So here's the news - keep the wound wide for as long as possible, because if it doesn't heal from the bottom up, another may be required. It sounds to me like you are already doing that, and that you are actually doing everything right; but the strange thing about fistulas is, apparently, we shouldn't heal too quickly! Pus and/or mucus drainage is normal and good because we don't want that stuff to build up and stay inside. So, anyway, Adam, you might want to prepare yourself for a bit of a painful follow-up examination - but given your pain tolerance, you probably won't even feel it! I'm a big whimp, but I only said "Ow, ow, ow, damn!" and then I was ok. (BTW, I saw an episode of Mythbusters that demonstrated that cursing can actually decrease pain sensation - I swear a lot even when I'm not in pain!)

I've learned something new. It makes sense though. I remember my son falling on a wire fence that jabbed into his leg when he was a teenager. When we took him to the Dr., he said not to put any antibiotic ointment or anything on it because it needed to drain and the ointment could cause the outside to heal before the inside...
Hope- you and Adam are awesome doing so well with this. I would swear too!! I hope the painkillers kick a** for ya and the follow-up doesn't make you too sore. I've read quite a few threads in here and I don't believe I have ever seen anything on the after care of this procedure. I may have missed them if there were, since I was trying not to think about infection when I got my LIS. I really am sorry you all have had to go through this.

Thanks Dawn :D It makes such a difference having folks like you on this forum to offer so much support!
I see that there might be some ambiguity in my earlier post - I should have said that 'another surgery may be required' if the wound heals too soon. (Yikes!)
I've read that puncture wounds sometimes need to be packed so that they heal from the inside out. Your son must have been very brave dealing with such an injury!
I also looked around for threads that deal with post-op care of fistulas and I didn't see very much either. Now I know I just have to be pretty vigilant about stretching the wound as much as possible. A week ago I was a bit freaked out because the wound looked so deep. I was wondering how on earth such a wound could actually heal. Now it doesn't look so deep. So the routine is every hour or so I wash off the drainage and give the wound a good stretch. When I do that, some pus comes out. I also have to stretch it when I'm soaking after a BM. Then I do an after-bath clean up and stretch it a bit more. It kinda hurts, but it actually feels better after I do that because it's good to get the pus out.

What a life!

Your Welcome Hope
Anyone who hasn't been through these types of problems would never understand or believe how it takes over your life.
I hope it isn't much longer and you are healed forever!!

Hopetoheal, Iron Man 2 is a lot better than 1 :roll: Lol just joking.. I loved all X-Mens, and all the Marvel Comics movies (except the Spidermans were too childish in my opinion), and last night I just finished watching X-Men Origins: Wolverine! Now I watched every single Marvel Comics movie up to date! Captain America is next, and after that is the Avengers I have a ton of comics from when I was just a kid... How do you think I gained my "super-human" pain tolerance powers? lol, joking again, I know mostly everyone here had more and bigger problems than me and for longer than me, so I would be in just as much pain if I was in your shoes, and you're all MY heroes.
Hopetoheal, your follow up sounded great! Good thing you got in there soon enough before your fistula tunnel closed up at the front! Did the crs give you any freeze before he re-opened it?? Did he just literally pull it open, or did he have to cut it with a tool inside the tunnel?
My fistula hole looks as big as it was from day 1 post op, remember I was pulling it open so hard it hurt? lol only because the directions told me to spread the cheecks "quite hard". I do get in the fisutla hole with just the tip of my finger as well with a little soap and then with water to rinse it. I hope that the inside hasn't closed ontop of pus, then that means they'll have to cut that skin again!
Oh well, we're both on a great path here to healing. And btw, my pus is becoming a lot like yours hopetoheal, it's a lot more liquidy than usual it seems!
I'm DYING to go back to work next week. But my follow-up isn't until another two weeks. I don't know what I should do.

"Hopetoheal, Iron Man 2 is a lot better than 1"
Them's fightin' words, Adam! LOL
I'm so glad your recovery is going so well. It's a good thing you can watch all the Marvel movies or you'd be bored out of you head! (Keep those comic books - they might be worth a lot of money one day!) Thanks for reminding me - I should watch X-Men Origins again :)
The doc just pulled the wound open his fingers - no freezing and no cutting, thankfully! It smarted, but it wasn't agony. Since then, I've been tugging on the damn thing a few times a day. Yesterday when I did that a very little bit of pus would come out. But today, nothing. The hole looks like it's filling in. The edges of the wound are still separated, but there is a small piece of skin growing in the middle of the wound now and I don't see a deep hole anymore. The drainage has basically stopped - there is only a tiny bit of white goo sometimes. I don't know if that's a good thing or not. . I am spreading the dern thing as hard as I can. The hole was never big enough for me to get my finger into it, but I am pulling the edges and cleaning quite a bit during the day and evenings. Man, I REALLY don't want to have to get cut again!!
I honestly don't know whether or not you should go back to work. My own feeling would be not to, mostly because of the hygeine issue. You really need to keep everything clean, clean, clean. And heavy lifting would put stress on the wound too. It's important to take good care of the wound so that it heals properly and there are no complications. Another surgery would really suck. Is the boredom bad enough to risk a complication? Anyway, that's my thinking. I understand about wanting to get back to your life though. I would love to have a life again too!

