Today is the anniversary of my visit to Mr. Brian Mehigan. Over a year ago I presented myself to a GP on O’Connell Street and informed him that I had diagnosed myself with Pilonidal Disease. Dr. Matthew McConville listened as I explained how I had discovered an open sore in my tailbone cleft and that a number of other physicians had seen it, and, failing to provide a proper diagnosis, had repeatedly treated it unsuccessfully with various courses of antibiotics. After each treatment it would return, and over time it grew steadily worse. It was only whilst watching a medical programme on the television (Embarrassing Bodies) that I recognised my own medical issue. It was an advanced and chronic pilonidal disease – a cyst of impacted hair and other organic debris lodged beneath my skin, causing infection and the build-up (and frequent drainage) of pus and blood.

Dr. McConville was wonderfully understanding and perfectly patient. He conducted his own probing examination and, professionally, confirmed my self-diagnosis. Following yet another course of antibiotics to reduce the swelling of my very own festering buttock cavity I returned to see him when it had returned yet again to its former glory. On this occasion he referred me straight to the Accident and Emergency Department of St. James’s Hospital in order to have it surgically drained. No such draining took place. After more than ten hours on a number of buttock-resistant blue plastic seats I was examined rectally and informed that I should have been scheduled for surgery rather than to be drained, and so with another script for more antibiotics I was sent home with a promise that I would be called to a surgical clinic. At this point I was rather hoping the rectal probing would have a placebo effect. No such luck.

A number of weeks passed before I received the promised appointment which was to take place a number of months ahead on Monday, January 27 2014. That was one year ago today. Congratulations to me?! Both Mr. Brian Mehigan’s registrar – who regaled me with sporting tales, took some not-so-pretty photographs of my bottom, and whose name I cannot quite remember – and Mr. Mehigan himself were splendid, and took great pains to put me at ease. I have no complaint about these men or the treatment they gave me. During our consultation Mr. Mehigan apologised in advance for the delay that I could expect before surgery and post-surgical treatment (including skin grafts). He said that it would be six whole months before he would see me performed upon in his theatre. That was one whole year ago this very day.

A massive nest of ‘communicating (not so much texting one another – think more the German trench network on the Somme)’ subdermal burrows interlinking cysts and pus-sacks oozing fresh gore daily hasn’t exactly become my favourite bodily feature, but neither will I say that I am in a great rush to have someone ‘excise’ it all with a scalpel. Nevertheless, I have had this unholy pestilence brewing on my backside for the better part of a decade now, and the lymph nodes knotted to my manhood are now challenging my tackle for space; a sure sign of perpetual infection. To top this all off, after the comments of a medical student friend at King’s Hospital, London, I began to do a little bedtime reading:

If a pilonidal abscess is not drained surgically it may respond to antibiotic therapy but this cannot be considered surgical standard of care. Abscess may rupture spontaneously, with discharge of pus, blood and debris and relief of symptoms. Alternatively the abscess can enlarge, spread and cause infection in the blood, called sepsis which can be life threatening. Left untreated, pilonidal cysts and sinus may be asymptomatic for an unpredictable period, or they may become intermittently infected and require repeated drainage procedures. This can occur without warning and at inconvenient times such as vacations or travel or during difficult work or family situations. Repeated drainage procedures leave enlarging cavities that can involve large portions of the buttock and back. Chronic non-healing wounds left untreated over years can also lead to skin cancer, which is potentially life threatening. Therefore definitive treatment with excision is recommended when convenient.

Do correct me if I am wrong, but – according to my count – there were definitely two occurrences of “life threatening” in that quoted litany of misery. Sepsis and Cancer! Not my favourite words. “Therefore definitive treatment with excision is recommended when convenient.” Well, now is a very convenient time for me – thank you very much. I have decided to put down this rant to get the whole matter of my chest, and hopefully with a very short term view to getting the whole bloody mess off my arse. From this moment on I intend to remind the hospital weekly (and daily if needs be) until I get some satisfaction. On moral grounds I refuse to support a two-tier health system, and will not steal care from my neighbours in the Liberties by buying private care. Our health is our right, and we all pay taxes. All that I have received from St. James’s have been three letters demanding (in bold script) to know whether or not I still hope to undergo surgery. Yes, yes I do!

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