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Posted 10/15/2009 1:02 PM (GMT 0)
Hello all - I had my abscess drainage with EUA yesterday and they ended up putting in a seton stitch by the looks of it. I could barely see it until I gently moved my butt cheeks.

So my one butt cheek is very swollen and my tailbone is killing me. They must have really been reefing on me. There's about a half inch incision. Mostly blood on my gauze right now, is that normal? Also, i'm having a hard time peeing - perhaps from some local freezing or the anesthetic?

I also have fairly large tags that are making it hard to clean down there after a bowel movement. I can't adequately wipe down there - I don't think the shower sprayer and sitz bath alone will clean the area. I am using baby wipes, but seem to be having a tonne of trouble getting all of it. Any suggestions?

Also, what positions did you find the most comfortable to lay in after your seton?
Posted 10/15/2009 8:21 PM (GMT 0)
I think you need to give things a little time, farfrmnormal. That whole area is going to be sore so soon after surgery, but should settle with time. As far as cleaning goes, what if you keep a squirty bottle next to your toilet, and use that every time you use the loo?
Posted 10/16/2009 4:30 PM (GMT 0)
Oh, I was expecting to be uncomfortable. I knew it wasn't going to be a walk in the park.

I'm still feeling pressure in the tailbone area - hoping it goes away soon.

I am going to have my mom purchase a perianal bottle for me to use - I do have to have a sitz bath after each BM but that doesn't get rid of it all.

I just need to find a comfortable position to lay in to avoid as much discomfort as possible.
Posted 10/17/2009 12:54 AM (GMT 0)
Yes, the blood is normal. Make sure you are drinking enough fluids...I had trouble having a bowel movement after mine once and that was no fun. We dont't need to be obssesive about cleaning the area down there. You don't have to worry about poop getting in the incision or anything because if it does...it really doesn't matter. The fistula is open to the bowel anyway.
Posted 10/17/2009 1:42 AM (GMT 0)
I've had a number of bowel movements since the surgery. I even had one the night of my surgery. Today I experienced extreme antibiotic induced diarrhea so as per the advice of the surgeon I took some Imodium. I spent about 2 hours in the bathroom this morning between being on the toilet and sitting in the tub after wards :)

I feel pretty good otherwise - just hoping for a speedy recovery.

I'll check in and let everyone know how things are going.
Posted 10/17/2009 2:01 AM (GMT 0)
Well good! Mine was speedy so hopefully yours will be too!
Posted 10/17/2009 11:30 AM (GMT 0)
Has anyone ever had this done and not been put on antibiotics afterwards?

I ask because I had an allergic reaction to the flagyl in the hospital and they told me to just take Cipro. Well, now I have severe D (I have been up since 4am in the bathroom - sitting on the toilet and then into the tub) and vomiting as well as my skin feels like its crawling. I don't know what else they would put me on. I'm going to call the pharmacist as soon as it opens as 9am. But, it's a Saturday and my surgeon isn't in her office again until Tuesday. I can't put up with the D. It's making everything hurt and swell up again. Imodium isn't even working. I have had this problem with Cipro in the past - I should have known it was going to be a problem.
Posted 10/18/2009 1:38 PM (GMT 0)
Hi Farfrmnormal!

I am glad you had the surgery. The first week is always a whirlwind of ups and downs. It takes several days to get rid of the anethesia drugs they give you and your body is still delaing with infection. I have always been on antibiotics. I was on both flagyl and levaquin (cipro's stornger cousin) -- talk about diahrea! I can't take flagyl anymore. I am wondering if you are allergic to cipro too. I was on antibipotics for months for my first abscess because I had run-away cellulitis. For abscess 2 and 3, I was on for about 10 days post-surgery. You had an abscess so it is just common sense that you will need antibiotics until the tissue can get rid of the infection. Hang in there!!

