My story starts with revenge: First AF

food poisoning + antibiotics = first af

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My story starts with revenge: First AF

Postby BROC » 03 Mar 2019, 22:56

Hi everyone,

I'm not very excited to be here (for obvious reasons) but I'm pleasantly surprised to find such a positive, supportive community built around something so painful, common and rarely openly discussed.

I would like to share my story in the hopes that it either helps someone else or maybe even connects me with someone that can help me. Thanks in advance for taking the time to read and care.

After battling ulcerative colitis for much of my adolescence (full remission now for over 5 years), and enduring countless bouts of food poisoning while living in Asia, I came to believe that my tolerance for digestive issues was quite high. That is, until I developed what I believe to be my first anal fissure 4 days ago.

I am currently working remotely from a tourist city in Mexico. I am an avid traveler, so I was careful about what I ate, the water I drank and how often I washed my hands. Still, after three weeks in the country, I suddenly contracted what is colloquially referred to as Montezuma's Revenge. And let me tell you, it sure felt like I was experiencing centuries of pent up cosmic rage: crazy fever, double vision, explosive diarrhea, fatigue - the works.

Luckily, I had made friends with a Mexico-certified doctor who not only prescribed but delivered antibiotics and acetaminophen
to my bedside and waited for my fever to break. I felt better within hours, but the diarrhea persisted for nearly the full one-week course of the antibiotics. On day 7, I finally felt fine.

On day 8, I did not.

Suddenly, going to the bathroom felt like passing glass, sitting on knives, pooping needles, etc. etc. you get the picture. Never had I experienced such pain before. I had to bite a towel just to get through the first couple of BM's. It was probably the most painful experience of my life. And it happened again and again and again.

I did some research online and discovered the joy that is an anal fissure. I called my aunt (a registered nurse) and communicated with my doctor friend and they both confirmed my suspicions. I likely had developed an anal fissure.

As soon as I felt capable, I went to the pharmacy and they gave me an anti-inflammatory pain reliever, preparation H and vitamin e/aloe wet wipes. I have since discovered that prep H is not a good idea and have discontinued using it, but the NSAIDs and wet wipes have been just enough to get me through the weekend. I do not have access to a bathtub but have been ingesting plenty of fiber and water. I'm not sure what else I can be doing at this point. It has gotten marginally better over the past 48 hours as I no longer need to bite a towel and there is no longer any blood in the bowl or on the wipes. I also have yet to develop a skin tag/external pile or any hemorrhoids. Thanks to Montezuma for sparing me those delights, I guess.

Looking forward, I have an appointment with a local proctologist tomorrow and an appointment with my proctologist back in the US in 2 weeks. I know there isn't a lot more they can do but a positive diagnosis, expert-prescribed treatment and encouragement that this will get better would be much appreciated.

I am really hoping for a swift recovery because this is pretty debilitating: I don't want to leave my apartment, I can't enjoy the foods I typically love (spicy! crunchy! cheesy!) and I am constantly uncomfortable. I'll be sure to post an update, if anyone is interested.

Final thoughts: I can't believe some of you have had to endure this excruciating pain for weeks, months, YEARS. It's amazing the conditions humans can become accustomed to and how quickly "normal" can change. Reading the stories on here have both inspired and terrified me. But at least I know that regardless of my own outcome, there are others out there that can relate and offer kind words and support.

Thank you for existing. Thank you for reading. And I wish all of you the quickest of recoveries.

-BROC
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Re: My story starts with revenge: First AF

Postby dmcff » 04 Mar 2019, 10:12

Welcome to the forum. I'm sorry you're having to go through this, but the good news is that if AF is treated early, there's a fair chance of healing. The main thing is to keep the stool soft - use Miralax (macrogol) or magnesium citrate. For pain - if you don't have access to a bathtub, a bidet toilet attachment can be useful (look it up on Amazon). Frequent warm sitz baths are recommended. You should be able to obtain GTN cream or ointment (glyceryl trinitrate) in Mexico, so you could give that a try. Good luck.
2014 Anal fissure
2015 CAT, EUA, sigmoidoscopy, 2 MRI
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physical therapy, pain management
2019-20 Living with it
2021 Still AF
2022 Therapy, meditation
2023 Onward, up
2024 CT scan
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Re: My story starts with revenge: First AF

Postby BROC » 04 Mar 2019, 10:50

Thank you, dmcff. Stools are soft, thankfully. I'll be sure to talk to the doctor in a few hours about GTN. I'm already past the point of intense pain, but am still quite uncomfortable. Feeling cautiously optimistic.
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Re: My story starts with revenge: First AF

Postby Abu » 04 Mar 2019, 11:32

Broc, keep your stools soft and since this is your first you might be lucky and not turn into a chronic fissure. But you must keep them soft 100% of the time, for at least 6 weeks. If you do this now you will thank yourself later.
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Re: My story starts with revenge: First AF

Postby BROC » 04 Mar 2019, 12:12

Thank you, Abu! Will do!
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Re: My story starts with revenge: First AF

Postby BROC » 25 Apr 2019, 14:39

Update: The fissure healed relatively peacefully (after the initial days of hell). I have since returned to the US and am back home with family. Unfortunately, after my return I developed an abscess (maybe 2). I saw a colorectal specialist and he initially thought that it was just swelling from the fissure and that he couldn't detect any internal signs of an abscess from a digital exam.

About 4 weeks later, the abscess suddenly swelled and became painful so I called him (on Easter no less) and he insisted I go in for an incision and draining the next morning. The procedure was not fun but it was relatively painless with the exception of the numbing shots. I am now dealing with the daily draining by using panty liners, taking regular sitz baths to keep myself clean and by reducing physical activity for a while. I can't quite bring myself to pack the abscess with gauze but have read studies online that reached the conclusion that it is typically an unnecessary practice.

I am now 3 days post-op and have some discomfort due to the rawness of the open abscess but essentially no pain otherwise, even during BM's. Drainage is constant but light and the dr said I can expect to "heal fully" in about 3 weeks. I have a follow up appointment scheduled already and honestly can't wait for this to be resolved.

However, there is another swollen lump on the other side of my anus that he said is not worth draining, but that we need to keep an eye on. I am really hoping to not have to go through the I&D procedure again. I am also really hoping to not develop a fistula because I really just want to get back to normal physical activity (I typically bike to the gym every day and lift weights). I know there is no specific way to prevent a fistula from forming so I am just hoping for the best and trying to take care of myself.

Hopefully this helps some readers out there and best of luck to all of you.
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