Tuesday, December 14, 2010

A Saudi surgeon's success

Resp. Dr.Bascom,

I am Dr.Iqbal Lohia from Jeddah, finished with 12 cases of cleft lift and am thankful for solving my surgical problem. All have healed and never midline problem. patient coming only once or twice for dressings. No dressing for 6 weeks after excision. Couple of patients having some wound infection at the rectal end ,but eventually healed without problem. At the end there is no cleft and patient even did not notice the same.

I have a request to obtain new DVD if possible. My address is

Dr.Iqbal Lohia
Medical Director and Surgeon,
Khalid Idriss Hospital,
P.O.B. 75, Jeddah 21411 (saudiArabia)

N.B. It will be nice if we can download from net as you are known to use advanced technology to educate other surgeon for solving their difficult problem (suggestion)........... Excellent suggestion. http://aboilonthebutt--pilonidal.blogspot.com/       I will try my blog.  I am depending on you to comment by email.  JUB 

 wrote:
Dear Maj Williams, Bcc:pilonidal  (That means copies of our messages go to an influential 64 + surgeons.  Keep records, publish, invent, improvise, you are already changing pilonidal practice all over the world.  Pass it on!)

Michele and others, do you have a CPT answer? JUB

Begin forwarded message:

From: "Williams, John W MAJ MIL USA MEDCOM BMACH" <john.wesley.williams@us.army.mil>
Date: December 14, 2010 6:02:54 AM PST
To: "John Bascom" <jbascomr@pacinfo.com>
Subject: Cleft lift (UNCLASSIFIED)

Classification:  UNCLASSIFIED
Caveats: NONE

Dr. Bascom,

Performed my first lift last week and things are looking great!  I hope
this is the answer my patients have been waiting for.

A question:  What CPT do you use for "pit picking"?

Look forward to the video.

Thank you,

John


John Williams, M.D.
MAJ, MC
General Surgery
Ft. Benning, GA

Will a cleft lift give permanent cure?


You feel uncertain, correct?   I also feel uncertain as to the precise answer to your questions.   Being an 85 year old retired surgeon, no longer in practice, informened with part information from the mail, and in an evolving field where no one knows the final answer.    I have offered you sources of information.  I guess your job is to investigate until you are content, make phone calls, ask experienced docs questions and ask them to examine you and finally it is your job to decide.  My choice is to whether to tell you my guess--which on incomplete evidence is "a pretty good chance".  What alternatives do you suggest?   

Tuesday, October 19, 2010

Patient feels uneasy about cleft lift


Sounds like you feel uneasy at the prospect of an unmet surgeon chopping on your rear end, right?  Natural.  You hope that this solves the nuisance quickly and permanently, correct?  We do, too.  We both hope the cigar works to avoid surgery (see prior blog post), right?


Thanks!  I will try wearing the "cigar" for a few weeks and see how it goes.  If this doesn’t work and I still have the open wound I plan on coming to Oregon to see you. Our plan also.
Since I will be coming so far to see you how would the appointment situation work?  Would you be able to look at my wound and see what needs to be done one day and then do a procedure on the next day?  
If you agree with our proposal after we see the unhealed Z-plasty, probably surgery the same day. 

  I would like to stay in Oregon during this entire time so I don’t have to be flying back and forth.  Since my z-plasty surgery a couple years ago the top 2 inches or so of my butt crack is gone.  I am left with a short butt crack (only about 2 to 2.5 inches worth above my rectum) with the z scar right above it.  Would I still be a good candidate for a cleft lift since my wound is only about a half inch above my rectum and extends up for about an inch?  
Yes, the operation is designed to solve that kind of problem.

Since the wound is right in the mid line of my crack and right at my rectum it worries me that it can’t be fixed.  How many cleft lifts have you performed and what percentage of them have been successful?  

Maybe 200.  As far as we know they are all healed.  Maybe 5-10 required repeat operations.  Maybe 3-5 patients three operations as we learned how to solve and teach these problems.  We are still learning.

How long would I need to take off from my job (it is a sit down office job)? Also, when could I go back to jogging and playing sports?
Tell your boss three weeks.  You have permission to back to both when you feel like it.  He will be surprised when you show up at 10d-2 wks
 

Sorry for so many questions, just trying to prepare myself for what may be to come.  Thank you for your time and have a good day!

