Pilonidal Sinus

  • Rowing_Ant

    Posts: 1504

    May 06, 2008 3:53 PM GMT
    My Doctor has told me this mornign my Pilonidal Sinus has returned/was never fully healed.

    I was signed off wtih a clean bill of health two months ago but now I am facing the prospect of a course of steroid cream and anti biotics for a fortnight and if that sdoesnt work, surgery yet again.

    My Doctor has told me in order to avoid a full relapse or things getting any worse to avoid prolonged sitting, avoid tight clothes, and crucially avoiud getting my backside sweaty and causing any friction or irritation down there from rubbing clothing, sweat or flesh rubbing against flesh. He sayas whilst being very fit and PT is praiseworthy but I have to give up running, rowing, bike riding and using any fitness machine and even things like swiss balls. He recommends washing twice or three times a day and avoiding doing anything to cause me getting very sweaty - so basically no work outs or heavy CV work.

    He says that due to the shape of my glutes, havnig a hairy bum and lifestyle make me a classic example and I need to change my lifestyle to prevent the condition worsening.

    How the f**K do I fit that in with being a PT?
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    May 06, 2008 9:12 PM GMT
    I think I'd get a second opinion.
  • joeindallas

    Posts: 484

    May 06, 2008 9:25 PM GMT
    I agree with spy seek out another doctor. Sweating is natural, maybe take the advice the advice of looser fitting clothing, Sweat should not he an issue if you shower after workout, and except those few who does not. See if you can get an antibiotic cream that can be based in a Zinc or Silver backed cream. Applied prior to working out. Whatever happens bet of luck. If you know any local athletic clubs seek out the Doc from their organization, they would be more knowlegable with sweat issues
  • auryn

    Posts: 2061

    May 06, 2008 9:49 PM GMT
    I know you need to vent and I, certainly, don't want to take that opportunity from you. At this time you need to get the frustrations out, especially since this affects your ability to create money.

    I just had a couple of thoughts that I hope are helpful. 1) What does your doc say about swimming? There are several ways to do it that may cause less friction in the gluteal and natal clefts than others. 2) Is it possible, and I only bring this up to brainstorm, but is it possible to adapt some type of upper body cardio. I know you can't sit for long periods of time, but is there something you can do with your hands, much like pedaling on some homemade apperatus? All, of course followed by an immediate shower.

    I've looked over info about pilonidal sinus disorders, and just started thinking. Maybe neither of those ideas would work, but I tried thinking about what parapalegics do for exercise and thought maybe you could adopt things that they do.

    I wish you well and hope you find something that will help you.

  • Rowing_Ant

    Posts: 1504

    May 07, 2008 9:12 AM GMT
    His advice is basically the asme ive gotten from two GPs straight after the surgery to stop it coming back, i.e. give up my sports or rowing riding and biking.

    He has said no to swimming due to God-knows-what being in the water and having a hole in my body doesnt mix well which kinda throws that into touch.

    I think I can train clients as a PT but I cant actually get fit and train myself. Demonstrating the odd exercise isnt going to hurt and showering after trainig with every single client, but its my own personal fitness that is really going to sugger.
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    May 07, 2008 9:32 AM GMT
    I did not know what a Pilonidal Sinus is so I looked it up on Wikipedia. Ugh. There is a photograph there that made me vomit. That is NASTY!

    I am warning you! Do NOT click on this link if you know what is good for you: http://en.wikipedia.org/wiki/Pilonidal_sinus
  • Rowing_Ant

    Posts: 1504

    May 07, 2008 9:53 AM GMT
    Yeah - very nasty. Be grateful you've not had one!
  • HereNBoston

    Posts: 221

    May 10, 2008 4:43 AM GMT
    It's a tough call to make without looking at your case, man. But, my understanding in terms of treatment and long term maintenance was that you should avoid such exercise while its healing to avoid a dehiscence (opening back up, really gross). But once the wound is closed, then you just need to listen to your body so to speak. Generally from what i've seen, if you maintain good hygiene and don't let the hair get too wild in that area, you should be okay.

