A successful surgery and then a 4-month relapse

Chris - chrisnovelli@aol.com

Posted 2010-11-28

In a nutshell: I had my entire coccyx removed in January 2010. The surgery was a breeze, and I had an amazing recovery. I felt so much better by March I started jogging again. I had a relapse and stopped jogging. The relapse lasted only a couple of weeks, and soon I was on the road to full recovery again. I was feeling almost completely recovered by July and started jogging again. I had another relapse, except this one has never gone away, and it is now November. The pain manifests itself as a slight soreness or little twinges which I can usually make go away with an Advil, but it keeps coming back, which means I can not sit. I seem to have reached a plateau, and have stayed there more or less for about four months. Needless to say, I'm never going to jog again — ever. My understanding at this point is that what I now have is a scar tissue injury, and that is probably why it is taking so much longer to heal. But it doesn't seem to be healing, and that is the distressing part. I'd like to know if anyone else has had a similar experience with reinjuring where they had the surgery, and if they plateaued did they ever heal eventually. Is there anything I can do to get better? I can be reached at chrisnovelli@aol.com . My full story is below.

I live in Richmond, Virginia, and I'm a guy. I first felt the pain while I was sitting in my kitchen in October 2008. I was 41. My problem with my tailbone was never the result of an event or a trauma. It happened all by itself for no apparent reason. I must add, though, that I had always led a very sedentary lifestyle and had an office job. Over the next year, I learned to live with this condition. I tried all sorts of pillows and cushions. I quickly discovered that circular doughnut cushions did not work, and that the black wedge-shaped coccyx cushions were completely worthless. (The notched cut out of the back is too small.) I finally discovered the U-shaped neck cushions that people use on airplanes. These come in a range of thicknesses. I found that the fuller ones, filled with microbeads work the best. The foam ones look thick, but when you sit on them, they squash flatter than a pancake. I bought U-shaped cushions for my car, my chair at work, and my chair at home.

I had the surgery at Virginia Commonwealth University's Medical College of Virginia on January 4, 2010. Dr. Cardea (see Doctors and specialists in the USA, Virginia) removed my entire coccyx at the joint. The surgery was a breeze. I had the general anesthetic, and it hit me so fast, I never knew what happened. When I woke up in the recovery room, the first thing I asked was, "Did they really take it out?" I didn't feel any pain at all. I stayed overnight and had no trouble going to the bathroom to urinate. Around 9:00 P.M., I walked around the hospital corridors with one of the nurses to see the status of my mobility. I was given a button to push for automatic doses of morphine, but I never needed to push it even once. The next morning, I could only feel the slightest sensation in the posterior area. I had a succession of nurses and attendants who looked in on me and checked my vital signs. The nurses said I was doing so well that they were going to cancel the previously scheduled physical therapy appointment to discuss how to use crutches. Dr. Cardea came in to see me around 9:30 A.M. I asked him if he really had removed the entire coccyx, and he said yes, he had. He said the incision was 3 centimetres, and that my problem had been a hyper-mobile coccyx. I was discharged around 10:00. I had no trouble dressing. I knew from reading accounts on this website that patients with this type of surgery are discharged in a wheelchair, so I came prepared with two U-shaped cushions. The ride in the wheelchair, suspended on the cushions, was no problem, and the 10-minute wait in the waiting room was no problem either—no pain. I had no trouble getting in the car or lying in the back seat. I discovered that one of my cushions could double as a pillow on the arm rest. I had no trouble getting out of the car, walking to the back door, or going up the three steps into the house.

At home, I discovered that I usually did not have any pain in the morning, but I would start to get some, though not much, around 3:00 or 4:00 in the afternoon. I stopped taking the 12-hour long-term narcotic pain pills after the first week. I stopped taking the 6-hour pain pills after the second week. (I had only needed to take one of the those in the evening anyway.) The unusual side-effects from the narcotic pain pills were a complete loss of appetite, a slight effect on my voice, and itching all over that seemed to dissipate after the first several days. I also slept really well. After two weeks, I had no more pain and needed no more pills.

I was out from work for two weeks. On the third week after the surgery, I returned to work for four hours a day, standing the entire time. I elevated my monitor, keyboard, and mouse on boxes. After the end of the third week, Dr. Cardea said I could start trying to sit for the first time. I started sitting on U-shaped cushions on the fourth week. On the fourth week, I increased my work schedule to five hours a day, using a kneeling chair with a U-shaped cushion periodically when my feet started to get tired. I also began to sit in the front seat in the car (on a U cushion). On the Saturday of the fourth week, I drove to the grocery store. No problem. On Tuesday of the fifth week, I drove to work (about 20 minutes). No problem. That Thursday, I drove across town (about 30 minutes). No problem.

A month after the surgery, I still sit on the U-cushions, but can not sit for too long because I start to feel sore. At work, I alternate between standing and sitting on the kneeling chair. I can drive wherever I want (in town). I have found I can sit on hard chairs with no problem if I sit up straight on the front edge of the chair.

