Coccygectomy--St George, UT

Anonymous, USA - rsrvd4you@protonmail.com

Posted 2017-11-19

I was in a car accident in Minneapolis, MN in July 2015 where I was rear-ended by someone speeding through a parking lot, who hit me while accelerating, myself being stopped at a stop sign, right foot on the break, my upper body slid forward in my seat, twisted to the left, my neck twisted to the left, and my arms on the steering wheel, all geared to turn left. Later, I found out this was possibly the absolute worst position to be rear-ended in. In hindsight, I was in shock, however, I didn't go to the hospital (no blood, no poking bones, happened on private property, so no police came out) so I thought, I'm shaken up pretty good but I think I'm ok. Well, I wasn't okay. I cowgirled up and tried to push through the pain. LISTEN TO YOUR BODY, NO MATTER WHAT THE DOCTORS TELL YOU!!! PAIN IS A SIGNAL THAT SOMETHING IS WRONG!!! Prior to the accident, I'd never had coccyx/sacral/hip/pelvis pain before. I am a young 39 otherwise healthy female (prior to the accident), was an avid trail runner, previously a professional athlete, firefighter, mountain climber, and we ran cattle on the ranch in Montana. I had to stop EVERYTHING and began what it felt like to lose my life, my identity, and everything I enjoyed. It became so excruciating, that I couldn't even function enough to get through a single day. I am allergic to most pain meds, so that was out, on such high doses of gabapentin, oxcarbazepine, ibuprofen, tylenol, baclofen, hyophen, (muscle spasms, bladder spasms, bladder retention, bowel retention, etc, that I felt like a walking brain mushed zombie, and had tried about every injection that the pain doc could prescribe, with temporary relief that lasted long enough to remind me just how much pain I was in. I hadn't properly been able to eliminate (slowly lost control of my bowels, as in I couldn't go, without an enema, and it didn't matter if I was constipated or the stool was soft, there was just no peristaltic movement of the colon).

I lost my job and my career with the forest service, haven't worked in two years, and have barely been able to take care of my 13 year old. It takes everything I have to get her to/from school, and to attend my doctors appointments, physical therapy, chiropractor, dry needling, deep tissue massage, although that's what has been helping me get by day to day (that and not doing anything else). I was seeing the chiropractor twice a week, physical therapy twice a week, pelvic floor therapy (which made things SO MUCH WORSE that my PT said to stop until we had a look at the coccyx) and a bi-weekly visit to the pain management doctor. I drive on an icepack, I sleep on an icepack, I had an icepack tied to my back and butt almost all the time. I had to quit wearing any tight clothes, or clothes that had any restriction in the pelvis, haven't worn underwear in two years because the tightness (even loosey goosey granny panties) was too excruciating in the groin area, and went from wearing stylish clothes to sweats. Basically, you name it and I've tried it. Except heavy duty pain meds, because I have such severe reactions to them.

And then, I found this website and it changed my life. Literally. My thanks to all those, both positive and negative stories, because there's nothing quite like finding out that you're not alone, and that out there exists something that I hadn't tried that just might work. My greatest thanks are to those who delved into their own personal, and agonizing, ordeals so that out of your experience, others could get help and advice. I was at an all time low, had just found out I also had venous tumors on my left kidney and renal vein and was told I might have a rare form of cancer, but nobody could get an official diagnosis. I kept doing all the WRONG things trying to get myself referred to doctors to help, but inadvertently had made my situation worse. I realized, the PCP (primary care physician) is there to orchestrate and organize specialists and referrals and after reading some wonderfully informative stories here, realized that's where I needed to start. So I did. And thank God I have a very attentive one who was also the first doctor to see me after my car accident. He knew I never had a single problem prior to the accident so he was on board to help get the problem straightened out. If your doctor doesn't listen to you, and you've asked for a CT/MRI of the Sacral/Coccyx area, and still don't have support, GO GET ANOTHER OPINION! The insurance deductible was well worth having a doctor listen to me.

Initially after the accident, over the next few weeks while on assignment for work (I traveled extensively across international lines on average 500-700 miles of driving a day across North America), I realized I was in so much pain I couldn't even get out of my car to film (I was a videographer and GPS field mapper). Over the next two years I saw many doctors, specialists, surgeons, including a spine surgeon that told me literally to "suck it up and get on with life" and I'd feel better. Well, as with other people's stories on this site, my coccyx had gone undetected in all the MRI's and CT scans until my neurologist caught it almost two years to the date later. I showed him the physical bone protrusion that stuck out below my sacrum, which would cut from the inside out and bleed pretty consistently whenever I sat. He immediately scheduled a referral to a spine surgeon. The spine surgeon then identified that I have multiple fractures in my coccyx, including a hairline fracture at the sacral haitus which allowed the bone to move 180 degrees and was razor sharp (hence why it was cutting me from the inside out whenever I sat down).

