I think it's time for me to find a different surgeon. Today I went again to see the dr who did my LIS 4 weeks ago because I was getting even more infection/abscess related discharge than before and I've been having a fever. He examines me, squeezes the abscess a bit etc, tells me it doesnt look too bad. Then mutters, I should just get you back in the OR and cut that out of there. I said what? He sat for a minute and I asked about a second round of stronger or longer dose of antibiotics. He was hesitant about this, kept looking at his typed report from my last visit. Then he said Its been 4 weeks since your surgerg. Im in no hurry to do another surgery. I said well I'm in no hurry ti have another surgery! He got up and headed for the door saying Get dressed and come on out. He does this everytime. I get dressed and go out to the area where his office girl sits, writes me an rx for ABs and instructions for a two week appt. Then he says something about going back in and putting in a seton. I said A seton is for a fistula. Do I have a fistula? He said yes. I said You didnt tell me that. That is exactly what I wanted to prevent. He said well your abscess has a hole at the top. After that, I felt so upset that I couldnt or maybe didnt want to talk anymore. I took tthe rx and left. And i wanted to cry on my way home. Why is it like pulling teeth to get information about my own body and health from my own dr!!?? Sooo damn frustrating but I gueess i am partly to blame because i didn't want to hear the details about how exactly the LIS is done a month ago. And the lesson to be learned from this is to ask many many questions before surgery like a lot of you advise. Unfortunately i didnt find this website until after my surgery :( And also to find a surgeon who will spend the time with you and that you feel comfortable with. I had an excrutiatingly painful fissure that had me in agony all day long and was looking for relief as soon as possible. Now wishing i had taken time to compare docs. I have ben out of work 4 weeks already. I don't know what I'll do if I have to have another surgery. I'm upset and could really use some comfort and hugs right now.

I'm so sorry to hear you suffering under a pretty indifferent CRS. hmm... i'm not sure if having another CRS to do your fistula is advisable since he/she will not have your medical history esp notes on ur LIS. But how about switching another CRS within the same hospital?
If fistula is truly present, surgery is inevitable (if i'm not wrong)...

Rosa-
Sorry to hear your having issues. From your description your surgeon sounds like he isn't very confident in how to proceed. Does he have others in his group that you could see for a 2nd input?
Also, did he elaborate on the seton? Is it draining or cutting? If it is a draining seton this isn't going to necessary cure the fistula. I would think in your case, assuming the abscess is at the LIS incision, that the fistula is shallow and could be dealt with with a fistulotomy like several others here with post LIS abscesses. It is almost like the CRS doesn't want to not deal with the problem now by placing a seton.....
Take care.

Oh Rosa! I'm so angry for you! Your doctor sounds like a real donk! I'm also a bit puzzled about why he would talk about putting in a seton. Those are usually for high fistulas. But if you got your fistula from the LIS incision, like I did, then it is most likely a very low, superficial fistula that can be taken care of with a simple surgery to lay it open (a fistulotomy). That's what my doc did and it worked like a charm. The fistulotomy was not fun, but it wasn't any worse than the LIS (and was actually easier, in my case). I think you should try to see another surgeon and get a second opinion. If you have a fistula, you will need surgery to fix it. I also don't understand why your doctor is putting you on antibiotics. ABs won't cure the fistula, and docs don't even use them very often for anal abcesses either, since they don't reach the abscess pocket - that's why doctors will drain an anal abscess.
I'm really sorry you are going through all this. But please don't feel too bad - up to 50% of abscesses will develop into a fistula and there isn't anything you did or didn't do to cause that - it's just bad luck, and I really sympathize! I know how you feel! I had a good cry too when I learned I had a fistula. I don't understand why your doctor wouldn't tell you. I really think seeing another doctor is a good idea.
Hang in there, Rosa! You can get this fixed. Just get assertive. You WILL heal!

Rosa i am so upset for you to be going thru this. sounds like another doctor who does not know how to communicate to their patients!!! makes me so angry that docs dont tell their patients what they should..

Thanks everyone so much for your advice. Dwarfs8 there isn't another CRS in the practice. There was a good one but she relocated out of state. Im thinking I can ask for a copy of my med record to go for a second opinion. Paul he didnt elaborate on the seton, maybe its just a draining one that he referred to but like you say, that wont cure things. The abscess was on my left cheek about a half inch away from the LIS incision. Does that mean its shallow? Hope, was your abscess inside or outside the anus? He didnt tell me what kind of fistula it is because I was so upset, i just couldnt ask more questions. I hope it is the single shallow type. The only other thing he talked to me about was ti ask if ihad symptoms or anyone in my family with chrons or if i ever had a colonoscopy. Said he could give me one. I just didn't want ti hear anymore at that point.

Thanks for your words and encouragement hope. I was the one who was pressing for ABs because i thought I had infection that i needed to get rid of since i have fever and it was before he told me I have a fistula. He had drained the abscess a week prior. If I find another dr and decide to wait a couple months, will the fistula get worse? Val if youre reading, I know you have lots if info. Anything you care to share would be greatly appreciated. Thanks all.

Hey Rosa - The ABs do sometimes help - they just aren't the primarily course of treatment. I'm actually not sure if the fistula will get worse by waiting a couple of months. For a low, superficial fistula, probably not. My surgeon told me that he has patients with low, superficial fistulas who just live with them because they are too afraid to have surgery, and they are fine. (I couldn't do that!) But I think higher and more complex fistulas can make new tracks and get worse. Maybe you can find out from your surgeon what kind of fistula you have and see if there is another surgeon around who can see you sooner.
I really feel for you! It is so difficult dealing with these issues when you meet donk-head doctors. I had to throw a major fit in the ER to get a surgeon to finally agree to treat me.
I hope this helps - I also hope Val chimes in too. She's very knowledgable about all this and is so helpful.
I hope you're feeling a bit better.

Hi Rosa-
My abscess was more deep tissue - my whole right cheek got really swollen. And I still have a draining seton for a high fistula (goes through 1/2 my sphincter muscle) from that event. Been over a year now....
If the abscess is near the surface then it would be considered shallow I would think. A draining seton is like a loop of string basically. So in my case it enters through my abscess incision and comes out my anus since my fistula opened up inside my anus/rectum. Laying open the fistula would compromise my sphincter muscle. So a seton is used to preserve muscle and keep things draining until it can be dealt with. A cutting seton slowly cuts the muscle over time so it preserves the muscle while treating the fistula.
Is the abscess draining from a bump on the surface? Or is it coming out of your anus?
An abscess needs to be drained in most cases. Especially if you are having a fever I would try to get it dealt with promptly. They are not to be messed around with. I would try to keep it draining(hot compress) until you can have surgery. Also, other fistula's could form if left unchecked.
Take care.

i was sent to the emergency dept after my gp thought that i have an abscess. And according to him, abscess can't wait, cos it will only gets worse. BUT thank God, i didn't have abscess, only fissure.
Sooo.. you shouldn't hold on anymore to the abscess esp now that u've fever, meaning ur body is fighting the infection already