As for cleaning, the shower sprayer is the best thing I have found. You can use a gentle or strong spray. It really does clean the best. I sit on the side of the tub (one foot in the tub and the other foot outside) and can use one hand to move things around while I spray with the other.

I just want to encourage you to relax and let the healing process work. A half inch incision may take a month or more to heal depending on how deep the abscess was. I know you don't want to hear that! I've had bigger incisions that have taken months to heal. We really just need to be patient and let it heal. I laid on my side with a pillow between my legs for months with my first nasty abscess. I could lay on my back if I but two pillows under my knees.

Get some good movies, books, magazines, surf the web, and just chill out. Take long sitz baths in the tub (much better the type that sit on top of the toilet). I consider abscesses to be an imposed brake from life, and I used them to catch up on books I've wanted to read. Not exactly my choice of vacation, but hey, you just have to roll with it.

Take care, and let know know how it goes!
Posted 10/18/2009 5:37 PM (GMT 0)
Hi Fall - thanks for your message.

The reason I asked about the antibiotics is because my pharmacist and home care nurse took me off of the Cipro and because of the Flagyl reaction at the hospital I am not on any antibiotics now. My home care nurse is going to call the surgeons office tomorrow.

They gave me about 200cc's of Cipro by IV at the hospital and I got three oral doses in me at home then all hell broke loose. I was also on Flagyl for a month before the surgery. Itchy skin, nausea, vomiting and severe D. My home care nurse said I was so dehydrated she was almost ready to send me back to the hospital. I still have D today, not as bad but it's still there and the home care nurse told me that if I still have D in 24 hours she will be driving me to the hospital. She said she hopes the Cipro will be out of my system by tomorrow. One good thing is, today is a new day and I can take more Imodium.

I have figured out the cleaning process now. The swelling has gone down quite a bit so I can see things more clearly. The home care nurse said I am keeping things really clean which will help with the healing. I'm going to stay positive and hope I can be back to work by the date the surgeon gave me as a return to work date.

One thing about being on antibiotics and being a female is the dreaded infections that come along with it - if you catch my drift :) Hopefully the doc will prescribe a new antibiotic and I can get the other female infection under control. I have some meds for that, but I figure, whats the point when it will probably just come back because I'm still on antibiotics.

Ok - I'm rambling now... thanks for the responses!

For those of you who have had abscess' - when was your last abscess surgery and what meds have helped you steer clear of an abscess since?
Posted 10/18/2009 7:37 PM (GMT 0)
Sounds like you are working things out! You may want to ask about getting a C-diff test if your D continues to be severe. It is something you can pick up in hospitals.

As for CD drugs, are you on anything? Remicade, humira, and 6MP (mercapturine)/Imuran are common. I am allergic to remi and Humira. I had 3 abscesses in 18 months. Then I started 6MP and have been abscess free for 17 months. Yea!!!

My surgeons said I could return to work and normal activities when I felt up to it. I am blessed to be able to work from home so I stayed home until the incisions healed.

Take care!
Posted 10/18/2009 7:46 PM (GMT 0)
Hi, Farfrmnormal.

I'm glad your home and I hope your feeling better soon but I have kind of a newbie question. What's a Seton? Also, I remember something about tags when I was first diagnosed and I haven't heard the word since so maybe someone could tell me what is a tag.
Posted 10/18/2009 7:53 PM (GMT 0)
Hi Solanges,

Farfrmnormal is talking about anal skin tags, which are fleshy folds of skin that can form around the anus. They are common in rectal CD and can get large.

A seton is a plastic tube that is used to keep a fistula open and draining (rather then becoming clogged and abscessing). The surgeon threads the plastic tube completely through the fistula and then ties the ends together. They really work (for most people) but they are a type of fashion jewelry that no one wants!
Posted 10/18/2009 8:27 PM (GMT 0)
oh no, not c-diff. What about my family? I don't want to be exposing them to that. How will we disinfect the house? Should I tell them I could have this? I guess I will talk to my in home care nurse tomorrow.

