Sebaceous Cysts archives

Pilonidal Cyst

Posted by Jaci Greene on September 06, 1998 at 03:05:58:

My boyfriend complained of pain and noticed a large cyst in Feb., 1998. It broke open and drained and he finally saw a doctor in April, who sent him immediately to a surgeon, who suggested surgery. The surgeon said there wasn't a hurry unless he was in severe pain and that it was good that they cyst was still draining. He has to wear a large bandaid over the area every day. Due to no health insurance and fear of the recuperation period of 6 weeks, he has tried to put it off. It is still draining and painful from time to time. Lately he has also had severe lower back pain that continues around the abdomen to the front of his legs. This has been for a few weeks and seems to be getting worse. He cannot find a comfortabe position and has tried Ibuprofen for his back, but it does not help at all. He can hardly walk now, and assumes he has injured himself. My question is, could the severe lower back pain be related to the cyst, or could the cyst be causing this? I feel so bad for him, yet helpless. He is 18 years old. Thank you for your time.


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Re: Pilonidal Cyst

Posted by Walt Stoll on September 07, 1998 at 08:17:54:

In Reply to: Pilonidal Cyst posted by Jaci Greene on September 06, 1998 at 03:05:58:

Dear Jaci,

His lower back pain IS likely related to his pilonidal cyst but not as you are likely thinking.

It is almost certainly the stress of this situation thart is causing serious muscle tension & THAT is what is causing the back pain.

By the way, this problem is not going to go away without surgery. The longer he puts it off, the more things are going to happen to him like the back pain. Finally, he will be unable to function. THEN, he will not only have no insurance but he will be unable to get any for the rest of his life. Already, his pilonidal cyst is a "pre-existing condition" that no one will cover. NOW, he is developing chronic back pain whicn no insurance will cover if he has any physician see him for it (it will be in his record).

For now, I would recommend he see a good masseur & get a deep, total body, therapeutic massage 3 times a week for 2 weeks. His back pain would go away, hopefully that would be proof enough to him that what I said is true.

Within a few weeks, his back pain would start coming back because he is still under the stress and he has not leanred an effective skilled relaxation technique to handle the stress.

In the meantime, the sooner he has his surgery the better. Things will only get worse.

Walt




Re: Pilonidal Cyst

Posted by Brad Tilley on October 19, 1998 at 17:14:41:

In Reply to: Pilonidal Cyst posted by Jaci Greene on September 06, 1998 at 03:05:58:

He should definitely get that thing cut out. I just had a pilonidal removed a week and a half ago. I'm 18 years old, and discovered it approximately Dec. 97/Jan. 98. I let it go and go, draining heavily the whole time. I was too embarrassed to say anything to anyone until July 98. By then, it had grown to such an enormous size, there were actually 2 cysts working together (cysts DO have a minds of their own!) and 6 openings which they were draining. I finally saw a doctor in September. He said the only choice was surgery, and he prescribed Keflex to reduce the infection for surgery. Here I am a week and a half after the operation. For the first week, I was in pain. Now, I hardly feel it. The incision was never closed, so I have to pack it and soak in a tub of warm water. The incision is 3 inches long, 1/2 inch wide, and 4 inches deep. IT ONLY GROWS!!!!!!! go to the doctor, get an antibiotic to reduce the size, then have surgery. It'll be a long road, but after the first week, it's not that bad. My healing time has been estimated at 1-2 months. But, I can't stress the fact that after the first week, IT DOES GET BETTER!!!!!! The hardest thing to do after the operation is to sit in a car. Other than that, things are pretty easy to deal with! Hope this helps!


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Re: Pilonidal Cyst

Posted by Walt Stoll on October 20, 1998 at 11:14:56:

In Reply to: Re: Pilonidal Cyst posted by Brad Tilley on October 19, 1998 at 17:14:41:

Thanks, Brad.