Thanks for the info hopetoheal :)
My fistula hole looks the exact same way too; the opening is still there, but there's a little piece of skin right in the middle that seems to be closing it up. When I take my showers, that piece of skin is pushed up against the opening, and it looks like the hole is almost fully healed. But after I spread my cheecks, it opens the hole back up to the point where I can't see the end anymorr, but it looks like it's almost where yours is at.
You're so right about work. I am bored to the point where I feel I have to start doing something. I went to the beach today for a few hours with a friend, and everything seemed okay, I didn't go in the water ofcourse, but I would've liked to! Driving home, so hungry, passing by all the restaurants, knowing I can't have them just made me more hungry lol.
The questions I'm going to ask at my follow-up are:
-When can I start weight lifting again and extreme cardio?
-When can I eat meat/fast foods/fried foods again?
-How long should I continue cleaning my bottom after every bowel movement?

And hopetoheal, I read up on a past fistula thread that Dawn directed me to. It wasn't too informative as our posts are, but one person actually posted after they were healed, and the time was about 1 month until we're back to normal

Hey Adam - it sounds like we are pretty similar in terms of wound healing. I'm not draining much anymore, just the odd little bit of pus/mucus, about the size of two pinheads. I don't know if I should be happy about that or not. Some other folks, like Afugh!, drained a lot for quite a while - but then they seemed to have had more extensive fistulas.
I manually make the wound drain. When I stretch it, some pus does leak out. I can barely see a hole anymore. I can tell when things need to be drained because I get an almost itchy sensation and there's a mild almost pinching senstation - the sensations are very subtle.
I know what you mean about hunger! I have been on a pretty radical diet for about a year now, since I got the fissure and I am dreaming about Dairy Queen, fries with gravy, steaks, cheeseburgers
Those are good questions for you doc. I was told I can eat whatever I want, but I don't quite buy that just now. I plan to be very good with the diet for at least a year because I don't want any BMs to cause problems until everything down there is good and healed.
One month sounds right too. My surgeon said that 4 weeks is the normal healing time. I'm in my third week now, so maybe I shouldn't be so worried that it looks like my wound is healing! Man, these things can make you crazy!
I hope you're not too bored. Today looks like a good day to go to the beach again. It's going to be a hot weekend. :D

Hopetoheal, I find also that when I spread my cheeks in the shower, I do see that the pus does come out a bit. My pus is starting to slow down as well, but not as much as two pin heads but almost there. You are about a week ahead of my post op, so that sounds about right.
I haven't been getting many pinching sensations or zingers lately, but as it heals more I wouldn't doubt that they may come back.
The only thing the doctor told me to stay away from was coffee, tea, and spicy foods! How is that possible when I'm eating like a rabbit now, and my bm's still aren't comfortable?!? lol
I'm not too bored, but thanks hopetoheal, I hope you're not too bored either :)
The beach was beautiful, but I don't think I'll be going again in the next couple weeks. My recovery hasn't seemed to suffer at all from laying down on a towel, sunbathing, and throwing a football around, but for some reason I just got a feeling all the heat/UV/humidity wasn't all good for my body as a whole, and it's already having to fight off infection to my fistula and has to work to heal it.

You're probably right that the heat and humidity isn't good for the healing process. But it's good that you at least got out into the world to enjoy life a little bit.
You do sound similar to where I was about a week ago. The pinching feeling is really subtle, and if I wasn't already hyper-sensitive in that area, I probably wouldn't notice it as much as I do. But after having had a fissure for almost a year, then the LIS, and then the fistula, any little thing down there gets my attention! Right now I don't see the hole anymore, as I mentioned; instead the incision looks deep and exudes pus when I pull it (ouch!).
Unfortunately, over the year of the fissure, I lost about 15 pounds, which was about than 14% of my body weight. I hate being so weak and frail. I've always been skinny, but I was much tougher than I am now. I'm working on gaining weight - eating healthy, but fattening food - and I am finally beginning to feel stronger.
I think the no coffee, tea or spicy food makes sense, at least for a while. It does suck when you eat rabbit food and still have uncomfortable BMs. If your healing goes like mine is going, BMs should get more comfortable very soon. I can pass decent-sized solid stools ok now The watery ones still sting like a &&^%.
I hope you had a great day and that you enjoy your evening. :D