My Absess->Fistula->Fistulotomy+Cutting Seton Experience

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My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby gizzard88 » 18 Jan 2018, 20:36

This board has helped me a lot through my fistula. Here is my story as another point of reference.

In Oct 2017, I noticed a growing pain in my butt crack (up towards the back). 3 days later, in extreme pain, I checked into urgent care. An abscess was identified and I was transferred to the local hospital where it was drained by a CRS (under local anesthesia). I was told by the CRS to rest and hope for the best.

1 week later the abscess healed. Two weeks after that I developed a small (pin head sized) hole 2 cm up from my butt hole. The hole produced pus and itched.

I waited two additional weeks and then returned to the CRS (late Nov 2017). Scheduled a Fistulotomy for early dec. Days before my surgery, the fistula closed. My CRS recommended we cancel the surgery (I was thrilled).

However, 1 week later it opened again. It then cycled between open and closed for the next month. I tried herbal meds to no luck. I then consulted with my CRS and re-scheduled the Fistulotomy for early Jan 2018.

The Surgery was easy. My first one. Woke up with sore hips and throat (from the positioning and the breathing tube). Was told that a Cutting seton was installed. Was told 3 weeks for it to drop. Went home same day (and then spent 2 hours reading about cutting setons on this board).

Here is my recovery story so far (keep in mind that I am a healthy 35 year old with no other issues):
Day 1: Surgery in the morning. No pain. Just really tired. Slept the rest of the day.
Day 2: Minor pain. Took 4 baths and spent most of the day in bed/bath.
Day 3: Same as day 2
Day 4: More pain, Took 4 baths and spent most of the day in bed/bath.
Day 5: Same as day 4
Day 6: Limited pain, lots of itching. Took 4 baths and spent most of the day in bed/bath.
Day 7: Major pain. Spent the entire day in the bath.
Day 8: Same a Day 2.
Day 9 Heavy itching, minor pain
Day 10: it fell out!
Day 11: Almost no pain. CRS confirmed that outer sphincter is strong. Gave thumbs up.

Notes: I believe that days 1 through 5, the seton was moving through my outer sphincter. Days 4 and 5 were bearable, but unpleasant (even with painkillers). Day 6, it sliced through the tissue between the sphincters. It moved almost a cm that day. Day 7 was really painful and bloody as the gash was now large. Day 8/9 it moved through my inner sphincter.

Pain control: For all 10 days, I was on ibuprofen + Acetaminophen, taking max daily doses of both.

Diet: Strict Soup, apples, and green veggies. Down to apple snacks all day + 1 soup/veggie meal for dinner. This helped minimize poops. Drank 3-4 liters of water day mixed with Chia seeds (for fiber). I lost 8 pounds in a week.

Stool softeners once a day.

Thoughts: My CRS used a rubber band seton and REALLY tightened it up on install. I believe this is why my experience was very painful, but quick (Relatively). 4 days after the seton fell out, I am now able to sit without issue. Butt hole still has a healing cut in the inner sphincter, but is holding pretty well (no issues holding farts or poops).

Not going to say this experience has been easy. However, I survived! My advice:
1. 1. Stay positive! (duh)
2. 2. Really force yourself to eat healthy. I think it helped a lot (although I have been dreaming about hamburgers for two weeks now).
3. 3. Anytime it hurts, just go float in the bath. Hot baths took all the pain away for me.
4. 4. Get Netflix, an ipad, and a bath trey to hold your ipad while you sit in the bath.
Last edited by gizzard88 on 24 Jan 2018, 20:43, edited 1 time in total.
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Re: My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby Dimitri71 » 22 Jan 2018, 10:28

Thanks Gizzard 88, good story.
Did you get a lot of drainage with the cutting seton?
Did you go to work, do sports?
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Re: My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby gizzard88 » 22 Jan 2018, 18:49

Hey Dimitri -

I was able to go to work for 3 half days during the first 10 days. It is pretty difficult to sit (my job is a desk job). Sports were impossible. I did some light exercise this last weekend for the first time since the surgery (18 or so days since the surgery).

I was wearing pads for the first 12 days. The drainage varied from day to day, but never horrible. I think the worst days I would drain around a tablespoon of pus every 8 hours (approximate). The pad + wiping in the bathroom every few hours managed it.
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Re: My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby Dimitri71 » 24 Jan 2018, 08:07

Thanks Gizzard really appreciate your input. Has drainage stopped and the wound healed fully? Let us know so we know the timeline if you can please!! I might be going through a cutting seton surgery at some point as well. All the best Dimitri
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Re: My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby gizzard88 » 24 Jan 2018, 20:43

Hey Dimitri -

Im now 4 weeks out from the surgery (2.5 weeks out from when the cutting seton dropped out).

Drainage mostly stopped 3-4 days after the seton dropped. Today, i have a very small amount of drainage each day (no need for pads or anything).

Pain and discomfort ended also 3-4 days after the drop. Today, it itches a few times a day (especially if i need to poop).

The visible gash on my butt hole has 60% healed so far. Started at 2 cm after the seton drop. Today it is less than 1 cm.

Best of luck.
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Re: My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby Dimitri71 » 25 Jan 2018, 03:37

Thanks Gizzard, good to hear all this and your speedy recovery and thanks for posting you're helping lots of people.
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Re: My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby Dimitri71 » 05 Mar 2018, 08:38

Gizzard I hope all is well.
Have you been fully cured (no draiange at all?)
I may have to go through the same surgery myself.
Is incontinence an issue at all for you?
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Re: My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby Cat001 » 05 Mar 2018, 17:53

Hi guys,
I am new and because I saw this post, and I am currently scared out of my wits wanted to speak to you.
I am due to have fistulotomy + seton as been informed I have a high fistula on the 16th March.
I have come back all clear for chrons but have always suffered with stomach issues.
I was informed that the MRI doesn’t show how high it is, and this will only become apparent when my surgeon goes in.
The hole seems to have got bigger and I am literally terrified, but know I can’t carry on as a have been for the last 8 months.
Thank you for sharing with us your story, it’s made me feel a little better as discussing this with friends is difficult (as you can imagine). X
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Re: My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby gizzard88 » 05 Mar 2018, 20:52

Hi guys -

Glad this post is helpful. I am now two months out from my surgery (seton install) and about a month and a half from the drop of the seton. My current status:

1. No drainage or fistula hole! The area is all smooth scar tissue!
2. No incontinence at all. Everything is working great. Even farts are held well.
3. Occasional itching: I am more susceptible to itching from a non clean butt. If I have a BM on the go and have no way to do a wash, I will more likely have itching than before.
4. Sometimes when i sit down hard, the scar tissue gives me a very short, light sting.

Overall, very very minor symptoms remain (I barely notice them at all). I feel that the symptoms are just the result of having scar tissue in a sensitive location. I am hopeful that they will become better with time.

Good luck guys! Keep positive: you will survive this!
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Re: My Absess->Fistula->Fistulotomy+Cutting Seton Experience

Postby Dimitri71 » 07 Mar 2018, 09:59

Many thanks gizzard, excellent news!
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