Looking for recommendations near Atlanta, Ga

nursemom

New Member
My 15 year old son has a pilonidal cyst/sinus which became evident last fall. We consulted with a general surgeon about options, but after reading the forum and other resources, I am very interested in pursuing the cleft lift procedure. I know choosing a surgeon is very critical to the success of the procedure and I'm worried about finding someone with experience. I found a listing for a Dr. Hope Rasque, MD in Atlanta, who supposedly performs the cleft lift procedure, but haven't been able to find anyone who has had the procedure performed by her. As you all know it is a sensitive and difficult thing to deal with, even more so for an adolescent. I'm hoping to have it taken care of this summer during his down time so that hopefully he can be back to normal for school to start in the fall. There have been a couple of flare ups and it is just a stressful and uncomfortable condition. Thanks in advance for any help or recommendations. We are willing to drive for a a good surgeon.
 

ATL85

New Member
Since your posting were you able to see Dr. Rasque? I've made an appointment with her for next week since she was also the only doctor in Atlanta I could find referenced to the cleft lift procedure.
 

nursemom

New Member
We have seen Dr. Rasque and have surgery scheduled for July. I was very impressed with her during the appointment. She seems knowledgeable as well as thorough and I have a lot of confidence that she knows what she is doing. She is going to do the cleft lift, which she referred to as the cleft shallowing. I will be glad to report the results of the surgery in July. She was the only one I could find in Atlanta that seemed to have extensive experience with the pilonidal cysts and the cleft lift.
 

ATL85

New Member
That's so great to hear and best of luck to your son. I wasnt much older than he was the first time I had an issue and I know how frustrating and embarrassing it can feel at that age. Unfortunately the issue I thought was resolved when I was 19 has reaurfaced now that I'm 31.

I have an appointment to see her on June 6th after the last surgeon I saw refused to accept any other method of treatment that wasn't excession with open healing. When I tried to explain I had just moved to Atlanta and the specifics of my situation I felt like he never even listened to my concerns.

Had your son ever had pit picking or another more conservative treatment before?
 

nursemom

New Member
He had not had a pit picking, in fact, when we went to our appointment, I was hopeful she might suggest that. He hasn't had the cyst long. He started having some discomfort last fall, but I didn't fully pick up on what was going on at that time, then in early December, he asked me to "take a look"... I'd never seen anything like it and had no idea what to think. It had ruptured at that point and was draining quite significantly.

I'm very thankful for the internet though b/c his primary Dr. sent us to a general surgeon and thanks to all the online resources, especially this forum, I knew his plan would not end well. That Dr. also did not listen well or thoroughly examen the area, so I wondered how he could be sure he was suggesting the right solution. Dr. Rasque did a very thorough examination and reported that he had some pretty good size sinuses and she felt the only way to really take care of them with any hope of permanency is the cleft lift. My experience in helping him deal with the drainage and issues over the last couple of months coincided with her examination.

I've been really surprised at how difficult it was to find a surgeon I felt comfortable with handling this situation in a big city such as Atlanta, with all the great hospitals.

I'm sorry that you have had to deal with this more than once, it is truly quite a challenge. I've also been quite surprised that I got this far in life and never heard of this considering how relatively common it is.

Please report back after your appointment and let me and everyone else here know what you think- especially since you've dealt with this before. I spent a lot of time on this forum reading before I ever made a post, so I know that people out there are learning a lot and getting great first hand info passively- it has been a great resource for me.

Good luck next week!
 

LILLY

Very Helpful
This is good news. There haven't been enough options for cleft lift in the southeast. Good luck and let us know how it goes for both of you.
 

nursemom

New Member
Post Surgery update:
It has been awhile since the surgery and the whole process has been a real roller coaster ride. I'm afraid at this point we're not 100% done yet.

Originally Dr. Rasque advised doing a cleft lift, which made perfect sense. When we went back for our pre-op evaluation in June, she reassessed and thought that we might be able to get by with something a little less drastic as the sinus did not appear as extensive as she originally thought. She recommended the Bascom's lateral incision, where she would cut off the midline go in, scoop out all the affected tissue, put a couple of sutures on the midline (though not cutting externally there) and then let the incision heal open, by secondary intention- which involves packing. She said this would be simpler and a much quicker healing time, but since she was not actually changing his anatomy she recommended following up with laser hair removal as soon as possible. He was excited about this option because she thought he would be able to return to sports and normal activity more quickly.