How is one tested for it and how soon do you get results back?

Now I'm really worried because that bacteria is really hard to get rid of - especially for someone like me who has been on so many antibiotics lately and given I am allergic to flagyl. Ugh... should I be taking Imodium then? I hear Vanco is bad for people with crohns and is really expensive.

I'm not on any meds currently for my crohn's. My previous GI took me off of my meds but didn't replace them with any. This was the reason I have since found another GI, but do not get to see him for my first consultation until November 30th.
Posted 10/18/2009 10:17 PM (GMT 0)
I am sorry if I made you really worry. It is possible you do not have this at all. It doesn't develop -- you catch it in the hospital. Just have everyone wash their hands very well if they handle any of your guaze, pads, underwear, etc. (it can be passed through exposure to stool). They test a stool sample to find out. A quick test. Ask your nurse about it tomorrow. I woudl also keep on the immodium if it helps, until your nurse/doc tells you otherwise.

Bad D can certainly happen from antibiotics and from the stress your body has been through in the last few weeks -- a bad infection/abscess and surgery really does add a lot of stress to your system. I remember being all out of sorts for weeks. A big part for me was not knowing when the darn incision would heal, and why I felt so sick and tired. Plus the flagyl made me very anxious and highly emotional (a common side effect). I was just plain nuts!

Anyway, I am glad you will see your nurse tomorrow. Chill out until then.

Take care.
Posted 10/18/2009 10:24 PM (GMT 0)
I have read that C-diff can develop from being on antibiotics as well. But also know that it can be passed through fecal contact.

I am relaxing lol - not much else I can do. I will try not to worry about the c-diff, it could just be because of all the antibiotics I was on and cipro has a habit of doing that to me.

I was quite emotional on Flagyl as well, but then the joint pain and tingling in my legs and arms started so the doctor told me to stop taking it in fear of causing nerve damage from serum sickness.

I am the only one handling my underwear, gauze etc - the nurse wears gloves when she sees me and uses an antibacterial spray on her hands.

So I will just hope that it stops soon and I will talk to the nurse tomorrow. How will I do the test when I can't leave the house?

Thanks again - I will keep everyone posted.
Posted 10/19/2009 1:36 PM (GMT 0)
Hi. My husband has had c-diff, so I can tell you something about it. C-diff is not just a hospital acquired infection - though it can happen in hospitals. It can happen when you take antibiotics that upset the normal gut flora, and it can happen for people with IBD even if you have not taken any antibiotics. I hope you don't have c-diff, but even if you do, you can beat it - so don't panic. If you are not having frequent watery diarrhea, and if the stool doesn't have a real odour to it, it probably isn't c-diff. Be sure to stay well hydrated - my husband could tolerate pedialyte when he was sick (gatorade made his stomach hurt). Also, the BRAT (Banana Rice Applesauce and Toast) diet (no applesauce, instead he eats bland chicken) + 24 hour fermented yogurt seems to help him when he has diarrhea.

My husband developed c-diff without taking any antibiotics, and wasn't in the hospital! Go figure. They say that people with IBD (like Crohn's and UC) are prone to developing c-diff infections because there is something wrong with the flora in their gut, which makes it easy for c-diff to take hold. C-diff is a very hardy spore forming bacteria, and the spores can be anywhere - not just at a hospital. When people ingest the spores, usually when they get to the gut, when the spores hatch to become bacteria, the normal flora in the gut crowds them out - so you don't end up with c-diff. But when you are on antibiotics, or if your bowel flora is imbalanced somehow (like for some people with IBD like my husband), the flora in the gut may not crowd out the c-diff . . . letting c-diff grow unchecked, to the point where you get an infection.

Because noone suspected c-diff (he'd had no antibiotic use), and my husband had not been diagnosed with Crohn's, we had a very difficult last year, with him being in the hospital for 45 days. It was no walk in the park, but with vancomycin and remicade, my husband beat both crohn's and c-diff and came back home.

