Pilonidal Sinus/abscess on the bum

[CantsitWontsit]

I have name changed but am a regular poster.

Last week I found a spot on my bum, that over the course of three days grew into a huge abscess that required emergency surgery under a full anaesthetic to drain and pack at the weekend. I have never known pain like it. Childbirth was easier.

The dressings need to be changed and the wound re-packed everyday by a nurse. They said up to 6 weeks to heal and I can't go back to work until it has.

I didn't even know this was a thing! I am shocked. The Dr said it is usually makes who have very sedentary jobs (Lorry drivers for example) with very hairy arses that get this! I am none of those things. My marathon training is now messed up, I can't work out, I can't go to work. I can't sit down or lay on my back.

Has anyone any experience of this? Can you tell me nice stories about how you recovered in 2 weeks instead of 6?

My poor bum! The poor nurses who have to look at my bum everyday! My poor husband who is doing EVERYTHING now.

Poor me, because when I tell people why I am at home/not at work/the gym/running club, they kinda laugh a bit

You have my full empathy, I have a recurrent abscess in that area, mine is currently inflamed and burst at the weekend, the district nurse is coming to pack it tomorrow properly, it has a temporary pack in it, I feel your pain literally.

No big words of advice except, keep it clean and dry, in times like this I use baby wipes for 2s and put wipe into a nappy bag. It stops cross contamination.

I spend the time when its bad lying down with a memory foam pillow under my hips so that my pelvis is sort of point at an angle to the celing but everything is touching the pillow except the top of my bum and coccyx

Handhold from me too

I had this once though nowhere near as bad as you & I can confirm it hurts like hell. I never realised how delicate the skin is in that area - it's very thin. You must take your healing very seriously because it's not uncommon to acquire Nec'Fas' in this area & that can super rapidly lead to major surgery. Do everything they tell you to to get better. & be very careful in future about even scratching there. I'm a year on & mine is fine now. Good luck.

My husband had the same thing. He did have the six weeks off work with the nurse coming every day. He was very happy after the surgery as the awful pain had gone so coped with not working etc. He felt well in himself during recovery, was just bored.

So sorry to hear this and that I can't give you a miracle cure.

The reason it takes so long is because it has to heal from the bottom up, that's why they pack it. If they didn't, it would just heal over the top and you still have a void under the skin which would again get infected and horrible. The packing make sure it heals from the bottom.

You're in it for the long haul I'm afraid

My Dad has this about 15 years ago. He travelled internationally and had done lots of long haul flights in short period of time. He was very active (played squash, golf, running etc).

Sorry to say he did need the 6 weeks to recover. He did have a rubber ring to sit on, which meant he could do some work from home.

Wishing you a speedy recovery.

Thanks for the replies. The nurse I saw yesterday said that this was one of her biggest fears, which wasn't helpful

Blimey Smurfy, poor you! How do you cope? Recurring abscesses must be a nightmare.

Bibble, I will do everything they say. I promise. The thought of it not healing or worsening makes me nauseous.

Hi there, I had this over 10 years ago when I was 22. I was working in my first office job and had put on weight so had gone from a small size 12 to a larger size 12/14. I would say my life was particularly sedentary and I am honestly the least hairy woman I know in my circle of friends?! So sometimes I think it just happens.

It did take me the full 6 weeks to recover so rest up and download some box sets. Keep the area super clean. My scar felt 'delicate' for a looooong time afterwards. It still feels sensitive now to be honest. Also, invest in underwear that has no seam at the back as pre-surgery all of mine had this and my scar did not like it at all, and perhaps a rubber ring 🙈

Good news, I completely recovered and it has never come back. I had heard that they could be recurring which terrified me but reckon for me it was just one of those random things.

