Pilonidal Cyst Excision

Day 1-Post Op

Today I woke up quite uncomfortable; my hips ached as if I had run a marathon.  Fortunately, there was no pain at the surgery site.  According to the doctor, this is due to the removal of the cavity and surrounding nerve endings.  However, he did make it quite clear that Days 3-14 would be extremely painful and uncomfortable due to the regenration of these nerves.  This does not make me excited.

The Daily Process

The open wound must be unpacked and packed twice daily, as well as, after each bowel movement.  After each unpacking, the doctor ordered I take a sitz bath for 15-20 minutes for general flushing and cleansing of the area.  Once the sitz bath is complete, guaze is dampened with saline and place in the wound.

Today August 20, 2009

God bless my mother!  She is helping me care for my wound because I can not reach around and pack my own tailbone.  We sat down to plan the first unpacking/packing process would take place.  After reading different accounts of post op for this specific surgery, I felt I had a pretty good idea of how I would like to do things.  About a half hour before my mom unpacked the wound, I took the prescribed pain medication.  Then, fifteen minutes later, I placed a warm, damp washcloth over the site.  I planned for this because in all the reading I have done, people have stated one of the most painful parts of unpacking is when the guaze dries to the tender skin.  While the washcloth was soaking the guaze, my mom and I set up the sitz bath.  The sitz bath is placed directly on top of the toilet bowl and is filled with water about 100 degrees F.  Conveniently, this sitz bath, which we had to purchase from a medical supply store, came with a solution bag; this allowed extra warm water to drip in when necessary.  Once the sitz bath was set up, I laid down on the couch with two pillows under my stomach and my bare butt in the air.  I was so anxious!  The anticipation of the pain was freaking me out.  Having been through packing and unpacking processes of pilonidal cysts before, I could only rely on my painful memories.  However, the packing was out within moments.  No pain.  That was a huge relief.  Next came the sitz bath.  Now, the tubing from the solution bag was set up to come through the back of the seat and hook into the bottom.  Originally, this seemed like an excellent idea.  Once I got into the bathroom, took a look in the mirror to check the wound (which was large, gross, and well gross), I suddenly realized the tubing set up in this manner may actually enter the wound.  It was time to change the game plan.  I removed the tube as it was previously set up and sat on the sitz bath while holding the tube.  Success.  I don't know how to described what I felt.  Physically, I could only slightly feel the water in the wound, and then I just felt like I had to pee.  After ten minutes passed, I stood up, and of course, human nature and curiousity forced me to look down.  A couple of drops of blood, but nothing too horrible.  At this point, my anxiety replaced by pure curiousity.  I think part of this comes from my defense mechanisms of intellecualization and rationalization; think about the process of things to avoid the pain.  I wondered what the water was doing inside of the wound.  I wondered if my insides would fall out.  I wondered if the wound would heal if I did not get it packed quickly.  I wondered about the regrowth of the nerved endings.  I wondered about what my mom was seeing.  When the 20 mintues was complete, I stood up and took a picture; then, I showed it to my mom.  "That does not do it justice," she replied with a chuckle.  I love my mother, she has made some of the most memorable faces and quotes over the past two days.  Anyway, after I showed my mom the picture, I laid back on the couch with the two pillows under my stomach and my bare butt once again in the air.  Meanwhile, my mom prepared her part.  She placed vinyl gloves on her hands and began the process.  This included her setting up a sheet with the 4 X 4 guaze sheets dampened with saline and a q-tip/stick thing.  She came over placed the guaze in and thankfully I felt absolutely nothing.  Relief!  Then I got to put on the awesome "mesh panties" the hospital was so kind to provide me with as my mom put dry guaze over the packed wound.  First packing and unpacking was successful and not so painful.  Emotionally, I feel great.  Although, I am still very anxious about the next days to come.  The anticipation of pain is never calming, and so we shall see.