    If it keeps coming back you may be a candidate for a wide excision of the skin in the area. It has a pretty low recurrance rate but the drawback to that though is longer recovery time. It's not very cost effective so that may be why it looks like it'd be a last resort in the UK, but it works.

    hope that helps some.
  • Rowing_Ant

    Posts: 1504

    May 12, 2008 8:25 AM GMT
    Ive already had a wide excision following two lancings.

    The two lancings didnt work and the wide excision has been a success appart from this little cavity where the wound refused to heal for weeks - it kept getting infected, not healing, got very smelly and grey etc etc.

    Its that little bit which has now re=appeared as a sinus - i.e. a sinus missed by the first excision.

    Its how to manage that - to be honest I want it out and gone for good. I do not want to have to wash and dress that area twice a day and the pain and mess of it all (.e.g heavy discharges).

    This bloomin thing has already cost me my last job and made me give up my sport of rowing...Im not having it messing up my life again.
  • HereNBoston

    Posts: 221

    May 12, 2008 12:07 PM GMT
    Rowing_Ant saidIve already had a wide excision following two lancings.

    The two lancings didnt work and the wide excision has been a success appart from this little cavity where the wound refused to heal for weeks - it kept getting infected, not healing, got very smelly and grey etc etc.

    Its that little bit which has now re=appeared as a sinus - i.e. a sinus missed by the first excision.

    Its how to manage that - to be honest I want it out and gone for good. I do not want to have to wash and dress that area twice a day and the pain and mess of it all (.e.g heavy discharges).

    This bloomin thing has already cost me my last job and made me give up my sport of rowing...Im not having it messing up my life again.


    I would find a specialist then. here if a patient has more complex cysts, they're told to consult a plastic surgeon. if theres discharge they obviously need a sample of it to make sure the antibiotics they've given you will work on whatever type of bacteria you have there, but some docs will just put on any old broad spectrum. I don't know your medical history, but intravenous(IV) antbiotics might have been/ be a good idea. in terms of managing it, unfortunately washings and dressing changes are what'll help keep the purulent drainage away from the wound bed and promote new tissue growth. they may need to repeat an excision or a debriedment to get that last sinus or a chunk of hair or whatever it is that may be in the wound bed.

    But the wound itself won't really start to heal until that infection and its cause are taken care of. again, I'm not sure how they manage things over there but here we've admitted people to the hospital just for the IV antibiotics and dressing changes to make sure its a more controlled environment. But first thing, I would suggest is find a specialist. If you really want it to be managed well, a dermatologist, or someone who works in plastics would be best in terms of managing the wound.
  • Posted by a hidden member.
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    May 13, 2008 2:23 AM GMT
    I had a pilonidal sinus infection in late December. I was treated in the hospital with IV antibiotics for four days. It has healed and keeping the area washed has kept it from returning (knock on wood). I hope I never have to live through that again!

    I was never told to stop working out or playing sport. As a matter of fact, I was encouraged to continue my exercise program. Then again my cyst was not very serious.

    I hope you're well.
  • Rowing_Ant

    Posts: 1504

    May 13, 2008 10:03 AM GMT
    Thanks for the advice and support guys.

    I saw my GP yesterday and he has referred me to a specialist surgeon.

    He says that the healing is the best he has seen for a pilonidal excision but is concerned about the cavity and that it is painful.

    So, in the mean time, he has put me on strong anti biotics and told me to stop rowing/running/cycling/swimming, avoid getting sweaty and keeping very very very clean by showering several times a day and avoiding prolonged sitting etc etc.

    Exercise wise he recommends moderate walking - but nothing more than that to avoid any irritation or chafing in the natal cleft and also sweat - and none weight bearing exercise.

    Not quite sure how that fits with me being a PT....
  • Posted by a hidden member.
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    May 13, 2008 9:03 PM GMT
    Hey Mr so sorry to hear that cant say I didn't warn you and they will pass in time.