In your case, it was exactly the right thing to do. Now, you need to be sure you don't do anything that "hurts" till this is healed. We all pray that they got every microscopic bit of trapped epithelial tissue with this one surgery. Sounds good so far.

Of course, the very best approach to this is prevention which requires that the delivering doc (or the pediatrician) carefully explain the embryology of the condition at birth and what parents can do to prevent the problem you have had to live with. It is EXTREMELY easy for the doc to make this diagnosis at birth. It is then the parents responsibility to pass this on to the child so, when they take up responsibility for their own hygeine, they know what they have to do.

Good luck! Walt




Re: Pilonidal Cyst

Posted by Jaci Greene on October 20, 1998 at 20:55:09:

In Reply to: Re: Pilonidal Cyst posted by Brad Tilley on October 19, 1998 at 17:14:41:

Thank you both for your responses, they have been very helpful. Brad, you seem to have gone through exactly what my boyfriend is going through. The doctor has put him on the Keflex and he has been soaking in the tub, but it just helps a little for a day or two. The back pain has moved down his hip and into his leg. Today, he went to the emergency room but the surgeon he had seen was not available and the doctor on duty couldn't understand why the cyst could cause the trouble in his leg and hip. Since it has been draining all along, he was hoping to hold off the surgery until xmas vacation from school, so as not to miss as much school his senior year, but I think he won't be able to wait that long. Have you had to be in bed the whole time since the surgery, and do you feel the week of pain was worse than when the cyst was bothering you before the surgery? Also, is the after-care difficult...the packing of the incision? How long was the hospital stay? Does someone come to your home to change the packing, or do you do it? These are some of the things that have made him nervous. Again, thank you both for your help.


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Re: Pilonidal Cyst

Posted by Brad Tilley on October 22, 1998 at 17:28:56:

In Reply to: Re: Pilonidal Cyst posted by Jaci Greene on October 20, 1998 at 20:55:09:

Jaci,

Mine was draining all along, too. I think the ultimate thing to do is to get rid of it...I waited until my fall break, and still missed some of my classes. I inevitably failed one (maybe possibly due to circumstances before). Tell him to expect his life to be on standstill for a while. No, I don't think he'll be able to wait that long either. This cyst has to be one of the most painful things I've had to endure (and I've had a thorocentisis). No, I've been in the bed very little. He'll still be able to do everything he could do before (almost). The hardest thing for him to do (as it's been the hardest for me) is to sit through class...at home, he'll be able to lay on his side, etc. Of course, I'm at college and he is at HS and has to sit through much longer classes. SURELY his teachers would understand...2 of mine had the same thing!!! The week of pain after surgery is comparable to the pain of before. Now, 2 weeks after surgery, it still hurts. It's still tender. It's going to be! The thing is, he'll know the pain after surgery is worth it...it's meaningful. The pain of the cyst is not meaningful and not good. The longer he waits, the bigger the cyst is going to be, the larger the incision, the greater the pain. After care isn't that bad. At school, I can go to the infirmary and get them to clean and pack it (BTW-Packing CAN hurt a bit, but he'll get used to it...it's SO much better if you can get someone to pour Hydrogen peroxide in it before you pack-because it makes it a little number and also fights infection). At home, my mom cleans and packs it...but then again, she's a nurse. If he doesn't have anyone to do it, he could probably go to his county's health clinic. They should be able to do it. Or, he could go to the hospital everyday, or he might know a nurse. The fact fo the matter is that any nurse is trained to handle this. Actually, I don't think you'd have to be a nurse to do it! I could do it if I could see it...it just involves pouring peroxide inside and putting gauze in it...no biggie...anybody can do it...It WILL be a lesson in humiliaty for him. Here lately, all I feel comfortable in is jogging pants, and that's not really my thing...There was no hospital stay....I got to the hospital at 10:30 and was out by 2...and my doctor was an hour late. The day of the surgery was the happiest day of my life. I wanted this cyst out of me, and I knew it would be gotten out. they usually sedate people for this, so I didn't feel anything the rest of the day...it was great. The pain afterward is mainly just soreness...tell him it won't be as bad as he thinks...but then again, it was worse than I thought...I didn't know I would have to pack it or anything like that, so if he knows anything about that, tell him it's not as bad as he's thinking!!


