Adding Fistula to the List of Problems!

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Adding Fistula to the List of Problems!

Postby brent1981 » 20 Nov 2020, 02:23

So as of November 11th, I've had a fistula. This is part of a domino effect from an ongoing issue I have with anal fissures. Here's how it went for me.

Back in August or so, I had yet another anal fissure. The bowel movement wasn't even that hard or anything, it was pretty normal to be honest. But it was so painful and it seems to be recurring more frequently as time goes on so I said "enough is enough" and booked an appointment at a specialist clinic. They examined me and said the fissure was almost healed and to come back in a week. The doctor said he viewed a few hemorrhoids in his exam and would do a banding procedure on me. So I go in, get the banding procedure done, and it's not so bad. I go in a week later, and he does one more banding. This time I wait two weeks, and do the banding again. And once more a week later. This whole time I've been using this nitro cream but I realized at the end of it I was probably not applying it very well. I think I was supposed to insert it way up there, but I was only applying it to the barely opening of the rectum. Anyhow, time goes by and I get INTENSE pain.

The pain is so bad, I cannot sleep. The clinic books me for the next morning, since it seems a bit like an emergency. I had never felt spasms of pain before that make my whole body shake, and this constant feeling I cannot explain, like a feeling after you get punched, but emanating throughout the whole body. Plus sharp pains... throbbing pains. Like, I had never in my life felt so much pain before.

So when I get there, the doctor says I've developed an abscess. I didn't really know what this is, but it turns out it's an infection. Perhaps an infected anal gland or an infected hemorrhoid. They put me on antibiotics for a week, cipro and metro. It really died down, and almost went away completely, but I could tell it wasn't quite gone. And within a week, it was back, but only half as bad as the first time.

So again, I go in, get examined, and am told to go on two more weeks of antibiotics. Cipro for two weeks, metro for the first week. I do that, and it really helps. I am almost back to normal, it seems.

But slowly I feel worse and worse, even though I am still on the Cipro. Finally, on Nov. 11, I experience the weirdest thing ever. And I know what it is. It's a fistula. So gross! There was a pink discharge, a mix of blood and puss. But also, maybe, a little bit of feces?

What really felt weird was when I had a bowel movement in the morning, I felt maybe some of the feces go into a cavity somewhere in there. I don't know if it did or not. But it felt different than usual. Oddly enough, the fistula went away. But a few days later, it came back... and my abscess seemed to be coming back too, so I went to the ER. They had a good look at me, but decided I wasn't really in 'emergency status' but definitely saw that I had a fistula. So I got an MRI booked. Can you believe my MRI is actually tonight at 3:45am? Crazy. So they're going to image me, find the fistula, and hopefully I can get surgery.

But like, this is just an addition to my already rather crappy times. It all started like this:
- severe anal itching goes back to 2001 when I was just a young guy
- constipation around 2001 to 2013ish. I started eating more fiber and being generally better, and the constipation has stopped mostly
- I am guessing my first anal fissure was around 2014 or 2015.. not sure.
- My first hemohrroid banding treatment was just in August, Sept
- My anal abscess started in Oct.
- Now I have a fistula as of Nov.

Anyways, I guess I'll be asking for surgery.

It's tough to live like this, having leakage from the fistula, and I hate having gas now. It's like the gas wants to go out of the fistula, making the fistula feel like a bee is stinging me along with this weird pressure sensation.

Any tips on riding this out? I've been finding that sits baths help a ton, doing three of those a day. Do you use Epson salt for it?

I am also taking ibuprofen. Wonderful drug.

I also apply HydroVal (Hydrocortison-17-Valerate Ointment) which soothes the itching and burning a tad.

I try to limit bowel movements to one a day, but for some odd reason in the morning, I have three in a row, separated by about 15 to 30 mins each. Usually the third one makes me feel a lot of pain.

Also, in order to stop the feces from doing that weird thing where it seems to be going into a cavity during a bowel movement, I press my finger against the fistula's opening to create pressure, and that seems to help. It also helps when I have gas. But it's pretty annoying to do this. Especially would be weird if I were in public.

Anyways, any tips on living with this? I am hoping the surgery I can get (hopefully soon) will cure me of it. But in Canada the wait is a minimum of 5 weeks. So I gotta live with it for now... sigh.
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Re: Adding Fistula to the List of Problems!

