Post by pilonidalstories.com on Aug 28, 2017 12:39:46 GMT
“I am a medical scientist and have met with a handful of specialists and a number of surgeons to discuss pilonidal. Fortunately for me, early on in my pursuit for answers, I met a specialist who helped me to understand the cause of Pilonidal disease. Unfortunately, most medical doctors are taught to diagnose a problem as recalled from a textbook and do not stop to think about origin and cause. Which leads to excision, long recovery, possible recurrence, and other detrimental effects. This is not necessarily their fault as that was their training and they also are under pressure to serve the masses, not so much the individual. To be noted, as many people can attest to on this site, excision solved their problem. However, I am on the side that excision should only be done in the fewest of cases.
While we call the open wound a Pilonidal Cyst, it doesn’t mean that it is a cyst and/or that it is hair related. It just gets categorized as such.
During in utero development, as the skin is being formed, it has been postulated that some of the last skin to be formed is in the natal cleft (butt crack). For some people, they may just have a thin layer of skin present at the dimple site. For others, like myself, not only is the skin thin in the cleft at the dimple, but the deep cleft (thanks to genetics) compounds the issue by not allowing as much aeration as do more shallow clefts. In addition, for reasons unknown (at least to me), women during their menstrual cycle may notice more tenderness in the cleft at the site of the dimple. I have ideas as to why this may be, but nothing founded. Suffice it to say, it does occur.
Basically, from my understanding and literature research, Pilonidal disease occurs due to tissue injury and subsequent infection. Depending on the thickness of skin around the dimple site, an injury as simple stretching one cheek too far may be enough to cause a tear and then subsequent infection. Alternatively, no tissue damage may be necessary and it could be that the dimple opening is large enough that bacteria present on the skin or hair or introduced from wiping, may enter into the dimple and start an infection. A deep cleft may lead to the ability of some bacteria that don’t need oxygen to replicate and in addition, it makes for proper open wound healing more difficult. This really isn’t a cyst at all, but a cavity in which bacteria can reproduce. Once lanced and open, it becomes more of wound care. With that opinion stated, some people really might have a cyst and the best treatment would be to have it excised.
For me, excision is not an option as it would only cause unnecessary injury. I also have a hunch that for me, it would not be successful and I would have to have it done again. I don’t have much luck with medical procedures. I met with one surgeon and showed him Dr. Bascom’s cleft lift work. He mentioned that he was aware of the surgery and that he also was aware of the success, however, he would not preform it. Basically he would get more money by doing the excision surgery again on the same patient. At least he was honest.
I have been living with Piolonidal for 13 years now. Much to my chagrin, it goes away and then decides to say “Hello!” randomly. I have treated the open wound 9 times now. I resort to self-treatment that the first specialist I met with recommended. He showed my wife how to do the minor procedure, knowing that most medical doctors would suggest I go and get the excision. For maintenance, I shave (rather my wonderful and gracious wife does), pluck hairs around the dimple, and soft scrubbing when showering or bathing. If the Pilonidal is open, I determine if it is infected (pus, redness, tenderness, smell . . .[I did a PhD in microbiology and now have a nose for what different types of bacteria smell like). If it is infected, I go the doctors to get an antibiotic. Whether or not it is infected, I cauterize the opening with a silver nitrate stick (bought on Ebay). This is also affectionately known as a “Fire stick.” 🙂 It will only react with wetness. So if you touch dry skin it will not hurt. The wet wound will turn brown. I then use a little portion of Hydrofera Blue foam (antibacterial, also purchased from Ebay) that I wet and then my gracious wife puts it in the cavity along with some gauze on top to keep the foam in place. It is important for this to stay put to keep the wound from closing back in on itself. You want to have the skin grow from the bottom up. I change the gauze twice daily for a week, then retreat with silver nitrate, change gauze twice daily for another week, then change gauze once a day until the wound is closed (about 2-3 weeks). In the mean time, I am able to function normally (sit, run, play sports, ect). I believe recurrence for me happens because my skin is so thin.
Fortunately, I only had to deal with tunneling the first go around and I had the first specialist, numb me and then cut open the tunnels.
Obviously, this not something I want to keep doing, but until I have insurance that will cover and a surgeon that will perform Dr. Bascom’s Cleft lift, I endure.
This really is a pain in the rear. I understand we all have our own ways of coping with it. I hope we can all put our good friend Pilonidal to rest someday. Anything, I have written above is my opinion and has worked for me. It may not be best or work for you or you may not agree. That is fine. I think it is a good way for pilonidal management, but I think anyone interested in this type of treatment should talk to their Dr. first. It is really frustrating going through the rounds of Drs and appointments and then differing opinions. Hence, I do my self-treatment to save money, time, and pain.
