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Hi

Postby cold_erin » 06 Feb 2016, 21:06

Hi all

Have been lurking but finally joined today. I previously had an anal fissure which healed, about maybe 4 -5 years ago, and I used this board as a lurker then, too :)
I'm an active 27 year old female. I walk for approx 7 - 8 hours a day (active job plus lifestyle), eat my veggies and am already mostly vegetarian, don't smoke and drink maybe twice a year, and climbed Everest last April. In all, pretty fit.

On 1 Jan, I had unexpected surgery to drain a perianal abscess, caused apparently by nothing in particular. The nurses seemed to think it had formed because I'm active and/or cycle a bit. This was healing well, and I was back at work and functioning normally after a week off. I'm due to see a CRS about this on 16 Feb.

About 2 and a half weeks ago, I noticed some pain when pooing. Because I've had that previous experience with fissures, I immediately started hot baths, wet wipes and coconut oil. Was hoping to avoid the Rectogesic headaches!
The pain worsened (and yes, I got the rectogesic) until I was finally in such agony I was sent home from work. Every poo has been an exercise in not passing out, although I did once. Luckily my husband was alarmed by the fact I'd stopped moaning so suddenly and picked me up. Distressing for both of us.
I was using 8 panamax and 4 advil a day, and my skin is pretty much permanently grey from dealing with pain.

About a week ago, I called my specialist and asked for appointment to be moved to earlier time, referencing extreme pain. They couldn't do it, and suggested I go to ER.
Went to ER. Saw junior doctor. Referenced pain and that I didn't think I could stand being examined without pain relief. Saw senior doctor at same time, who was very gentle.
After some fairly rough examination from second senior specialist, told abruptly that yes, I have fissure, and to take some nice warm baths and it should go away. When I scoffed at this she was a bit taken aback, and when I asked what I should to to prevent passing out again, they prescribed me Endone (oxycodone and yes, I did tell them it constipates me) Ducolalx (bisacodyl) Flagyl (metronidazole, to combat any potential infection of open abcess wound) and Rectogesic. I've also been off work for the last four days.


I'm due back at my active job on Tuesday and am worried about having to poo at work/walk for 7 hours. Today I'm going to post box, an adventurous 700 metres away. I'm still not sure if I'll be able to do it.
I normally go three times in the morning, plus once mid afternoon or early evening. Because I'm eating less (yes, I know, I know) I'm minimising the times I have to go, but I also get little warning of the need. The antibiotic I'm taking seems to be acting as an irritant to my stomach and body in general, causing me to conk out for two hours after taking them, and poo fairly soon after waking. The laxatives are supposed to be 10 - 12 hours active after taking, but I've felt them taking effect about 4 -5 hours later, meaning painful 1am and 5am BM's. The Endone makes me dopey as all hell and I'm worried about the constipation/addiction effects - and the fact it's not actually making BM's less painful or stopping my spasms through the day, just allowing me to barely function. I've also had this heaviness in all my limbs, which I assume is the Endone but could be from any of the things I'm taking. I'm nervous about cross contaminating my open and draining abscess and my fissure.

I've had a few days where BM's have been less painful, but still require intense care to not want to top myself immediately afterwards. I'm still barely staying conscious. Is it normal for the pain to be this excruciating for this long? It certainly didn't happen last time, where the pain decreased as soon as I started Rectogesic.
Help.
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Re: Hi

Postby Savaici » 06 Feb 2016, 21:32

:wel: and so sorry you're in such pain. You seem to be doing just about all you can, and know exactly what it's like with the passing out and the intense pain, and the pooping. Have they done a test for Crohn's? Glad that you will be seeing a specialist, even if not as soon as you'd like. :smilyhug:
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Re: Hi

Postby cold_erin » 06 Feb 2016, 21:36

Thanks. :) Nah, no tests for Crohns, colitis or IBD. I was planning on bringing up with specialist. I was asked about it initially, but because there's no family history, no medical staff seemed interested in further pursuing.
I've also lost about 6 kgs (or 13 pounds) over past two weeks, which I'll also be discussing. It's not entirely unwelcome, but unhealthy because the method is no bloody good!
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Re: Hi

Postby cold_erin » 07 Feb 2016, 20:55

Holy wow. Has anyone else used a TENS machine to relive their spasms?
My husband just rolled up with one (all he wants to do is make my pain go away, he also bought epsom salts, Hydralyte, Powerade...and two big books on reducing household waste lol) and about 20 mins after I attached it the stimulation made me need to do a BM. Kept it on while I was going, and pressed the 'acute pain relief' button at the worst point It was strange but wonderful.

