10 yrs living with fistula,, any suggestions?

Hey,

10 yrs ago, found a perianal abscess, didn't bother me for 2 yrs. finally became inflamed and had it drained in ER. Since then I had another 4 surgeries over two years, whenever the wound would close up. The 4 surgeries ended up with 2 drains each and 2 packed wound each. The last packed wound dressing left me with a tiny hole on the side of my cheek that would drain a minimal amount per day, not even noticeable which I was very happy with. I lived with that for the next 5 yrs and in the last 6 months my hell has come back with a vengeance. The tiny hole closed up and a week later I was in ER. In huge amount of pain, I was just consenting to anything including a seton procedure carried out by a general surgeon. She explained but it didn't hit home until I got home the next day. The pain was almost unbearable, the rubber seton was large, kept slipping in and out , which meant the knots on the seton adjustment part kept going inside me and I'd have to pull it out through out the day. I went back to work 2 weeks later but could hardly walk, just limped everywhere, 6 weeks after seton placement for follow up I was referred to a colorectal surgeon who works at my local hospital. Very unfortunate circumstances, where I was crying in pain and lying on the reception chairs, he was very apprehensive as he wasn't the surgeon who carried out the seton and all the seton procedures he's done have been very successful with no pain. So he booked me in for surgery to check it out and change the seton. The new seton was like a fishing wire and tight, that was on 2nd of May. The surgeon said the first surgery had caused a few fissures. I couldn't walk at all after that, I was completely bed ridden, I used an old skateboard from the garage with a cushion on it to get to the toilet on my knees. On the tramadol and was in so much pain all day, first time I saw the dark side in my life. I have no other medical issues all my life, so massive shock and still so traumatised from the pain experience. I managed to wait 4 weeks thinking it will get better but eventually was back into surgeries on 25th May to take the seton out as I was very unwell. Lost over 10 kgs since the first surgery in the end of March unable to eat from the pain endured, I was able to walk to the toilet after 2/3 weeks after he took it out. Went back to work reduced hours mid July. Two weeks on to current I'm now able to do some house tasks and some grading but still having problems with wound management. My fissures have almost gone, not painful anymore but itchy after BM if I ate the wrong foods the day before. Still some internal rectum discomfort which I'm assuming is from the hole they have made from my rectum wall and fistula. The other issue is the faeces coming out of my wound after every BM, this is a tiny amount however very distressing. My next appointment with surgeon is in December, to give the rectum time to heal. Then he wants to put another seton in which I have refused and want to look at other options. He suggested a flap. And that's where I'm up to , stressing about a flap and how much more pain can I endure. Don't know much about the flap apart from pain and may not be much gain.

 

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