Anal Trifecta: Hemorrhoids, Fissure, Now Fistula!

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Anal Trifecta: Hemorrhoids, Fissure, Now Fistula!

Postby Jchem1 » 13 Sep 2013, 02:02

Hi All

Posted about a week ago about huge hemmies after BOTOX.....well, CRS said fisuure was gone, but I now have a fistula, which I mentioned in the end of that post. Had two opinions and both say exact same thing..superficial and could be taken care of with standard fistulotomy. But I am really worried and need some advice/ support. These hemorrhoids that developed after BOTOX will not go down, fistula is draining right into one and so they are remaining irritated. They have settled from original swelling but will NOT go away, now CRS would like to remove one while doing fistulotomy. Thus combined fistulotomy/hemorrhoidectomy

Anyone ever been in this situation? I have been in pain for so long I forgot what it was like to have a normal day, and I will be doing surgery most likely in less than two weeks, I have trouble concentrating of course and now I fear---not so much the pain as I know its coming---but how long I will be down, long-term consequences etc. Looking for help from the group. Posting this at 2:50 am as sleep can is also be fragmented with thoughts of what's to come.. :?

Another issue: those who had BOTOX (which I will NEVER do again and wish I did not do it..), besides feeling like rectum is falling out (see other posts), BM's, while regular, are still "unsatisfying" as it still feels somewhat numb at the end of a BM, and hard to say what is "left"...always seems like something remains (I am 4-weeks post BOTOX). I clean thoroughly after each, I am not taking Miralax or other agents as I go regularly and these make me go more, which is not advised with my hemorrhoids...in other words, living through hell on earth......but I know some are in worse shape than me, so I am thankful for small favors, and look for support from those who are "in the know"

Thanks all for your help!

JC1
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Re: Anal Trifecta: Hemorrhoids, Fissure, Now Fistula!

Postby Ever the Optimist » 13 Sep 2013, 16:59

JC1,
So sorry to see you are now in the Fistula section!
I did wonder if there was something more to that hem that popped on you as it just didn't sound normal of a typical hem!! - the fistula link makes sense of it.
I'm just here to reassure you hugely that a Fistulotomy is nothing major, especially if the fistula is as simple and superficial as your CRS suspects. The recovery is much quicker and less painful than anything I dealt with with my fissure (I also developed a fistula with my fissure, although they were unrelated)
The procedure is simple, and they literally drain, deroof the thing to allow it to heal from the bottom, up. After surgery, you are left with a red type groove, which all being well, will heal pretty quickly in about generally 6 - 8 weeks. It is really nothing to fear - honestly! and recovery is generally really successful with very low risk of recurrence. Given a choice, I would have a fistula over a fissure anyday!! It really will not be as bad as you think... although obviously you will feel a little uncomfortable for a couple of weeks. To be honest, I think I took pain-killers once during my own recovery.
I'm not in a great position to comment on the Botox, since I never had this, nor a hemmroidectomy, but hopefully someone will pop by who has experienced this. I'm pretty sure I have, however, read comments similar to yours post-botox and I'm pretty sure, it takes some time for the Botox to kick in fully, so you may still be adjusting and hopefully, what you are going through right now, will pass with time.
Is your CRS thinking of removing the hem connected with the fistula???? This itself may well improve anyway once the fistula is treated.....
It's hard to say how long it will be before you are feeling completely better again because of having the additional hems to worry about, but straight-forward fistula surgery hopefully, will not cause you any major issues....I was back at work after 10 days off and felt OK to go back then too. Like I said, it's a bit uncomfortable for the first couple of weeks but gets steadily better & better, so please try to take that one stress off your mind!...You will be absolutely fine!! & you will get through ALL of this in the end, so just hang on in there and have faith that everything will be OK long-term. You take care & keep updating :)
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Anal Trifecta: Hemorrhoids, Fissure, Now Fistula!

Postby TriplePlay » 14 Sep 2013, 08:38

Thanks so much for the wonderfully encouraging response ETO---(I am under a new username as I tried to reset my password and never got an email, so jchem1 is now TriplePlay)

Right now yes it sounds superficial so I hope this will be rather routine...the em problem is the complicating factor, since I have heard some horror stories about pain management for that procedure, it will depend on how inflamed things are and, to be honest, I would love to be rid of those things as well, just the thought of it all at once is perhaps is a bit worrisome, only because I would not like to be off from work for too long. The last 4 weeks has seen me laid up a lot, but fighting through to keep up with things (I am a research scientist that runs a group and hate to be away for ANY amount of time!)

So thanks a million once again.... things with the hems actually seem to have calmed a bit in the last 48 h (using Tee Tree Oil, and it is pretty amazing in seeming to settle things after the initial sting....) Will update again

Cheers
J
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Re: Anal Trifecta: Hemorrhoids, Fissure, Now Fistula!

Postby Ever the Optimist » 14 Sep 2013, 17:02

Oh J,
How frustrating with the password thing but I will remember you are TriplePlay!!
I had a real issue with a couple of hems too after my last surgery - It just seemed like they were constantly inflammed and wouldn't budge for months to the point I considered banding them but for some reason, they then began to reduce and settle - I don't know if this was the result of months of non-straining on the loo/ keeping everything soft/ exercise....but all these things finally seemed to pay off. I also noticed they were significantly better after I had been on holiday so rest/ relaxation/ sea water??? Tee Tree is supposed to be really helpful too, so I hope this gives you the relief that you need and starts to help shrink the irritating blighters!!!!
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Anal Trifecta: Hemorrhoids, Fissure, Now Fistula!

Postby TriplePlay » 16 Sep 2013, 08:16

Thanks again---yes these things are a hassle and it seems I have these days (yesterday in fact) where I have multiple movements (4 to be exact) which does not help reduce these things....lucky it was Sunday and I could clean, bathe and ice after each one. I need to set things right since I am always worried about being "out" when things happen and I need all my "supplies"...this BOTOX has not worn off and is causing slight incontinence, which I never had with LIS or anything else. Today seems better, so I will try and exercise, as I am a nut for that and have been having trouble getting any workouts in....found swimming is great since it still feels like the bottom is "heavy" so jumping around (and my beloved Basketball) are out for a while

Always enjoy your comments ETO, and will have you in my thoughts also

TP and Jchem1!!
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Re: Anal Trifecta: Hemorrhoids, Fissure, Now Fistula!

Postby TriplePlay » 29 Sep 2013, 15:41

So ETO and All fistula/hem/fissure sufferers--Had surgery on Thursday and I admit, things are much better than I had anticipated! Pain, but truly manageable. Took a total of 4 pain pills in the first 30 hours or so and yesterday things felt really good. Today things feel a bit more swollen and "bruised"---what was your experiences with anesthesia? Almost feels like some residual "wore off" last night (after 2 days) and it was more sore today, even after an identical kind of day to yesterday. Laying down almost felt like I didn't have surgery, after two days! So, so far so good, but time will tell and I will keep you posted

Had superficial fistula so standard fistulotomy and skin tag/hem removal also---so I am knocking wood that the pain will remain light. Staying pretty much in bed watching football today!

Cheers
TP
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