Monday, October 18, 2010

A "CIGAR" TO GIVE THE FINAL PUSH TO HEALING







Subject: Vent cigar A patient describes an almost healed surgical wound in the cleft--no symptoms aside from minimal moisture. He wants final healing.

The buttocks, like lips, seal pus in the cleft. You might improvise around this idea and see if it helps. Minimal risk carrying this open wound for years. Surgery practically guaranteed to cure it if a Cleft Lift is used.

MD, from Seattle, wrote, "Photos, both of the products, the assembly process, and the final product, both on the table and in situ, would be an enormous help. I think I understand it, but could always improve my understanding." As soon as I learn to post photos I'll add photos to this blog.

This may interest you. The message includes three pictures that may not come through. If you don't see them, tell me. I'll try again.

The aim of this device: To let air reach non-healing wounds trapped in a cleft. I used this sort of device to heal one challenging patient with Crohn's and a non-healed wound from top of cleft to vagina where the proctectomy had fallen apart 2 years before. Plus, she had, between the coccyx and the back edge of vagina, an open cavity 7 cm deep!

A cleft lift healed almost all. However, a 2 cm skin defect refused to heal at the posterior edge of the vagina.

The defect remained open for months. Then I realized the problem! She sat with her legs together all day and lay all night with her legs together . I drew a "rim trail" on the line of contact of the thighs, down the front of the thighs from pubis to knees and up the posterior side from knees to the top of the cleft. I spread thighs to examine. The defect lay in the center of the huge airless area. She kept the cigar against the raw area day and night and it healed.

Details of construction:
Screen is soft fiberglass window screen or "fly screen". Orange is plastic kitchen scrub sponge everted by patiently pulling out the center. The steel scrub sponge is included for comparison. The thread is common cotton. A monofilament might be better.

Details of use:
Insert the "cigar" in the cleft with the side of the "cigar" against the wound. Wash the wound and cigar 1-2X/day.

Concerns expressed:
Irritation of the wound or discomfort. Falling out. Sharp ends of broken fiberglass.
Experience: The patient did not experience them. I wore the above device for a night and for several hours in a day. I found it comfortable. It did not fall out with walking despite my slack form. It did fall out with large steps or stairs. Tight briefs or other inventions should solve that.

The fiberglass is so fine and soft that I found no ends even after hours of wearing.

My interest:
I want to hear of experience of others. I will share any experiences I have or hear of. The "cigar" seems a low risk preliminary step for patients to use or doctors to recommend. It can be discontinued if uncomfortable, useless or irritating. In theory the "cigar" should help all forms of persistent pilonidal disease.

Thursday, September 30, 2010

New approach to non-healing

I share with all "pilonidal" some recent correspondence Bcc:pilonidal

Those of us that get fixations are hard to talk sense to.

I predict, in absence of good photos, and holding true to theory, that exists a micro-abscess with micro-lips at the lower end of the tunnel. There anaerobic pus is pushed into the tunnel (I wonder why the solid step of Dakin's does not cure?) I predict the cigar alone will cure him. We'll see! JUB

Surgeon wrote

Good analogy! The cigar would be great, IF he had a ‘seal’ there, which he USED to have, prior to the procedure; now the skin is out in the air, and has healed splendidly! It’s that stuff underneath which, in this nice fellow, won’t heal without additional work!
Thanks for your response.


JUB wrote

I apologize for bursting in without acknowledging the prior work and query. Obviously either we do not understand what surgical steps we are taking or we do not teach well.

May I try my latest analogy? It concerns lips and the buttocks. It may explain my latest conviction (or my fixation) to wit: "All raw pilonidal wounds are the three walls (bottom & sides) of a sealed-in, poorly drained anaerobic abscess." Note the TOP is absent from all such abscesses THAT WE SURGEONS SEE! The examiner has destroyed the TOP (and has FOR THE MOMENT destroyed the closed abscess) by standing the patient and by spreading the cleft, thus destroying the air tight seal of the "lips of the buttocks"! (Hovever, the seal and abscess is only temporarily destroyed, because the seal and abscess is re-created when the inspector releases the pull and the buttock LIPS fall together)

Several issues follow. If there is no cleft there is no disease. That explains the success we have had with a ventilating "cigar" which brings lethal oxygen to the anaerobic contents of the anaerobic abscess.

