Over the last few months I have had the misfortune to have what is known as a perianal abscess. If I could pick one part of my body where I would not have an issue to contend with it would be exactly where it is - right between the anus and the scar from where my coccyx was removed. It's unrelated to the coccyx stuff apparently - and I have checked with both Dr Maigne and the colorectal surgeon I have eventually seen for treating this. However, I must admit there is a part of me that does wonder though... after all, during the coccygectomy the anoccoccygeal ligament was cut/impaired as it used to be attached to the end of my coccyx, which has now gone. The other end of this ligament attaches on to the anal sphincter muscles in order to help support the anus, and it is within small glands located close to the sphincter muscles that most perianal abscesses start. Hopefully it is just an unlucky coincidence, but I will continue to ask the question if this does not clear up.
Anyway, the main reason I decided to write this was to alert people to the experience I once again had with how the NHS manages these sort of things - and this problem is far more routine than coccydynia. The first time I noticed the tender bump the GP quickly diagnosed it as a perianal abscess and gave me some antibiotics as thought it could be nipped in the bud early as it was not very large. Fair enough I thought, despite having read that antibiotics rarely work and that drainage is necessary. It cleared it up...but two months later it was back with a vengeance. Once again he gave me the same antibiotics and dismissed my concerns that it needed someone more experienced looking at it. They didn't work this time and a week later whilst away from home working in London I had to take myself to A&E. After a long wait the junior Doctor also thought it not too concerning and gave me some stronger antibiotics in the hope it would clear up. It didn't and continued to get bigger and more painful. Having had enough of the runaround I kicked in my private health insurance and went to see a colorectal surgeon who within seconds diagnosed it as large perianal abscess that required urgent draining. He confirmed that antibiotics should rarely be given as drainage is nearly always necessary and that by prolonging it the proble, simply worsens. The next day I was admitted to the hospital where under general anaesthetic it was incised and drained. The recovery is tricky, due to location and the fact it has to heal from inside to out, in the hope that no fistulas (tunnels that lead to subsequent abscesses) develop. The open wound needs packing daily until it starts to close up. It's nothing like the coccygectomy pain and recovery but it's not much fun!! And after all the care regarding infection for the coccygectomy it is a bit disconcerting to have an open wound even closer to you know what. So long as it heals without any fistula or scar issues, and this is not the start of another chronic problem, I will be happy.
As for the ongoing progress from the coccygectomy things have been going well (this aside). I sit more, and with less awareness, as well as exercise more and more. I hope that once this wound heals up that will continue. Sitting will never be perfect for me, I know that, but if it just means I need to get up quite regularly and move around a bit, I can certainly live with that. To be honest that is something we are all told we should be doing more of anyway, so at least I don't need a reminder!!