Day of surgery everything went well, but when she got in there it turned out the sinus went further than she thought and she had to make a bigger and deeper incision. As a result, we had to go to her office the day after surgery for instructions on wound packing. If you have not gone through this, let me tell you it is far more daunting than any office explanation from a surgeon can ever prepare you for. I am generally not squeamish at all, but this process initially had me light headed and wondering if I would be able to handle it. Though, since my son was face down on the table and I didn't want to alarm him, I did my best to keep a cool head. For the first few days, the wound packing was quite a challenge and we looked into a home health nurse, but there was no one in our area who would come out- reportedly b/c he is considered pediatric- at 15. He also had a very bad reaction to the percocet given for pain. It made him nauseated, dizzy, on edge and paranoid. Once we figured that out and got it out of his system things improved dramatically.

The wound healed fairly quickly considering the size and depth and I learned a lot about how to do it and have a million tips and suggestions for anyone else going through this. I won't share it all here, but if you have questions, please feel free to message me. I think I could save you a lot of headaches.

We are now at almost 2 months post surgery and the primary incision has pretty much fully healed. He's been back at his normal activities for around a month and feeling pretty good. The only issue we've had is holes opening on the midline. This is a tricky thing to assess and handle. The first one opened a little less than month from surgery about two weeks after she took out the midline sutures. It completely freaked me out. The doctor used a silver nitrate stick to cauterize it and then I had to pack it with a wick to let it drain and heal from the inside. I thought my son was going to lose his mind from the continued processes, but it took a little over two weeks and that closed.

We were finally just putting a small gauze over the original incision to keep it clean, when on labor day, I noticed another VERY small hole on the midline. It was bleeding, just ever so slightly and I could see the tissue below. So, I got the area cleaned and shaved and put a very small piece of dry antibacterial packing strip over the hole and then covered it with the silk wound tape. Within two days it had closed. I have continued to keep the tape on it for the last week because I am hopeful that the skin is just weak and not fully healed and the tape gives it some stability through the daily activities allowing healing, HOWEVER, I and the doctor are concerned about the possibility that she missed a pit. And there in lies the next section of this crazy roller coaster.

Dr. Rasque is changing practices and won't be available at the new place until mid-October. We could see another dr. at that practice, but it is over an hour from our house and requires missing classes and other complications, so I'm trying to avoid that. In addition, he is really about done with having his mom looking at his posterior, taking photos and trying to figure this ever changing problem out. At present, I am wanting to start the laser hair removal as soon as possible and just keep an eye on the midline. But, the possibility that a pit remains is very real, so it niggles at the back of my mind constantly. It is not red, swollen, painful or draining, it just looks like newly healing skin. Though it is very hard to tell...

Overall, we were happy with Dr. Rasque and I still have faith in her knowledge of all things pilonidal, but anyone who has gone through this knows that it is a constantly moving target and every situation is different. You have to stay on your toes and be prepared for complications. My son, is actually less optimistic than I. He feels like the whole thing has been an excruciating nightmare and at the moment, he'd rather go back to his presurgery issues. I think that is coming from a short sighted 15 year old. And also he didn't have much pain prior, the draining was intermittent and it was more of an irritation. It didn't require constant attention from mom. Also, the return to sports after the surgery was a couple weeks longer than originally anticipated, so that was big for him.

Hopefully this is helpful to anyone in the Atlanta area and anyone else going through this craziness. If anyone has any experience with missed pits, I'd love some input.

thanks!
 

Atlgirl

New Member
Post Surgery update:
It has been awhile since the surgery and the whole process has been a real roller coaster ride. I'm afraid at this point we're not 100% done yet.

Originally Dr. Rasque advised doing a cleft lift, which made perfect sense. When we went back for our pre-op evaluation in June, she reassessed and thought that we might be able to get by with something a little less drastic as the sinus did not appear as extensive as she originally thought. She recommended the Bascom's lateral incision, where she would cut off the midline go in, scoop out all the affected tissue, put a couple of sutures on the midline (though not cutting externally there) and then let the incision heal open, by secondary intention- which involves packing. She said this would be simpler and a much quicker healing time, but since she was not actually changing his anatomy she recommended following up with laser hair removal as soon as possible. He was excited about this option because she thought he would be able to return to sports and normal activity more quickly.