coccyx x-ray angled coccyx coccyx sacral hiatus fracture

He immediately recommended a coccygectomy, but because of the rarity of the procedure had to refer me to another surgeon, Dr Fox. Dr Fox was on vacation for the month of July, and when he got back, notified my PCP that he no longer performs those surgeries but referred me to Dr Stouffer (see Doctors and specialists in the USA, Utah). Dr Stouffer and I had an interview (this was three months after my initial appointment with the spine surgeon who recommended the coccygectomy). Dr Stouffer said I was a good candidate based on the physical abnormalities and severe angulation of the coccyx (94 degrees in a standing position), though the saddle parasthesia would not be effected by the surgery. I wanted a surgeon with experience, and he had done five coccygectomies in residency with a 70% success rate--I wanted a second opinion. Either way, I knew my body needed those rotting bone segments out. We live in a very isolated area, so I traveled over 300 miles north to a medical research University in SLC, though was sorely disappointed by the top neurosurgeon that there wasn't a single surgeon in the whole campus who performed coccygectomies. There was, however, one surgeon in the SLC area that did do them, (his name is on this site at the St Marks Hospital in SLC, UT), but he didn't take my insurance. (Also, I've had some very close friends that DO NOT recommend Dr Parry in St George for a coccygectomy).

There were three distinct fractures, one at the sacral haitus of 180 degrees, one right below the first coccyx segment, and then another fracture (not dislocation, but true fracture), where the coccygeal segment had literally splintered and had become embedded into soft tissue adjacent, but not impeding into, my colon and bladder. The surgeon later said he spent more time digging through the scar tissue to remove the bone splinters than any other part of the surgery because of the significant amount of scar tissue that existed.

I was terrified of surgery, and prior to the accident, a very healthy fit individual at 39 years old, I figured, the only thing that I haven't tried yet was surgery. With my PCP, PT, Chiropractor, GI specialist, and neurologist all supporting the surgery, I decided to do it. Dr Stouffer has performed five operations before, all in residency. He is definitely a younger surgeon, HOWEVER, he is cautious and open enough to be willing to take the time to answer my questions. He is a reserved, quiet, surgeon and not a man of many words. his Physician Assistant, Dr Hafen was very talkative and had a wonderful bedside manner. He talked with me after the surgery at some length, answering every question (and believe me, I had many, many questions). I have studied and researched everything about a coccyegectomy from every medical journal I could find. Being a scientist, I have a tendency to over-analyze and wanted to ensure that I had covered all questions with Dr Hafen while the surgery was fresh in his mind.

He was blown away at how well I was doing post-surgery and both he and Dr Stouffer, along with my nurses, commented that they'd never had a patient come in and look better post-op. Attests to the amount of pain I'd been living with. I knew the surgery was right for me. The evidence in support of surgery was blatent: multiple fractures and even a possible iliac/sacral fracture which the ortho surgeon will be reviewing at my coccygectomy followup. Those bone fragments had to come out. They were not going to "heal on their own" nor were they doing anything but literally continue to dig deep, impeding my colon, my bladder (that fragment was deep into the tissue), and continue to make a mess of my pelvic floor and levator ani tendon.

I went into surgery at an average of a daily pain between a 7-8 and came out at a 2. The sacral/coccyx pain was completely gone. The pain from the incision was almost non-detectable. Day 3:

coccygectomy day 3

AND LAST BUT DEFINITELY NOT LEAST: After careful consideration, and after a lengthy discussion about possible epidural blocks with the anesthesiologist prior to surgery, we agreed an epidural caudal block would help with the pain and recovery. I AM SO GRATEFUL THAT I DID THIS. I am CONVINCED this has aided exponentially in my quick recovery. I am also very grateful the anesthesiologist explained to me other options as well that would be possible, but that wouldn't have the strength of a caudal block. I highly recommend discussing with your surgeon/anesthesiologist about doing some sort of an epidural block while the surgeon is in doing surgery. It's a very non-invasive procedure and the benefits of calming your nerves for post-operative healing and pain management are highly beneficial. All research I identified stated nothing but positive feedback and increased healing time.

So my pre-operation plan was as follows:

Also, I make a disclaimer. I am not a physician, nor recommend what I did for anyone else. I have grown up using essential oils, homeopathics, herbs, and have a vast personal understanding of how MY BODY reacts to these prior to the surgical procedure and knew what to expect. I DO NOT recommend trying these methods out for the first time immediately prior to surgery as you will not know how your body will respond, nor unless you are a trained professional, under the guidance of a trained professional, or have immediate and lengthy experience doing alternative treatments, would have the experience to manage a care plan using these methods and could potentially jeopardize your medical situation.

Now that the red tape is out of the way:

I prepared with essential oils, homeopathics, herbs, vitamins, probiotics and mineral supplements.

