Several years ago I suffered very severe food poisoning.... Christmas day, fantastic! It was miserable. It took about a month to really recover from, but I thought the worst was over. After this, I seemed to suffer from what I thought was hemorrhoids. Welcome to my 30's I thought. Knowing these were normal, I did not think twice. Fast forward to last summer, 2013, I get a nasty GI bug. Working in healthcare you pick things up and I didn't think about it. After this GI virus, I notice anal tags and again what I considered hemorrhoids. To be safe I schedule a rectal exam at the end of summer of 2013. The PA nearly looks at me like I am crazy for being so cautious and sends me home with Anusol cream for hemorrhoids. No info about how long to use, if I had hemorrhoids... Just on my way.
Fast forward to March 2014. I notice light bleeding and discharge. Hemorrhoid cream never worked, I used it like crazy. But I'm under immense stress in my grad program and in life. I brush it all off to internal hemorrhoids which they say can have discharge. I notice a "tiny hole" when checking things out, but given the fact a fistula was not on my radar.. I thought nothing of it. Get to beginning of May, still on and off very light discharge and bleeding and my "tags" seem inflamed. No pain, though I do have a tender tiny lump. Again, I'm all about hemorrhoids. Finally, I email my general doctor and ask him for a referral as I want to feel human again! He agrees and scared, I make my 1st appointment with a colorectal surgeon.
Early May, see the colorectal surgeon with over 8 years experience. At this point through my anxiety & nerves, I have researched the heck out of many rectal conditions and learned about fistulas, fissures and so on. Go to this CRS, he performs a digital rectal and a rigid sigmoidoscopy. Consults with me and states "that little dot looks like a fistula but is NOT one". Errr OK?! He informs me because he knows I deal with anxiety and am in a busy grad program he thinks I am "wiping too much" and this "not a fistula" he tells me is simply an abrasion. Surely he can't be serious, but I am relieved. He said my hemorrhoids were pretty much two tiny internal ones. Everything looks normal. Sends me on my way with new cream: Analpram, tells me to use Desitin on this tiny spot that is NOT apparently a fistula, and gives me Bentyl (for undiagnosed IBS?aka my nervous stomach).
2 weeks in, nothing is changing. I'm very particular at checking down there now and my fiancé kindly offers to help with the creams. I am convinced its a fistula, he is unconvinced as it isn't common. Until one day, he finally states "that is interesting" and says he saw everything he read about online with fistulas happening with my "spot". Call the original CRS, tell him what we see, he NOW agrees he thinks its a fistula. Hello!?? I appreciated his kindness overall in the office and the phone call. But the lack of diagnosis from the get go = frustrating!
End of May, decide to go after this "fistula". Make multiple 2nd opinion appointments, including one in a major city well known for medicine and schedule to see a top CRS. Can't get in till June 9th. In the meantime, JUST before my 2nd opinion appointment I get a UTI... why? Due to the Analpram according to the doctor who sees me... Yep steroids in the cream breaking down my ability to fight bacteria. Awesome, a cream that I should have never gotten gives me something else to deal with. Tack on another co-pay for insurance and $$ for a prescription. Nothing like a 3 hr trip to see the new doctor having to go to the bathroom constantly!
Finally we go = Doctor immediately and easily confirms fistula diagnosis with external exam, digital rectal exam and anoscope.He sees internal and external opening. He reviews the notes from the 1st CRS and is utterly confused how it was missed. (Later my primary care doctor reviews the same notes and states the same... the notes show everything for fistula). We ask about doing surgery now or waiting. Issue: I have to be in another state on the east coast ready to begin my own clinical rotations by June 30th. No flexibility can be made to help me adjust for recovery due to the nature of my program... Either take a full medical leave, risk hoping you recover in time or wait on surgery. He firmly believes based on his diagnosis: simple superficial anal fistula that he's 95% sure it would be a straightforward fistulotomy and he would not have to cut much of the sphincter muscle. Surgery would be June 18th. If I wait till when I am done with my program, I'd be in yet another major city, but well known for medicine. He offers up a colleagues name and states he thinks the chance of it getting more complex is low. BUT in order to keep it basic, I have to keep up sitz baths twice a day, expel the "stuff" from the hole and use Neosporin internally to keep the risk low for infection.. abscess... so on.
He's a fabulous doctor, very kind, and I have confidence.. I just don't know if I can make it all happen and move, and be ready/recovered! We spend the next few days back and forth about options. Lots of tears, fears, posts on here. Lots of research (probably too much), consulting by email with my very supportive primary care doctor and speaking to my program about the many "what if's"....
Deciding factor: It will cost much more in the state I finish up my program clinicals in to have this surgery, his colleague is not on my insurance (sigh), the BIG what IF it gets worse, and finally... this will be hanging over my head and I'm already anxious.
Decision = After 8 weeks of trying to get answers, lots of tears, lack of sleep, panic attacks, diagnosing myself, being angry, the why me's... I schedule and decide to have surgery on June 18th. Here goes NOTHING!
Sorry for the long story of how I got here... But here is my journey.