You might not want to hear my story - abcess in my abdomen - since August, still having it dressed daily. I hope yours heals quicker, but if it takes a long time insist on referral to wound specialists at hospital. You have my utmost sympathy.
(on the plus side for you, mine was completely mismanaged and misdiagnosed form the start, yours has been properly drained, mine wasn't, and I have weak immune system - so don't heal well)

Jesus Kurri
That is awful! Are you mending okay now?

Just had my dressing changed and cried because of the pain

My dp had this about 12 years ago, I have never seen him or anyone in so much pain and i have birthed 2 children with no pain relief!!

It healed up nicely, about a week after the op he was fine in himself and doing jobs around the house, he has a manual job with over an hour commute and I think he was off for 8 weeks in total.

He says the packing was the worse pain ever especially the first few times, he was told to take pain killers about an hour before he went.

After about a week the nurse showed me how to pack and dress it so he didnt need to trail out to his dr surgery every day or could have been every second day, and he only went once a week to get it checked and get more dressings!

Its been a very long haul Cantsit - I have another appointment with the wound specialist soon, they are saying that by Christmas they are hoping to get dressing changes down to every other day. It has been horrendous, but don't want to alarm you - nurse said she had never seen an abcess so determined not to heal as mine, so if you are generally otherwise well yours will very likely be much quicker.

Mine should only have taken six weeks,but as I say it all went a bit tits up.

A friend had a PS like yours and they are incredibly painful, but hers healed in six weeks IIRC. Have you tried taking painkillers half an hour before your dressing change ? - Might take the edge off the pain, and make sure you have good strong painkillers from the GP. The dressing changes are very painful

Mine is on my front - but I always sleep on my front, I have found lying on a bean bag helps a bit to cushion everything. Also I've been told to take a vitamin and mineral supplement - you need to keep up your levels of certain minerals to heal well (I can't remember what they are - but I take centrum vit and mineral supplements) and also eat lots of green leafy veg.

Good luck with it all

Oh god... I remember my great pilonidal abscess of 2012. Being 7 months pregnant right now I am hoping childbirth is truly easier as it was simply AWFUL.

I started with a spot on the Sunday night and by the Wednesday I was in agony. Saw the GP who sent me straight to hospital to be drained. Hospital made me feel like an idiot as they "had seen worse" and sent me on my way with Tramadol and antibiotics.

It got progressively worse. By Sunday I was in tears so I again made my way to the GP who was apoplectic that the hospital hadn't treated me the week before. Straight back to hospital I went and I was sent to an outpatients type ward. I arrived at about 9:30am and no one even breathed in my general direction until after 3pm. I couldn't site down because my right bum cheek was on fire and twice the size. I wasn't offered a drink. I was in so much pain and so dehydrated my eyes were sinking in my head. When I was finally seen they were suddenly whipped into a frenzy at how bad it actually was. I was out of the operating theatre by 5pm!

Had it drained under a general anesthetic and didn't feel anything until the hospital nurse packed it the next day. OH MY GOD I CRIED. I have a really good pain threshold but Jesus Christ did it hurt. The hole was MASSIVE. About 2" side to side, up and down and deep.

I was discharged that day and told to go to my GP for packing every day. I was turned away on the first day because the hospital had failed to provide me with a prescription for the packing. So my arse was an oozy disgusting mess for another 24 hours.

Had it packed every day at the GP for the first 2 weeks and they commented that I was healing really well and could go to every other day and skip weekends for weeks 3-4. I didn't need to have it packed after week 4 and I could cover it myself with a fresh dressing each day. Seems I heal good!

The pain after the op was fine unless I was sat down. I was off sick for the first week and worked from home the second (bully boss who didn't understand and I was too wet to argue). After that I was good to go back to work.

I have had 7 of these. Well it was the same one that kept returning.

Look for the support forum called pilonidal.org
To look for a surgeon that specialises in the karydakis flap procedure. Mine has never come back after 6 previous surgeries. My 7th surgery was successful because my surgeon ordered an MRI for me to see exactly where it was and where it had tunnelled to.