The test for c-diff normally done is a toxin test. The test should test for both toxins A and toxin B (make sure of that by asking your doc if they'll be testing for both toxins). It is a stool test. The results can even be available in a few hours (in the ER, but normal labs take 24-48 hours). It is best to submit a stool sample from the first bowel movement of the day. If it is going to take you longer than 45 minutes to get the sample to the hospital, you need to put the sample on ice, or put it in a bag and in your freezer because the toxins disintegrate at room temperature.

Don't be scared of vancomycin, it really does work very week against c-diff - much much better than flagyl, and has very few side effects, because almost none of it is systemically absorbed. My husband was on vacomycin for about 10 months last year, and he fared fine. This year in september he had to take another 2 week course of vancomycin since the c-diff came back. But he's off of it again, and seems to be doing ok.

If you can tolerate some probiotics, I highly recommend them when taking any kind of antibiotic - the SCD (24 hour fermented) yogurt is an excellent source of good probiotics, as is VSL#3. Also, if you do have c-diff, I recommend a product called florastor (which is a yeast called saccharomyces boulardii) which as shown some efficacy in keeping c-diff in check. In any case, probiotics are good for people with crohn's so I highly recommend starting some probiotics.

In a lot of people with c-diff, just stopping the offending antibiotic can result in the gut flora stabilizing. I hope you don't have c-diff - it's no fun. But if you do, don't panic - you can beat it, and you can go back to being normal.

((Hugs))
PV
Posted 10/19/2009 4:34 PM (GMT 0)
Thanks PV for the info.

Well, I am having frequent movements and boy do they smell bad! I thought at first it was because of the Cipro, but I have been off of the Cipro since Friday and nothing. My stomach is upset constantly and I'm having a hard time even wanting to eat. I am drinking lots of water, ginger ale, gatorade and eating jello-o and fruit juice popsicles.

I was on Flagyl for a month before having surgery and then just before my surgery they gave me 200cc's of Cipro. My bowels were fine before starting the meds at the hospital and I was taking a daily probiotic - I feel that either the surgery or the meds are the culprit. I am going to talk to my nurse when she comes today.

Would you mind if I contacted you via private message to ask questions in the event it is c-diff?
Posted 10/22/2009 8:50 PM (GMT 0)
So here I am a week post op and still stuck in the house. I need some advice or suggestions on how to get me out of this bed.

Here is what has happened since surgery.

- Had reaction to Flagyl before surgery and was taken off
- Had reaction to Cipro post surgery and was taken off
- Suspected C-Diff. Have to submit 3 fecal samples. However, homecare nurse now believes I don't have C-diff as my BM's are firming up and becoming less frequent.
- Put on Pentasa
- Not on any antibiotics after surgery. Doctor felt the scraping and irrigation of abscess was suffice. Abscess is draining still, brown/yellow coloured discharge from where the abscess was cut open (would this still happen even if I were on antibiotics?). Because I am so sensitive to antibiotics the doctor has not prescribed any more. Also, due to the c-diff fear.
- Groin pain in the evening, only in the leg that is closest to the surgery site.
- Can see seton - It's BLUE :)
- Tender areas below original abscess site - Is this common?
- I find if I spend too much time up and about I get a lot of pain and pressure in the area that I had surgery.
- Urgency has increased as well as some incontinence (Incontinence is usually just mucus, never stool). If I am standing I have to run to the bathroom. It NEVER was like this before the abscess.

For those of you who had abscesses - how long after the surgery did you still have drainage coming from the abscess alone (and not the seton)?

As mentioned previously I have fairly large rectal tags that have made cleaning difficult. This concerns me and has prevented me from leaving the house. When I am home I use the shower sprayer and then finish with baby wipes. I was also told to have sitz baths after each BM. What can I do if I am out in public or at a friends house? I have a house warming party that I would like to attend on Saturday but worry about keeping things clean.

