Newbie here!

Hello all, I am new to these forums, but have been lurking for the last few days, soaking up information. So nice to have this available. Let me get the details out of the way first.

38 yo female, dx Crohn's '96, had resection of end of small intestine(10")/beginning of large intestine (4") due to fistula into bladder in '97, previously on prednisone, asacol, 6mp. No problems for the last 10 years, daily (non bloody) diarrhea, very rarely get constipated. Worse around my period, but for the most part, just something I have learned to live with. I had a job with no health insurance and sadly, stopped taking my 6mp/seeing my gastro because I could not afford it. Last saw her/on regular meds in 2005. All in all, have had a very easy time with my Crohn's compared to others I have read about. Not complaining! I do know where all the restrooms in town are though!

New problem has just come up. about a week before Christmas, I was on my period and thought that my pad was just placed wrong and was irritating my hind end. After the period was over and the pad was no longer there, the pain and irritation still was. I knew something was up, as I started to bleed a little and there was some pus like discharge, so I called my GP to get a look see. He performed a basic rectal and pretty much confirmed what I suspected, an abscess in my perineum. Set me on a course of Levaqin to get me through the holidays and set up a time to see a Colon-Rectal Surgeon on Jan. 9th. During this time, the abscess would swell, pop, drain, go down, be fine for a day, lather, rinse, repeat. Not terribly painful or debilitating, just kind of annoying and vaguely yucky. After seeing the CRS on Thursday and being examined in this office, he says it is a fistula and I will have to have surgery for it. Based on the fact that he can obviously only see so much in the office, he was vague on what he was going to do, but I think he's leaning toward a Seton, rather than a fistulotomy. But I guess I will find out what he did after I wake up tomorrow!

I have a great support system, I work for my parents in the family business, so time off is no problem. My spouse is awesome about all of this (oh, and I should also mention I'm a ***, so if I say wife, it may be confusing). I have her check things out for me back there, and let me know how she thinks it looks (easier for her to do then me get the mirror out!). Thankfully my wife's work considers us a "couple" so I now have good insurance, so this will make having things taken care of much easier.

Maybe it's just me, but up till this point, this whole fistula thing has been mildly annoying but not horrible. Has anyone else had one start just kind of eh? Not raging pain or oozing or anything. And I will be totally honest, I am the biggest wienie about pain, I mean, I really don't like pain, so this has been really nothing so far. I predict after tomorrow it's going to suck though, so I'm prepared for that. I will say that I am very thankful that my last 10 years have been so problem free, but that probably just means that horrible things are taking place inside me that have not gotten bad enough to come to light yet, sigh.

Just thought I would introduce myself so that in a few days when I'm freaking out I will be able to come here and get it off my chest and/or ask for advice.

Now I'm off to buy a sitz bath and groceries so I can cook ahead for the week since I'm probably not going to feel like doing anything tomorrow.

Hello Jenn! Welcome to the forum!

I am so sorry you have to go through this! I've had a couple per-rectal abscesses and fistulas, and have two setons. The typical way to deal with a peri-rectal abscess is to cut it open, clean it out, and let it heal from the inside out. Depending on how big it is, the healing could take weeks. I am so glad you have people who support you!!

I'd like to share some of my experiences with you and tips for how I dealt with it all. Also, here are suggestions for your shopping list and what to do before you leave the hospital:
-- Buy several boxes of 4x4 guaze pads for later -- get the nurse to give you a whole package or two before you leave.
-- Buy several boxes of flushable wet wipes with no alcohol.
-- Crossword puzzles, magazines, books, etc. you can read while taking sitz baths. Get cheerful, uplifting ones to help keep your mood up.
-- Also get your doctor to write a script for large bottles of sterile saline (like 5+). After you clean the wound, pour saline on guaze before you pack the wound. Saline keeps the wound as sterile as you can get down there and promotes healing.
-- Also, my surgeon packed gauze up my rectum (stand procedure) but it was difficult to remove. Last time, I asked him to not do it and it was much better.

My first abscess surgery was for two huge, very deep ones. I had no idea what to expect, and when I removed the packing I nearly fainted from the look of it! Strangely, it didn't really hurt -- just looked sooo deep. The next time I was prepared and it wasn't so shocking. Not trying to make you nervous, just trying to prepare you so you will know what is typical and OK. I stayed on 2 percoset very 4 hours for several days just in case (I don't like pain!) and I was pleasantly surprised that there really was no discomfort. I tapered off slowly after that. Don't feel at all badly about taking pain meds! The best thing you can do is be quiet for a couple of weeks so it will heal. Moving around too much will delay healing. Consider this time as a vacation to catch up on your sleep, reading, friends, movies, etc. It will all be worth it to get rid of the infection!

You will need to clean the wound after every time you use the toilet. The best way is to get a hand-held shower head sprayer. Straddle the side of the tub and gently spray the wound and everything else clean. I very strongly recommend this!! I still do this to clean the setons. I rarely use toilet paper or wipes when I'm at home.

Be sure to take 4+ sitz baths a day -- not the kind you put on top of the toilet. Both my colo-rectal surgeon and GYN said there is nothing better than putting you butt in a tub in warm-hot water for 10-15 minutes. My docs say the hot water gets the blood flowing around the body and speeds healing.

One thing to mention, I was shocked that I didn't get a huge infection!! Think of the "stuff" down there that could get in the wound! But my docs said that the body knows what to do down in that area now, so it can handle it. Just do your part and shower it clean, use clean guaze, and you will be fine!

On a positive note. I felt "toxic" before each of my surgeries. But when I came to, I immediately felt much less toxic!!! I felt much better! My docs said that is not suprizing and that is a common comment from other patients. I do not regret the surgeries or setons at all!! This is the only way abscesses will heal. You can read others on this forum who have just had abscesses drained --- but they recur. Ick! opening it up and throughly cleaning it out is the way to get healing. Be gone foul infection!!!

I really want to offer you every encouragement! This really is going to be OK, and you will start to heal. Please, please let us know how you are doing and share all your expereinces. There are many here who have had this done! If you want to contact me directly, please email me (the right-hand email icon under my name).

And to answer one of your questions, I too had little discomfort when I first got the first abscess/fistula.  Too busy to deal with it and not knowing what it was, I let it go way, way too long.  I went to the doctor when I got a fever and had swelling all down there.  Cellulitis!!  It almost went septic and killed me!!

Take care!! Praying for you tomorrow!

Hi Welcome and good luck
Jo

jen- I am so happy you have a pretty good support system. My DH has been a Godsend. He is there to hold my hand, to just be there when the tears and spasms of pain wrack my whole body (not a good night, last night) and yes, even look in places where I can't see to see if I REALLY need to see a doctor.(how many times can you all use the word see in one sentence?)

I hope you appts go well. I wish all the best for you too (short duration of illness, less pain, etc...I wish for all of us).

Good luck Jen and nice to meet you.

Glad things went well for you Jenn, hopefully you get to see your Dr. soon for those maintenance drugs :) Good luck with that.
Jo

Hi Jenn!

Glad you are doing so well!! And of course now you must take very frequent sitz baths in order to entertain your kitten!! "Isle of Mom" -- how cute!!

So they just put in a seton? They didn't open the abscess and clean it? Are you on antibiotics?