Northern Virginia Cleft-lift Surgery

Discussion in 'Pilonidal Discussions' started by CaptainA, Feb 15, 2017.

  1. CaptainA

    CaptainA New Member

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    Greetings,

    I wanted to begin this thread for ANYONE who is seeking treatment in the Northern VA/DMV area. I am going in for my 3rd procedure now (cleft-lift) tomorrow on Thursday, February 16, 2017. My surgeon is Dr. Daniel Otchy from Fairfax Colon & Rectal Surgery. Now my background...

    I noticed this issue probably 1.5 - 2 years ago, and just sat on it thinking it was nothing to worry about. I never had pain, simply occasions of seeing blood on toilet paper after bowel movements. I was referred to Dr. Daniel Otchy from my primary care physician around July 2016. I don't believe I ever had an actual cyst, just an infected point that needed excision/cleaning. It was determined I needed surgery and here has been my surgery timeline:

    1st Surgery (Early August 2016) - Outpatient procedure, and Dr. Otchy performed an excision with open wound healing. Procedure was quick, and their wasn't much pain post surgery. I admit I was lazy in thoroughly cleaning the wound and it became infected. My first post-op was about a week later and Dr. Otchy prescribed me antibiotics. I saw him again a week after that and everything was looking good and healing...Unfortunately it stopped healing at a point, and refused to close completely. I probably had about 1-2 centimeter wound that just wouldn't close. It was here where I learned that my biggest hurdle was that I had a very "deep cleft" which was making the recovery difficult because oxygen wasn't getting to the wound. After a couple months of post-ops, it was determined I needed a 2nd procedure.

    2nd Surgery (December 30, 2016) - Outpatient procedure, and Dr. Othcy performed an excision but closed the wound with stitches this time. Procedure was quick, and wasn't much pain after. I saw him 5 days after the surgery, and he looked at the wound and found NO SIGN OF INFECTION and the wound was looking good, but he left the stitches in. I took stool softeners, but stubbornly didn't for 1 day and I paid the price...After a difficult bowel movement (about a week post surgery) there was a decent amount of blood on my toilet paper and I knew one of the stitches opened. I saw Dr. Otchy 1 week after this (2 weeks post-op now) and he confirmed that the stitch closest to my anus had opened, but still no sign of infection. I saw him about 1 week after that again (2.5 - 3 weeks post op) and he removed the remaining stitches and said that the area where the first stich opened had healed a little, but not to where he thought it would be at that point in time. We then scheduled another post-op for 3 weeks after this, because he went on vacation and the appointment was around 6 weeks post surgery. The wound was now WORSE than before, but that was due to my fault mostly. I am very active and performed a lot of physical workouts during this break, so I didn't give the wound appropriate time to heal. At this point he now confirmed that we need to do the cleft-lift procedure.

    3rd Surgery (February 16th, 2017) - Dr. Otchy will be performing this procedure on me tomorrow. As a side note though, I asked him about this procedure before but I believe he uses the phrase "Gluteal-Lift" instead of Cleft-lift. After hearing him discuss the procedure, I am 99.9% sure it is the exact same procedure, he just calls it "Gluteal-Lift." He was reluctant to use this procedure on me in the past because the size of my wound has been tiny compared to those that he normally has to do this procedure on. I haven't made it easy because I am very active, but I do think I have been one of his more perplexing patients because my wounds seem to heal and then suddenly stop. He has come to the conclusion that it is because of my more than normal "deep cleft."

    3rd Surgery Recovery Notes - He has given me a timetable of about 2-3 weeks off of work. I work a desk job, so sitting is the big issue here. I've done research where people come back quicker than this, but I believe Dr. Otchy wants to play it safe here because this is the 3rd procedure in 6 months and wants to give it the MAX time that it can to completely heal. I am committed to this approach and will not do any physical activity for the 2-3 weeks.

    I will post frequently post-surgery on my recovery!!!

    Please feel free to message me about Dr. Daniel Otchy. I personally am fine/happy with him as my doctor, but I can see where some patients might get frustrated at times.

    I also thought it was strange I couldn't find much on DMV (DC, Maryland, Virginia) pilonidal surgeons/experiences for being such a large metropolitan area, so hopefully this will help someone!
     
  2. LILLY

    LILLY Very Helpful

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    It's very important that you are completely certain what will be done. There have been many times that members went into surgery thinking they were getting one thing and something completely different happened. Were you told what your scar would look like afterwards? That can tell a lot.
     
    Last edited: Feb 15, 2017
  3. CysterAct

    CysterAct New Member

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    I go there, too! I see Dr. Stern. I had my surgery back in August and the wound still hasn't healed. Very frustrating.

    He has no answers for me. It feels like it just stopped healing. He says it looks clean but... it's just not doing anything.
     
  4. CaptainA

    CaptainA New Member

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    12 DAYS POST-OP

    My apologies for not getting on here sooner. I will give a brief summary of significant time periods in the last 12 days since my procedure. I forgot to confirm that the procedure I received was in fact the "cleft lift", because Dr. Otchy called it the "gluteal lift." I will be confirming the type of procedure I did this Friday during my 3rd post-op(March 3rd).