I'm going stir crazy here. I have fears too. I fear that this abscess will never stop draining, or that I will have another one form (Or that there is one hiding because of the tenderness I have from the surgery last week). I NEED to get back to work in 3 weeks. I can't afford to have this happen again - I really need to have all my areas covered to ensure I don't get back to work and have to go out on temp leave again. Ugh - the unknown!
Posted 10/22/2009 11:07 PM (GMT 0)
It sounds like something is really, really wrong. How big was the abscess? I went to the colorectal surgeon today, and I showed him some pocket of pain I was having by my a@us, and they thought it was an abscess. They cut it open. OMG. The pain I was in was so sharp. It hurt a lot to touch, and then when he put on the anaesthetic, it felt like acid pouring into a wound. The last time I had this kind of sharp pain was when I had a bad reaction to Cipro.

I have a bad reaction to Cipro, as well. When I was in the hospital, I told them that I am allergic, but they gave it to me anyway. They took a CT scan when I first arrived to the hospital and then after Cipro. The second CT scan was so bad. They took me off it.

10 months of Vancomycin? Are you in the US? You are only supposed to use it for about a week.
Posted 10/23/2009 8:51 PM (GMT 0)
I'm not sure why you say something is seriously wrong?

I wasn't on Vancomycin for 10 months...
Posted 10/24/2009 12:05 AM (GMT 0)
Hi Farfrmnormal,

I am so sorry you are experiencing this. I am not sure anything is seriously wrong. Its sound typical to me. You had a serious abscess infection. Your body needs time to clear the infection and heal the damaged tissue. And it needs a lot of time to heal the incision. Look at the size of the incision. If that were elsewhere in your body, you would expect it to take many weeks to heal. I am afraid it is the same for a large wound down there. I very much know how it isn't easy to hear this, but it could take many weeks to heal. I know you may say that it can't take that long because you have things to do. I would be dishonest with you if I said anything else but it will take the time that it takes, and there isn't much you can do to make it hurry up and heal. Except to take several sitzs baths a day and keep to clean. Please please accept that I am just trying to help. You just really need to learn patience. Lots and lots of it. I learned patience the very hard way.

You don't need antibiotics after abscess surgery. If your nurse doesn't see signs of infection, the tenderness and pressure you are experiencing is probably just from damaged tissue. But obviously I am not a doctor and can't see what you have. When is your follow up appointment with your surgeon? Don't feel at all shy about calling him/her and getting an appointment. For post-surgeries, they expect that they may have to squeeze you in. You are paying them, so call or go in if you have any questions.

I found that some days I made more progress than others. Two steps forward and one back, but some days were two steps back. This is all normal. Get off of your feet so you don't irritate the wound, and take more sitz baths. The D may simply be a reaction of your body to the stress of the infection, the drugs during surgery, the wound, and the emotions that naturally happen when you go through something so tramatic. I really feel for you! I remember how distressing and bewildering it all was the first time. I didn't know what was happening, how to do the daily care of the wound, or deal with the effects of the anitbiotics. I just so wanted it all to be over and healed. I saw my doctors every week for 2 months (but I had a huge case of cellutis, which you do not have -- thankfully!). They were so kind to me and helped me through it.

The drainage sounds normal too. Some will be from the fluid the body is using to clear the tissue or infection. More from the body sealing the wounded tissue and knitting it together (all too slowly for me), and some will be from the seton. I was amazed that I didn't get infections from the seton drainage getting into the wound, but my doctor said the body knows how to deal with it. If we clean the wound routinely, they body handles the rest. As long as the drainage doesn't get trapped, which is how you got an abscess in the first place, and why they leave the incision open and don't suture it closed. Please be aware that the drainage can irritate your skin -- you can get a skin yeast infection that is the same thing as baby diapher rash. I got it and it is incredibly painful!! Use a baby diaper creme like Balmex all over down there to shield the skin from the nastyness. My doctors said it is OK if some of the creme gets in the wound, and they are right. It doesn't hurt or case any problems, and it feels soothing. The creme can prevent yeast infection, but if your skin is still irriated, your doctor can give you something like Diflucan to kill the yeast.

