Seeking advice on flare-up almost gone and upcoming trip.

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I’ve been long suffering from pilonidal sinus. Mine has never really leaked, but it has become inflamed on a few occasions and required incision and drainage twice, last time it was in December 2012. Since then, I had no symptoms until last week.

Last week I started feeling something strange and in a few days it became more painful. I started on Augmentin (prescribed in the UK where I live) and the surgeon who visited me after 2 days of antibiotics told me that there was no abscess and he was pretty sure the antibiotics alone would suffice.

In the meantime I went to Italy (where I’m from) and saw another surgeon because the pain was getting worse and I developed a mild fever. After a visit and an ultrasound, the surgeon confirmed that no abscess was present but there was a hematoma instead. He aspired a bit of blood with a siring and changed the antibiotics to a combination of Ceftriaxone and Metronidazole for 5 days, claiming that these would be more effective against the kind of bacteria present in the area. Today I’ll have the third injection done and I’m feeling much better. The swelling has pretty much gone, I can sit comfortably but I still can’t (and don’t want to) lie on my back without pressing on the residual swelling.

Before I get to my questions, let me say what my BIG problem is right now. I have a trip starting Tuesday next week that I’ve been looking forward to for very long. This trip will involve a lot of flying (10 flights, two of which on long haul on a flat bed), in the space of 14 days. The main destinations will be Chicago and Washington DC. You can obviously imagine I am now both worried I won’t be 100% fine before my trip or that the sinus will flare up again whilst I’m there.

I’ve just bought a scrub puff and the No Bump solution to keep the area clean throughout the trip and a coggyx cushion to use on the flights.

So here are my questions:

- Have you ever had a hematoma with no abscess that was painful and led to a fever (although, this could have been a mild flu too)?

- Should I have a flare-up whilst in the US, and this required draining, do you think they would do an incision that would either allow me to continue my trip (i.e. that I could dress by myself) or that would at least allow me to go back to the UK? Should I go to ER or try to find a private surgeon?

- Would it be crazy to stay on such strong antibiotics for the whole duration of the trip just as a preventive measure?

- More generally, what would you do? Any advice?I also need to contact my travel insurance. I disclosed the pre-existing condition when I took the insurance and they accepted it, however I would like to make sure they won't be funny about it!

Thank you in advance!

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5 Replies

  • Posted

    Hi. Although my situation is abit different than yours (I just had my 3rd operation of an Pilondial sinus excision and I'm only 18), I would recommend to continue taking your antibiotics. I'm not sure if you experience any side effects, I did when I was on them multiple times, but you don't want to risk aggravating the infection or causing it to worsen, and hence reliving this all over again. And I've found that by doing daily dressings/ cleaning of the area around the sinus will keep infections and bacteria away and I'm sure you'll be fine.

    Just remember to keep taking your antibiotics and not to miss a dose, and to daily clean the area.

    I'm aware that I haven't answered all your questions, but I hope this helps smile

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    • Posted


      Thanks for your reply.

      I wasn't planning to stop taking antibiotics before I'm meant to, however I have only been prescribed until tomorrow. I meant whether it would make sense to take antibiotics even after this course and for the whole time I will be away. I am currently in Italy and I feel really lost about what I should do. I'm really afriad I will have to cancel this trip.

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    • Posted

      I don't think you should take antibiotics after the course your're already on. You don't want to take too much in case you become resistent to the effects of your antibiotic. I think it's best to complete your course till tomorrow. Is it very painful? 
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    • Posted

      It's not very paintul. Far less painful than a few days ago. However I'm not sure whether there's been any improvement since yesterday. The slight pain is now only on one specific point, slightly on the side. I'm still trying to only lie down or sit on one side to avoid putting pressure.

      I only have very little time to decide.

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    • Posted

      I think you should finish your course of antibiotics and thats it. I started my course of antibiotics last week and just finished them on Friday. I was in excruciating pain until just yesterday and hence, I know that the anitbiotics have taken affect. I'm sure there has been improvement which will become more visible in a few more days.

      I think you should also consult your doctor by phone. Seeing as you have very little time, you can have a phone consultation if that will put your mind to ease.

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