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Re: Pilonidal Cyst

Posted by Jaci Greene on October 23, 1998 at 00:34:10:

In Reply to: Re: Pilonidal Cyst posted by Brad Tilley on October 22, 1998 at 17:28:56:

Brad, Thank you so much for your information. You seem to have had the same experience as my boyfriend, and I've passed all this information on to him. I know he felt better having some answers, as doctors can be brief at times. He went to see the surgeon yesterday and had it lanced, and they feel this will get him by until xmas vacation. As soon as they did it, he could feel the pressure come off where the cyst is. He is sore, but taking it easy through the weekend. I think he was also at the point where he just didn't care and realized something had to be done since it was affecting his life. The doctors do not feel that his leg pain or back pain is related to this, so we'll have to wait and see if it's just coincidental. It could even be the way he has carried himself to compensate for the pain of the cyst. Thanks so much for your help. I'll let you know how things work out. You have the same last name as my grandparents, which is not really a common name...it was nice to hear from you.


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Re: Pilonidal Cyst

Posted by Brad Tilley on October 23, 1998 at 12:09:49:

In Reply to: Re: Pilonidal Cyst posted by Jaci Greene on October 23, 1998 at 00:34:10:

Tell him to take care of himself (and you take care of him too!). Best of luck to both of you! DO keep me posted on how things are going for him (and you, because you'll have to help him out a bit, which can get frustrating). Yes, Tilley is DEFINITELY not a common name, so that's really neat!

~Brad


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Re: Pilonidal Cyst

Posted by Jaci Greene on October 27, 1998 at 23:41:56:

In Reply to: Re: Pilonidal Cyst posted by Jaci Greene on October 23, 1998 at 00:34:10:

We made it through the weekend, and since he had to cyst lanced, it does feel better. He's trying not to sit too much, other than school and taking hot baths. He feels the cyst feels better but the back pain is really getting to him. The doctor feels it's not from the cyst and says it couldn't cause that pain. The pain is in his lower back, down to his hips and down his right leg. It is affecting his walking. His father has Multiple Sclerosis and that has passed his mind, but again, the doctor says he wouldn't inherit this. I know it sounds like he's a constant complainer, but he's not. I feel bad that he's feeling so rotten and doesn't know where all this is coming from. He also has smaller cysts (large pea-sized) on his shoulders...several of them and they are purple. Could this be related? Thank you so much for your time...it is really appreciated.


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Re: Pilonidal Cyst

Posted by Walt Stoll on October 29, 1998 at 12:06:11:

In Reply to: Re: Pilonidal Cyst posted by Jaci Greene on October 27, 1998 at 23:41:56:

Dear Jaci,

I have seen (several times) that the present doc keeps saying that the pain in his back & down his legs is not related to this condition. I have not said anything because this is such a ridiculous position that I just "knew" that the doc would soon change his mind.

Since that has not happened, I can tell you that it IS directly related! Pilonidal cysts & sinuses go all the way to the bone. That is part of their technical description.

For the doc to not know that is a serious indictment of his knowledge.

Even if this did not go to the bone (which would mean that the diagnosis was wrong) an infection of this severity & chronicity would have to cause a lot of associated muscle pain & spasm. This mechanism is the basic cause of more than 95% of all back & leg pain such as you have been describing. SO, for the doc to say that they are not related is just silly.

Walt



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Re: Pilonidal Cyst

Posted by Jaci Greene on October 30, 1998 at 20:15:35:

In Reply to: Re: Pilonidal Cyst posted by Walt Stoll on October 29, 1998 at 12:06:11:

Thank you so much for keeping me informed with this whole situation. You have helped me to put his mind at ease. I will continue to keep you informed as to his progress. As it stands now, surgery will be right after xmas. Thank you again.



