Fistula repair not healing fast enough

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seraphina
Regular Member


Date Joined Apr 2010
Total Posts : 39
   Posted 6/17/2010 10:16 AM (GMT -7)   
It has been 3 weeks since I had my fistula repair.  The surgereon shortened the track, I'm not completely sure how, all I  know is I had sutures and she wanted to try this option instead of the major fistula surgery where they just cut it open and let it heal.   I just saw my Surgeon and she told me I needed to come back in 3 more weeks because its not healing as quickly as she would like.  I asked her if she felt it was moving in a good direction and she said she didn't want to speculate at this point, which has me very nervous.  I do not take steroids and I'm not diabetic but I have always been a slow healer even when I was a kid, so I'm hoping that maybe this is some of the problem.   From the second day after the surgery I started taking vitamins  that are recomended in helping surgery wounds heal, so I'm very distressed about this situation.  Does anyone have any suggestions on helping it heal faster?  Should I continue doing sitz baths or exercise or just stay still as possible? Right now I would say the drainage is very minimum, like I could could through an 8 hour work day with out changing the gauze, which I do change often, I thought I should keep the area as dry as possible.   Any suggestions would be appreciated, I'm starting to panic I had a very bad experience while I was  in the hospital, so much so that I'm having anxiety attacks from it, I really don't want to have to go through another surgery.

SeanM
Regular Member


Date Joined Dec 2007
Total Posts : 44
   Posted 6/17/2010 12:24 PM (GMT -7)   
I would suggest to continue with the sitz baths, they were essential in the healing of my two prior surgeries. The healing time of both surgeries varied greatly, the 1st time it took 6 weeks to heal and the 2nd time it took 3 weeks to heal. Same procedure, same fistula. I guess it depends on the condition of your crohns at the time of your surgery. That's how i try to make sense of the different healing times.
32 yr old male
Diagnosed with Crohns in 1994 (lower bowel/ileum)
Medication history:  prednisone, azacol, sulfasalazine, cipro
Current Medications: entocourt (periodically-as needed), Remicaid, flagyl
Surgeries: 2002 (remove fistula), 2004 (6" of ileum removed)


cleo35
Regular Member


Date Joined Feb 2007
Total Posts : 430
   Posted 6/17/2010 2:59 PM (GMT -7)   
seraphina: I had fistula surgery at a Chicago suburban hospital in Jan. 2006. By March 2006 I was having major surgery (total colon/rectum removal) at the U of Chicago. The fistula surgery still hadn't healed completely at that time so the surgeon from U of C went in and took a look while he was doing the other surgery. The fistual track had not been completely removed by the previous surgeon. He took care of it and it was closed completely within two weeks. Obviously the first surgeon didn't have enough expertise to do the job right and that might be the case with you as well. Get a second opinion from another surgeon. You should NOT have to put up with that!

MAG102886
Veteran Member


Date Joined Jul 2008
Total Posts : 674
   Posted 6/17/2010 4:41 PM (GMT -7)   
It took a good 4-5 months for my fistula to heal completely after surgery to repair it.
Dianogsed with Crohns: At 16 years old. 23 years old now.
Surgeries:3 Bowel Resections, Gallbladder Removed, 3 Abscess Cleanings, Fistula Repair
Current Meds: Methorexate, Vitamin B12 (injections), Nexium.
Next Surgery: None.
 

seraphina
Regular Member


Date Joined Apr 2010
Total Posts : 39
   Posted 6/18/2010 5:16 AM (GMT -7)   
Thanks for all the advice. I am going to keep doing the sitz baths, its hard with work, so I can really only do two a day which I figure is better than nothing. I told myself last night not to get worked up over it, because that probably won't help heal it any sooner, so I'm just trying to think positively and my mantra is, "this will heal" :) Cleo I went to a Colorectal surgeon. There is only one group in the city I live, I chose a female surgeon because I thought I would be more comfortable with her and because mine is a high fistula and she specializes in pelvic floor problems etc so I thought her expertise there would help. I am starting to have second thoughts because apparently she is the least experienced in the group. But, I don't know how she would feel if I said hey I was to switch to someone else in the practice, I could see nurses being mean or something. I'm just going to stick with her for now, and god forbid I need another surgery I'll just really quiz her on how often she has performed the surgery, which I asked her before this surgery if she had done a lot and had a good sucess rate etc.

