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Back to work after 6th surgery

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Crohn's Disease
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Posted 10/3/2015 5:42 AM (GMT 0)
So after my 6th surgery for what started as an abscess and ended up as a fustula that ended up a branch in all sorts of ways I had a fistulotomy on 9/16. I took two weeks off of work because it was "stressed" that I do this to not only "heal" in corporate terms but also to prove a point for attendance policy. Guess they still don't believe me when I said it's a work in progress and I don't know when I'll be 100%. They seem to think all will be well now. The area where my surgery was done on 9/16 is healing nicely. I ended up with 6 surgeries bc there ended up being a nasty breaching, complex fistula on top of the first. Now the Drs are leaning towards Crohn's so I'll be having a colonoscopy, biopsy and blood work here soon. Guessing it wont be to bad considering my experience with the six surgeries and one self induced enema.
My question for all of you out there is that in the last month, I've had nausea when I eat anything or a straight run to the bathroom and hope I can make it in time experience. . After the 6th surgery I had problems going number one and went a week to go number two which I figured was psychological, bc I knew it would hurt with the new seton and huge wound. But I've never experienced an accident and now I've had two. Not good for 40 hrs a week at a job and 15 hrs a week at college. Is his just because I've had stomach issues since the last surgery and I can't keep anything down or in because of nerves? Or what? I've never gone to the bathroom this much! Especially considering I'm not really eating.
Posted 10/3/2015 7:44 PM (GMT 0)
I'm surprised no one told you after so many surgeries.
As a result of fistulotomy, most people, especially women, experience incontinence, not to mention the trauma to the vaginal wall.
It's why perianal/perineal surgery is considered so risky for people with Crohns.
http://emedicine.medscape.com/article/1582312-overview
"Complex fistulae include high transphincteric fistulae (with or without a high blind tract), suprasphincteric fistulae, and extrasphincteric fistulae, in addition to recurrent fistulae; rectovaginal fistulae, fistulae involving multiple tracts, anterior fistulae in women (higher risk for postfistulotomy incontinence); and fistulae associated with inflammatory bowel disease, radiation, malignancy or preexisting incontinence"


"All symptomatic anorectal fistulae require anal fistulotomy. The only exceptions are in patients with Crohn disease. The primary treatment for perianal Crohn fistulae is medical (ie, immunologic agents), and surgery is reserved for control of perianal sepsis, where less is more (eg, placement of draining setons"
Posted 10/3/2015 7:53 PM (GMT 0)
Yes, fistulae surgeries will weaken the muscles that hold things in. As awful and humiliating as it seems, sometimes wearing those adult incontinence pads actually provide emotional relief because if there is an accident, it's more manageable and not as noticeable.

Also, have you been on pain medication? Opioids will slow your motility, which could explain why it took so long to go the first time. As you wean off them, it can lead towards accidents or urgency until your body regulates itself. And nausea is common with coming off opioids. Ask your doctor if you can have a prescription for Zofran, which is an anti-nausea medication that has very few side effects.

I know, it totally sucks. :(
Posted 10/5/2015 4:15 PM (GMT 0)
I had my 5th surgery on 24th August. I too have urgency to get to the bathroom after the Fistulotomy/seton placement. Before the fistulotomy things were worse, I was incontinent on 7 occassions. I have had this urgency all Summer since 4 consequtive ops and first seton. Unfortunately it looks like it comes wigh the territory. I also have a weak lower core which doesn't help continence, but I get physio for this. This is building strength which will also help continence.

Post Edited (MOUSE) : 10/5/2015 1:02:58 PM (GMT-6)

Posted 10/8/2015 5:15 AM (GMT 0)
Thanks for all the responses. I'm mostly off the pain meds. One or two a day, usually one in the morning before work/school and one at night before bed bc I find that the tossing and turning I do at night causes quite a bit of discomfort and pain. I haven't taken miralax for 5 days but find I'm still having an unusual amount of diarrhea for me (I'm usually more of a constipated woman-since childhood). I will probably start taking it again bc the harder my stools are getting the more pain it causes me after a BM. I'm finally able to go number one without having to sit there and concentrate for a couple of minutes which is great but the passing of gas without even realizing it and worrying about not making it to the bathroom is still weighing heavily on me, especially bc I'm back to work and school full time. Mouse-your 5the surgery was on my 33rd birthday. My 5th surgery was one week before then in the 17th. Here's to hoping we can be surgery free for awhile-I'm not counting my upcoming colonoscopy as a surgery even though it'll be my 7th anesthesia since April. I'm hoping the biopsy won't be painful.
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