    DAYS 1-3

    I spent 100% of my time on either my back or standing. I was very nervous during this time period of re-opening because of my previous 2 surgical experiences. My first test came during my first bowel movement around day 1.5/2. I admit this might be disgusting, but I will be honest with what I did because I did NOT want to sit on the toilet (It's how I believe my 2nd surgery opened back up)...I passed my bowel movement STANDING UP in the shower and slightly bent over with a trash bag underneath to catch the release. I know it sounds gross, but I didn't want to risk anything...I was HAPPY to see that their was no blood while I cleaned up, and if their was any it was VERY tiny (But I believe their was practically none)....All in all, there was no issue passing this bowel movement. I was on stool softeners/laxatives which made me have the "runs" but at least it was all SOFT.

    DAY 4 (1st Post-Op / Tube Removal)

    During my visit, Dr. Otchy removed the tube and recommended that I just keep gauze over it with medical tape to hold it down. The tube drained fine and that part of the recovery was done (WOO-HOO!)...Unfortunately I got embarrassing feedback and was told to essentially "go home and clean/wipe your ASS." I thought I took great care with this in the first 3 days, but I was a bit hesitant to wipe hard out of fear of opening/disrupting anything, and part due to it being painful.

    DAYS 5-7

    After hearing from Dr. Otchy that I needed to clean better, I took a shower at the end of every day and after EVERY bowel movement. What I did was essentially stood in the shower and used baby wipes (wipe down instead of up towards the wound) to clean around my anus. After I thought it was all clean after using the baby wipes, I got a solo-cup and filled it with water and essentially stood/squat over the cup and threw the water up towards my anus. After "rinsing" the area with the water (warm/hot), I would use large gauze pads, get them wet and apply anti-bacterial (Dove soap) soap onto the gauze and then continue to clean around my anus. After doing this, I used my same solo-cup technique and threw water up towards the washed area, so to get all the soap removed...This is a decently long process, but it got the job done (explained in next section).

    DAY 8 (2nd Post-Op)

    This post-op was 4 days after my 1st post-op. 1st post-op was the Monday after my surgery (previous Thursday) and this 2nd was on Friday. Up to this point, I had minor drainage (white-ish / yellow-ish substance) and that was my only real concern to share with him. I had no real bleeding issues, just minor occasional pink-ish discoveries during cleaning that didn't really scare me. Bowel movements also weren't causing any issues. And now to the FIRST LEGITIMATE GOOD NEWS in my mind.......I told Dr. Otchy about the minor leakage, and he believed their might have been a tiny infection. After observing the area/wound he actually said it looked "damn good." He told me that their was no sign of infection and that everything was looking good compared to where he thought it might be at this time. He even cleared me to go back to work early!

    Day 12

    I am now back at work (desk job) and began sitting. This has been the first legitimate time I have been siting for a decent chunk of time. Surprisingly, I haven't really had any issues/pain so fair with sitting, as long as it is straight up. I still experience some soreness when sitting on my sides, but I expected this with the surgery I received and having a 3-5 inch scar down my butt crack. I also am still not cleared to run or do any real physical activity. I still have the same leakage issue I described previously and still see some very minor red/pink-ish spots on the baby wipes at times, but I also think this might just be because I am over cleaning and wiping more than I need to (potentially causing minor rashing). I see Dr. Otchy again this Friday (15 days post-op) and hopefully everything still checks out good!
     
    poosri and ellysparkles found this helpful.
  5. CysterAct

    CysterAct New Member

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    Any update?
     
  6. CaptainA

    CaptainA New Member

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    SORRY FOR NOT GETTING TO THIS SOONER!!!

    I have an update on my recovery, and here it goes:

    Day 39:

    I never thought I would say this, based on my past recovery efforts...But I am now PILONIDAL FREE AND RECOVERED. I went to see Dr. Otchy last Monday (Day 33 of recovery) and he confirmed that my scar is fully healed and authorized me for full physical activities. I will caveat that the bottom of my wound opened slightly during my recovery, and there was occasional/small bleading when I would use baby wipes after bowel movements. The wound looked like an open blister, meaning the wound was VERY SHALLOW and Dr. Otchy said it would heal very soon. I have not seen any blood in the last 4 days and my fiancé even looked and said the wound is VERY CLOSE to all the way closed.

    I am now sitting perfectly fine without any discomfort and resumed full activities since last Monday (Day 33 of recovery). I pushed it hard and worked out 5 days last week, including strength/conditioning/full-court basketball and have no discomfort.

    I cant thank Dr. Otchy enough for finally getting this issue resolved for me, even though it took 3 procedures. The cleft-lift is definitely the way to go and I recommend just opting for this procedure!

    Please fell free to ask me any direct questions you may have!
     
    poosri found this helpful.
  7. poosri

    poosri New Member

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    Hi CaptianA,
    Thank you so much for sharing your experiences. I have a surgery scheduled with Dr.Otchy next week for cystectomy and am very scared. I have had excision and drainage 3 years ago with a different doctor...it was a nightmare...it hurt pretty bad for almost 2 months... Have you had any pain since March? Was your first surgery cystectomy or something else?
     

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