Pilonidal Cyst

I had another doctor appointment yesterday. Upon viewing the wound, he said "It looks better than I could have hoped!" Kudos to Lisa for the her superior dressing-changing skillz. I mentioned that one spot around the edge was a bit tender and he remarked that this is just where one of the sutures is coming through and that I should not be concerned. The past few days has unleashed a few pimples around the area, which is why I haven't taken any pictures of the wound (you are welcome). He said that less saline will probably do the trick. He mentioned that the wound is definitely filling in on all sides. No mention of how long left.

So, fairly good news. I'll take some pictures for you when I am zit-free. Yay, acne!

I'm doing well, thanks for asking. Totally off pain meds. Lisa has the distinct pleasure of changing my dressing twice a day. I drove myself to work every day this week with no trouble (other than the usual Chicago traffic). No idea how long this will take, but I'm guessing two months.

The doctor sent me three pictures. The first is the "before" picture, which is great, since I forgot to have Lisa take one. The next two are pictures of the removed cyst. Very cool. He asked that I not post to my blog, but let me know and I can probably email them to you.

And so we are caught up. It has been two weeks since the surgery. Today, feeling pretty good. I now have plenty of supplies. Pain is minimal - I'm off the vicodin.

Here is a pic of the dressing supplies. Lisa wets 2 pieces of 3x3 gauze with saline and inserts them into the wound, being careful to cover every bit of the wound with the gauze. This gets covered by two pieces of dry gauze. A little tape holds them in place. Then two thicker pieces of gauze, called "ABDs", get placed over that. This gets taped around all sides, with a space on the bottom open for me to poop.

Doctor visit today at 10am. Carol drove me in to the office and Jeremy picked me up afterwards to go back to work. Thanks, guys. I also need to give a shout out to Steve, my neighbor for driving me to and from work all week. We owe you guys dinner.

Anyway, the doctor appointment was great. I went in and they took my vitals and got my booty nekkid. They pulled off the dressing and the nurse said "it looks really clean!" which made me happy.

The doc finally came in with Kathleen and said the wound looks good. He asked a bit about the story with the wound vac and then said we'd talk in his office after they re-dressed the wound. Kathleen put new dressing in and I was off to the doc's office.

The first thing I asked for were the pictures. He asked me to email him and he'd send them my way.

The next topic was the wound vac. He said that it works for some folks and not for others. That particular area is very sensitive due to the numerous nerve endings there near the tailbone. He was very upbeat and positive and said that we should discontinue the wound vac and change dressing of simple gauze and saline twice a day. I am to shower after the dressing removal and clean out the wound. Then, Lisa gets to apply new dressing. (She's a saint for doing this - thanks, honey.)

He said that in about a week the wound will get very red. "Beefy red", he called it. And that it would bleed quite a bit. Not to worry, this is normal.

So we got to fire the home health organization and send back the suck-o-matic. Not bad. Ful healing of the wound will take more time, but I am feeling really good now that all that pain is gone.

Felt good Tuesday. Took one vicodin overnight for the pain. Other than that, just Tylenol. Being back at work is great, although tiring. My body gets really tired at the end of the day.

Quite a bit of frustration with the home health organization. I am VERY unhappy with the organization as a whole - not much follow-through, lots of talk. I was supposed to get some supplies delivered, and they didn't make it, although some other mysterious supplies did make it.

I had thought that we would be using the calcium carbonate dressing, but since we were out, it was back to plain old gauze and saline, although we are running out of both.

Hey, all. I'm ok. It has been some time since my last post and a lot has gone on. I'll detail the past few days.

Monday morning, I went to work. It was good to be back, and Lisa was happy that I was not at home. :-) Anyway, I showed everyone the wound vac and explained how it worked.

Later that morning, I called the doctor's office and spoke with Kathleen, one of the very nice nurses there. I explained all that had gone on and all the pain I had been through. I told her about the home health organization not really knowing what settings should be for the wound vac and some confusion on exactly how things should be working. She listened patiently and explained that I should not be in that much pain and said the the doctor was in surgery today, but she would talk to him and get back to me.