We have tried to emphasize the importance of the "rim trails", the vertical lines we (I) NOW URGE ALL SURGEONS TO DRAW, ON THE STANDING PATIENT, LINES WHERE THE BUTTOCKS MEET. ALL RAW WOUNDS lie between the "lips", between properly drawn "rim trails", whether of primary disease of failure of healing. Success will follow results where there is no cleft, it is impossible to draw rim trails because there is no cleft.

Perhaps we have not enough stressed how to eliminate the cleft just behind the anus. Build a fat pad to eliminate the cleft behind the anus. Bring the suture line to the SIDE of the anus to move the suture line out of the vulnerable midline.


Both lips and buttocks are soft tissue barriers able to create an air and liquid tight seal. Aa active seal created by the lips, and a passive seal is created by the buttocks, especially when sitting on the buttocks! I placed an infant feeding tube on an unhealed wound, had the patient sit, slowly injected saline to mimic accumulating pus. Before first leak appeared the saline in the manometer had risen to above the patient's head!!!!! I calculated the leaking or sealing pressure as 140 mm Hg!!!! (Have your fellows repeat this demonstration for the interns. It may explain why one can leave the walls in place as one drains the abscess and stops contamination as one does a cleft lift.)

In the standing patient it falls to 30 mm Hg, not to zero. Therefore, in all pilonidal patients, they seem to me, they carry a poorly drained anaerobic sealed abscess in their cleft 24/7! Except when examined!

John

Surgeon wrote:


John:
I had written you about this patient, who has contacted your office several times. Here is the text of my question to you:

Interesting! BTW, John, I have a problem patient I want to ask you about. 17yo boy, (lives in X, referred from your office) on whom I did a cleft lift ~3 months ago (assisted by X, another disciple of the Church of Bascom, (Beware of those with those with fixations and limited teaching talent...JUB) who has come to Mecca to watch you guys do the real stuff), which fell apart about a week after the surgery. Parents quite distressed, sent you pictures, and you counseled conservative management, which we have done. After initial indications that he was healing nicely, he’s left with 2 openings, top and bottom of the flap, in the midline, complete healing of the skin and obliteration of the gluteal cleft in the appropriate area, but a tunnel underneath, connecting the two openings. I suspect he just needs another cleft lift, opening, cleaning out, and resuturing, but without needing any excision. He’s been irrigating the tunnel with ¼ strength Dakins’ BID for a month or so, without improvement. Any other suggestions? If he needs a redo, I suspect he’ll come down to you and Tom, which is certainly fine with me. He’s just starting college , so whatever is done would likely be at Christmas time.

I subsequently spoke to Tom, who confirmed that it will need to be redone. (If the "cigar" fails.....JUB) The skin over the top is healed, with a tunnel beneath, so I doubt that the “cigar” is going to help the underlying defect. Unless you have some magic which we haven’t tried, I will contact the boy’s mother, and tell her of the fact that it needs to be redone. I know she and her husband will accept nothing less than Tom and yourself working with them on this.






Dear X,

I reviewed the pictures of Y's huge nuisance. I suspect you feel frustrated and heartily fed up, correct? For you would like this healed promptly and permanently, right? So would we all! I would be helped in understanding the problem and its solution if you can have taken some special photos. Michele in Tom's office can send you directions. We are helped if the pictures arrive in jpeg format.

Occasionally in our practice we have had similar results. A recent device has not been described in the literature. We have had good results recently with a simple plastic mesh "cigar" made out of a curly plastic scrub ball. The purpose of the device is to ventilate the bottom of the residual cleft--admit dry air and bacteria killing oxygen. If you will send me Evan's mail address I will send the "cigar" I fashioned today. This has a reasonable chance of solving the problem--there are others means but this is the simplest and is worth a try. He is to scrub the cleft with a soapy rag twice a day and wear the cigar at the bottom of the cleft 24/7 for a few weeks..

Your are on the right track to healing for you will continue learning about the disease at pilonidal.org and are asking good questions. I predict this nuisance will solved by Dec 1.

If you have have looked at the list of surgeons at the pilonidal.org site there may be a pilonidal surgeon near Evan's school if it is not convenient for him to visit Dr. Z for follow-up:

http://www.pilonidal.org

under Find a Surgeon.

If you have considered working with one of them in his area, and after a time still feel a visit to Eugene is your best option then we would be glad to see you. You can arrange a visit with Michele.

Call or e-mail if you have further questions after you study the material at the web site www.pilonidal.org especially at http://www.pilonidal.org/medical_profs.htm.

