Posted: 2/3/2009 1:47:55 PM EDT
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I've got a pilonidal cyst that is in serious need of being surgically removed. The pain is like a 10 out of 10. I went to the E.R. yesterday because, as usual, my doctor is busy, the receptionists won't even let me talk to him over the phone, and they won't have him call me back.
The E.R. doc then refused to lance the cyst (which would have made it stop hurting immediately), stating he wanted the general surgeon to do everything. He prescribed me a one day supply of hydrocodone/apap 5/500. This shit is now gone, it didn't help at all, and he told me that since he's an E.R. doc that it was the only thing he could give me. To top everything off, after three weeks so far, my doctor's office still hasn't gotten me a referral to a general surgeon. Have the fucking junkies made it this ridiculously difficult to get some fucking relief? This thing hurts so bad I'm about to take a knife to it myself. Is the E.R. doctor full of shit that he can't prescribe me something better until my doctor's office pulls their head out of their ass and gets me to that surgeon? I'm really suffering here and I don't know what the fuck to do. |
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Not a doctor but I feel your pain. I had one of those and I was almost crying from the pain and frustration. I couldn't even sit sometimes. Strange that your doctor wouldn't lance it and clean it up.
My GF lanced mine. It was fucking gross. I saw colors I'd never seen before on the gauze. |
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My girlfriend is too fucking squeamish to do it. I already asked her to try. Not to mention the E.R. doc said it'd be best for the surgeon to do it so he could see the extent of it.
As far as getting a new doctor, there are no other doctors here that will accept my insurance. |
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Yup, cut that shit open.
Take a few dozen pulls off a bottle of whiskey and take your pocket knife to it. The problem is that it's just going to come back and these doctors are being fucking unreasonable. All I fucking want is something that I can take until the surgeon removes it. I'm a clean-cut white computer programmer, it's not like I look like a fucking junkie. I've been to the doctor 10 times 10 years. They get their fucking money, I get some relief. I guess the fucking pill seekers have ruined it for me and I'm fucking pissed and hurting. The fucking receptionist has been giving me an attitude all goddamn day as well which is really pissing me off. ETA: Fuck the war on drugs. |
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I don't know Cali's specific laws, but most ER docs do not prescribe more than a few days worth of pain meds at a time after being scammed frequently by seekers. It's not a legal thing (at least in my state) but a cautionary instinct.
A surgeon removing the cyst is the ideal solution as at times these cysts are huge and if they aren't removed, they'll just come right back. And unfortunately most primary doctors are so busy that it is impossible to get a walk in appointment. Unfortunately, this is the way it is at the time. |
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Piss and pus must come out.
If it's infected, it needs to be drained and packed. It also needs to be repacked every 48 hours or so. To be fair, yours may not have been fluctuant enough to drain (eg. there was no soft spot in the center for the doc to cut into). Go back and let them re-examine it, especially if it's red/hot and has a head on it. The ER doc could have been a little more generous with the pain medication, but in his defense, I rarely prescribe more than a few days worth... primarily so that the patient will run out, and actually come back to the ER and let me repack it (some of my street people ONLY come back when they're out of pain medication... at which point I seize the opportunity to re-examine the wound, pull the old packing, and repack it with fresh iodoform gauze). Definitive treatment is usually at the hands of a general surgeon... because without surgical excision, these things can recur. |
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If you really want help, and want it right now...