*Phoebe*
Veteran Member


Date Joined Sep 2005
Total Posts : 769
   Posted 6/19/2010 4:48 AM (GMT -7)   
My fistula surgery took about 9 months to heal up, and it is still healing, remicade was the thing that made a huge difference for me .... I would read these posts where people said they only took a few weeks to heal, so I was very disheartened (to put it lightly) to discover mine was taking MONTHS on end (and I had to have 2 surgeries as the first didn't drain the abscess adequately) ..... but my fistula was big and they laid it open. I think it really depends on the fistula and is individual depending on how your body is healing etc..... be patient, it will get better each and every day, and take comfort in knowing the worst is over! that always made me feel better :)

Sitz baths with water that is salty and as hot as you can handle it, at least twice a day, and be gentle on yourself, that's very important :)

P

seraphina
Regular Member


Date Joined Apr 2010
Total Posts : 39
   Posted 6/21/2010 9:03 PM (GMT -7)   
Phoebe, thanks for the reply, I'm trying to be positive, its hard not to get depressed.  I think I'm just scared it won't heal because the last option would be the surgery that lays the fistlula open and since its high there is that risk of incontience.  What I think is odd is everyone has told me on this forum and I have read elsewhere to soak in a bath as hot a possible and on the instruction sheet from the doctor it says Plain lukewarm water.  Honestly right after the surgery I soaked in pretty warm water just because it helped with the pain.  I did get some epsom salts and I have been soaking .  I'm hoping its going to help.

*Phoebe*
Veteran Member


Date Joined Sep 2005
Total Posts : 769
   Posted 6/21/2010 9:28 PM (GMT -7)   
It definitely helps the pain, and the salts will sterilise the area…. I found the hot water helped numb and also, when the abscess was still there, it helped the abscess drain, by encouraging the sepsis to come out (much like a hot shower encourages a pimple to come to the surface). My abscess would drain slightly, but the sepsis was too deep and too big and built up to the side of the fistula tract. The antibiotics slowed the infection, but didn’t stop it, so in the end it was black and so painful I was in tears on my way to surgery.

It does take a long time, but it will get there…. How are you going with sitting? Mine was located to the right of my bottom-hole (he he) – I have a lot of disease there, tags etc – and now I have a scar, but you cant even notice it unless you really grab it and look! I remember being so relieved when I could sit normally again (for months I was ‘lying’ slightly on my side instead of sitting. A good, puffy cushion is your best friend (I had one in the car, one at work etc)

It is all very frightening. If you want to email me I would be more than happy to chat to you about it. Explorative surgery, where they can’t tell you ‘exactly what they’re going to do until they’re in there’ is very frightening. I remember crying on the phone to my dad at work once, breaking down and asking ‘is my whole life going to be like this?’ – The answer is NO! You are going through a really hard time but you are being brave and you will be all the stronger for it in the end :)

seraphina
Regular Member


Date Joined Apr 2010
Total Posts : 39
   Posted 6/22/2010 8:34 AM (GMT -7)   
I feel so bad whinning Phoebe, you had a lot more serious surgery than I did.  When the first surgery did the I&D on the abccess, He apparently chose a really bad place to do the incision.  I know this is graphic but its the only way to explain it, he cut it,  basically in the taint but a little towards the rectum but like on the inner chee, so sitting really wasn't a problem after about 4 days.  My Colorectal surgery said she has no idea why he cut there.  So she shortened the tract and then had to do cut the outer incision longer, she did mention that because its a wider incison it might just be taking longer.  I did come home yesterday and I'm staying home today because for some reason the wound starting draining a ton more and it was tinted pink.  I call my surgeon and the nurse said it was fine and not to worry, but I do notice when i'm lazy and just rest and don't do a lot it barely drains at all. 
 
