Bump on Top of Bottom and History With Fissures and Fistulas and Dr. Bidhan Das

Recently int the past couple of months I had noticed that I had a bump on the back of my bottom. I had noticed it after taking a hot shower. At first I knew it was not urgent and it did not hurt or have any blood or pus. I had decided to get it checked out and had a appointment with my dermatologist for something unrelated and had him look at it. Initially my dermatologist had said it was just me getting older and part of my tailbone shrinking. To me, even as a non medical professional, this did not make any sense.  Given this I decided to get a second opinion with a colorectal surgeon. Dr Bidhan Das. Previously, I had blogged about him discussing choosing a colorectal surgeon. I had my appointment on a Friday a few weeks ago. When I came into the office payment for the visited is expected upfront (however they tell you what the cost is). When I entered the office Dr. Das I noticed that almost every chair was taken and on the way out, I noticed that some people were even sitting outside the office on the floor. This tells me the type of popularity that he has as a doctor. As I write this he has over 500  reviews nearly all of which are positive. I was called in fairly quickly to talk about the reason why I was there. She had mentioned that Dr Das would be in in a couple minutes. This turned out to be a roughly 30 minute wait. Don’t don’t get me wrong I know some people are very impatient when it comes to waiting for doctors. The positive of my appointment was that I had made it within the same week, which is very unusual for specialist colorectal surgery. I could hear Dr Dallas chatting with other patients However, given the rooms were close to one another, I couldn’t tell exactly what they were talking about. Dr Doss was chatting with patients, and I could hear him laughing with him as well.

I have been following Dr Das's career over a number of years and even listen to him on Gut Check (sponsored by the American Society of Colorectal Surgeons), which is a podcast for colorectal surgeons so I felt like I was in good hands. Dr. Das greeted me with warmth and started the conversation with “brother how can I help?”. I explained the issue to Dr. Das and he asked me questions in terms of how long I had noticed it, pain, and other questions. He discussed common possibilities such pilonidal disease (however very unlikely since my Crohn’s is under control) or a pilonidal cyst. I pulled down my pants and he placed his hand on the right side of my bottom first and then said moving, moving, which I felt was helpful in terms of no surprises. He asked me where the bump was and I showed him and he said “Yup I sure do feel it”. Dr. Das believes it is a benign soft tissue cyst. He had recommend I get an MRI since it was a soft tissue mass but believed it was a “nothing burger”. I felt Dr. Das was compassionate, extremely articulate, knowledgeable, and spent enough time with me and didn't have his hand on the door like many doctors do. 

I ended up getting an MRI yesterday at the hospital and had scheduled it in the early afternoon and they were able to get me in. What was funny is I was able to sleep in the MRI machine and just close my eyes. There are loud noises during the MRI but it didn’t bother me. I will be curious to see what the results say. Also I see my regular GI in a couple of weeks and will be able to get his view as well as well if he thinks there are any risks to surgery. From everything I had read the risk of surgery to remove is low given the Crohn’s isn’t active.

The results of my MRI were posted last night on MyCharts (results for an MRI within 24 hours is pretty good). The results showed a 1.9 cm cyst that was a chronic hematoma (previous blood pocket). The results were similar to what Dr. Das had predicted from our visit. He had said that once he got the results we can decide if we do nothing or have it removed. Given it is nearly 3/4 of an inch in size and sometimes it is hard to lay down (at the gym)/sitting down evenly I would be more apt to have it removed.