Anyway, I don’t even know if this is the right place to post to. I haven’t been on the site in a couple of years, but decided to give my rare opinion. This may or may not be helpful, but I hope it can be to someone who like, me lives with a caboose reminder.”
While we call the open wound a Pilonidal Cyst, it doesn’t mean that it is a cyst and/or that it is hair related. It just gets categorized as such.
During in utero development, as the skin is being formed, it has been postulated that some of the last skin to be formed is in the natal cleft (butt crack). For some people, they may just have a thin layer of skin present at the dimple site. For others, like myself, not only is the skin thin in the cleft at the dimple, but the deep cleft (thanks to genetics) compounds the issue by not allowing as much aeration as do more shallow clefts. In addition, for reasons unknown (at least to me), women during their menstrual cycle may notice more tenderness in the cleft at the site of the dimple. I have ideas as to why this may be, but nothing founded. Suffice it to say, it does occur.
Basically, from my understanding and literature research, Pilonidal disease occurs due to tissue injury and subsequent infection. Depending on the thickness of skin around the dimple site, an injury as simple stretching one cheek too far may be enough to cause a tear and then subsequent infection. Alternatively, no tissue damage may be necessary and it could be that the dimple opening is large enough that bacteria present on the skin or hair or introduced from wiping, may enter into the dimple and start an infection. A deep cleft may lead to the ability of some bacteria that don’t need oxygen to replicate and in addition, it makes for proper open wound healing more difficult. This really isn’t a cyst at all, but a cavity in which bacteria can reproduce. Once lanced and open, it becomes more of wound care. With that opinion stated, some people really might have a cyst and the best treatment would be to have it excised.
For me, excision is not an option as it would only cause unnecessary injury. I also have a hunch that for me, it would not be successful and I would have to have it done again. I don’t have much luck with medical procedures. I met with one surgeon and showed him Dr. Bascom’s cleft lift work. He mentioned that he was aware of the surgery and that he also was aware of the success, however, he would not preform it. Basically he would get more money by doing the excision surgery again on the same patient. At least he was honest.
I have been living with Piolonidal for 13 years now. Much to my chagrin, it goes away and then decides to say “Hello!” randomly. I have treated the open wound 9 times now. I resort to self-treatment that the first specialist I met with recommended. He showed my wife how to do the minor procedure, knowing that most medical doctors would suggest I go and get the excision. For maintenance, I shave (rather my wonderful and gracious wife does), pluck hairs around the dimple, and soft scrubbing when showering or bathing. If the Pilonidal is open, I determine if it is infected (pus, redness, tenderness, smell . . .[I did a PhD in microbiology and now have a nose for what different types of bacteria smell like). If it is infected, I go the doctors to get an antibiotic. Whether or not it is infected, I cauterize the opening with a silver nitrate stick (bought on Ebay). This is also affectionately known as a “Fire stick.” 🙂 It will only react with wetness. So if you touch dry skin it will not hurt. The wet wound will turn brown. I then use a little portion of Hydrofera Blue foam (antibacterial, also purchased from Ebay) that I wet and then my gracious wife puts it in the cavity along with some gauze on top to keep the foam in place. It is important for this to stay put to keep the wound from closing back in on itself. You want to have the skin grow from the bottom up. I change the gauze twice daily for a week, then retreat with silver nitrate, change gauze twice daily for another week, then change gauze once a day until the wound is closed (about 2-3 weeks). In the mean time, I am able to function normally (sit, run, play sports, ect). I believe recurrence for me happens because my skin is so thin.
Fortunately, I only had to deal with tunneling the first go around and I had the first specialist, numb me and then cut open the tunnels.
Obviously, this not something I want to keep doing, but until I have insurance that will cover and a surgeon that will perform Dr. Bascom’s Cleft lift, I endure.
This really is a pain in the rear. I understand we all have our own ways of coping with it. I hope we can all put our good friend Pilonidal to rest someday. Anything, I have written above is my opinion and has worked for me. It may not be best or work for you or you may not agree. That is fine. I think it is a good way for pilonidal management, but I think anyone interested in this type of treatment should talk to their Dr. first. It is really frustrating going through the rounds of Drs and appointments and then differing opinions. Hence, I do my self-treatment to save money, time, and pain.
Anyway, I don’t even know if this is the right place to post to. I haven’t been on the site in a couple of years, but decided to give my rare opinion. This may or may not be helpful, but I hope it can be to someone who like, me lives with a caboose reminder.”