenses and on top of that possibly paying more for an out of network provider. Here’s where things got a bit positive. Since, I have Blue Shield of Ca healthplan, it turned out that a doc in Los Angeles, who is also on the list, is in my network. That basically meant that other than travel expense I wouldn’t have to pay extra for the procedure. I got in touch with him as well as Dr. Bascom’s office (to get his opinion) and was told by both that if I can email pics of the area, they will be willing to discuss my case over phone, that would save me some more money. I did something that I never thought I would do, take out my dslr and started taking pics of my butt in various lighting conditions with cheeks spread and all, real glamorous stuff! Sent them off to both docs.
Few days later, they both called (on different days obviously) and discussed my case. Luckily, both said that my case looks rather straightforward and that Pit Picking should be enough. Even though Dr. Bascom is a known surgeon when it comes to pilonidal treatment, him being in Oregon meant him being outside of my Blue Shield of CA insurance (i.e. out of network provider) and longer travel time. So I decided to stick with the surgeon in LA. However, it turned out that he was going on vacation, so I had to schedule for a month later. Later I found out that while the doctor was in network, the surgery center wasn’t, so I would have to pay more for that.
During that time, I was in contact with Dr. Bascom’s office and by stroke of luck found out that Dr. Bascom would be considered in-network provider and so would be the hospital because my insurance is part of Blue Cross Blue Shield network. I immediately cancelled the surgery at LA and scheduled it with Dr. Bascom.
Pit Picking 2.0: During my research into Pit Picking, since that’s the treatment I was primarily interested in, I did a lot of research online and one of the most interested variations I found was this one:
The original Pit Picking method as described by Dr. Bascom I, actually talked about cleaning out the sinus and picking pits i.e. cutting out the enlarged follicles. The problem with this is that if a hair or debris remains, then the pilonidal will return again. The technique in the video, however, removes the entire sinus – the video is pretty self explanatory. During my phone call with Dr. Bascom this is the procedure we had discussed. At that time, it seemed like Dr. Bascom was interested in performing the original procedure, however, on the day of the surgery, he performed the one in the video – more on that later.
Surgery: In one line, it was an amazing experience. Dr. Bascom, the staff, the facility everyone and everything is top notch. If you can have this procedure with Dr. Bascom, then do it, don’t waste your time researching other doctors.
On the day of the surgery, I arrived at Dr. Bascom’s office and was greeted by very friendly staff and a nurse took me to the office – it’s an out patient procedure. Dr. Bascom came over took a look and said that I don’t have a deep cleft and it seems like there is one pit and one drainage point, so hopefully Pit Picking should take care of it for good. This was great news for me right there! Then Dr. Bascom left to see other patients and the nurse prepped the area for surgery (shaving, cleaning and numbing etc). Few mins later, Dr. Bascom came and like a pro got to work. Honestly, I didn’t feel a thing! other than minor tugging, pulling sensation. I think the whole procedure took 10 mins total. When Dr. Bascom was done he said it looks like its going to be fine. I asked him if there were a lot of hair/debris in there. He said that he actually took out the entire sinus, he then showed it to me – it actually looked just like that thing in the video, except with no blood. Interesting thing was that Dr. Bascom pointed to the white stuff all around the sinus and told me that’s all fat and that means there aren’t any other tracts. That was just icing on the cake for me!
Dr. Bascom then stitched the middle part and plugged the draining hole with Aquacell (?) which basically absorbs serous fluid and prevents the opening from closing prematurely. That was it!
I went back to my hotel room and other than a lot of blood/serous drainage – which I was told about, there wasn’t any pain at all. Next morning, I took a shower, just like I normally do and went for my check-up with Dr. Bascom. He looked at the wound, told me that I was healing fast, replaced the dressing and aqualcell and I was done.
From there on it was just a waiting game, I followed the dressing instructions provided by Dr. Bascom’s office and ate a healty diet plus relaxed! 2 weeks later the wound had healed up perfectly and other than minor redness there was no sign of any surgery, scars etc.
Its been 14 months since I had the surgery and I’m glad to say that I have my normal life back. I haven’t had any issues whatsoever, whether with flare-ups, pain and/or wound healing. The only routine I follow is to clean the cleft area daily with soap while showering and hopefully, this disease will stay away from me forever!
Cleaning & Care: One word of advise, make sure you don’t use any anti-bacterial liquid soap. With the ban on Triclosan, the only antibacterial being used in soaps is Benzethonium. While it is a good antibacterial, it does attract hair/skin, which is the last thing we want in our case. So just use a plain old liquid hand soap and clean your cleft with that.
In Summary: Go with Dr. Bascom, if you can. Don’t waste your time with regular docs they don’t have a clue. Had I known about this new technique with literally No downtime, I would have had this taken care of back in 2012 and moved on. I’m still glad and happy the way things turned out. Hopefully other people will benefit from reading this.