Good luck!

John Bascom MD
65 W 30th St Apt. 3512
Eugene, OR 97405
Phone 541-343-4118


Patient's mother wrote

I had contacted you regarding my son's pilonidal disease last spring having heard about your cleft lift procedure. Under your suggestion, we sought out a Surgeon in our area (X) who performed the surgery in mid June 2010 It is now the end of Sept., and he is still not healed, and in the last couple of weeks has developed what looks like a new cyst, just above the cleft line. x has just gone off to college, and this has become an enormous stress point in his life. We were under the impression that with the cleft lift procedure, he would have healed within a couple of weeks. Dr. X tells us that this is normal and it just takes time and that it is healing well. He does not know about the new cyst yet. As X is away at school, he suggested X follow-up with a physician in the town where his college is. I have included some photos of X dated Sept 24, 2010 and am hoping that you can give me your opinion. We would not hesitate to come to you if you can help. We desperately want to get rid of this problem in X's life, so that he can focus on his new college life and education with the confidence and self esteem that this has taken from him. Feeling lost! Please help!

Sincerely,

Friday, September 17, 2010

Choice of treatment

A new font is much easier for me to read (I am 85). The Font "Arial Black" Size 18 under Format, under Show Fonts is easier to read so please use it when you type your message.

If you continue to have little trouble I advise you to continue cleaning. If you continue to have discharge you have probably considered seeing Dr. A again, also Dr. B. The knowledge on pilonidals is changing rapidly. They have 6 years and 1 year of experience and may have learned new skills. Their job is to give advice. They do not own you. Your job is to decide, to learn about pilonidals and hear many opinions and to decide which course is to bring the result you want. Pilonidal.org lists many doctors in Saudi Arabia, Israel and in countries closer than Oregon. You have my permission to call or Email 5 of them, continue to learn opinions.

After study of your photos, if we were taking care of you, we would recommend a cleft lift to permanently eliminate the cleft. The trouble starts, in my opinion, at the depth of the midline fold and likely will cause repeated infections as long as a cleft exists...

Tuesday, July 27, 2010

Shave hair?

Q: When you say “we have not used laser”, I wonder what you do recommend. Is hair removal essential? Pilonidal.org seems to say so. A:......... Opinions change. I once thought so, and many good people still do, my attention is currently focused on the pit and the abscess, poorly drained and anaerobic because sealed at the surface as the buttocks and the cleft are squeezed closed 24/7. Hair plays a part and removal is never hurtful but I see removal as not essential. .....

Saturday, July 24, 2010

Flight Home?

A patient asked about travel after a cleft lift. I replied.......With surgery on August 3 and visit to the office on August 6, I mispoke, a trip on August 3 would be possible but uncomfortable for I expect you to be in the hospital overnight. The sutures will not be removed August 6th, they dissolve. You and the wound would probably tolerate the flight August 6. A trip on August 10-12 would sound reasonably comfortable following the usual course after a cleft lift. Each day brings a stronger wound and more comfort.

Wednesday, July 14, 2010

Response to pilonidal query

A patient wrote, "I have a few questions for you which I was hoping you might answer:"

How and why do people like me keep developing sinuses again and again? Two answers--the buttocks fall together and seal close the cleft, much like the Zip-Lock on a re-sealable plastic bag, seals 24/7, creating a poorly drained anaerobic abscess which will not let surgical wounds in the cleft to heal. Second reason--more common in earlier disease, pits in the midline, enlarged hair follicles, continue to inject bacteria into underlying fat where bacteria generate abscesses--painful pus under pressure.
Is it a bad idea to wait till December to have another surgery? There are ways to get the problem likely solved by Sept 15--on the basis of your good photographs we likely would recommend a cleft lift operation.
I can probably get my internship shortened if need be.
Will the pain keep rising/stay constant, or is there ANYTHING

