Coccyx woes in Aviano, Italy

Les -  Leslie.Williams@aviano.af.mil

Original posting, 2002-07-21:

My name is Les and I'm a 34-year old male living in Aviano, Italy. I have the privilege of working as a United States Air Force Air Weapons Controller and am extremely proud to be part of the greatest Air Force on the planet!

My story begins with me developing testicular cancer (Seminoma) in August 2000 and having surgery in Germany to remove the cancerous testicle. In September 2000, I began radiation therapy as a precautionary measure. After the radiation, I began exercising vigorously to get back in shape. About 3 weeks into the exercise program, I injured my lower back on a cross-trainer machine and had to stop due to the pain. My flight surgeon prescribed pain killers and physical therapy and over the next 8 months, my lower back pain became tolerable. However, I began to notice a "very low" mid-line pain around the coccyx area. I saw a orthopedic surgeon a few weeks later and through an x-ray, he discovered that I have a fractured coccyx (the last 3 vertebrae). My coccyx is situated 90 degrees from my sacrum and points "backwards" and hurts like the dickens when I sit down. Jon, your own testimony reminds me of my situation. :)

My doctors referred me to a neurologist and spine surgeon in Udine, Italy for a surgical evaluation. Once there, she said the procedure was beyond her expertise and she knew of no doctor in Europe who was capable of performing the surgery that I need. So in November 2001, my doctors referred me to the orthopedic clinic at Walter Reed Army Medical Center in Washington D.C. The doctor there basically "blew-me-off" (..."I don't perform surgery on first-time patients...if you still have the pain in 6 months...come back and see me and I'll think about performing the surgery.")...Army surgeons...what a knucklehead!

I returned to Italy and in January of this year was referred to Texas and Wilford Hall Medical Center. There the orthopedic surgeon did all his homework (MRI, bone scan, blood work, etc.) and found no fracture but said that 25% of people are born with a coccyx such as mine. He couldn't explain why my coccyx all of sudden started giving me problems. But he did order a steroid shot and Jon...it worked like "magic"! No more pain...that is until late April of this year. My doctor now has me seeing a "pain clinic" doctor and I have received 4 out of 6 scheduled steroid injections. The injections are not working and the pain is worse than ever. I am taking Vicodin at night for the pain but must suffer through the day at work. I am hoping to see if the Air Force will pay for me to be seen by Dr. Paolo Marchettini in Milan, Italy. He's one of the doctors you listed. Hopefully, he can help!

Update, 2003-01-05:

After much prayer and homework, I decided not to see the spinal cord "stimulator" doctor in Milan and instead sought out Doctor Michael Wright (whom I found on this website) at the Oklahoma Sports Science and Orthopedics (OSSO) clinic in Oklahoma City, Oklahoma (OKC) for surgical removal of my tailbone. Let me say upfront - this surgery is a "PAIN-IN-THE-BUTT" . . . literally! Do not take it lightly. Do your homework . . . then if NO other option(s) exists, proceed. BUT you must, have a good after-care "plan" planned out ahead of time. You must have family or friends located nearby to help you.

I departed Italy in early August and on 15 Aug, met with Doc Wright and his physician assistant (PA) Mark Denney. After a quick exam and x-rays, he felt I was a good candidate for the surgery and scheduled me for the O.R. the following Monday. My family flew in from Italy and MS to be there (but only for 10 days and then my wife had to return to Italy) for the surgery.

