A Checklist For Coccygectomy Surgery

I had my tailbone (coccyx) removed in a procedure known as a coccygectomy, or coccyx excision. Its been difficult to find information online about how to prepare for the surgery, so I wanted to provide a checklist for others preparing for the surgery. Be sure you follow all instructions from your physician. I’m not attempting to provide medical advice here, I just want to make it easier for others to anticipate what might be needed.

Before the coccygectomy surgery

1. Make sure your insurance company has pre authorized the coccygectomy, and if you’re going to remain in the hospital afterwards, make sure they have authorized the hospital stay. My insurance company approved the surgery, but approved any overnight stays in the hospital on a contigency basis. The insurance company indicated they could not approve overnights stays until after the surgery and after they determined the stay was “medically necessary”.

2. Ensure your surgeon has experience performing surgery on the coccyx. This is not a surgery that any surgeon can perform as a coccygectomy is not a common surgery. My surgeon was an orthopedic surgeon specializing in the surgeries of the spine and had performed between 5 and 10 of these. While not a lot, his experience was significantly greater than other surgeons in my area.

3. Setup a support system. You are going to be laying down for many weeks, and you will want someone that can help you with meals, cleaning, etc. My church set up an account at mealtrain.com which allowed people from the church to sign up to bring me meals.

4. Prepare for the emotional toll of the recovery. I was not at all prepared for this. I was out of work for 8 weeks, and spent most of that time laying in the bed or on the couch. After 5 weeks, a deep depression set in, and I was not at all prepared for this. Again, be sure you have a support system in place.

Things to buy or ensure you have before the surgery

1. A cane or walker. I bought a walker and a cane annd found I did not need the walker. The cane sufficed and turned out to be my best friend for about 2 months after the surgery.

2. A handheld shower head. You will need this to properly clean yourself after every bowel movement and I took up to 4 showers in a day. Infection is one of the most common complications of a coccygectomy due to the location of the wound, and some estimates indicate up to 40% of patients experience an infection.

3. Hibiclense soap or Dial yellow soap to disinfect your wound. I ended up using about 5 bottles of the Hibiclense. When applying the Hibiclense, be sure to let the soap stay on the skin for a few minutes before rinsing.

4. 5 x 7 surgical pads for the wound drainage. I bought 5 boxes of 10 pads from drugstore.com for less than $8 per box. Dont forget the surgical tape that youll need to adhere the pads to your wound.

5. A knee pillow. If you have plenty of other pillows laying around you can skip this, but I found the most comfortable position in which to lie was on my side with a pillow between my legs.

6. Some people have had success with a massage table which allowed them to sleep while laying on their stomach, since it has a cut out for the face. I didnt find that I needed this.

7. A raised toilet seat. I bought one, and it was helpful for the first couple weeks. Bending down too far put a lot of pressure on the wound, so this was helpful.

After the surgery

1. Make sure to take a stool softener such as Colace or Miralax. Youre going to be on opiods, and these have a constipating effect.

2. Make sure you shower after every single bowel movement. Do NOT attempt to cut corners here. Approximately 40% of coccygectomies result in an infection. Its only natural, due to the location of the tailbone. Use Hibiclense or Dial soap to wash the wound thoroughly.

3. Be sure to watch closely for signs of infection. This could include: increased pain at the site of the coccygectomy; fever/chills; increased redness at the wound site; a putrid smell; pus draining from the wound. Some drainage is normal my wound had some level of bleeding for about 8 weeks.

4. Make sure you have reasonable expectations with regards to the recovery time. Most experienced surgeons will tell you that the recovery time after the tailbone excision could be up to 18 months.