Start calling general surgeons out of the phone book, find one that isn't busy, and offer cash to remove a cyst ASAF'nP. That is how I would approach this problem. It's worked for me with other things, going directly to a specialist I mean... I don't know how it'll work for this, but it's not like it's a hard procedure, so give it a shot. |
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Quoted:
Piss and pus must come out. If it's infected, it needs to be drained and packed. It also needs to be repacked every 48 hours or so. To be fair, yours may not have been fluctuant enough to drain (eg. there was no soft spot in the center for the doc to cut into). Go back and let them re-examine it, especially if it's red/hot and has a head on it. The ER doc could have been a little more generous with the pain medication, but in his defense, I rarely prescribe more than a few days worth... primarily so that the patient will run out, and actually come back to the ER and let me repack it (some of my street people ONLY come back when they're out of pain medication... at which point I seize the opportunity to re-examine the wound, pull the old packing, and repack it with fresh iodoform gauze). Definitive treatment is usually at the hands of a general surgeon... because without surgical excision, these things can recur. I can't even get in to see my primary care doctor for over a week. Isn't there something this E.R. doc can do prescription wise so that I can at least function until my personal doctor can do his thing? It's not like I don't have an actual injury for him to see. Nearly the entire small of my back is inflamed, painful to the touch (I'm wearing extremely loose pants because just clothing touching it hurts like hell). It literally feels like it's on fire. I don't know if it's infected because he wouldn't lance it, and wouldn't prescribe me any antibiotics just to be on the safe side. Do you have any recommendations on something I can ask him for that will eliminate most of this pain? I know there's no miracle drug and it's still going to hurt until I get the damn thing surgically removed, but all the vicodin did that he gave me was make me itchy. |
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Do you have any recommendations on something I can ask him for that will eliminate most of this pain? I know there's no miracle drug and it's still going to hurt until I get the damn thing surgically removed, but all the vicodin did that he gave me was make me itchy. You should lay on a heating pad. It'll help it to hopefully burst and drain. You aren't going to get rid of that pain until the pressure lets up. |
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Quoted:
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Piss and pus must come out. If it's infected, it needs to be drained and packed. It also needs to be repacked every 48 hours or so. To be fair, yours may not have been fluctuant enough to drain (eg. there was no soft spot in the center for the doc to cut into). Go back and let them re-examine it, especially if it's red/hot and has a head on it. The ER doc could have been a little more generous with the pain medication, but in his defense, I rarely prescribe more than a few days worth... primarily so that the patient will run out, and actually come back to the ER and let me repack it (some of my street people ONLY come back when they're out of pain medication... at which point I seize the opportunity to re-examine the wound, pull the old packing, and repack it with fresh iodoform gauze). Definitive treatment is usually at the hands of a general surgeon... because without surgical excision, these things can recur. I can't even get in to see my primary care doctor for over a week. Isn't there something this E.R. doc can do prescription wise so that I can at least function until my personal doctor can do his thing? It's not like I don't have an actual injury for him to see. Nearly the entire small of my back is inflamed, painful to the touch (I'm wearing extremely loose pants because just clothing touching it hurts like hell). It literally feels like it's on fire. I don't know if it's infected because he wouldn't lance it, and wouldn't prescribe me any antibiotics just to be on the safe side. Do you have any recommendations on something I can ask him for that will eliminate most of this pain? I know there's no miracle drug and it's still going to hurt until I get the damn thing surgically removed, but all the vicodin did that he gave me was make me itchy. No. The treatment for an abscess is surgical drainage. Antibiotics will not get rid of it. I'd go back, and if it's at all ready or amenable to incision/drainage, I'd insist the guy drain the bloody thing. If it's an abscess, that's the treatment... period. Full stop. Not antibiotics, not pain medication, not see-your-regular-doctor-next month... DRAINAGE. If he won't do it, ask for one of the other physicians working... or go to another ER. ETA: adjunctive antibiotics may be used to help treat a surrounding cellulitis... but they will not get rid of the abscess. Pain medication is just being humane. |
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Well, I managed to get another E.R. doctor this time and he took care of business. IV sedation, anti-biotics, and morphine. Lanced the whole thing, prescribed me anti-biotics (and more worthless vicodin) and told me to follow up with my doctor. Thank God.
I don't think I'll be needing the vicodin anymore now anyway, now that the pressure is relieved I feel absolutely no pain. My faith in medical doctors is restored. 
ETA: Forcefully got an appointment with my primary care doctor for tomorrow at 9:30am, and I'll demand to know when the surgical referral is going to be done. That way this thing can be completely removed and hopefully won't come back. Pray to God none of you ever get one of these things. |
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Quoted:
Well, I managed to get another E.R. doctor this time and he took care of business. IV sedation, anti-biotics, and morphine. Lanced the whole thing, prescribed me anti-biotics (and more worthless vicodin) and told me to follow up with my doctor. Thank God. I don't think I'll be needing the vicodin anymore now anyway, now that the pressure is relieved I feel absolutely no pain. My faith in medical doctors is restored.
ETA: Forcefully got an appointment with my primary care doctor for tomorrow at 9:30am, and I'll demand to know when the surgical referral is going to be done. That way this thing can be completely removed and hopefully won't come back. Pray to God none of you ever get one of these things. Excellent... that's how it's supposed to be done. |