DAY 4 POST OP POST MORNING BM:
My bm today wasn't bad at all; it had a little hesitation at the beginng to flow out, but eventually did and the stools were fluffy soft. I thought the whole wheat, no-cheese, veggie pizza pockets would've been a mistake but they were okay!
However in the shower right after, it was more painful this time to spread my cheeks. The pain wasn't coming from my fistula wound, but from higher on the skin. I think it may be from spreading them apart too hard so I'll have to be more careful with that. Also, because of that same pain it's been just that little harder to walk around along with the little pain from the fistula. The doc said by today I could be able to go back to work, but I definitely would not feel comfortable working today.
Last night I went grocery shopping, drove for maybe 15 minutes to and from the grocery store, and spent about an hour shopping. No pain at all, but I'm still not 100% comfortable and it seems like in another couple weeks I might be alright.

Adam,
You really need to try and take it easy. Setting on your butt so soon after surgery and doing too much may prolong the healing. I'm convinced over doing it hinders the healing.
Do you have a removable shower wand you could spray in that area without spreading the cheeks? The constant aggravation is most likely going to keep the wound open.
It would seem keeping the pressure off and not over washing, airing that area as much as possible would help. I was told to not use soap. I've read it can mess up the PH in the skin down there. I know you were advised to use soap but I would try to limit how much I did that and just use some warm water and cotton in between.
Good to hear your bm's aren't too bad! Healing can be such a long process sometimes, under the best of circumstances:)

Today (day 4) a few hours after my bm the little pain went away all together. I then took it easy the rest of the day and then went to a friend's place for a little while, they needed me to fix something since last week so I did, also played a little badmonton, and chopped some wood for the fire. When it came down to dinner, I had to leave and say I had somewhere to be.
I took a shower, cleaned myself, and still after the shower there is still a bit of stinging in the same spot, just above the fistula wound. It had to be from spreading to much and using too much soap and it got really dry and maybe a bit rashy. I will have to definitely use less soap, and spread my cheecks more gently.
Dawn, I know I may be over-doing it. But the directions my doctor gave me in writing say, for cleaning in the shower, "...bend forward and pull the buttocks apart quite hard to open the wound so the water from the shower can get in. If the wound is still painful, you have not pulled the buttocks apart enough! DO IT AGAIN!". I use a mirror and I pull enough so I see the wound open enough. I do have a bidet (what you sit on and water flows up into your bottom) but I don't have a removable shower head. But I use the shower because I feel more comfortable, the bidet is hard and cold to sit on. I was also confused on when to use soap. The directions say use soap after a bm, and after my bm I take the first of the two showers I'm supposed to everyday. So in that shower I use soap to clean it.
I also know nothing of how this fistula is supposed to heal or even what position it is in right now. Basically right now I see that I have two holes, one my anus and one the fistula above it seperated by about a few millimetres of skin. Is that okay? I'm wondering if the fistula is supposed to be one with the anus hole? Also I'm wondering if the fistula is still connected to my anal canal? Or is it closed there and if not how will it start to close? I wish I could ask my doc this I may see my family doctor and see if she can answer these questions.
The reason why I am so up and about is because my CRS told me I should be back to work in a few days right after he finished the surgery. I'm going out and doing light activity to see how I react to it, because I really would love to go back to work as soon as possible. I am taking the whole week off next week most likely. I do feel like I am at about 80 %, and the fear factor of knowing what my bottom looks like takes away a lot of confidence, that maybe it shouldn't be taking away. Sometimes I don't think doctors understand what most construction jobs are like. Some of them are totally slack effort, but mine and a lot of others are crazy physically demanding, everyday is like a workout, at least cardio-vascularly. I did tell my CRS that it was, but maybe he already forgot as it was even before he checked me out.
I do have the option to stay home and take it easy for a month, and my crs follow-up appointment is in a few weeks.

Hey Adam,
I have no idea what it should look like
Val, PaulsPain & Hopetoheal have had surgery for fistulas and would have more knowledge of what it may look like after the procedure.
Chopping wood, driving and all the things you are already doing seem like too much to me. I understand it's boring and it would be nice to get back to work now, but considering the work you do, I think you shouldn't!
I know w/ LIS and my skin tag removal, I was told no heavy lifting. I think anything that puts a strain on that area would be bad for you?!
Hopefully the others who had this procedure will be able to share more. I really have no idea, but I'm going to read some older threads. I'm really interested.
It seems CRS's always give quick recovery time lines on these butt procedures and it just doesn't happen. Most will agree that they were told they would be able to go back to work, etc much quicker than they really were. A few were gave more realistic time lines, but it usually doesn't go that way...

