QUESTION: I am a 40-year-old woman. I had a chestnut-size pilonidal cyst removed from my lower spine 10 years ago. It had to be packed with gauze daily and the gauze would stick to the tissue. It was a pain I'll never forget, worse than childbirth. Now I have pain and swelling in the same area, and a pin-size hole is there. Does it sound as though it has recurred? I heard these cysts can contain hair. Is this true? - S.S.
ANSWER: Many people are born with the malformation that leads to pilonidal cyst. It is a tiny sinus (passage) under the skin at the lower end of the spine, just above the buttocks crease. It is usually invisible or perhaps noted as a tiny pimple there.Most are not aware of the irregularity until their 20s, when the cyst may develop and become inflamed. Swelling causes pain. And yes, the process can be aggravated by things like invading hair. In fact, this gives the cyst its medical name - pilonidal, literally hair cyst. It also got the name "jeep driver's cyst" from the tendency of bumpy jeep rides to precipitate cyst development.
When it is painful or infected, it is removed surgically. Sometimes tiny branches of the sinus passage are not found in initial surgery, in which event the cyst may recur. From your description, you should check out that possibility, for your own comfort as well as to avoid any further complications. I know you will not find the second removal and aftercare as traumatic as the first 10 years ago.
QUESTION: I know that the vagus nerve has to do with creating acid in the stomach. If one gets excessively nervous and has constant acid buildup, would cutting that nerve help? - J.D.W.
ANSWER: Your idea, vagotomy or severing of this nerve, was once an all-but-standard ulcer surgical option, and for the reason you state - reduction of acid production in the stomach.
However, the surgery was not without its price. One of the serious side effects was a diarrhea very difficult to control. Vagotomy remained high on the option list, nevertheless, until medicines came along that did as good a job in reducing acid production.
I would see such medicines as the first consideration. Let me take that back. The first consideration might be to find out what's causing all this anxiety you associate with your digestive problems. Why not try to get that under control first? For more on ulcers, see the booklet on the subject. Write to Dr. Donohue/No.25, P.O. Box 19660, Irvine, CA 92713-0660, enclosing a long, stamped, self-addressed envelope and $1.
QUESTION: I was scheduled to have endoscopy and was scared to death. But my fears were unfounded. They sprayed my throat also with anesthetic, and if I had memory loss it wasn't lasting. They inserted a needle in my arm, gave me a mild relaxant and placed me on my side. The next thing, I was waking up in my room and it was over. I had no pain and I had just had my esophagus stretched. So tell R.A. (recent writer) not to worry. It's not as bad as it sounds. - L.M.O.
ANSWER: That was basically my own experience. I hope our recollections ease R.A.'s mind.
QUESTION: What does the drug spironolactone do for unwanted hair growth in women? - Mrs. D.O.
ANSWER: It blocks action of androgens (male hormones), which are responsible for masculinization features, like undesirable hair.