That Time When GoodKid Was Going Through Bad Stuff

Mom had almost given up hope. How could this problem go on for so long?

Her young son Goodkid (not his real name), 12 years old in May of 2022 informed his parents about “something weird going on with my butt.” His tailbone and sacral area looked unusual to both Dad and Mom, so the next day—which happened to be Memorial Day of that year—they took him to Urgent Care to get it checked out. The Urgent Care doc said she would refer him to pediatric surgery and would be in touch. 

Goodkid's referral “fell through the cracks.”

Mom, who works both full time and part time and manages her family's bills, prescriptions, and appointments, for multiple family members with chronic illnesses, had faith that the medical providers would do as they said. She waited for a phone call.

About a month later, Dad and Mom asked each other “Have we still not heard back about a referral?” The next day, June 28th 2022, Goodkid had a “well child” appointment with their primary care doc for routine vaccines. During that appointment, Mom asked Nurse Practioner Nicelady to look at Goodkid’s sacral area, asking if she could help? “We are still waiting for a referral to pediatric surgery,” said Mom.

NP Nicelady's team immediately got on the case! Goodkid got scheduled to see Dr. Dudeguy, Pediatric Surgeon, the next day. The very next day (6/30/22 now) was his first surgery: I&D (incision and drainage) of a pilonidal cyst. {Do not Google “pilonidal cyst” unless you’re ready for some appallingly dreadful images, dear Reader!}

They went home with some special dressing supplies (Vaseline gauze) and orders to change the area twice a day, and an appointment to follow up with Dr. Dudeguy on 7/9/22. The drain, which was supposed to stay in “for a week or two,” fell out that same night. The distraught parents did dressing changes twice a day with Vaseline gauze until they ran out of Vaseline gauze. Then it was twice a day with wet-to-dry dressings. Goodkid’s wound was stubborn. It tunneled, it got various infections. Goodkid struggled to heal! He never complained, not even when Mom started taking pictures of his wound to track the progress more closely. They saw Dr. Dudeguy for multiple post-surgical follow ups, sometimes 1-2 months later, sometimes a week, sometimes 2-3 weeks. Goodkid took multiple courses of antibiotics. Mom started seeing a mental health counsellor to cope with her feelings of inadequacy due to her son’s wound trouble. Dad’s depression got bad, too.

On December 28th of 2022, Goodkid needed another surgery. The slow healing was a problem, and Dr. Dudeguy was concerned that the wound edges themselves were infected, so he wanted to “core it out” and let it heal back together by secondary intention. 

Something else happened that day. While chatting with a pretty cool male nurse prior to going under, Goodkid was talking about playing tuba in the school band, among other young lad conversational subjects. The nurse asked “Anything else going on?” Goodkid spontaneously said “There's something weird next to my penis.” Dad and Mom asked Goodkid why he hadn't told them? He didn't know. Dr. Dudeguy looked at the groin area while Goodkid was under, and thought it looked fungal. He cultured it, and at the follow up after this 2nd surgery he discussed that the fungal swab had turned up an unusual result: Phlebia tremellosa, a tree fungus! How does a human get a tree fungus? This is a total mystery! Dr. Dudeguy referred Goodkid to pediatric infectious diseases; he had no idea how to treat a tree fungus growing on a human being!

Dad and Mom kept on faithfully changing their son’s dressings, wet to dry, every day. 

The specialist with infectious diseases prescribed Goodkid an oral antifungal: two very big pills twice a day for over 4 months. 

Goodkid’s wound kept looking rough, but things went on as they had for 6 months already: twice a day dressing changes, various antibiotics, continuous follow ups, dwindling hopes. Mom cried frequently. Dr. Dudeguy several times treated Goodkid’s wound with silver nitrate, which hurt Goodkid a lot, and always made his wound look much worse for days after! 

Goodkid had to have a CT scan and an MRI of his groin to figure out what was going on there. Then an ultrasound. The scanners eventually decided he had a splinter in his groin! The parents figured (and Goodkid confessed) that he occasionally peed outside, and must have gotten a thorn or splinter from a bush.