Essential oils:

Preperation: Using cold pressed unrefined coconut oil as the carrier oil for its healing properties, I combined 18 drops of sage, 20 drops of frankinsense, 18 drops of myrrh, 12 drops of oregano, 16 drops of lavendar, 14 drops of roman chamomile, 6 drops of lemon, 14 drops of sandalwood, 12 drops calendula, 4-5 drops of neem, 12 drops cajeput (melaluca's cousin), 12 drops tea tree, and 10 drops of eucalyptus into about a 30ml blue glass bottle with a sprayer. I heated the coconut oil in a glass jar under running water until the temperature was warm, but not hot, then added to all the oils into the bottle.

Application: Prior to surgery, for four days, around where the bone protruded out of the sacral area of my back and down the crack, massaged oil 2-3 times a day into the area. Followed with rubbing in a pea sized amount of a CBD+THC herbal salve (legal in Nevada, Colorado, and Washington without a medical card), which worked as a great analgesic and antibacterial for the area. Continuing post-surgery to apply oils, CBD salve, and homeopathic ointments every 4-5 hours, or as needed. *BE AWARE* Oils WILL remove the top glue layer over the stitches so it's important to not apply oils directly to where the stitches are until the skin has healed thoroughly. Applying oils around the incision area will increase healing to the area as the oil is absorbed. No need to directly apply to the incision until the skin has closed. The doctors were concerned about lotions or oils applied around the incision due to the risk of infection and lotions/oils give bacteria a breeding ground. HOWEVER, essential oils used in this combination have antibacterial, antiviral, and antifungal properties and as such, the risk for infection was minimal.

Homeopathics:

Preperation: Thuja occidentalis (30x, though would've preferred at least 200c), Aconitum napellus (200c), Arnica Montana (200c), Hypericum perforatum (30c, though again, would've preferred 200c), Ledum palustre (30c, again would've preferred 200c), Ruta (30x) and Rhus Tox (both 30X, prefer 200c). Homeopathic creams include Calendula Ointment (Calendula officinalix 1X HPUS 4%), Arnica Ointment (Arnica Montana 1X HPUS-4%), Arnica Gel (Arnica Montana 1X HPUS-7%).

Application: I applied to the area around the incision, topical homeopathic creams, and gel, immediately upon coming into my hospital room out of the recovery room, about a pea size amount to the area surrounding the bandage and did so every 15 minutes to 45 minutes, when I was awake. Once the top of incision healed and closed, just right at the top (day 3), began applying topically calendula and arnica ointment following the essential oils to the closed area of the incision. *NOTE* I had the surgery Wednesday morning, and it's Saturday afternoon. Stitches are still in, and the skin is healing so quickly, it's healing around the stitches faster than I believe the doctors anticipated. May have to call the surgeon Monday to advise. External stitches are not dissolvable and may need to be removed sooner than the 14 days post-op appointment.

Prior to surgery, began taking Arnica 200c, one dose of 2-3 pellets, two days prior to surgery, twice a day, once in the morning, and once before bed. Post-surgery, once out of the recovery room, began immediately a dose of all homepathics, every 10-15 minutes (as I could between doctors and nurses). Continued for several hours. Then continued to take every 30-60 minutes for the first day. Day two, I continued to take homeopathics every 2 hours, or whenever any pain became evident.

Herbs:

Stopped most herbs 5-7 days prior to surgery as some are blood thinners, and can cause complications to surgery: St Johns Wort, Fish Oil, Pau D'Arco, Neem, Butternut Bark, Uva Ursi, Cornsilk, Oregano, Fennel, Anise, Allspice, Rosemary. Slowly introducing in at 7 days post-op.

PAIN MANAGEMENT:

The surgeon refused to check me out of the hospital without some sort of a narcotic. He and I had already discussed my displeasure at my request to only use Ibuprofen 600s and said that I would most certainly need a stronger medication. After significant bartering, I agreed to take home a perscription of Lortab 5, and to use it with Ibuprofen 600 for at least 24 hours, every 4-6 hours, after which I could change to extra strength tylenol and ibuprofen, as long as I didn't exceed 4000 mg tylenol. I agreed. I used a half a lortab without ibuprofen approximately 8 hours after surgery. In the recovery room I received an IV dose of phentanyl and dilaudid. I did not feel very well on these medications, but they used the smallest dose which I felt wear off by 5:00pm. I wasn't in much pain at all, actually at just barely a 2 and the nurse gave me half a lortab 5. I took it and then took the other half 20 minutes later to ensure that I didn't have a reaction to it. I took another dose of Lortab and ibuprofen when I got home that evening at around 11:00pm. The following morning (day 2) I took ibuprofen 600 and 1300 mg of Extra Strength Tylenol, and a dose of CBD oil (without THC). This did just the trick. I took a shower and that wiped me out for the day. But not very much pain. I also had been prescribed Xanax .5 and I took one of those and was finally able to sleep (I was so anxious about potentially ripping out the stitches, as I'd taken off the bandage), that I couldn't sleep well. Day 3 I've taken one dose of the Lortab and Ibuprofen and it's good that I have it. I don't like to use the Narco because of my already existing problems with my GI tract and pain meds cause constipation, so I'm taking two stool softners with stimulants (senexon-s) twice a day to help make sure that I elminate properly. I had a bowel movement no problem right when I got home same day of surgery, and went five times yesterday (which, btw, was the FIRST TIME I've gone by myself in over a year)!!