Day of surgery everything went well, but when she got in there it turned out the sinus went further than she thought and she had to make a bigger and deeper incision. As a result, we had to go to her office the day after surgery for instructions on wound packing. If you have not gone through this, let me tell you it is far more daunting than any office explanation from a surgeon can ever prepare you for. I am generally not squeamish at all, but this process initially had me light headed and wondering if I would be able to handle it. Though, since my son was face down on the table and I didn't want to alarm him, I did my best to keep a cool head. For the first few days, the wound packing was quite a challenge and we looked into a home health nurse, but there was no one in our area who would come out- reportedly b/c he is considered pediatric- at 15. He also had a very bad reaction to the percocet given for pain. It made him nauseated, dizzy, on edge and paranoid. Once we figured that out and got it out of his system things improved dramatically.

The wound healed fairly quickly considering the size and depth and I learned a lot about how to do it and have a million tips and suggestions for anyone else going through this. I won't share it all here, but if you have questions, please feel free to message me. I think I could save you a lot of headaches.

We are now at almost 2 months post surgery and the primary incision has pretty much fully healed. He's been back at his normal activities for around a month and feeling pretty good. The only issue we've had is holes opening on the midline. This is a tricky thing to assess and handle. The first one opened a little less than month from surgery about two weeks after she took out the midline sutures. It completely freaked me out. The doctor used a silver nitrate stick to cauterize it and then I had to pack it with a wick to let it drain and heal from the inside. I thought my son was going to lose his mind from the continued processes, but it took a little over two weeks and that closed.

We were finally just putting a small gauze over the original incision to keep it clean, when on labor day, I noticed another VERY small hole on the midline. It was bleeding, just ever so slightly and I could see the tissue below. So, I got the area cleaned and shaved and put a very small piece of dry antibacterial packing strip over the hole and then covered it with the silk wound tape. Within two days it had closed. I have continued to keep the tape on it for the last week because I am hopeful that the skin is just weak and not fully healed and the tape gives it some stability through the daily activities allowing healing, HOWEVER, I and the doctor are concerned about the possibility that she missed a pit. And there in lies the next section of this crazy roller coaster.

Dr. Rasque is changing practices and won't be available at the new place until mid-October. We could see another dr. at that practice, but it is over an hour from our house and requires missing classes and other complications, so I'm trying to avoid that. In addition, he is really about done with having his mom looking at his posterior, taking photos and trying to figure this ever changing problem out. At present, I am wanting to start the laser hair removal as soon as possible and just keep an eye on the midline. But, the possibility that a pit remains is very real, so it niggles at the back of my mind constantly. It is not red, swollen, painful or draining, it just looks like newly healing skin. Though it is very hard to tell...

Overall, we were happy with Dr. Rasque and I still have faith in her knowledge of all things pilonidal, but anyone who has gone through this knows that it is a constantly moving target and every situation is different. You have to stay on your toes and be prepared for complications. My son, is actually less optimistic than I. He feels like the whole thing has been an excruciating nightmare and at the moment, he'd rather go back to his presurgery issues. I think that is coming from a short sighted 15 year old. And also he didn't have much pain prior, the draining was intermittent and it was more of an irritation. It didn't require constant attention from mom. Also, the return to sports after the surgery was a couple weeks longer than originally anticipated, so that was big for him.

Hopefully this is helpful to anyone in the Atlanta area and anyone else going through this craziness. If anyone has any experience with missed pits, I'd love some input.

thanks!
Hi nursemom,

Just checking in to see how your son is doing now. I’m also in Atlanta (2nd pilonidal occurence) and curious to know if you still are recommending Dr. Rasque for dealing with pilonidal issues?

I appreciate your help and hope your son is fully recovered now!
 

vaibhav

New Member
Hi nursemom,

Just checking in to see how your son is doing now. I’m also in Atlanta (2nd pilonidal occurence) and curious to know if you still are recommending Dr. Rasque for dealing with pilonidal issues?

I appreciate your help and hope your son is fully recovered now!



hey. did you find any doctor? I am looking for a doctor as soon as possible. My pilonidal is draining continuously since last 2 months.
 
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