Postby Savaici » 26 Nov 2020, 08:36

Sorry to hear about it all, Brent. Hope you can get it sorted soon. Make sure that you THOROUGHLY research it all, but you seem to be doing that.
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Re: Adding Fistula to the List of Problems!

Postby brent1981 » 05 Jan 2021, 18:13

So, today I had a consultation with a doctor. He said they looked at the MRI scan and it indeed appears I have a fistula. He said that there is a 5% chance it will heal on its own, and a 50% chance it will heal if I get surgery.

50% so basically a coin toss.

I sure wish it were a higher percentage! He said that it would require a 2-3 day hospitalization and that they won't know exactly what procedure to do on me until I'm actually in the operating room and they can see more details about the fistula.

But it might be a long wait, he said around 6 months. I am in Canada, and for non-emergencies like this you sometimes do have to wait a while, especially now with Covid making everything go slower.

So, what do you think? Should I go for the surgery? I am thinking I should.

But who knows, maybe I get lucky and it heals all by itself. It still hasn't healed, there is still stuff coming out of the fistula every now and again.
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Re: Adding Fistula to the List of Problems!

Postby Make.it.stop » 14 Feb 2021, 02:34

Hi Brent, sorrynto read you going through this awful experience in Covid times no less...I'm in somewhat of a similar spot as you regarding contemplating options for my fissure. Had my second real one appear about a month ago and it hasn't gone away, not after conservative measures or the first topical prescription. Just switching to the second but I always think worst case in that I'll have to make the call on LIS, and I'm also in Canada meaning even if I do want it, god knows how long I'd have to wait (once I've even found someone I felt confident enough in having slice open my arse).

Have you made any progress this last week, either in healing or decision making? As long as nothing gets worse, if you schedule the surgery and it's far off, you could always wait and see whether it heals in the interim right? 5% doesn't sound too inspiring to me tbh, but only 50% with surgery isn't so reassuring either. Sigh...
10/17-31/12/17 – First signs/annihilated by Fissure 1
3/18 – Fissure 1 healed by sitz bath/toilet & GI bugs
1/21 – First signs/annihilated by Fissure 2
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Re: Adding Fistula to the List of Problems!

Postby posertiermadness » 20 Mar 2021, 23:35

I’m going through a very similar experience with a smaller fistula and history of fissures. I agree the fistula is the weirdest, worst, sensations of pain/pressure and sometimes numbness, cycling round and round. Such a ridiculous wait time here in Canada that I’m considering the Mayo, savings and Covid be dammed over living like this. Docs here are like, “You are not dying of cancer so suck it up.” I’m having a call with the CRS on Monday to diplomatically ask why he said there was nothing on the MRI when (I got a copy of the report) it clearly says there’s a fistula. Anyway, I say all this to expressed understanding, but mostly to say you definitely need to look at the research yourself. The healing rate for fistula surgery when done properly is substantially better than 50%, but they need to use the right procedure for the right type and severity of fistula. So sorry you are suffering. I get it :(
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Re: Adding Fistula to the List of Problems!

Postby brent1981 » 30 Jun 2021, 21:59

Well, here is my update. I went in for surgery. The first time was in the Spring, but when I was there, they cancelled it on me - right in the hospital. Because the surgeon had been dealing with a tough case, and it took a lot of time.

The second time was just yesterday! And it was a success.

I went in for surgery, they interviewed me about stuff (covid questionairre, about any health issues or medication I am on), and then I went into an operating room. There were about four or five staff there. And they gave me general anesthesia. I woke up like an hour later, and it was done. I was not in very much pain. The nurse asked me to rate it out of 10, and I said 1. She gave me some painkillers and then I was off.

Today there is almost no pain where the surgery was. I have a little rubber band or something in there, and that's supposed to help 'drain' the abscess or heal the fistula. I don't really know how it all works, but I was just worried about there being pain. But so far so good, I haven't even had to take the Tramadol they gave me. To be honest, it's almost like the pain is LESS than it was with just the fissure in its natural state. I don't know if he cut into me and took something out, just inserted the rubber band thing, I really don't know what all he did as he didn't stay around afterwards to tell me in detail. I will say this surgeon (Dr. Meneghetti) is a professional of the highest regard, super logical sounding, very honest, just a smart guy and I felt very comfortable to be operated on by him. I think he's done this exact surgery a zillion times. He's a fistulotomy expert.