I'm now NOT in the bath after a poo for like the first time in two weeks and I've just professed my undying love for this thing. Just keep massaging, little machine!
(Er, sorry if I sound like ad, I'm not, I promise. Will keep you all updated on the progress with the machine.)
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Re: Hi

Postby Deleted User 4903 » 07 Feb 2016, 22:42

I know how you feel with the flagyl. I was on high doses of flagyl and cipro simultaneously for 2 weeks and my infection still survived. I ended up needing surgery because my abscessed fissure became a fistula.

If you have a fissure, I would recommend taking a warm bath after EVERY bowel movement. According to my CRS, I developed a fistula from a fissure that got infected because I didn't take proper measures after each BM.

As for pain, the number one thing is avoiding strain and high frequency. I use to go 2-3 times a day and strained most of the time. I changed my diet to include high fiber choices (shredded wheat breakfast) and metamucil every day. I now BM once a day and generally at the same time every morning with no strain.

Good to hear you found some relief with this magical machine. Whatever works!

Good luck and hope you see more progress soon!
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Re: Hi

Postby cold_erin » 08 Feb 2016, 00:26

Thanks Mike.

As of tomorrow, I need to be back at work, and my workplace very inconveniently doesn't have a bathtub. I'll be able to pop on the tens machine to kill the spasms, clean up properly with wet wipes, whack on some Rectogesic and be able to walk back out into the office without swaying/fainting etc. It's going to allow me to get on with my life, rather then being stuck at home.

My biggest problem with going frequently at the moment is the antibiotics, which make me poo every time I take them - and that's after a meal, three times a day. So I have my natural movement, plus the antibitotic poos. Crossed with Endone and laxatives to counter those, nothing is normal right now.
Once I finish these bloody antibiotics, I should be able to work out my natural needs and add fibre as necessary. I already eat well, with high fibre, soluble and insoluble, and don't normally strain, so may just need to add a fibre supplement at night or something.
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Re: Hi

Postby Savaici » 08 Feb 2016, 06:00

You don't need to use an actual bath... Invest in a Sitz Bath which fits over the loo. If you are in the US, Rite Aid has the best one. Could not do without mine! Is your abscess still draining and is it giving you pain? 50% of them develop into a fistula, so it is good that you have an appointment to see a CRS soon. ER doctors are notorious for missing these things. That why CRSs get the big money :men45: They know what they're looking for.
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Re: Hi

Postby Deleted User 4903 » 08 Feb 2016, 10:25

Savaici wrote:You don't need to use an actual bath... Invest in a Sitz Bath which fits over the loo. If you are in the US, Rite Aid has the best one. Could not do without mine! Is your abscess still draining and is it giving you pain? 50% of them develop into a fistula, so it is good that you have an appointment to see a CRS soon. ER doctors are notorious for missing these things. That why CRSs get the big money :men45: They know what they're looking for.


I bought a sitz bath after my first appointment with my surgeon. After the 2nd appointment they yelled at me and said "NO, I SAID BATH, NOT SITZ BATH". She seemed to think a sitz bath causes pressure in the area that's trying to heal.
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Re: Hi

Postby Savaici » 08 Feb 2016, 13:47

Well, CallMeMike, your surgeon must be bucking the trend or else simply not thinking about people in countries who do not have baths...As for yelling at you!

Here are couple of reports:

A small randomized, controlled study: 

http://www.ncbi.nlm.nih.gov/pubmed/17534541

Another recommendation:

http://www.uptodate.com/contents/anal-f ... chor=H8#H8

Sitz or bath, both the same. Having spent a lot of time in recent years in a country where people in general have showers in their homes, I found sitting in a bath incredibly uncomfortable, whereas the Sitz Bath 'saved me'...so to speak :sunny:

About fistulas:

https://www.fascrs.org/patients/disease ... nformation
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Re: Hi

Postby Deleted User 4903 » 08 Feb 2016, 14:45

Didn't mean any disrespect and thanks for that information! As long as you can stay clean and find relief, that's what counts I suppose!
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