Supplements/Vitamins/Minerals (doses listed are for a single dose):

Twice a day, started second day post surgery, ongoing daily:

Glucosamine/MSM combined, Vitamin D3 (1600 I.U. of D3, 2400 I.U. of Vitamin A), Borage Oil (740 mg Omega 6, 320 mg Omega 9, 440 mg Gama-linolenic), Bio-cell Collagen (600 mg)/Chrondrotin Sulfate (200 mg)/Hyaluronic Acid (100 mg)/MSM (500 mg).

Three times a day, started day of surgery, ongoing daily:

Bone Essentials: Vitamin C (3000 mg), Natural MK-7 (Vitamin K2 as menaquinone-7) 30 mcg, Calcium 667 mg, Magnesium 333 mg, Zinc 10mg, Copper 667 mcg, Manganese 667 mcg, Potassium 66 mg, Boron 2 mg.

Rainbow Bright Advanced Nutritional System (by far the most complex multivitamin that I've found after YEARS of comprehensive research for performance athletes), 6 tablets a day. You can read about it here: https://www.amazon.com/Rainbow-Light-Advanced-Nutritional-Tablets/dp/B000EEDZB8

Also, note on the pictures that there is virtually NO BRUISING. I completely attribute this to the Arnica. I could feel that there was bruising beginning to develop. When I was applying the oils and ointments I made a point of gently massaging where the levator ani was tight and I could feel crunchy scar tissue from where the bone had been. Frankinsense and Myrrh are wonderful for tendon and muscles, especially in breaking down scar tissue, so I have massaged those areas around the incision, gently, but firmly enough that I wouldn't disturb the internal stitches, but would be able to break up the scar tissue.

I also make my own homemade goat kefir, and kombucha and have been drinking both round the clock since getting home to help build the probiotics back up in my body from after

having such a heavy duty dose of antibiotics while in surgery.

I will update as post-op continues. :)

God bless!

Update, 2017-11-19

A picture of the incision taken November 19. Still no bruising anywhere. I'm just stunned at how well I'm healing.

coccygectomy day 3

Update, 2018-06-24

I suffered several significant complications approximately 2 weeks after surgery and subsequently also my last update. I had a post-op hematoma which ruptured, causing me to lose over 500 cc's of blood in 4 minutes. I was rushed to the ER. It was later observed that a stitch tore, leaving me to visit the wound clinic weekly for 3 months as the wound would not fully close. I was put on a wound vac for 5 days but had an allergic reaction to the hypoallergenic sponge. So I was then put on home health and had a nurse come out once to two times a day, for 2 months. I finally healed up, with A LOT OF REST, no activity, continued using the essential oils, homeopathic, and ibuprofen.

I would recommend the surgery to anyone who has tried every alternative. Due to the surgical risks involved, this surgery is not for the faint of heart. I have a history of complications with surgery, and I would do this surgery again in a heartbeat, even though I've pretty much been on bed rest for 7 months. It's been 7 moths since the surgery, and I still bruise at the base of the sacrum where the coccyx was removed. I recently underwent a rectocele repair (the coccyx fracture impeded into the rectal organ tissue prior to the coccygectomy and had acted like a knife, cutting the tissue, which required a repair) which I also experienced complications with requiring extra healing time.

At the end of the day, I personally should've had a coccygectomy performed considerably earlier than I did, as it could've potentially prevented the organ tissue damage. However, I also had significant complications with the surgery, that likely, even if preventable, wouldn't necessarily have altered my decision to pursue the surgery. Be aware, that even if the surgery is successful, the recovery is LONG, LONG, LONG and I cannot stress how important it is to NOT OVERDO ANYTHING, DON'T DRIVE IF YOU CAN HELP IT, AND EAT A HIGH PROTEIN MEAL. Ask your doctor about lifting restrictions, sitting restrictions (how long is your commute to work and do you have to sit at work), and bending restrictions! I cannot emphasize this enough. Even if the surgical site heals on the outside, it's not fully healed on the inside for a long time. How long? Well, mine took 3 months of creating scar tissue to fill in the wound enough that the wound clinic didn't need to have a nurse pack my incision site with enough gauze to make a fist with.

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