I hesitate to write on this subject because in all honesty it is one of the most horrifically embarrassing medical problems I’ve endured. And I’ve endured some. But honest -to- pete, I know there is some poor soul out there Googling “fistula” and coming up with nothing but medical reference material. Medical reference materials are, of course, helpful but sometimes you need the personal non-sugar-coated-right-between-the-eyes perspective of someone who has been there, done that. Plus, I have all of one reader so at least this is cathartic and cheaper than paying an actual therapist and the chance of anyone reading this is fairly slim.
What is a fistula you wonder? Well according to the fine people at MedLine Plus Encyclopedia:
A fistula is an abnormal connection between an organ, vessel, or intestine and another structure. Fistulas are usually the result of injury or surgery. It can also result from infection or inflammation.
In my case – my fistula was the result of a perianal abscess. I know. I must have lost a bet because who gets inflicted with an anal abscess and a fistula on top of that? Apparently I do.
An abscess is a whole other bucket of fun and can be caused by a whole host of reasons. Mine was caused by bad luck. I endured weeks of walking around thinking I had some type of angry internal hemorrhoid. When I couldn’t stand, sit or walk without searing pain, I finally called the doctor.
Generally an abscess is “handled” in the office. If you read between the lines that means a localized numbing agent is administered in a delicate area with a needle while the patient is chest down-butt up on a proctology table – just to add further embarrassment to the whole experience.
Important tip: If your doctor says anything along the lines of “most people tolerate this procedure really well in the office”, ask for a bullet to bite on. They are lying.
Perianal abscesses are wickedly painful and an injection in an already tender area is very low on the fun scale. At least I got 2 days off of work and prescription of hydrocodone for my trouble. In my ignorance I figured the worst was over. My abscess was “taken care of” … let the healing begin. Unfortunately rates of fistulas’ after an abscess are staggeringly high. Like somewhere is the neighborhood of 50% - 65%. And there is pretty much nothing the patient can do to prevent it. 12 sitz baths a day won’t improve your chances of better healing. I know. I tried. More bad luck.
The worst part of the abscess/fistula tango, is the waiting game. The patient (in this case me) has to gut out 3 long months of potential healing time before confirming a fistula diagnosis. Basically where the abscess was, never heals and there is a tiny tunnel from the inside of the body (in my case the rectum) to the outer incision. Good times. The fistula spasms pretty much constantly (pain) and the patient walks around with a wad of gauze tucked in-between the butt cheeks 24x7. Suffice it to say I now own stock in Johnson & Johnson.
Three months later I was able to trot back into the surgeon’s office for a 5 minute, $178, exam to confirm what I already knew. Congratulations, I had a bouncing baby fistula and now required a Fistulotomy to repair it.
Yes, I’m pretty sure there is a black cloud over my head.
Very Sorry to hear that. I had fistula problem for almost 5 years and it took 2 years for the doctor to confirm that I have fistula only after I demanded to see a Surgeon. Not to scare anyone but be very careful what doctor you are seeing. I strongly recommend a Colo Rectum Surgeon and not a general Surgeon. I had a bad experience out of my first surgery in 2008 performed by a General Surgeon. You know the meaning of "General" you need a specialist not General :-) it took very long time to heal from this one. And I noticed bleeding and the annoying feel of wetness in the anal area again. This time I went to a Colon and Rectum Surgeon and he confirmed another fistula and Keeloid formation from previous one. I know how bad is the healing for me and hearing that I got little sad and depressed. He assured me that it will not be the same experience as before and He did all the right tests to confirm that a Surgery is required to fix this issue. He did a Colonoscopy that gave him a good picture of whats inside and also helped him to see if I have Chrones disease. Came -ve and was happy to hear that. Ended up with a good Rectum surgeon and is just recovering from my surgery yesterday. Still in Pain and my daughters make fun of me that I am walking like a Penguin. :-)
ReplyDeleteWish you best of Luck with yours.
I agree. My surgeon specializes in Colon/Rectal. 2 weeks post-op it was healing great. But you do go through ALOT of guaze pads...
ReplyDeleteI have SO much to add. My 'nightmare'as I like to call it started 1 yr ago. I had to have 3 surgeries in the past 8 months, but I am truly blessed. I believe the last one, the actual fistulotomy (I had a complicated horseshoe anal fistula), was a success. It has taken approx. 6 weeks so far, but it is the first time that I have been without pain or the need of a sanitary pad in 1 yr. I will share more details later, but it's late and I need to watch the debates..
ReplyDeleteI see that you wrote this some time ago, however I have never been so happy to read a blog before. This is me exactly. When you go in for treatment they say "this is very common". Really? I have never ever heard anyone talking about their rectal health problems. Or the surgery. and then another one. There is no fund raiser or support group or pretty ribbons to wear. although ours would probably be brown and not at all inspiring. Thanks for writing this.
ReplyDeleteI am just recovering from my second fistulotomy. I see that the originial blog was from a few years ago. But it was so comforting to hear that I am not alone. Mine started EXACTLY the same way. Everyone I speak to (acutally the select few that I have the nerve to speak to about this due to the embarrasment factor) says they have never heard of this. I have been feeling all alone. So to hear that someone else first had an absess and then some month later had the fistula somehow comforts me. I ahve a very good surgeon but he is a man of few words. So I never really knew exactly what was going on down there. Just knew that I was going thorugh underwear like crazy. I pray this surgery takes this time
ReplyDeleteI would sure like to talk to you. I had a fistulotomy 11 days ago. I thought I was having a follicular cyst removed and was not prepared for the extensive surgery it turned out to be. The surgeon told me it might be a fistula but didn't tell me the surgery he would do if it was. He didn't warn me of any of the possible complications, so I don't feel I made an informed decision.