    Being a fellow "hairy bum disease" sufferer in the past you do grow out of them, however, something that didn't occur to me before but does now, why not go back to your GP and demand they pay for laser hair removal. I have heard them do similar things for women for psychological reasons so if they are willing to do that then surely it would work out cheaper than the cost of future operations and recuperation.

    Without hair there is no problem. However, reading it like that you could misconstrue it. Waxing or other forms of hair removal are not the resolution as the problem mainly comes from fresh growth or regrowth. Something you may wish to try if you do remove the hair is a follicle cream ie both Nair and Veet do a cream that prevents ingrown hairs, but first check with a chemist that it is suitable for the area as wouldn't wanna see ya walking round with a sweaty bum rash icon_lol.gif

    You have my deepest commiserations as the operation is most unpleasant and takes its toll on your well being after a while.

  • Rowing_Ant

    Posts: 1504

    May 13, 2008 9:10 PM GMT
    Cheers man

    Ive been referred back to a surgeon as they think they didnt quite get all the infected material out...so back under the knife I go.

    ARGHGGHGH icon_cry.gificon_cry.gificon_cry.gificon_cry.gificon_cry.gificon_evil.gif
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    May 13, 2008 9:25 PM GMT
    Rowing_Ant saidCheers man

    Ive been referred back to a surgeon as they think they didnt quite get all the infected material out...so back under the knife I go.

    ARGHGGHGH icon_cry.gificon_cry.gificon_cry.gificon_cry.gificon_cry.gificon_evil.gif


    I would seriously suggest that to the specialist tho as I bet its an option that they just dont advertise.

    Thats a bit shocking that it didnt get cleared up totally! They had me on augmentin (amoxycillin) and that did the trick no worries, but saying that yours seems more severe. I hope they dont stuff ya like a Christmas Turkey! Aint nothing worse than have a yard and a half of material yanked out of the wound!!!!
  • Posted by a hidden member.
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    May 13, 2008 9:49 PM GMT
    best of luck! I actually have been having irritation in that area from running. Hoping it does not exacerbate.
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    May 13, 2008 9:52 PM GMT
    DJBens77 saidbest of luck! I actually have been having irritation in that area from running. Hoping it does not exacerbate.


    word of advice get it checked out. the first time I had one I kinda felt bruised/sore. I didnt realise what it was until it ruptured and boy was it painful then as was the operation afterwards!
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    May 13, 2008 10:08 PM GMT
    will keep an eye on it. Right now its neosporin and a break from running. prolly just some friction.
  • HereNBoston

    Posts: 221

    May 14, 2008 1:19 AM GMT
    Rowing_Ant saidCheers man

    Ive been referred back to a surgeon as they think they didnt quite get all the infected material out...so back under the knife I go.

    ARGHGGHGH icon_cry.gificon_cry.gificon_cry.gificon_cry.gificon_cry.gificon_evil.gif


    glad to her your got referred to a specialist. it'll suck if they do have to do another excision, but at least you'll know this is the last of it and it'll get resolved. as far as pain goes, motrin and low dose oxycodone go a long way for incisional pain icon_smile.gif
  • Rowing_Ant

    Posts: 1504

    May 19, 2008 9:08 PM GMT
    yeah good to know Ive got an appointment with a Sacro Anal specialist. YaY! :-)

    Ill take your advice re painkillers....man I was uncomfortable and crotchity at work today from it. grgr

    Hugs
  • Posted by a hidden member.
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    May 20, 2008 1:26 PM GMT
    Rowing_Ant saidCheers man

    Ive been referred back to a surgeon as they think they didnt quite get all the infected material out...so back under the knife I go.

    ARGHGGHGH icon_cry.gificon_cry.gificon_cry.gificon_cry.gificon_cry.gificon_evil.gif


    Well. At least it'll be the last one hopefully! icon_razz.gif

    For once, I realize being naturally smooth has its advantages. icon_confused.gif

    Good luck and hope you get rid of it soon. icon_biggrin.gif