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Really confused and scared. 19yo female with first Abscess/Fistula

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Crohn's Disease
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Posted 10/24/2009 8:36 PM (GMT 0)

Hey there, I joined this forum because I am so confused and scared to death.

Here is a little information on whats ben going on the past year:

 

For years I have had problems with diarrhea. I believe it has ALOT to do with anxiety( I have severe anxiety).

As of a year ago I started to feel a pain to the left of my anus, it was deep and very uncomfortable to sit on.

Just about one month ago I was rushing myself to the hospital for about 5 days in a row. All them telling me I had an abscess but only the last ER doctor wanted to do anything about it, so he gave be a shot of GRAVOL, DEMEROL, and 2mg of ATIVAN before he cut into it. He didnt drain it completely so the surgeon could do it the next day. All I have to say is... EXCRUTIATING.

So for the past month I have been having it packed daily with an anti-microbial dressing. Sadly it has REFUSED to heal up. With a starting depth of 6.5cm and is still the same today.

It has been draining ALOT of thick greenish pus the whole time.

I went to see my surgeon a week ago to see if he wanted to do the fistulotomy surgery, he said not yet. He wants to see if it will heal up. But I cant deal with the pain and discomfort anymore, so I got my mom to call and have a surgery appointment set up.

So now I have my surgery set for November 3rd. I am scared to death to have it layed open or possibly cut up and have a big chunk missing out of my bum.

Also I am afraid that I will never be the same after this surgery, will I always have trouble controlling gas? Will I always feel discomfort? Will I always be worrying about a chance it may come back?

I am so scared, I have not been diagnosed with Crohns. So I dont know what to expect.

Someone please help me.

I am scared to death about this whole thing, I am only 19, I dont want to live my whole life suffering.

After the fistulotomy, within a year will I be almost 100%? cry

Posted 10/25/2009 12:42 AM (GMT 0)
Maybe im in the wrong forum.
Posted 10/25/2009 1:15 AM (GMT 0)
I was 19 when they discovered my first fistula (I'm now 22). Shortly after they discovered the fistula, I developed an abscess. I had the abscess drained surgically and had to pack the wound for about 6 weeks. It never healed so they decided to do surgery again. Again, I was having to pack the wound twice a day and it still would never heal. I finally went to another doctor, a colorectal surgeon, who told me to quit packing the wound. He put me under anesthesia and explored the wound and saw that the fistula was continuing to drain through that opening and that as long as that stayed open, I shouldn't have any problems. I still have the wound there, it is a small hole now. It doesn't bother me at all anymore, except on occasions where I am having really frequent bowel movements. I know being young and having these types of problems can be very scary and intimidating but in my case, everything turned out fine. I will say that once I discovered I had Crohn's and got my Crohn's Disease under control, everything seemed to be much better. I wish you the best of luck, and if you have any more questions, I'll do my best to answer them. Like I said, I'm 22 now and I do everything that girls my age do without any trouble!
Posted 10/25/2009 1:26 AM (GMT 0)
Before I even had stomach problems I had a pilonidal cyst.... This developed when I was about 18 (im 21 now)
Posted 10/25/2009 1:35 AM (GMT 0)
Have they tried giving you a course of Flagyl (metronidazole)? It can be very helpful in healing up fistulas.
Posted 10/25/2009 1:46 AM (GMT 0)
Thank you for the support Malibu.

And Writer, no they didnt.

I am just so worried about incontinence because it is a ischiorectal abscess and is very deep.
I dont want to be wearing depends at age 19. That would ruin everything.

The fistulotomy is November 3rd and I am afraid I will end up in worse condition than I was in before the surgery.

I am experiencing discomfort and abit of pain after bowel movements and sitting for longer than 30 minuts at a time.

Does anyone know about Ischiorectal abscesses and if they are more difficult?
Posted 10/25/2009 1:53 AM (GMT 0)
Hello WhatDoIDoNow,

I am so sorry you are experiencing this! I'm guessing there is much more to your story if this has been going on for a year! These wounds can take a very long time to heal -- I know this from hard personal experience! But a year is excessive. I do think the healing time depends on how your surgeon treated you, whether you are on medication/antibiotics, whether you have Crohn's, and whether your doctor knows what he/she is doing. I am a little confused because you said your surgeon said he didn't want to do the fistulectomy, but then you have scheduled it. What type of doctor is he? Is he an experienced colo rectal surgeon?? Have you seen other colo rectal surgeons for second opinions? A year is a very long time, and I wonder what your doctor has done for you. If you care to give more details about your doctor and his treatments, maybe we can share our expereinces that are relavent to you.

Take care!
Posted 10/25/2009 2:02 AM (GMT 0)
Hi FallColors,

This has been going on for a year yes, but I only went to the doctor once in the begining to have it checked out, but the walk in doctor I saw GUARANTEED that it was hemeroids.
It was just on September 10th of this year that the abscess became too large and swollen to ignore. So I had it drained on September 16 with it still draining alot of thick pus to this day.

The surgeon said he didnt want to do the surgery. He is a general surgeon and he was the one who didnt the insiscion and drain. I think he is wanting me to wait for it to eventually heal up. But I am in too much discomfort to wait and see. So I asked my mom to see if she could get me in for the fistulotomy. I am scared because he is a general surgeon and not a colorectal surgeon. I am most afraid of incontinence after the surgery due to possible cutting of the spinchter muscle. :( Should I be scared of this?
Posted 10/25/2009 2:03 AM (GMT 0)
did*
Posted 10/25/2009 3:02 AM (GMT 0)
Please consult a colorectal surgeon before you do anything. Hope you feel better.

