Coping With Fistulotomy

Hi, I am 28 year old female and my whole life changed in August 2008. Being a nurse…doesn’t mean that you can pick up on the signs. Felt really unwell for a week or so and with a new pain in my rear end. Went to my GP and she thought I had a small perianal abscess. Prescribed antibiotics and pain relief and sent me on my way.

After only keeping one dose down and vomiting for 8 hrs, my friend took to me to the hospital (where I worked). I was septic, blood pressure dangerously low, dehydrated, febrile (high temp) and was admitted. Rushed in for an MRI where a horseshoe abscess discovered. Had surgery that night for incision and drainage and my lung collapsed in recovery. I spent the next month in hospital, three weeks in high dependency due to being so septic and reinflating my right lung. I had two more incision and drainages and they were unable to locate the fistula tract. Eventually a colleague recommended a wonderful colorectal surgeon and he inserted two seton drains as I had a primary and secondary fistula tract.

Things seemed to be going ok after I was discharged and went back to work slowly. Then I developed a fissure as well. I can tell you, that a fissure caused me much more pain then all the surgeries I have had for the fistula. I was prescribed GTN cream which I had to apply up my rectum with horrible side effects of dizziness and headaches. Sitz baths ruled my life. My advice, when the doctor recommends stool softeners - take them!!!

Eventually the fissure cleared up and in December 08 my surgeon decided try the fibrin plug to the secondary tract and leave a seton in the primary tract. Post-operative pain was minimal and I felt great and went back to work. Unfortunately abscesses formed, the plug had failed.

I went back in February where he performed a fistulotomy so my two tracts became one and one seton drain left remaining. It was quite a large wound and stayed in hospital for a week and it continued to be packed by the district nurses for another 3 weeks. As I am from Australia and was living in London with no family, but had the amazing support of my boyfriend and friends, i decided I had enough and returned back home.

I had an EUA (examination under anaesthetic) on Monday and he changed the seton (a larger one). Which seems to be draining more effectively. My new surgeon who is lovely said that “it didn’t look as bad as he thought” and is thinking I have enough muscle to do another fistulotomy in about 3 months. So here is hoping……