I can do
to alleviate it? e.g. If I stay off my backside for a couple of weeks,
will it get better? Not likely.
Am I allowed to exercise i.e. play soccer and squash, or is that bad
for the situation? Little difference
How do I remove the hair in that area because it is difficult to
reach? The hair removal creams say not to apply to perianal regions so
what other methods can I use? We have not found hair removal of much help. Some doctors do.
I received the list of cleft lift surgeons who do your procedure, but
do you know of any personally that have good records with this? No. Telephone calls to surgeons in your area are a nuisance for you but give much information
How effective is the cleft lift? It is usually the best way to fix
this problem? What is the recovery time associated with the cleft
lift, as I will have a maximum of 4 weeks in December of winter breaks
to get this taken care of? After Cleft Lift surgery 90% are ready to go back to class in 2-4 weeks--ready to fly cross country in 5-7 days.
If there is any other advice or information you could give me, I would
really appreciate it. Study the material at http://www.pilonidal.org/

pilonidal questions

It sounds like you feel tired of a pilonidal problem, correct? For you would like this problem solved quickly and permanently, right? You are headed for a good solution for you are learning and asking questions. This is my reply to a seeker with 6 years of failed pilo.

Learn about what other questions to ask by studying the web site http://www.pilonidal.org especially http://www.pilonidal.org/medical_profs.htm and then check the list under Find a Surgeon on http://pilonidal.org home page for MDs near you. We depend on patients like you to keep the list up to date so tell us at sasha@pilonidal.org what you learn.

It is fair to call these MDs, who have heard of the cleft lift operation, to ask them of their current methods and how they turn out. Do not be discouraged. You may have to make 5-10 calls. You are on the right track. Conventional treatments often work well. From your description it sounds like a cleft lift would likely solve your problem. There is even a chance that a simpler operation, pick pits, might be worth a try. We could make a better informed comment if we had a photo taken according to Michele's instructions.

Post a comment if you have further questions after you study the material at the web site www.pilonidal.org .

Good luck!

Tuesday, July 6, 2010

pilonidal-small primary

This may be useful....... learncolorectalsurgery.blogspot.com/

PILONIDAL-small primary

I reviewed the pictures of your nuisance stacked on all the other nuisances, right?. I suspect you feel frustrated and heartily fed up, correct? For you would like this healed promptly and permanently, right?

I think this kind of problem, in our hands, has responded best to pick pits. Nature can always interfere with recovery but I think you have an excellent chance to achieve healing with pick pits, though a case could be made for the cleft lift operation.

Your are on the right track to healing for you have learned about the disease and are asking good questions. The incising doctor did exactly the right thing--incised to one side of the midline and stopped to let the edema fade for 10 days. Your problem started with the pit visible in the midline. It injected bacteria into fat under the midline and that started the abscess. You are well advised to learn about pits. Destroy the pit and the problem is likely solved. The treatment of pits is new so the topic is unfamiliar.

You have a tough task, as if you are unacquainted with tough tasks! But fortunately you have lots of time. Start by reading Pingree on the web site. The list of surgeons is those that know of cleft lift--fewer know of pick pits but the list is a place to start. You probably will have to call 10-15 before you get your problem solved. Do not be discouraged--you will solve this nuisance by Sept-Oct! Rosengart is a good source

If you have have looked at the list of surgeons at the pilonidal.org site at this address: http://www.pilonidal.org under Find a Surgeon. and have considered working with one of them in your area, and still feel a visit to us is your best option then we would be glad to see you.

Call or e-mail if you have further questions after you study the material at the web site www.pilonidal.org especially at http://www.pilonidal.org/medical_profs.htm.

Thursday, July 1, 2010

News from Norway

Dear Dr. Ruiken, (To you on the "pilonidal" emailing list, I will send this time "open Cc:", instead of "blind Bcc:" so you can see what a spread your news reaches!)

Dr. Ruiken, you feel heartened by your experience, right? For you try always to bring health to patients, correct? This is very good news from Norway! Publish and teach! Thank you!

I will share your experience with some 70+/- from around the world and add your name to the email list and to the list of doctors who do cleft lift. Learn of new and improved pit picking for early pilonidals, and of saline overload in the USA which needs similar work!

John Bascom, MD
65 W 30th Ave. #3710
Eugene, OR 97405
Phone 541-434-4118

Begin forwarded message:

From:
Date: July 1, 2010 4:03:38 AM PDT
To:
Subject: SV: doc list

Hello,

i am working in Norway, at the "Ålesund sjukehus".
To years ago i started operating pilonidalcysts with "cleft lift procedure".

At the beginning i was alone, now we are three who do this procedure. Very little "open procedure" (excise and lay i open).

We have don 42 operasjons:

38 primer tilhealing
2 seromas med spontan perforation
1 infeksjon med sugical opning at it was good 4 weaks after operasjon.
1 with an 1 cm dehiszens in the scar. I took 1 year to get rid of this open 1 cm: He cam from an other city, and in our treatment with barbering the hair it was good after 3 weeks.

