Hi
I had a chronic fissure that occasionally flares up. In June/July, it was bad and lasted for 2 months. I had lots of bleeding and pain. I used OTC hydrocortisone cream and it seem to heal up. About 2-3 wks ago, I didn't feel well (fever, nausea) and had alot of pain/pressure/burning around the fissure plus high white count. When I went to the bathroom, I noticed a large very painful bump and pus/blood drainage. I got in to see a proctologist who specializes in fissues/fistula. He drained it and placed me on antibiotics for 2 wks. Couldn't really get a good exam due to the pain. This week, I noticed pus/blood coming from a small hole. We suspect it is a fistula. The abscess is fairly deep and he didn't want to open it in the clinic. I am scheduled for surgery on Dec 18. He is going to drain it, place a seton and do a better exam. I have been in shock because this progressed so fast.
I got a second opinion this week from a CRS. He examined me in under 2 minutes and said that there is no fissure. It is very obvious that it is a fissure. I can even see the white anal muscle fibers. He suggested another cream and wait a month. I did not like his bedside manner and he was extremely rough during the exam. I am paying for it today.
I will most likely go with the 1st surgeon. I don't think I can handle any more of the pain and swelling. Still running low grade fevers. What is involved with getting a seton placed? I am a teacher so I will have about 20 days off during winter break. Will that be enough time to recover?
thanks
Jennifer

Hi Jennifer - I had two fistulotomies 6 weeks ago. I had a seton placed in one of the tracts. I personally haven't looked down there yet so I don't even know what it looks like! I don't really notice that anything is down there, and I haven't even felt it yet. I do have bleeding, and sometimes a little pus from the area. My nurse mentioned that it looks like the seton has cut through the muscle and moved lower - so I'm keeping my fingers crossed that it'll hopefully eventually heal the area and fall out - as I really don't want to go through a second procedure! I definitely need to leave it in for a few more months to ensure the area heals up nicely.
I was back to working from home about 10 days post-surgery, and I was back in my office 3.5 weeks post-surgery. I could have technically gone in earlier but opted to work from home. I would think that 20 days should be enough time to go back to work. I'm still healing, but as of last week I've even been back to the gym - although I am taking it easy.
I hope that's helpful?

Hi
That was helpful. I will be recovering at home alone. My dogs will go into daycare for 3-4 days.
How was the pain afterwards? What was the last straw for you to get the surgery? I keep thinking that I can hold off but I am still so sore. The dr hasn't been able to find the hole but there is a harden painful area. If I squeeze it or press down, pus will come out along with a little air. The dr wants me to mark it before my appt on Thursday.

I think it's a good idea to put the dogs into daycare. I think you won't be feeling too great for at least the first 5 days or so - but do keep in mind, everyone's different.
The first 1-2 days weren't painful and I think it's because of the effects of the anesthetic. I did take percocet for a couple of weeks - just before my packing changes. The most painful part of the healing process was the packing changes for the first few weeks. I don't know if you'll be getting any packing? The percocet caused me to become constipated on Day 4 and that was truly the worst part of the ordeal. If you're on any narcotic type pain killers, please ensure you drink lots of water, eat lots of fiber and take stool softeners and laxative. I'm usually very regular so I didn't take it very seriously which resulted in the constipation.
I have been dealing with this issue for over 3 years now. My surgery kept getting delayed due to the long wait times to see a specialist here. Unfortunately the first surgeon I saw here didn't give me any real answers and then managed to disappear on me for a year! When I realized that she was that disorganized, I got referred to other surgeons but the wait times were a few months. Finally saw someone else that seemed great, but his wait for surgery was 2 years. I also saw a lot of obgyns along the way as I really didn't know for sure what was wrong with me. I realized I just couldn't live like this - I was only dealing with one abscess/fistula, and then I got another abscess. That was probably the final straw for me - I felt so helpless! I ended up having constant pain and then constant discharge and bleeding from both. Those few months prior to the surgery were the worst. After surgery, I was told that I actually had a golf ball sized infection -which even surprised my surgeon.
I definitely think you should get it taken care off sooner rather than later. I do believe if I had surgery 3 years ago - it wouldn't have been as complex for me!

Hi
I am at a point where I can't keep living like this. I hate wearing pads. The first abscess was very pain and I was exhausted from it for several days. I still haven't fully recovered from it. I am not sure I want to relive that experience again. I know that my risk is high since I already had one plus a fistula is right around the corner.
The unknown is what is bugging me. Why is this happening? How deep is the infection? I am afraid to go in to surgery and they find out that it is worse than they originally thought. Not sure what I will wake up to.
thanks
Jennifer

I totally know what you mean. I was wearing pads daily. The worst was that the smaller abscess was near my tailbone and I would constantly have "accidents" at work or at home - I would sometimes see wet "stuff" on my clothing. Pretty depressing and embarrassing! And let's not get into my non-existent sex life (I started a thread on that) - still waiting for that to get back to normal, but at least I'm feeling so much better.
Since the surgery, I've been wearing a panty liner and just sticking gauze where the seton is. That is so much more comfortable - and I haven't had any accidents. I initially had packing, gauze and tape in the whole area but after about 4 weeks I'm down to just sticking gauze in.
The unknown was bugging me too - I was expected to wake up with 2 setons, but ended up with only one. Turns out my infection was a lot worse than expected so I'm very grateful it was taken care of.
My nurse told me she saw some pus today (hasn't happened in a while) and the opening near the seton is trying to close over so can no longer be packed. I've been feeling "off" since.. took a long sitz bath and feel better now. My surgeon's nurse had mentioned that sometimes the wound stops draining if there is no packing in there - so sitz baths help it continue draining. I would definitely recommend lots of sitz baths! I should be taking 2-3 a day but can't seem to find the time for more than 1 these days.
I think it's good that you're having it taken care of. Although this is technically considered elective surgery - I do think it can get worse if left untreated. Do you have any other underlying causes - chrons?