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another perianal abcess and now a cathetor drain installed.

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Posted 6/19/2011 4:47 PM (GMT 0)
so i was on my 3rd remicade infusion and giving myself a methotrexate shot every week for crohns colitis. my stools were forming  again just about half the normal size, bathroom runs were down to 2 to 5 a day and WHAM.....another abcess and another wonderful 3 day vacation at the hospital to drain a ping pong sized abcess. This time it was too high up in the rectum for a seton drain so they put in a cathetor drain...they bored a hole straight into my cheek and left a drain tube dangling out. Supposed to be in for 10 days and hoping it will be the last for a while if not forever. its very painful and oh so sore...especially when i need to shoot hydrogen peroxide in the tube to clean the abcess once a day...My question is to anybody out here....has anyone ever had a cathetor drain in what was your experiences and or any tips to relieve the pain and to help with comfort.
Posted 6/19/2011 10:06 PM (GMT 0)
I have had 2 of these.  Mine were put in with ct guidance.  Were yours?  Both of mine were failures.  Of course, they work initially, but the abscess always came back.  My new surgeon explained it this way, instead of going in the operating room and having it drained and cleaned out and then left open to heal from the inside out, the drain tube will remove the fluid build up but there is no way to clean out the abscess.  So even one little bacteria left will multiply and start the whole thing over again.  Once I had the abscesses drained in the operating room the correct way, they never came back.  Mine were very deep and could not be seen from the outside.  Hope this helps!
Posted 6/19/2011 10:23 PM (GMT 0)
hey chroniemom....my doc told me before i went under they would use a ct scan locally to locate abcess so i believe this is what you had too.. They also did a ct scan before i was admitted ...my procedure was done in the OR....this one was deep aswell....too far for a seton for fear of damaging rectum "incontinence"......from what the staff said they used a needle to locate abcess and drained it. then opened it up larger and i presume cleaned it out....then put it diamond shaped head with drainage cathetor....You mention the "correct way" what was done for that....did they cut it open and pack with gauze????
Posted 6/20/2011 1:22 AM (GMT 0)
You must also have a fistula because they were talking about a seton. Mine was just an abscess. The ct drainage...they did a scan to locate it, then drained it, openede the hole up farther so they could put the drainage tube in...and I was awake for this both times! They gave me morphine, but obviously, morphine does not work for me, because I have never had anything hurt so bad in my life. What my new surgeon did after my old surgeon let them do the ct drainage on me, was put me out :), then drains the abscess, cleans the abscess cavity, inserts dye in the abscess then looks inside the rectum with an anoscope to see if he can see any internal openings which would mean a fistula. If there are no openings, he leaves the abscess open to heal from the the inside out. I have had him pack it once with gauze, and another time he put a mushroom drain in, which the end that is in is shaped like a mushroom. Then he pulls that out in his office about a week to 10 days later.

The first time I had the cathetor drain in a week, and it came back 2 weeks later. Then that time they left it in for a month...and a month after that I was having surgery (the correct way) to finally get rid of it!!!
Posted 6/20/2011 3:01 AM (GMT 0)
I had a catheter inserted to drain an intraperitoneal abscess....probably different from your situation. Mine stayed in for a month and a half while I was awaiting my bowel resection. As far as the tenderness goes, it improved with time, but the skin around the insertion site became extremely raw and began to grow around the tube. I doubt this will happen to yours as it is will be in for 10 days. I can't imagine how uncomfortable you must be with the catheter being in such a tender place. I will definitely be keeping you in my thoughts and prayers.



Chroniemomx2 - my procedure was CT guided as well and they attempted to give me versed and fentanyl despite me telling them it didn't work (found that out when I had my first colonoscopy). I remember everything from the procedure it is not something I want to go through again that is for sure.
Posted 6/20/2011 4:15 AM (GMT 0)
@ crohniemom......i failed to tell you that i had a previous abcess and fistula that was operated on and a seton placed in which is still in.....i cant believe you endured the pain while given local anestesia....this whole operation was last friday and i plan on seeing the doc this week....but he told me before going in that he was putting a mushroom drain in as and that it was only an abcess #2.. anyhow i am hopeful this procedure was done correctly which sounds like the correct one you had.....thanks for the comments and insight...

@melevens..... ive been out of surgery only 2 days so i have to expect this rawness...thanks for the comment...and good luck with your health...
Posted 6/20/2011 4:49 PM (GMT 0)
I recently had this done, except my mushroom cath was put in rectally instead of from the outside (so I had a tail). It was supposed to be in 10 days, but i only made it to day 4, as when i went to the bathroom, it felt like I was being ripped apart!!! So, of course, the opening they made healed up and made it all pointless. Thanks to the location of my abscess and the way the fistula tract runs, a week later, I have another abscess in the same place, the only difference this time is that I get a little bit of drainage in the other direction (my fistula is a rectovaginal one with an annoying L shaped branch), but it can't drain all the way, so we are trying another antibiotic as of today.

New surgery is scheduled for the 15, the get rid of the fistula, and hopefully stop all this mess.....LIFT procedure, here we come!

As to advice, I found quickly that pain meds were my friend in this situation. Normally, I hate the things, but that and being careful about sitting and moving were the only things that helped. If it bothers you when using the bathroom, I would advise steeping into the shower and letting the warm water run over the surrounding muscle tissue for a few minutes (not the cath area per se, but the buttock muscles), and try to lie on your side as much as you can to relieve the tension.

Will your doc let you dilute the peroxide a little to help the stinging?
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