I can say that this experience with good results will motivate oss to continue with "cleft lift".

Greetings

Roland Ruiken
seksjonsoverlege dagkirurgi
Ålesund sjukehus
Helse Sunnmøre HF
6020 Ålesund
Norge
Fra: John Bascom [mailto:jbascomr@pacinfo.com]
Sendt: 29. juni 2010 16:15
Til: Rosen, Nelson G.
Emne: doc list

Nelson, Bcc:pilonidal

TTT Things Take Time! Keep throwing mud at a wall--some of it will stick! Look at Sandy's list- http://www.pilonidal.org/pdfs/PiloMDs_NON-USA_06_2010.pdf - 100 surgeons from the US and 70 from all over the world know of cleft lift. And when Sandy started a web on pilonidals there were NONE! Plus this message and others addressed to pilonidal goes by email to some 70+ professionals from over the world. Give us your experience and we will spread it around. Keep learning! Publish! Thanks for your past contributions and thanks for your teaching of the younger generation. And in August we will host a surgeon from Denmark to Oregon who comes to learn. And I, at urging of Sandy, have just started a blog. Do you have anything the world should know? Send it and I will get it out--the world may not listen but at least it will be off your mind. JUB



On Jun 28, 2010, at 10:36 AM, Rosen, Nelson G. wrote:

Very frustrating to read.

I am a pediatric surgeon but have not been turning away anyone who would benefit from a lift.

I have not been successful at encouraging my adult colleagues to adopt these techniques. I guess you can lead a horse to water, but that doesn't make the horse any smarter.

-Nelson Rosen

Nelson Rosen, MD, FACS, FAAP
Director, Trauma Center
Steven and Alexandra Cohen Children's Medical Center of New York
Rm. 158
269-01 76th Avenue
New Hyde Park, NY 11040

Assistant Professor of Surgery and Pediatrics
Hofstra School of Medicine

Office (516) 470-3636
Fax (718) 347-1233

Tuesday, June 29, 2010

PILONIDAL

Nelson, Bcc:pilonidal

TTT Things Take Time! Keep throwing mud at a wall--some of it will stick! Look at Sandy's list- http://www.pilonidal.org/pdfs/PiloMDs_NON-USA_06_2010.pdf - 100 surgeons from the US and 70 from all over the world know of cleft lift. And when Sandy started a web on pilonidals there were NONE! Plus this message and others addressed to pilonidal goes by email to some 70+ professionals from over the world. Give us your experience and we will spread it around. Keep learning! Publish! Thanks for your past contributions and thanks for your teaching of the younger generation. And in August we will host a surgeon from Denmark to Oregon who comes to learn. And I, at urging of Sandy, have just started a blog. Do you have anything the world should know? Send it and I will get it out--the world may not listen but at least it will be off your mind. JUB



On Jun 28, 2010, at 10:36 AM, Rosen, Nelson G. wrote:

Very frustrating to read.

I am a pediatric surgeon but have not been turning away anyone who would benefit from a lift.

I have not been successful at encouraging my adult colleagues to adopt these techniques. I guess you can lead a horse to water, but that doesn't make the horse any smarter.

LIFT WORKS FOR OTHERS

An endorsement from a plastic surgeon in DC area.......

i do the cleft lift - done about 15 now. 2 i had to redo and the 2nd time all were succesful.

the two i had to redo i had to bring further from the midline. i didnt bring it far enough off midline.

i havent done pit picking yet as i am a plastic surgeon and mostly do recon surgery and only see others train wrecks.

the cleft lift flap in my opinion has revolutionized the treatment of pilonidal disease as before i had 50-75 % redos over and over again prior to doing cleft lift surgery.

thanks again for all the updates.

Saturday, June 26, 2010

SELF CURE PILONIDAL

I will describe a self-cure for those interested. It is cumbersome but it works. Write a post and I will reply

Friday, June 25, 2010

Worried--pilonidal?

Worried over a sore over the tailbone? It may be a pilonidal? Look on www.pilonidal.org and tell us if we were useful. Paul, did you read this?

Thursday, June 24, 2010

BOIL ON THE BUTT

If you are wondering how to deal with a sore over the tailbone, see www.pilonidal.org and ask questions of this blog.