I know you are worrying about the future, and when you can return to work. Worrying will only make you miserable and could make the D worse. Please, if you can, try to let the worry go for a week. I really do know how difficult that is. You will know much, much more in a week. Patience!

I don't want to leave this post without encouraging you that you will get though this! And a blue seton! How very fashionable!! I had a blue seton once, but now I have red ones. I liked the blue color so much better.

Please continue to share what you are going through. We are here for you!
Posted 10/24/2009 12:08 AM (GMT 0)
Hi NostraHistoria. That sounds very, very painful! What type of doctor or surgeon are you seeing? How big is the wound?? I am concerned about you!
Posted 10/24/2009 12:47 AM (GMT 0)

FallColors said...
Hi NostraHistoria. That sounds very, very painful! What type of doctor or surgeon are you seeing? How big is the wound?? I am concerned about you!

Hi. Thanks for your concerns. The pain is insane. It is worse now than before. It felt like the colorectal surgeon took an electric saw to my skin. I do not even think he got it either because there is a huge bulge down there still. I can barely sit down straight without it hurting. I am so pissed off right now. Everything was going so good, and now this new abscess formed. I am supposed to start Humira as soon as I get it in the mail. I hope this does not delay it. I am supposed to go to the GI Tuesday. She is very proactive. She might just send me to the ER. I am telling that they give me some drugs to knock me out, because the pain was so sharp and intense. I was gasping almost everytime he touched me. The worst part about it was when he put the anaesthesia on it. OMG. It felt like he just had a drop of it on his finger. It hurt so much.

In other news, I had a barium enema exam. I think there was some problem with my appendix. I hope not. I do not want to be in and out of the hospital every few weeks. Hopefully I get Public Aid so I can go to any hospital I want.
Posted 10/24/2009 1:42 AM (GMT 0)
I am so sorry for the pain you are suffering! I had my first abscess darined in the ER and it was the worst pain EVER. Doyou have pain meds??? Call the surgeon now and tell him what you are experiencing. Insist on talking to him, his assistant, or the surgeon on call. You may need to go to the ER. Tuesday is a long way off. Don't worry about calling after hours. You are paying them for this! And he will want to know if you are suffering, so please call him.

My doctor said he drains abscesses in his office for non-CD folks, but not CD people. He wants to take CD people in the OR and really examine them so he can see all that is going on. With our disease processes -- inflammation and ulcerations -- he said he just needs to do a thorough exam.

Please let us know how you are doing!
Posted 10/24/2009 3:49 AM (GMT 0)

FallColors said...
I am so sorry for the pain you are suffering! I had my first abscess darined in the ER and it was the worst pain EVER. Doyou have pain meds??? Call the surgeon now and tell him what you are experiencing. Insist on talking to him, his assistant, or the surgeon on call. You may need to go to the ER. Tuesday is a long way off. Don't worry about calling after hours. You are paying them for this! And he will want to know if you are suffering, so please call him.

My doctor said he drains abscesses in his office for non-CD folks, but not CD people. He wants to take CD people in the OR and really examine them so he can see all that is going on. With our disease processes -- inflammation and ulcerations -- he said he just needs to do a thorough exam.

Please let us know how you are doing!

Where was your abscess exactly? Were you screaming in the ER when they drained it? What kind of anaesthesia did they give you? Were you feeling better right away after the drainage?

Man, this thing hurts. I do not have insurance. So, I go to the free clinics and wait times there are really, really bad: 4 hours for a clinic visit, 15 hours to be admitted to the ER, 31 hours to be taken into the hospital.

I will demand that they give me some anaesthesia that knocks me out though if they did not get it.
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