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Advancement flap for fistula post op-advice needed

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Crohn's Disease
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Posted 5/18/2018 4:21 AM (GMT 0)
Hello,

I am one week out from a rectal advancement flap surgery for a complex fistula. This was my tenth surgery in 14 months, though i was only diagnosed with Crohn’s in January (currently on Imuran).

I am desperate to hear from someone who has gone through this. I am shocked by how painful this is, even 10 mg of Norco/alternating Advil is not providing relief. I was told not to lift more than “a milk jug” for 10 days, and it frankly hurts too much to move around anyway. I also have a drain in the original abcess cavity, though frankly i think the drain does nothing.

Any advice on how long recovery will take? Pain management? Much appreciated.
Posted 5/18/2018 2:29 PM (GMT 0)
Hi, sorry you're having such a rough time. Have you contacted the surgeons office to see what advice they have? I had a failed procedure in 2015 that had post op complications that I put up with for a couple of weeks before I called the doctor. It required a return to the ER --- not what you want to hear I'm sure.

Also, did you know crohns patients shouldn't be takiing Advil or any other NSAID? It will aggravate the disease (been there done that). It was actually one of the first things my GI asked after my recent surgery.

Hope you heal up soon!
Posted 5/18/2018 2:30 PM (GMT 0)
Hi Chitowncrohns & welcome to the forum. Wow, it sounds like you have been on a rough path for quite some time. I sure hope this last procedure helps. I have no experience with this procedure. However, we have a member called Dimitri71, I believe is the name that may have had this done. Please click on page 2 here & look for this member's posts. There is a chance the member will check in at some point & reply. But if you will go to page 2 & read you may get some good info.

Keep us posted.
Posted 5/18/2018 4:31 PM (GMT 0)
@lamb61 thank you for the advice, I've been in contact with the doctors who said that 2-3 weeks of pain is 'normal'. My next follow up isn't until the 31 of May so I may try to get in sooner...

I did know about the Advil but my GI said it was ok in extreme circumstances. But thank you for looking out!

@straydog thank you!
Posted 5/21/2018 5:07 AM (GMT 0)
Hi,

I've had an advancement flap about a year ago. It was successful but I had another fistula further up and I'm hoping to get another advancement flap to fix that.

From my experience the flap was much more painful than a regular I&D or a seton placement. However I don't remember it being as painful as you are describing. However I know that fistula vary from person to person. My fistula aches and throbs after a bowel movement whereas other peoples just oozes without much pain at all. It's a very complicated area, with lots of different nerve pathways. Unfortunately it sounds like you just drew the short straw with where your surgery took place. I'd monitor the pain, if it feels hot or burning or different than it does now then go see a doctor as it may be infected. Until then just try keep up the pain meds and don't move too much. A few weeks is nothing in the greater scheme of things and it WILL lessen with time. My experience was that it got less painful gradually to begin with and then it got less and less painful quite dramatically. Hang in there!
Posted 5/21/2018 4:14 PM (GMT 0)
So sorry to hear you are in pain...I have been there.

I have had several procedures and surgeries, including a standard advancement flap and later a flap using gracilis muscle. The first, sadly, failed to repair the fistula.

I definitely echo talking to your surgeon and advocating. I was told it was normal pain wise (which I believe) but I also knew relatively early on that I probably wasn't responding as favorably to it. If it doesn't heal completely, I understand that secondary healing can happen (which is why surgeons I think hold out hope). but definitely make sure you are getting what you need to minimize pain (sitz baths really do help, as well).

Best of luck!
Posted 5/21/2018 8:21 PM (GMT 0)
Thanks all. I am seeing my doctor Thursday to get the drain out so hopefully will get some relief from that. I love sitz baths as well, they provide some relief for a few minutes!
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