Thanks again Phoebe, you have been such a help thank you so much, you really cheered me up today :)

exit 4
Regular Member


Date Joined Apr 2009
Total Posts : 148
   Posted 6/22/2010 3:08 PM (GMT -7)   
Phoebe, you are giving me hope - my lay open surgery was in October of 09 and i am still not healed - my wound is about 95% closed. I am on Remicade, had 3 infusions so far, developed reaction last time, not sure what to do next. My belly is doing a lot better, it's my wound that is taking so long to heal. I am leaking fecal after BM. it's so scary and painful. I have trouble sitting after BM and not able to sit at work after BM - need to soak and clean in a tub. I am very scared that this IS my life from now on...
Male, 45; UC 15 years, Lexapro helped with stress and UC.


*Phoebe*
Veteran Member


Date Joined Sep 2005
Total Posts : 769
   Posted 6/23/2010 2:03 AM (GMT -7)   
Seraphina, I’m so glad I was able to cheer you up, even just a little. Don’t ever feel bad about ‘whingeing’!! you are not whingeing, not one bit, what you’re going through is so difficult, and the fact that you can’t just tell people so easily makes it even harder (in my experience). Your abscess sounds like it may have been in a similar position to mine, on the ‘cheek’ but close to the entrance.... my abscess was big, and the wound felt huge, I literally felt like I had a ‘gunshot wound’ (as others described it). I think if its draining that’s great..... mine would drain more as I moved around too, and the sitz baths will help it drain even more. I think you’re doing all the right things. I know how scary it is – when I had my first surgery and then it began to hurt again, I knew something was up, and to hear the news that I would have to have a second surgery, like you did, it was devastating, because during the first surgery I kept telling myself ‘it can only get better from here’.
Fistulas and abscesses are horrible things..... I wouldn’t wish one on my worst enemy! You are doing really well though – how are you going pain-wise? Are you sitting ok?




Exit 4 – hello!! I’m glad I can give someone hope, because I know how hopeless it can feel, it is so frustrating when your body doesn’t want to heal its self as fast as you would like it to. When do you find out about your next treatment option? I know for me the surgery wound started healing freakishly fast after I started remicade, but it did take many infusions before it was no longer raw and started turning into ‘normal’ skin colour again. My wound is not completely closed either, but I am loving the fact that I don’t have to look at it every day (do you get a mirror and flip with your head between your legs? I was always scared someone would catch me doing that!).

I know how horrible it is also to have the fecal matter problem – words can’t describe how yuck it makes you feel. I found that babywipes were fantastic (you can get flushable packs of wet-wipes now, packs of 20 which can fit easily into a trouser pocket, I still use these at work), and a little piece of 2x2 gauze (you can buy these from the chemist for wound dressing) folded and placed carefully helps absorb anything that comes out after a BM– so you don’t have to worry as much because you can just flush the gauze if it gets messy. These are all measures to deal with things in the short term though, I hope your GI gives you some answers regarding your next biologic option. That was the clincher for me. I felt like I was never going to heal and would never again sit flat on my butt but after a long long wait it finally happened.

You’re both being super-brave, and I’m glad I can give you some hope, the experience definitely made me stronger and more understanding.... please please please keep posting and let me know how you are going....

gerry505
New Member


Date Joined Jul 2010
Total Posts : 1
   Posted 7/10/2010 2:25 AM (GMT -7)   
I had a perianal abscess drainage done on me on 22 May 2010. I suppose its a technical term for anal fistula.

The doctor did not tell me what i was in for. He said I would be fine in 3 weeks and that I could go to work after that. He did not tell me of the smelly stuff coming out of me and did not tell me about how difficult it would be to sit.

I had my surgery on 22 May 2010. I then wore sterile gauze pads and changed them every 4 hours or so. When I went to see him after a week he wanted me to stuff the gauze into my bum. Boy that was not easy. So I gradually did this over that week.

He told me to eat anything and everything and did not tell me that i would bleed when i moved my bowels.

The reality is that you cannot eat anything and everything. I merely lived on a high fibre diet and 2 large Metamucil spoons at night. Plenty of prunes, paw paw, grape fruit, kiwi fruit, salads wholemeal bread. I did a Google on the foods that constipate and found out that tea, coffee, dairy products, eggs, white bread, pasta, rice and things like canned snacks cause constipation.

I kept away from all this and found my stools fairly soft and easier to pass. However, there was still blood. Apparently this is normal.