She called back later and said that the doctor wanted the wound vac removed that evening. Kathleen had already talked to the home health organization and the nurse was coming out that night.

So, Laurence came out that night. It took 20 minutes for the foam to come out. Quite a lot of pain involved. I was very relieved to have it out when it was all done. Laurence put in some plain old gauze and saline and covered with dry gauze. Ah, sweet relief.

Here's the second wound vac canister and how the wound looked Monday night - very red. Looking good.

 

At 8:00am today, Laurence came to change the wound vac dressing. Lisa and I had already turned off the wound vac and had soaked the sponge with saline. Still, the sponge would not come out. It took 40 minutes to get the sponge off and it hurt like hell. The good news is that the wound looks VERY good. See the first picture below.

Laurence put the bridge on the left side this time. She got the whole shebang setup and we decided to lower the intensity and pressure of the wound vac in the hopes of avoiding the sponge adhering to the wound again.

Lots of pain afterwards - I sat around and tried to nap when I could.

The last picture shows the first wound vac canister replacement.

And lots of it.

What I didn't mention in the previous post was the intense pain I was in after we turned on the wound vac. I mentioned previously that Thursday night we noticed a tender spot on the right side of my wound. Very painful. Well, it got worse when they manipulated me getting the wound vac installed. Not horrible pain, but the spot got touched pretty often. At that point, I was still off the vicodin and taking Tylenol.

So the moment of truth comes, Rachel has me turn on the wound vac. It has a 15 second countdown before the suction begins. When the timer winds down, there is nothing. Apparently, there is a small hole somewhere. Rachel and Laurence find that some of the tape has come up a bit. They simply press down with a finger and WHAM! Every nerve in my body fires and I grab the edge of the bed. I may have actually flown off the bed and hit my head on the ceiling.

Eventually the pain recedes a bit and I can get up and put on my clothes. I decide that going back on the vicodin is worth the bit of head-swimmy that it does to me. Everyone agrees.

Rachel wants me to walk a bit and try to sit. Walking is fine. Sitting is painful. I get back up and I get the nausea/sweats/light-headed feeling that comes before passing out and I sit down and then lie down. Rachel is kind enough to fan me with a folder. A few minutes later, I feel better and get up. My dreams of going into work for the rest of the day are dashed.

I did work from home the best I could. But it took about 4 hours before I could get back in front of the pain. Once that happened, I was just tired.

Many thanks to Jason and Jeremy for covering for me at work. I had some scheduled installs that couldn't be rescheduled. They stepped up big time.

Anyway, the pain is now under control, but still is there. Although I hate the vicodin, it seems I'll be on it for a bit longer.

NEXT: Laurence and I set the schedule for wound vac changes. Every Sunday at 8am. Every Tuesday and Thursday at 6pm. So tomorrow, I find out if turning the damned thing on again will kill me or not.

Friday morning at 8:30 is wound vac time. The KCI (wound vac manufacturer) representative, Rachel, arrives at 8:10. The home health nurse, Laurence, arrives at 8:30 and we get to it.

The old dressing comes off and Rachel discusses how this will work. The dressing kit comes with tons of clear tape that is a bit stretchy. It's designed to make an airtight seal against my skin. Think of Saran Wrap with one side being a bit sticky. The kit also has a big piece of foam, tubing and a connector piece for the tubing to mate to the foam.

They start cutting the foam. One big piece needs to fit in the wound. Another needs to form a "bridge" to the side so the tubing connector can be installed. And the whole thing needs to be taped with the clear tape stuff.

In the pictures below, you can see the whole shebang. Very cool. Notice that the last three pictures show the foam after the wound vac has been turned on. Note that the foam gets sucked against my skin and has a very low profile.

LOTS of pictures here, but this is a really neat device and getting it installed correctly takes some skill. The clear tape must adhere to form a perfect seal.