I would press your doctor to get properly operated on...

But yeah, I mean, I just got my surgery yesterday so I have no clue if this will work. So far, I feel better than before I had the surgery, so that's promising. Very little pain. I wear a pad thingy behind my underwear and it seems to catch a lot of blood. I had a look, and my wound is kinda gross looking... but I think it's doing its thing cuz there is very little/no pain. And is draining, which is probably a good thing. The surgery didn't take long at all, they said like 45 mins, so maybe it was a simple surgery for him to do. This gives me confidence.

So I will go see my surgeon in approx 3 weeks and he might remove that rubber band thingy. I am hoping it's all good. So far, no pain, no further infection, and I haven't had a bowel movement yet after surgey... I am a bit worried it will hurt. They said it's normal not to have one for more than 24 hours after surgery, so I guess it's all good.

But I have a bath and salt and painkillers at the ready if it's painful.

But yeah, so far, so good. At this point I would say: get the damn surgery if you can. It's not that bad at all. I am just worried about how the next 3 weeks will go. If they stay like this, I am golden. If I start getting weird infection-type pain and/or fever, then I am in for a boatload of pain and suffering and really hope that doesn't happen again!

If you want any more info on the surgery, surgeon, or whatever, just lemme know! I will report in again here to let you know how I am in three weeks too...
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Re: Adding Fistula to the List of Problems!

Postby posertiermadness » 30 Jun 2021, 22:31

The numbing agent will wear off and you will feel things more 2-3 days post. I did not have to take any of the strong stuff they gave me after fissurectomy and glad b/c it can constipate. Keep stools really soft and try to get moving around as you can. I started with really slow 1 bock walks and worked up to 4-5 10-15 min walks a day, which I've kept up since May 10 surgery. Things will be swollen and don't be freaked out by it. If not LIS that was done, then it is going to take quite awhile to heal...some people don't have much pain after 3-5 wks and other take 10-12 months to improve. Hope you recover quickly.
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Re: Adding Fistula to the List of Problems!

Postby brent1981 » 03 Jul 2021, 19:31

Hi Posteriermadness. By the way, I love your name, haha.

Anyways, you were right: I ended up feeling more stuff about 2-3 days post. But overall, it's not so bad. As for taking medication, they recommended I take Trapadol (opiod mixed with tylenol-like painkiller) approx 2 pills every four hours. Well, I only took one pill ever four hours on July 1st, a total of 3 pills. Took 2 pills on July 2. Took 2 pills so far today, spaced four hours apart. So in total, I've only taken just 7 of these pills over a period of 3 days. So yeah, the pain is certainly manageable and sometimes it's not even there. Other times it is this constant feeling of being 'pinched' mixed with stinging, but more of a pinched feeling.

As for walking, that's been no problem at all really. Even right after surgery I walked home from the surgical center to my home which was only like half a kilometre. The nurse was very worried about it, but I had a friend with me, and I was fine.

And daily I've been walking at least a kilometre or two at a normal, slightly slower than normal, pace.

I don't think an LIS was done. I just think a seton was installed. Actually I don't know exactly what my surgeon did, because he left before I woke up from surgery... but he did tell me that I would likely have a seton installed and that did indeed happen.

This surgeon has done this particular surgery several times, and he specializes in it, so I am sure he did everything right. And to be honest, I think I feel BETTER than before the surgery! Believe it or not. Maybe it's just mental... maybe it's the opium... I dunno! But I feel great that it's done, that I am healing, when I see that puss come out of me I think of my abscess dying a slow death. But it is dying... going away... slowly seeping out.. and I believe that's a good thing! Someday it will all be out. That day, when it comes, I will celebrate. I don't know when it will be, but I will be a happy lad.
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Re: Adding Fistula to the List of Problems!

Postby posertiermadness » 03 Jul 2021, 20:33

Oh just remembered. I've never used Milk of Magnesia before, but did as directed (3 tablespoons) one time at 5-6 days post. Had been feeling almost nothing, but then that gave me a blow out stool and my fissure has pretty much remained mildly stinging ever since with no additional healing. So just be careful not to overuse softeners. I've been using PEG daily and used Mag one time since (2 tblsp and it worked fine). Hope all continues on the mend for you!
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I was in severe )( pain at the time and typed it wrong. Oh well, read quickly it makes sense.
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