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Extreme pain and slow healing after flap surgery for fistula

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Posted 2/5/2016 2:25 AM (GMT 0)
Hello everyone. I posted about a week ago about having the advanced flap surgery for my fistula and didn't get much feed back. I'm hoping I get some this time because I could really use some feedback from anyone who has also had the advanced flap surgery. I had it last Friday. I experienced a lot more pain than I expected Friday through Tuesday. Wednesday I seemed to be feeling a little better until I was finally able to use the bathroom early this morning. I have been in extreme pain since my trip to the bathroom. Like back at a 9 or 10 on the pain scale. I got ahold of my doctor/surgeon and he said that while most people don't experience this kind of pain it is not completely unheard of. It feels like I just have a ton of pressure down there; when I'm sitting, standing, in the bed, trying to use the bathroom...I don't think I'm constipated because I'm pretty sure I got it all out. The doctor said I might have ripped some of the sutures or irritated or ripped the flap that they sutured...they didn't really give me any clear advice and told me to try and get my BM's in the comfort zone, stop taking Milk of Magnesia, and continue taking warm baths. I have been out of work since last Thursday. I thought this would be a simple surgery considering it was my 7th but I had to call out of work the last 4 days because of the pain and amount of pain pills I've been taking. I know the pain meds cause constipation so I've really cut back on those the last two days and it hasn't helped one bit as far as my pain/pressure go. I just have more pain because I'm not taking the meds when I should. Has anyone experienced the flap surgery? If so, how long did it take you to heal or get back to normal? Any help, advice, etc would be greatly appreciated. Thanks.
Posted 2/5/2016 4:11 AM (GMT 0)
One concern is that one part of the flap didn't take (since these are like tunnels) and it's abscessing, which could explain the pressure. I haven't done flap, but I did do a plug surgery and it was the most. painful. thing (and I've had a c-section without pain meds afterwards!). I hit a 10 on the pain scale after coming down from from the surgery and had to be admitted with 3 mg of IV dilaudid every 2 hours just to get my pain to a 7. But that was right away, not later on. The largest concentration of nerves in the body is in the rectum, so things can't get really painful.

Honestly, though, it might be worth an ER visit to make sure something hasn't gone wrong. I'm kind of surprised your surgeon didn't have you come in to check it out and make sure things are okay. Ripping the flap doesn't seem like it would heal on its own....
Posted 2/6/2016 12:28 AM (GMT 0)
So today when I was in a hot bath I realized that I have stitching coming out of either my anus or my fistula track. This is concerning to me because the surgeon only put sutures on the inside for this surgery and they were supposed to be dissolved inside of me. I'm wondering if this means that the surgery failed and if this is the cause of my pain. Any advice from anyone out there who has experienced something similar?
Posted 2/6/2016 12:55 AM (GMT 0)
Think you need to place a call to the surgeon's office. Since it is the weekend, the office answering should have instructions on how to call him.

If no stitches were supposed to be on the outside, then sounds like something isn't correct.
Posted 2/6/2016 3:38 AM (GMT 0)
Like I said, I worry that your surgeon wasn't willing to even take a look. If the pain continues or worsens, it really might be worth an ER trip, especially if the on-call surgeon isn't helpful.
Posted 2/8/2016 1:48 PM (GMT 0)
So I went into work on Saturday and it proved to be not a good idea, as I should have remained in bed and resting, especially with the sutures now outside of my body. I called the Triage number I had for the ER where I've had all of my surgeries and was able to finally get some input/advice from a nurse who was corresponding with the Dr. on call on Saturday. They wanted me either to go to the ER in my small city or go to the ER where I've had my surgeries, just based off of what I was telling them about my symptoms and sutures. Before my partner Peter and I rushed off to the ER we decided to bite the bullet and call my surgeons personal cell phone (he had given me his number after my 3rd surgery because of his concern for me but I really didn't want to ever call him on his personal number unless I really needed too). He told me not to go the ER because 1) the local ER probably would have sent me straight to the hospital where I've had surgery due to my relationships there and 2) the doctors or nurses would have either given me a digital exam or a small scope exam and it would have ripped the "flap" or whatever the surgeon had done down there and we would have ended up back at square one and doing the same or a different surgery. My surgeon explained that my pain was to be expected and the sutures I was seeing were probably just due to them coming outside of my body due to straining or BM's. He also explained that it was still too early to really know if the surgery was successful or not. So, I'm basically on bed rest until I go back to the Dr for my post-op this Thursday. My pain seems to be subsiding but is still always at a 6 or higher. The sutures are an annoyance and painful at times but nothing I can't deal with after having setons, catheters etc. What does have me worried is that at times the pain and pressure I've been experiencing feels a lot like when I had my abscess before they were finally able to fully locate and drain it. As always, I'm just frustrated because of all of this and all of my surgeries and still not having any kind of diagnosis.
Posted 2/8/2016 7:43 PM (GMT 0)
That is weird that your surgeon said to not go at all. I would think he would call the ER and tell them not to do scopes or digital exams, but to do an MRI to see if the abscess is coming back or something. How totally frustrating!
Posted 2/8/2016 8:25 PM (GMT 0)
Hell, I would go in just for a blood test to see if you're battling a bad infection!
:(
Do you have a fever?
I'm trying to remember what it was like before my abscess. I remember really bad rectal pain that lasted about a week and then went away, an 8 hour round trip road trip that I did in 2 days, and then the appearance of a lump that cipro/flagyl made worse.
Posted 2/8/2016 9:28 PM (GMT 0)
When I had my abscess I remember in the beginning the pain and pressure for a month and then the discharge started along with fatigue and low grade fever. I'm having all of those symptoms but I'm not sure if it's not just due to my flap surgery and still healing from it. The pressure/pain seems to be worse when I relax all of my muscles down there instead of keeping them clenched a little. A lot of pain when I sit on the toilet or try to go pee as well. I'm having a tiny amount of discharge which is worrisome bc the fistula is sutured up and discharge is supposed to have stopped right? That's one of reasons we chose the flap surgery. I'm just feeling at a loss once again. I haven't had blood work done since this all started last April. My abscess was a deep internal one so I didn't have any tell tale signs other than my symptoms and what later could be felt from the outside bc of growth of the abscesses.
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