DeleteI had my fistulotomy with seton last Tuesday. It began in 2010 as an abscess on the seat of my left butt between my rectum and upper left thigh. I've had it drained through procedure 3 times since then and decided to finally do the surgery because the pain from my last inflammation was too much to bear. The abscess was complex but not huge and the fistula tunneled from my rectum straight into the abscess. I am 4 days post op and started working from home the day after surgery. I only take my percs at night and can tell you the pain is definitely there, but it is manageable. Walking is difficult. Urinating is not a problem, I did this after my surgery with no problem. Passing my first bowel movement was terrifying; this occurred about 24 hours after surgery. With the aid of stool softeners it actually wasn't that bad. But my cut is pretty deep and long and runs right next to my rectum, so a sitz bath is mandatory after every time I pass a BM. I do at least 3 a day and take a shower in the morning. I am burning through gauze pads. Taking it off the cut is very painful and uncomfortable, but I do it slowly and breathe and get through it. Honestly the sitz bath is the best and worst part of my day, very painful to sit in but it feels great after a few minutes, plus it helps to keep the area clean and drain the gland that caused the abscess in the first place. My diet is mostly veg right now, soups, cereal. I am a big meat eater and know I have to change my diet going forward, which sucks, but it can deal with it. I drink plenty of water, probably 8-10 glasses, to help soften my BMs and keep me hydrated. I can sit down on a soft seat but it is rather uncomfortable. To work, I've been laying on my stomach on a pillow on a yoga mat in order to avoid sitting and putting pressure on the wound all day.
DeleteI empathize with you that this is very embarrassing. I can count on one hand the number of people I've given the details to about my medical issue. I know I'm not alone with this. It's very reassuring that there are people talking about it on here because as much as this is a physical problem, it's also really hard to deal with emotionally and it really helps me to read your post and all the great comments.
My surgeon is the same!
DeleteMy surgeon is the same!
DeleteI actually did do a Google search for fistula recovery and found your blog. I'm through my first week, and blissfuly soaking as I type. My situation resulted from a surgery I had done at a Veterans hospital, where they truly "practice" medicine. 8 years of foolishness, and I finally went to a colorectal specialist outside the VA system. Great guy...small fingers. Although it's still draining, and hurts a little, I am already impressed that my bm's are solid...big enough to name, but small enough to flush. I am coming to peace with the fact that there will be a few more weeks of recovery, but glad that I have an experienced Doc. I highly recommend getting a well referred Colorectal specislist...and ask for the one with small fingers.
ReplyDelete- David
This comment has been removed by the author.
DeleteDavid,
DeleteMaybe I have a similar situation, so I wanted to see how it was going for you, some two years later. I had a perianal abscess drained at a Military facility (once they stopped treating like a hemorrhoid). That was in 1998. Since then, I'd occasionally (seldom, really) get minor swelling in that spot then draining from what I'd call a little vent, always in the same spot. Well, that little vent of mine likes to heal up really good these days, so now when I get the swelling, it gets pretty angry before it gets to the point I can do something about it (help the old vent open). I'm long out of the military and recently been to a colon rectal surgeon. He says he won't know what he's dealing with until he takes a look the next time it gets angry as part of an incision and draining (InD). I'm scheduled for this InD tomorrow, and I understand that if they find a fistula (pretty likely, I'd think), they plan on dealing with it. Are you glad you went ahead with the surgery?
I apologetically dealt with having an anal abscess/fistula for 10 years because my gynecologist told me that most people don't have it removed unless it's problematic. My young self took that too literal. I also was reluctant to pursue surgery bc it seemed like no one was familiar with my condition and I doubled that up with scaring the crap out of myself by looking at Google images. One fistula turned into two and a bad infection led me to get immediate help. I had seen a general surgeon and do NOT recommend anyone letting a general surgeon even examine your bum. After they tried to send me to another general, I argued until they sent me to a colon/rectal surgeon. 2 weeks later, the surgery was done. Thankfully, only a dual fistulectomy was required (no seton) and I only lost about 10% of my muscle. Other than some scar tissue issues and having silver nitrate applied (ouch!), I have not had any major issues. It's still early, but I feel truly blessed for finding the surgeon I did. If you're reading this and have a fistula/abscess, do not give in until you find someone you're comfortable with and trust. Do some research, ask questions and keep your chin up!! Also, don't be afraid to talk about it...after 10 years of keeping to myself and a few close ones, I found out it's a lot more common and most people were more curious than grossed out.
ReplyDeleteI truly agree with you.
ReplyDeleteI truly agree with you.
ReplyDeleteI Agreed with you, Fistulotomy also help you
ReplyDeleteHow long will the incision from the fistulotomy remain open and draining? My surgery was 6/17/16. Abcess removed as well as 2 internal hemmorhoids. I am a thin active 63 year old. Guess I had an infected gland. Surgical nurses told me the procedure is very common. 4 that day. I'm an RN and didnt know much about it.
ReplyDeleteDoes anyone know why they use silver nitrate as part of the treatment. My abcess/fistulotmy is a copy of what was already stated. I have a seton near the anus and a mallencroft drain in the middle odf my left buttocks and 3 inches long by 1/4 inch diameter. My journey through this primevil torture began on 2/22/17 and now 8 procedures and three surgeries later my next surgery is on the 7/20/17 for a second seton.
ReplyDelete