I had a coccygectomy 15 days ago at the Epworth Hospital in Richmond, Melbourne, Australia, and all is going very well so far with my recovery. My wound is just about healed over and my pain levels are such that they are being managed by osteopanadol and the occasional endone at night (after approx two weeks of endone and panadol, gradually decreasing the endone over this time). I was in hospital for five days, and initially on IV morphine, oxygen, a saline drip, plus IV antibiotics, endone and IV Panadol for the first twenty-four hours, and then oral panadol, endone and lactulose after that.
I recommend people get as fit and healthy as possible in the 12 weeks prior to surgery, as I did this and it seems to have helped my recovery a great deal. Also, my mother is a nurse and we made sure I had a microlax enema the night before and the night before that I had laxatives, which proved to be good preparation, as it wasn't until the fourth day that I was able to have a bowel movement, induced by lactulose and a microlax enema, which as you know, is very painful after this particular surgery due to the particular muscles and ligaments that have to be cut and reattached. Despite my misgivings about this particular aspect of the surgery, however, it has actually been much better than I expected and not at all as unbearable or debilitating as one might think. I must say, though, that I still find it quite extraordinary that this is performed as day surgery in some countries. I think it speaks well of the quality of Australian healthcare that I was looked after in hospital for five days. I can't imagine having to go home on that first day; it seems to me that this is very risky. My blood pressure was quite low for the first 24 hours and needed monitoring every few hours.
I would like to wholeheartedly recommend the Epworth Hospital in Richmond for the very high level of professional care that I received, and I cannot recommend my surgeon Mr Peter Wilde and his assisting surgeon highly enough for the quality of surgical care and expertise that they demonstrated (see Doctors and specialists in Australia). I would also highly recommend my referring doctor, sports medicine specialist Dr Paul Blackman (see Doctors and specialists in Australia), who has had experience with patients suffering from coccydynia and is knowledgeable about the correct way to proceed in treating this condition.
I am very relieved that I have had this operation at last, and feel that the end of the whole saga is in sight!
The experience all began when I suffered a trauma (fall down a flight of stairs on my rear) in December 2010 that fractured my coccyx. Following this, I had just over two years of pain that was not relieved by conservative treatment by chiropractors or physiotherapists. Treatment included manual therapy plus months of stretches and regular physio-led Pilates plus physiotherapy exercises at home, which did make me very strong, but ultimately did not relieve the condition. I also saw an ostropath to no avail. Last year I reached crisis point with the pain levels impacting severely on my ability to function despite using coccyx wedge cushions since the trauma and avoiding sitting on hard surfaces for the whole of this time. I still could not drive or sit without experiencing severe pain and my referred pain in my lower back was worsening. At this point the physio suggested I go to Dr Paul Blackman and arrange for an MRI and seek his opinion.
The MRI showed an abnormal sacrococcygeal joint / disc and bony protuberance at the site of the original injury. Mr Blackman then suggested a CT guided cortisone and local anaesthetic injection into the site, which I had in August last year. This in itself was very painful initially, requiring me to lie down for a week and not sit for weeks afterward, and while it may have lessened the amount of inflammation and spasm I was experiencing over the months that followed, the problem did not go away, and I was still experiencing pain sitting and had to avoid activities such as driving, going out to dinner or the cinema or theatre, extended travel etc (other than my office job, which could not be avoided, but involved prolonged pain and a horrible crunching sensation in my hypermobile coccyx).
After a few months Dr Blackman referred me to Mr Wilde for an opinion and Mr Wilde confirmed that I was a candidate for a coccygectomy. Anecdotally, I have since heard from a few sources that Mr Wilde is the best spinal surgeon in Melbourne and certainly he has demonstrated his ability in my case. He performs around 4 coccygectomies per year and is very experienced, having performed approximately 200 in his career. The wound I have is tiny and much less alarming than some of the photographs you see on the internet. It is only about five centimetres long and completely hidden from view under normal circumstances; it is not directly in the centre but is to one side slightly. Both he and the assisting surgeon confirmed that the coccyx was abnormally hypermobile when they removed it and I was definitely much better off without it.
Everything is going well so far. I will send further updates as my recovery progresses.
Incidentally, I have been having extra zinc, vitamin C, A and E plus arnica to aid my recovery. Also, it's important to stop taking fish oil and some other supplements at least a week before the surgery because some studies have shown it thins the blood. Of course, people should be guided by their surgeon's recommendations about supplements and let them know of everything that they are taking.
22 days post-surgery
My advice is avoid bending and avoid getting in the car for as long as possible after your coccygectomy. I was less careful over the weekend and at the end of last week, and went on a 2 x 30-40 minute car trip as a passenger lying on pillows horizontally and also did more bending than I should have. As a result my wound has reopened at its base by about a centimetre. Now I need to be very careful once again to keep it clean to avoid infection and will have to avoid sitting and bending for longer still. Oh dear. It's disappointing because I am meant to be resuming normal work duties next week (albeit working from home). It makes me think I am glad that I will be working at home for two more weeks because I may have to do it from a horizontal position!
I will continue to contribute more updates over time, as I know how helpful these can be for fellow sufferers.