If your in Scotland, I can recommend 3 surgeons (all NHS)

Once you've healed, it you get a flare up, have a bath with Epsom salts. It really does reduce the swelling.

You have my sympathy, these things are absolutely awful. I'm 4 years post op from my 7th surgery.

My DH had similar, his hairy bum may have been a factor!

It was a very long road for him, ultimately he had 8 surgeries over a 3 year period, but his was perhaps a little different to yours as his had tracked inwards as well as outwards and had perforated his bowel in 2 places.

My top tips are rubber ring as pp have said, jogging bottoms, and a appropriate cover story to prevent your dc telling all and sundry whats going on! For DH it was a 'bad leg' that meant he couldn't sit down on floor, school tiny chairs etc.

Hope all goes well for you

Oh you poor thing! Huge sympathy from here.

I suffer with abscesses, but instead on my bikini line. I had one drained under GA a few months ago and it was about 5 weeks of daily packing and dressing appointments before it was healed.

Just do what they tell you religiously. It's got to heal from the inside out, which is fucking grim but totally necessary.

My only advice is be pushy about the appointments - I found my GP surgery very lacklustre in their understanding of the need for daily appointments (which is what I was told was needed) and ended up having to use minor injuries several times.

Are you still in hospital? Ask for entonox whilst they do it. We used to keep ours in until the pain of the dressing change was manageable.

If you're already out, make sure you pre load on painkillers before the dressing change

I had this OP. I had a bandage pressure stitched into my back. I remember a group of medical students peering at my nether regions after a adhesive bandage was removed. I'm allergic to adhesives and one of them remarked that it looked like I had nappy rash. The consultant recommended salt water baths to help healing. I could only sleep on my side or tummy. It never came back, thank goodness.

Oh my goodness, there are some horrendous stories here. I feel like such a wuss in comparison.

I am home but my Drs have been really good and I have all my daily appointments scheduled for the next two weeks, not sure what happens weekends so will ask.

It is reassuring that I am not being dramatic with the pain reaction. It is vile!

My weekend dressing happens at an out of hours place in the next small town, or you might be able to get visit from district nurse (although in my area they have become quite restrictive who qualifies for district nurse visit - you have to be completely immobile, but your HA might be different).

Can I just ask, were you all okay going to the loo after? The anaesthetic has constipated me. Was it painful? I am so frightened of any pressure!

It's probably the painkillers that have constipated you, particularly morphine.

I used to stretch out on the loo (tmi sorry) as that helped. It is hard to keep the area clean so wet wipes are useful.

Would laxatives be a bad idea?

I suppose it depends on what you're thinking? Like you don't want to be shitting through the eye of a needle. At at a risk of TMI, how often are you going/last actually go? It could just be effects from anaesthetic or the painkillers you're taking (what are you taking?) or even psychosomatic due to the fear of it hurting/getting infected etc

I feel your pain, I had one a few years ago when my daughter was 8 weeks old, it was a nightmare. I had to breastfeed her standing up or lying down and take her to the hospital with me every day for dressing changes.

One thing I did that helped was had a bath in salt water (I even found some posh bath salts that only contained sea salt and lavender essential oil) before going for a dressing change. Sometimes it would soak the dressing out wgich made things easier, and I think the salt helped with the healing.

It did take a very long time to heal though, sorry.

I am so sorry. I had one at 16 and I'd never known pain like it. I have since had 2 children with only gas and air and hands down my abscess was far far worse. It came back in my mid 20s and I had the op again. Now if I get run down it gets very tender so I'm so so careful and if it starts to hurt I'm straight to the GP for antibiotics. Luckily it's never needed to be operated on again (8 ish years now). I had no risk factors I was and am very active hardly sat down didn't have sedentary job. I was just unlucky. With my first I was back at school after two weeks and my second back at work after about three. I wasn't fully healed though but going out of my mind with boredom. Good luck