It is week 7 today and I have still not wiped my bum with toilet paper todate. What I did from day one was install a little rubber hand shower to a tap and then after my bowels I would scot and run the water up there. It would work like a powerful Bede. I would then dry the area with a hair dryer on the cold cycle.

Then I would place the gauze.

I keep a hand mirror on the floor, scot over it and have a torch as well so I can see what on earth is going on there.

For 5 weeks the sight was scary.

Now I can't see the wound unless I open my but cheeks with my hand. And yes I do have some tags as well down there.

I had 3 salt baths daily. Very concentrated cooking salt. Nice and warm or warm to hot.

After 5 weeks I went down to 1 bath a day in the morning after i move my bowels.

The first week was very painful. Nobody told me that it would take this long to heal, nobody told me that there will be stuff coming out and nobody told that i would not be able to sit at least until 4 weeks passed.

I am going to visit the doctor on the 15th.

I still have to change the gauze about 3 times daily but the stuff coming out of my bum is nothing like the quantity that came out in the first 4 weeks.

I still get depressed when I see a streak of something that looks like pus. I fear that this will never end. I fear that it will never heal and I fear that the operation has not been done properly and that I would have to do it again. Boy, I would not want that.

Coming to forums like this and reading stuff helps but sometimes it scares you as you because each person's condition is different.

I hope I have been able to give somebody some valuable information.

What I worry is about the stuff that still comes out. Sometimes its a little streak and sometimes it is slightly more. I wonder if this is normal.

My email address is UBERQ01@optusnet.com.au for anybody who wants to correspond

seraphina
Regular Member


Date Joined Apr 2010
Total Posts : 39
   Posted 7/10/2010 4:52 PM (GMT -7)   
I haven't posted anything on this topic, because I have been very depressed. I waited the 3 weeks that my doctor recomended. I started draining more and it was tinted pink. I called the Doctor's office and a nurse said not to worry. Then finally the drainage lessened and then came to a stop, well 6 days ago i was having pain, then I felt a kinda pop when i sat down and it started bleeding. I just broke down in tears I knew this wasn't good. Later that week was my 3 week, 6 weeks since the surgery and I told the Doctor and she probed the fistual with something and let me just saw it was quite a horrible pain and it bled quite a bit. She told me she doesn't want to get to aggresive and to come back in 2 weeks and see how its healing. I don't know what to do she said that she has a few other tricks. I have a horrible fear of doctors, I was attacked in a medical office, not by a professional, so just the thought of going to a doctor or any type of meidcal office I have near panic attacks. I don't think I can go back, I haven't even made the appointment yet, I couldn't get out of that office fast enough I thought I was going to faint. I know to the Doctor my behavior is probably childish, but I told her I had a horrible fear of doctors and all she replied was nobody wants to be sick..... well no crap. My primary physician knows about my issues and I don't have to sit on the exam table unless completely necissary and he won't even touch me unless i'm ok with it, I don't know if I should tell this physician, I nomrally don't tell physicians because I feel that they might think I'm going to say they attacked me or something. I rarely go to the doctor but I'm seeing this as an ongoing situation and I have been in constant distress about it.

*Phoebe*
Veteran Member


Date Joined Sep 2005
Total Posts : 769
   Posted 7/11/2010 11:23 PM (GMT -7)   

Darling I can completely understand you being scared about going back to the doctor - - any doctor, let alone one who is going to have to poke around your butt. Its a horrible situation to be in. I think if you say something general like ‘I have had a traumatic experience at a doctor’s and so I am quite afraid’ and ask them to talk you through what they are doing etc, it might make it a bit easier? It must be very difficult but I think it is very important that you get it sorted because I learnt the hard way that these things don’t resolve themselves….i put it off again and again until it went black and I could not ignore it anymore because of the pain.

 

Maybe if you see a colo-rectal surgeon you will feel more at ease? I know mine had a great way of making me feel comfortable and not silly at all (after all, all they ever look at is bums!)

 

Is there somebody close to you that you could take along for moral support?

