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

Hi,

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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