The surgery was performed in a private 9-room facility partially owned by Doc Wright approximately 8 miles from his clinic office. Doc Wright made a 4" incision very near the cleft of my bottom on the right side (not in the middle as I had heard from others), removed the tailbone, and sewed me up with about 20 stitches. This was a mistake (which I've heard from 3 other surgeons since) and I indeed paid for it and am STILL paying for it as I write this e-mail. A wound of this caliber CAN NOT be simply stitched up and left to mend or heal. It must be "PACKED" with gauze (two months in my case) and kept very clean at ALL times. This is the ONLY way to ensure the incision/wound heals from the "inside-out" and NOT "outside-in". Let me clear something up. I DO think Doc Wright is a very capable surgeon. He and his staff were always totally professional (well . . . Doc Wright could use some bedside manners) AND I WOULD go back to see him/them AGAIN if I lived in OKC. HOWEVER, post-wound care is PARAMOUNT! This may mean you are on your stomach for two weeks or more without being able to move. IF YOU TAKE AWAY anything from this story . . . take away this . . . PROPER POST-WOUND/INCISION CARE IS VITAL!

After 5 days as an in-patient I was released and stayed in a local hotel for the next 20 days. My wife was with me for 5 of those days and then I was on my own. THIS IS NOT THE IDEAL situation! I had to do everything myself, including meals and travelling back and forth to OSSO clinic to see Doc Wright. 21 days after the surgery, PA Denney removed the stitches and the wound/incision "opened up" at the very top. Mark told me that in time it would heal and after an additional visit, Doc Wright released me to travel to MS and recuperate at my folks place. Once on the airplane, the wound came "open" some more and once in MS I had to be rushed to the ER for additional stitches (Again . . . a mistake!). I didn't find this out until my return to Aviano.

I stayed in MS 18 days and then returned to Aviano, Italy. Once here, I saw my primary care physician and he referred me to a visiting general surgeon (Doc Valerie Leis) from Keesler AFB, Biloxi, MS. She took out the stitches on my second visit with her and when I asked, "How deep is it?", she told me she could see my spine! I just about fell off the table! Mind you this was 55 days since the operation and I hadn't healed at ALL! She ordered an MRI to check for infection and the results were negative. She then left for MS for a week and started my wife on a plan of packing the wound 3-times a day. Two days later, I woke-up with severe pain in the incision area and generally in my right buttock. The pain grew more intense as the day progressed and at 2300 that night, the abscess which had been forming in me ruptured! Blood was everywhere (I mean lots of blood) and I couldn't stop it from bleeding. I've cleaned deer and pigs where there wasn't that much blood. It scared my wife and me to death (we thought an artery ruptured)! Of course, the local USAF hospital doesn't have an after hours ER, so I had to call the Italians! If you've never experienced Italian medicine . . . DON'T!

Post ER and ICU in the Italian hospital, I was transferred to a USAF in-patient unit (rented from the Italians) and the wound became infected and I was hospitalized for 8 days. Upon Doc Leis' return, she took me to the OR, irrigated the wound, and started me again "packing" the wound 3-times a day (I CAN NOT again emphasize to you the importance of this). From that point on (Oct 18th or so to present - a total of 79 days), the wound has totally healed over. This is NOT to say that I am pain-free . . . I AM NOT! I am having to stand even as I write this e-mail! BUT my quality of life has improved steadily since Doc Leis (who by the way is an ANGEL in disguise - she took great care of me) took me to the OR.

I CAN however sit for short periods of time in a soft chair. Believe it or not, hard chairs are more comfortable than soft!

LONG story short - I THINK I'm happy I had the surgery and in time, hope to be pain free. But for the present, that remains to be seen. Okay - Lessons Learned:

  1. Do your homework . . . if no other options exist (steroid injections, etc.) find a reputable surgeon.
  2. If you decide to have the surgery, ensure the surgeon starts you on an after care plan of "PACKING" the wound!!!
  3. Don't sit on your incision/wound or bottom for at least 4 months!
  4. YOU MUST have family or friends in the area to help you recuperate!!!

Again, Jon, I thank you for your service in helping others. Hopefully, others will learn from our experiences and not have to "re-create the wheel again" like some of us have.

Have a great 2003! God bless you all!

What is coccydynia? | Investigation and diagnosis | Treatment | Coping with coccyx pain | Find a doctor or specialist

Medical papers | Personal experiences | Links to other sites | Support groups | Site map