* * *

It is now November 2010. I've really done it this time. I was healing fine, and was feeling so much better by March (3 months after surgery), that I thought I would try to start jogging again. One night after a couple of weeks of jogging, I felt a soreness in the spot where I had my surgery. I stopped the jogging immediately. This setback lasted only about a couple of weeks, and soon I was on the road to recovery again. By July, I thought I had almost completely recovered. I was able to sit at work again, though still on a cushion. I felt so much better that I thought I would try to start jogging again. That was a big mistake. I jogged for a couple of weeks, and then around the end of July I started feeling that same soreness in that same spot. Like the first time, it didn't happen while I was actually jogging, but manifested itself later. I knew what it was and stopped the jogging again, and thought that after a couple of weeks, it would eventually go away. Well, it didn't. First one month, then two went by. I noticed that when I woke up in the morning, I wouldn't have the pain, but after sitting at work during the morning, it would often return by around 10:00. I started sitting only in the morning, and then standing the rest of the day. The pain was never bad, and usually Advil would clear it up temporarily, but it continued to persist. I also noticed that some things seemed to irritate it this time that never had before — like kneeling and walking.

I had scheduled a vacation to England (first time ever) for the first two weeks in September and almost cancelled it, but then decided to go anyway. To my surprise, the plane ride didn't seem to cause a problem. During the first week, I noticed that excessive walking would tend to irritate that area. For some unexplainable reason, during the second week, the condition seemed to improve and almost vanish, and my focus switched to my feet which were in pain from all of the walking and standing. When I started feeling sharp twinges of pain in my arches, I bought arch supports.

When I returned to work on September 20th, my backside felt so much better that I started sitting most of the day again, and to my distress noticed that the soreness in that spot got worse and worse every day. By Friday I realized I would have to stop sitting entirely (except to drive) and go back to living life as I had right after the surgery. I noticed that the condition improved somewhat when I stopped sitting, but also noticed after a week or two that my progress seemed to have reached a plateau. I'm still at that plateau, and it's November 21st. The pain only manifests itself as a slight soreness, which I can make go away usually with one Advil, but I know I am only masking it. The fact that it refuses to go away means that I still can not sit. I've had to invent a new way of driving, hoisting myself up in the air with my left foot and leg and my left arm, and driving with my right foot and right arm. When I stop at lights, I hoist myself up on my elbows to give my wrist and foot a rest. At work I alternate between standing and kneeling on my chair, which I turn around backward. I also walk around the office a lot. Since I'm doing so much standing, I'm still using the arch supports in my shoes. I took a course of oral steroids for a week in October hoping it would speed up the healing, but didn't notice any difference. It is taking longer for this injury to heal than the original surgery did. Actually, it doesn't seem to be healing at all. It basically feels the same now as it did in August.

My understanding at this point is that what I now have is a scar tissue injury, and that is probably why it is taking so much longer to heal. I've started taking supplements and a couple of amino acids and minerals to help it heal faster. I've heard fish oil might help, so that will be next. I'm taking about two Advil a day — one around 10:00 and one in the evening. I've noticed that if I have to sit for a short time (on a cushion or perched on the front of the chair), it doesn't seem to irritate the area any more than it would normally be. The U-shaped neck cushions are still the best. The ones with microbeads are better than foam and even air—they give more support. I've discovered that if I stack two on top of each other and align them across the front of the car seat, they support my legs very well when driving. By using the cushions along the front of the car seat and by hoisting myself up in the air with my arm and foot, I can drive with my bottom completely suspended in the air. All of the shaking and vibration, however, still, I think, irritates it.

It is now the week of Thanksgiving, and I'm taking the entire week off from work and from driving to get this thing to heal faster. Needless to say, I'm never going to jog again for the rest of my life. If I knew last summer what I know now, I never would have tried to start jogging so soon (or ever). I would still highly recommend the surgery. I would have been completely recovered by now if I hadn't been so stupid this past summer and tried to start jogging again. Though, now that I think of it, I probably would have wanted to resume a normal life and start jogging at some point, and who's to say that even if I had waited several months or a year more that I still would not have had a relapse when I tried to start jogging again. The thing that was so insidious about this was that when I was jogging, I was apparently injuring the place where I had the surgery without even knowing it. I felt fine when I was jogging. It was only afterwards that I felt the pain. And by then it was too late. Right now, I can make the soreness go away with an Advil, so I realize I'm more fortunate than many, but my life is far from normal. I can only sit normally for brief special occasions, and even then on a cushion. Forget going to a movie or even sitting on a couch. I've started to realize that even sitting on my side seems to irritate it. It has been about four months since I injured this in July, eleven months since the surgery. Now I'm wondering if there is a surgery that would correct this current problem or if disturbing that area might just make it worse.

I'd like to know if anyone else has had a similar experience, and if they plateaued did they ever heal eventually. Is there anything I can do to get better? I can be reached at chrisnovelli@aol.com.

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