Julia
Posted 10/25/2009 4:15 AM (GMT 0)
My mom who works at the local hospital just informed me that it is hard to find a colorectal surgeon in Southern Ontario (Canada) as most of the surgeons who do this procedure are general surgeons. The surgeon that is going to be doing my surgery has been in practice for 29 years and has had no bad reports.

My father says I should have faith in the surgeon, and to get my head straight as it will help with the whole recovery process.

Posted 10/25/2009 4:17 AM (GMT 0)
I just wanted to add that I was afraid I would be wearing depends forever too. I'm not sure on the exact location of your wound so I don't know how well this would work for you, but I would use 4x4's and fold them half and just kind of tuck them in there. This was much more comfortable for me, and it didn't look bulky like depends can sometimes make you do.
Posted 10/25/2009 4:46 AM (GMT 0)
I had an anal fistula before being diagnosed w/crohn's. I was so afraid before the surgery that my fiance had to carry me inside the hospital. Afterwards it took 8 months to heal completely. Make sure to do the sitz baths. They help the pain tremendously. They may even help ease your discomfort now. You will be fine. Stay positive.
Posted 10/25/2009 12:22 PM (GMT 0)
Hello Msceleste08! Welcome to the Forum!

Hello again What. You would only be incontinent if the sphincter muscle is cut. Hopefully your surgeon will know not do that! It is true that general surgeons perform abscess Incision and Drainage (I&D). For the more complicated cases, and for those of us who have Crohn's Disease, it is highly recommended that a skilled colo rectal specialist surgeon do the procedure. I think you should trust your doctor -- I think he will only do what he is comfortable with. Maybe he will just drain it again. If that doesn't solve it, you can see a colo rectal sugeon later.

There are antibiotics and other medications that help with abscesses and help heal fistulae. A Gastro Intestinal (GI) doctor will know about these. Remember surgeons cut, but GI's manage disease. I suggest you see a GI as soon as you can.

I want to encourage you that you are going to be OK. This things are difficult to deal with and unfortunately, you may have to see several doctors before you find one that knows how to help you. Also, these things take way to long to resolve, in my humble opinion, but you will heal and you will be well! It sounds like you have more to go through, so please hang in there!! The kind folks on this forum here can help you deal with it all, so please keep posting! Here are websites that talk about fistula and abcesses. They link to other articles too. I suggest you share them with your parents so all will have a good understanding of what you are dealing with:

http://emedicine.medscape.com/article/190234-overview
http://www.fascrs.org/patients/conditions/anal_abscess_fistula/

Let us know how you are doing!!
Posted 10/25/2009 5:53 PM (GMT 0)
Thank you all for the support.
I am still very scared, but everyone is reassuring me that I will be fine because I am young I will heal better and faster.

I am seeing a GI three days after my surgery.... yikes. I know.

But I really want this to all be over.
Posted 11/9/2009 5:13 PM (GMT 0)
So...how are you doing now? Did you have the surgery?

I hope you are well :)
Posted 11/9/2009 7:23 PM (GMT 0)
Hey there everyone,

Yes I had the surgery on the scheduled date (November 3rd).

The surgery went great, my recovery from the anestesia was abit rough though. I felt very sick and was white as a ghost. But that passed after a few hours and was ready to be sent home.

The first two days after surgery was pretty good. Pain was bearable. EXCEPT the first dressing change, because the surgeon literally stuffed the wound like a christmas turkey. Ouch.

Then there was the third day, oh boy. I didnt take stool softners as the surgeon rathered me take metamucil. So I did... but still ended up constipated beyond belief. It was so painful but my advice is to ride it out and take stool softners and mineral oil caplets till it pushes it out. So by saying that, the fourth day I was free of all hard stools. YAY.

The fifth day I ran out of the percocets the surgeon perscribed me... so that WASNT FUN. As I had many muscle spasms in my back side that feel like someone is pulling out my rectum.

Now I am on day 6 after surgery. Still with no pain meds... SUCKS.

This morning I had my sitz bath before the nurse came to change the dressing and go figure half way through I felt the urge to have a BM. So I got out and went... wiped.... and TA DA! I pulled out the packing and re filled it with abit of poo... WHAT A MESS. So I hopped back in the tub to try to clean off and didnt I feel the worst burning/stinging sensation EVER. I was balling my eyes out trying to tell my boyfriend what is wrong and for him to get a piece of gauze to clean it out. What a nightmare.

So all together I have to say... it hasnt been as bad as I thought it would be, but there is some down sides to it all.

I will update you all after my birthday on the 17th to tell ya how good im doin smilewinkgrin   haha.

BTW. MY WOUND IS 7cm long from my bum cheek to just over my bum hole  tongue and 2cm deep. Not bad.

Posted 11/9/2009 9:47 PM (GMT 0)
I am glad to hear you are doing well!  Do you have a hand held shower sprayer to clean out the wound?  They are the best!!!  No ouchy wiping and it gets the wound really clean.  And you can hold it far away at first so the spray isn't hard.  I can't recommend it enough!

I hope you have a swift recovery!

Posted 11/10/2009 12:09 AM (GMT 0)
That sounds like a great idea!!!!

Thanks for the advice!
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