Oh Adam, that advice sounds like torture - or a sick joke. Most of us have been advised not to use soap, and as for pulling the wound apart - I honestly shiver to think about that. I would think gentle would be a whole lot better.
I haven't looked at my wound , I am phobic and squeamish,but my crs said it was still open. My fistulotomy was 15th june, and it it still painful and open. Can you get any advice from another crs, regarding going back to work, or your gp? I was told, like Dawn, no heavy lifting. When I overdid it this time, it became infected. Maybe a coincidence, but I still feel fragile.
I would take as long as you can to recover properly.

Adam - it really sounds like you are doing too much too soon. It's great that you are not in a lot of pain, but you are still healing! Everyone heals differently, but I do think you need to be careful because a complication will likely mean more surgery. I'm not sure why you have two holes, perhaps you had a fistula and a separate abscess? Maybe you can ask during your follow-up. A fistulotomy is supposed to deroof the tractotal the wound is kinda like a ditch, which will heal from the bottom up. It's very important that things heal properly, which is why the doc wants us to spread the wound to clean it. You can do that gently :)
I really think you should take at least another week off work. It's impossible to do manual labour without using the ole sphincter muscle and i'm not sure if a construction site is quite sanitary enough for your needs right now. Just my opinion :)

Thanks everyone... Even though the crs said I can be back to work two days ago, I will calm right down this week and only go out and do what is necessary.
Val, when your fistula got infected, could you tell it was inftected or getting infected? For example, was there any type of pain or anything associated with the infection during bm's, showers/baths, while sitting or walking? Or was the pus turning a different colour? Or did you not feel a thing until you seen the crs who concluded it was infected?
I know I may seem stupid for doing so much lately but my crs said I could be back at work by now, and the stuff I've been doing isn't even a full quarter fraction of what I really do at work.
A worry I have for it being infected is that I feel pointy sharp sting pains when I spread the cheecks. Also when I touched it after I dried it to make sure it was dry, it felt very sensitive as if it was bruised, and also a little stinging. While I was walking today I kind of forgot and was walking in normal stride and a couple of sting pains set me back down to a slower pace. I really hopen it didn't get infected from cleaning it with soap or spreading my cheecks too much.
I also notice that these sting pains don't always come from the fistula hole. It's more around it, and sometimes inches away from it right between the cheecks.
I have been checking the wound at least 3 times a day. It looks exactly the same as day 1 post op, except not as swollen and purple... It's now exactly the colour of the skin around it, and it's been that way from about day 2 post op.

Hey Adam - CRSs consistently underestimate recovery time! That is so common. Many say a few days to a week, when the truth is it's more like two weeks to a few months. It sounds like you are healing up well, so if you don't push it too much, you might be one of the lucky ones who can get back to life in two weeks instead of two months. Just remember you will still be healing for at least 8 weeks, so even when you do get back to your life, please take care of yourself for a good long while!
The pains you describe sound familiar to me, and I'm two weeks post-op. I should be hearing today from my doc about my rescheduled follow-up, which should be this week. I'll let you know what my doc says about those kinds of pains. When is your follow-up? My guess is that these are normal post-op pains, since pain does radiate. My pains have diminished over the last few days (KOW!). My guess is that we are both ok and just experiencing normal post-op pains and 'zingers'. But, of course, I'll feel better once I get checked out by my doc, and I'm sure you will too!
I hope you're having a good day today!

Lmao @ "zingers" haha... Thanks hopetoheal, I feel a bit more relieved now... My pain seems to have diminished as well. I'm at the mechanic today and I'm finding out so far that sitting without a pillow under my thighs to keep my bottom raised from the seat doesn't hurt! We'll see how long I can sit for.. That's one of the main issues for me as I have an hour ride to and from work.
My life will change too as I need to get up an hour before work for probably this whole year to make sure I have a bm at home before I go to work, because it's conisdered outdoor work because we're building, and the washrooms aren't sanitary for an infected wound or fistula hole to be in the airspace of.
When I do go back to work as well, I will eat more and probably have two bm's a day. So maybe I will take time off until the pain during bm's is at zero.
Thanks hopetoheal, I'm doing pretty great today :) how have you been? You said your pain is almost diminished that's amazing to hear!! Maybe soon or already are you off the painkillers?
It's good to see that everyone here is being taken care of and getting better

Hey Adam,
I knew it was infected because the pain changed, it leaked pus, which it hadn't done before, and had an infected smell.I think you'd know if it was infected, it hurts a lot! I never had any drainage apart from what looked like diluted blood, either of my fistulas, so I knew something was wrong when it started to leak pus, although nearly everyone else has had leakage any way, and it's been normal.
My crs checked it last wednesday as it started leaking again after the antibiotics cleared it up. He said it was the high part of the fistula draining. I thought high fistulas needed setons, so I'm a bit jarred off that it's hurting more but still draining - I don't get the point of having the surgery!!
Glad you're doing great today - great news!