 

Big hugs

 


seraphina
Regular Member


Date Joined Apr 2010
Total Posts : 39
   Posted 7/13/2010 12:58 PM (GMT -7)   
Thanks Phoebe for the support and the advice, I'm going to mention to the surgeon about have a bad experience so she can understand more. I brought my husband with me when I went to a General surgeon and he came in for the exam, I think actually having him there just made me break down. I'm very reserved about emotions and I broke down in tears in front of my husband who rarely sees this side of me and he had a hard time with consoling me. I am going to a colo-rectal surgeon and she is super super nice. I thought it was going to heal up again because it stopped drainning, but I felt pain and pressure and it burst or whatever it does while I was at work I just had to come home because I bled through 2 gauze pads and I'm waiting for the nurse to call me back to see if I need to come in or anything. I did just call my primary doctor as well, because I went to see him about a month ago with all the anxiety I'm having with going to the doctor so often and he gave me Xanax, which had a reverse effect on me, I got very mean and aggitate. I called and asked if there was something else they could call into my pharmacy, so maybe if I take something before I see the colo-rectal surgeon, I can be more calm to discuss things with her.

*Phoebe*
Veteran Member


Date Joined Sep 2005
Total Posts : 769
   Posted 7/13/2010 3:43 PM (GMT -7)   

Yes sometimes having someone present at examinations like that can make things worse (that’s my experience anyway) – I would always go alone into examinations like that to lessen my embarrassment, but everyone is different.

 

I know the feeling – that horrible let-down feeling of telling yourself ‘things will get better from here’ and then finding out that they are getting worse again. I My abscess also started healing for a week or two and then got ‘clogged’ again – and it sounds like a similar thing is happening in your situation. I remember bursting into tears and just ‘losing it’ when I found out I’d have to have a second surgery for it – I just wanted it to be over and done with and I was sick and tired of the pain and not being able to sit properly, and sitting in a dang hot water tub every morning and night. But at least you have recognised nice and early that things aren’t right, and you can go about getting it sorted. It is such a hard thing to go through, I wouldn’t wish it on my worst enemy……  I hope you are doing ok, and staying strong, or breaking down if you need to, just make yourself number one in life right now, because you need it …. If you ever need someone to talk to (I’m not sure where you live) we could always chat over the phone, if you would like. Just know that I’m here for you however I can be and I understand how much it sucks, but you will get there, the frustrating and most difficult part is happening right now, so things will get better, slowly but surely.


seraphina
Regular Member


Date Joined Apr 2010
Total Posts : 39
   Posted 7/15/2010 2:54 PM (GMT -7)   
Thanks so much Phoebe, I have to say I have had great support from a friend who I confided in about this whole "situation" lol. I went to my primary doctor and he gave me a very small dose of valium and told me to take them when i feel a panic attack comming on and right before I have a visit with the surgeon. I have another appointment on thursday and we will decided a plan of action then. So I'm trying to stay calm and not think about it :)

Ahmed1979
New Member


Date Joined Jul 2010
Total Posts : 2
   Posted 7/19/2010 2:02 AM (GMT -7)   
Hello; I would like to seek some advice from you guys; I had abscess and developed into fistula for about 2 years from now; I had small surgery to open and remove the ***** from the abscess; however from that period up to now the place is not healing properly; every day I am experiencing some ***** and blood sometimes clotted blood coming out from the hole. Some days the hole heals and covers by its self and after a day or two it fills up with ***** and blood as well as bursts. I have small hole in the opening of the anus and small hole out near the anus, so when I stool, some of it goes in to hole in anus and comes out from the other hole outside, so I think there is small channel or transit point in between that need to be opened. So guys anyone who has like similarities and can help me will be thankful.

Ahmed1979
New Member


Date Joined Jul 2010
Total Posts : 2
   Posted 7/19/2010 2:05 AM (GMT -7)   
Hello; I would like to seek advice from you guys; I had abscess and developed into fistula for about 2 years from now; I had small surgery to open and remove the ***** from the abscess; however from that period up to now the place is not healing properly; every day I am experiencing some ***** and blood sometimes clotted blood coming out from the hole. Some days the hole heals and covers by its self and after a day or two it fills up with ***** and blood as well as bursts. I have small hole in the opening of the anus and small hole out near the anus, so when I stool, some of it goes in to hole in anus and comes out from the other hole outside, so I think there is small channel or transit point in between that need to be opened. So guys anyone who has like similarities and can help me will be thankful.
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