Re: Pilonidal Cyst

Posted by Roxanne on November 01, 1998 at 20:02:42:

In Reply to: Re: Pilonidal Cyst posted by Brad Tilley on October 23, 1998 at 12:09:49:

Brad,

Now that it has been several weeks since your surgery, would you still say the surgery was worth it? My surgery is scheduled for the Friday before Thanksgiving and as it gets closer I am having second thoughts about the recovery period and process. I have had minor flare-ups for the past 8 years lasting no more than a day or two. My most recent was the worst and what brought me to a doctor finally for diagnosis. The draining was the most painful thing I have experienced since labor pains. That is what made me agree to surgery in the first place. However, since it was drained, I am feeling fine and wondering if the flare-ups will continue to be extreme or go back to minor inconveniences. I am also worried about the cleaning and packing. Thanks for any advise you can give me.


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Re: Pilonidal Cyst

Posted by Walt Stoll on November 02, 1998 at 10:10:25:

In Reply to: Re: Pilonidal Cyst posted by Roxanne on November 01, 1998 at 20:02:42:

Dear Roxanne,

If your diagnosis is correct, you have no options (that I know of) other than the surgery. I have placed on this BB, several times, what one can do to heal up faster, post-op; look at the archives on this subject.

Good Luck.

Walt




Re: Pilonidal Cyst

Posted by Brad Tilley on November 02, 1998 at 12:43:00:

In Reply to: Re: Pilonidal Cyst posted by Roxanne on November 01, 1998 at 20:02:42:

Roxanne,

For a while after the surgery, I didn't think it was worth it...now I do. I know that in a few weeks it will all be over with. Packing CAN be a pain the first few times...I definitely do NOT suggest doing it yourself, or you'll never be able to. It's not a very hard thing, and I've learned that packing feels better when you're laying down/bent over. Then again, it really depends on what you pack it with...when the doctor was finished with his surgery, he put EIGHT feet of iodoform in there...it wasn't pleasant to pull it all out, but now I pack with 2x2's...The incision will be tender at first, but that all goes away. But, to answer your initial question, YES, the surgery is worth it...as long as you have someone who is able to help you take care of it...if you work, tell all your co-workers about it....tell all your friends about it. I've found that everyone around me was more than willing to help (not packing, I'm talking about mundane things like sitting). Go for it, and good luck with it! let me know how things are going for you. Don't stress over this, after a week, you'll notice tremendous progress-for the best!

~Brad



Re: Pilonidal Cyst

Posted by Jaci on November 10, 1998 at 01:25:03:

In Reply to: Re: Pilonidal Cyst posted by Brad Tilley on October 19, 1998 at 17:14:41:

I'm still reading through your site...many people have sent in questions about this pilonidal cyst. So, I realize it's seems fairly common. My boyfriend is still waiting to do the surgery during xmas vacation. It was lanced a couple of weeks ago and bled for several days, then stopped, and now is draining again. He tries not to sit for long and is taking the baths and feels the cyst is feeling much better...not nearly as painful as before. But, of all of the letters I have read here, nobody seems to complain of the severe back pain. I guess he won't know until after the surgery, if this is really related. He complains of a pain in his lower back, down the hips and down the side of one leg. Will let you know how we do.


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Re: Pilonidal Cyst

Posted by Walt Stoll on November 11, 1998 at 10:13:04:

In Reply to: Re: Pilonidal Cyst posted by Jaci on November 10, 1998 at 01:25:03:

Dear Jaci,

If the diagnosis is correct (and it is an easy one to make) "lancing" it will never give more than temporary relief---and for THAT it is worth while.

Once you both look at the embrological pictures, upon which this condition is based, you will understand what this is ALL about.

Let us know how he does.

Walt




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