Eventually the fungal infection went mostly away, but recurring painful bumps came up in Goodkid’s groin, both right and left sides. Goodkid had his 3rd surgery on 7/6/23, to remove the thorn from his right groin, and drain the pilonidal area again. Mom's 7/6/23 pic of Goodkid’s poor bumbum is the worst of the bunch! She felt that Dr. Dudeguy cut him too much, too deep, too far. His post-surgical incision was at least 6 inches long. The twice a day wet-to-dry dressings continued, this time with packing the deeper parts of the wound. They found out the name of the newer groin problem: Hidradenitis suppurativa. Now Goodkid was following up with dermatology, infectious diseases, and surgical. 

It was heartbreaking when the family went to Florida that year with Grandma and all the aunts, uncles, and cousins. Everyone who went to the beach could swim in the ocean—except for Goodkid! He kept up his resolve not to complain, though! He built a lovely sandcastle with castle walls, and various rooms and motes!

In August of 2023 his bumbum wound appeared to be closed, meaning for a little while they only had to keep dressing his groin areas. But in October of 2023, when Dr. Dudeguy felt the groin bumps needed “deroofing” and Goodkid went in for his 4th surgery, it was noticed that his pilonidal area had opened up again. Now twice daily dressing changes to the front and back continued.

Dad and Mom remember asking Dr. Dudeguy if Goodkid sitting down to play video games could be putting too much weight on his wound. Dr. Dudeguy said he didn't think so, but recommended he “sit up a bit straighter.” 

Around December again, Mom asked Dr. Dudeguy if Goodkid needed a wound care specialist. At that time, Dr. Dudeguy said there wasn't much a wound care doc could do for a pediatric patient. He dismissively said “They mostly see old people.”

Mom tried to hold out hope that Goodkid would heal, and the dermatologist was helping a lot! The medication for hidradenitis helped his post-surgical areas to be less “boggy.” 

But in 2024, the economy got super bad! The copays went up from $40 per visit to $50. Mom began to get irritable with the various office staff members. “Let me pay the copay now! No, don't just wait until after the insurance company does their part! Let me pay the $50 now or I’ll have to pay you $100 next month!” 

Then April rolled around and Mom was mad! Sick and tired of this nonsense of her baby boy not healing, she told Dr. Dudeguy, “He needs a referral to a wound care specialist!” She was no longer asking.

To absolutely nobody’s surprise, Dr Dudeguy failed to come through with a referral to wound care for Goodkid. Dr. Dudeguy wanted Goodkid to see pediatric rheumatology, because “maybe they can figure out what the underlying problem is!” 

Angry Grizzly Bear Mom called the wound care specialist at the hospital herself. She cried on the phone telling them Goodkid’s story. “June will be 2 years! 2 years we're still trying to get him healed!”

Dr. Godsend the Wound Care Doc ordered a different type of dressing, to be done every other day instead of twice a day. On this first visit, he also said “Of course Goodkid sitting down to play video games is causing issues! You never sit flat with a midline gluteal wound, or you're spreading and reopening the wound every time you sit down! He needs to stand up as much as possible, or sit on one side or the other!”

Wow. Who knew? Mom marveled at this. Well, maybe a surgeon should have!

Goodkid resolutely stood for hours in the evenings to play his Xbox, or sat “sidesaddle,” or laid down on the floor for his video game sessions. There was almost immediate improvement! Within 2 weeks his upper wound was nearly closed and his lower one, nearer the rectum (which Dr. Dudeguy never addressed!) was “getting there.”

Tired of being Dr. Dudeguy’s personal cash cows, the parents cancelled Goodkid’s next appointment with Dr. Dudeguy, and never went back!

July 11th of 2024, the family finally got to see the order they had eagerly awaited for 2+ years: "Follow up prn!" Dad and Mom cried and thanked God repeatedly for Goodkid’s healing! 

They still Thank God frequently! Goodkid’s massive wounds were healed on time for him to start High School without missing so many class periods for appointments. He was still on the dermatology med for a few more months to prevent the hidradenitis from getting too bad. Soon he was done with that, too! And so very thankful that he doesn’t have to sit “side saddle” anymore! 

GoodKid’s Sandcastle