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Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Surgery on 3/28 - a couple of questions



03-26-2014, 09:21 AM   #1
Emily626
 
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Surgery on 3/28 - a couple of questions

Good morning,

I am brand new to the site and during all of my research, this site popped up over and over, so I decided to join. I should state that I have not been diagnosed outside of having a fistula in ano. Back in 2010, I had an abscess that was drained by my family doctor. Since then, I have had problems on and off which lead me to a Colon/Rectal Surgeon on 3/13. The doctor confirmed my concerns that I have a fistula.

I am having surgery on 3/28 to have a seton put in place. The seton will remain for 2-3 months and then I will have a second surgery to have a fistulotomy or a LIFT to complete the repair. The doctor is going to determine which kind of repair is necessary during my surgery on 3/28.

I have a couple of questions about what to expect when I wake up on Friday. My main concern is keeping the area clean and how much pain I will be in? I can handle pain, I have had prior surgeries that were invasive and I handled them well for the most part. Will I be able to return to work on Monday? (I work from home, but I sit about 10 hours a day.)

Secondly, this issue has delayed my getting pregnant. My husband and I were planning on TTC in April after a miscarriage in October. I am hoping that by July this will all be behind me and I can move forward with starting a family. Is this unrealistic based on the recovery time for a fistulotomy or LIFT surgery in late May or late June? My doctor talked as if those surgeries took 2-4 weeks for recovery?

I am not nervous about Friday, I am more nervous about the next phase of dealing with the seton and then the next surgery......coupled with our impatience to try to conceive.

Any thoughts/insight/experience would be greatly appreciated!
03-26-2014, 09:38 AM   #2
nogutsnoglory
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Best of luck with your surgery and speedy recovery!

As for the pain, it's not terrible but I wouldn't likely return to work that quickly. Give yourself the flexibility to see how you are doing? Personally after a few seton surgeries it was too painful to sit long and I mostly was laying down.

Make sure they give you adequate painkillers for a few weeks worth so you have the option as needed. Sitz baths are really important to let it drain properly and keep the area clean. After initial healing I like to add baby wipes that are natural and chemical free.
03-26-2014, 09:43 AM   #3
Emily626
 
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Thanks! I had not thought about the baby wipes after some time, that is a really good idea for on the go when I can't get to a shower or bath!
03-26-2014, 11:03 AM   #4
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I would agree. Keeping the area clean isn't as much of an issue as you would think. I used the shower head to make sure it was clean and salt baths help alot both for cleansing and pain relif. I just used painkillers. I wouldn't go back to work too soon even if it is just sitting a desk as that will cause more pain if you can work laying down then great. I done everything laying down after surgery and it will heal quicker that way.
03-26-2014, 11:11 AM   #5
Emily626
 
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I have the luxury of working from home, so I think I will try to work in bed and keep from sitting too much. I don't want to delay healing by pushing myself.
03-26-2014, 07:45 PM   #6
justbreathe8
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When I had my first seton put in, I think it took about 2 weeks for me to feel decent. The first couple days was pretty bad pain wise, but taking the pain meds def helped. But after the first few days, you should be able to at least work from home (laying down). Sitz bath definitely bring relief to the area. My doctor told me that if getting pregnant was a priority to me, Id be able to get pregnant with the setons in (I have 3) and then after I had the baby he would do the LIFT to take them out. But I don't want to have a new baby and then be healing from surgery at the same time either. So my husband and I decided to wait to try to have a baby until I get the LIFT (in August). Ive heard the same thing, that it takes 2-4 weeks to heal. But it might be good waiting a month or two after you think your healed, just in case. That way you won't be pregnant and have something go wrong. Good luck with the surgery on Friday! Hopefully its the first step in healing!
03-26-2014, 07:45 PM   #7
lgpcarter
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I had two setons, a fistulotomy and some skin tags removed in December. I was off work (office type job) for two weeks.

I had percocet for about 10 days after surgery. I took them religiously for the first week and then weaned off.

I had a peri bottle from when I had my daughter and used that instead of wiping for the first week or so. Lots of sitz baths, too. I used both the toilet insert and got in the full tub several times a day. Helped with pain and kept things clean.

You will probably be able to work after a couple of days lying in bed on your side on on your back with you knees up so the pressure is on your tailbone/top of you butt.

I don't know anything about the LIFT procedure, but July might be too soon after the fistulotomy to TTC.

I was quite anxious about the procedure and the pain, but it ended up being better than I expected. Good luck!
__________________
Diagnosed in with Crohn's in large and small bowel in 2000.

Seton placement (2) and fistulotomy December 2013. Setons removed July 2014.

Laparoscopic Right Hemicolectomy July 2016, 25 cms removed

Current meds: Entyvio every 8 weeks, Imuran 50 mg, Flagyl and Cipro 500 mg twice a day
Previously: Remicade, Humira, Simponi, Pentasa, Sulphasalazine, Entocort, Stelara, Methotrexate, Prednisone
03-26-2014, 07:59 PM   #8
If*
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Hello, like said above Sitz baths really help, lots of them every time bathroom is used. I wouldn't suggest baby wipes some contain alcohol. Ask for a peri bottle to use at home. Have a stack of soft cotton washcloths to pat the area dry after cleaning with the peri bottle, or sitz bath. I would not suggest a doughnut (the inflated thingy) since it can cause pressure and not relief in the long run. Working from bed or the couch reclined is awesome!! Just remember to get up and walk around as per Dr. orders.

I don't know anything of the lift.

The fistulotomy can very from each individual and depends on the location.

Take care!
Prayers for a speedy recovery.
03-27-2014, 07:09 AM   #9
Emily626
 
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justbreathe8 - My colon/rectal surgeon had told me the same thing about TTC. That I could go through a pregnancy with the setons in and do the repair after delivery. I spoke to my OBGYN and in over 20 years she has never had a patient with a seton in during pregnancy, so I opted to just have the whole thing fixed before trying. My husband and I also discussed the same thing you spoke about regarding having the repair with a newborn and just figured a few months is worth the wait to just take care of it completely.

Is a peri bottle something you can buy in the store? Or do I need to get that at the hospital on Friday? That sounds like a great idea for cleansing!
03-27-2014, 07:19 AM   #10
justbreathe8
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yah I have my yearly appointment with the gyno so it will be Interesting to ask her opinion just for fun. As for the bottles, I got one in the hospital when I asked, but I didn't want to use the same one more then two weeks (I didn't want bacteria or anything to collect in it) so I bought some on
eBay http://www.ebay.com/itm/140622529616...84.m1439.l2649
These work just as well as the ones from the hospital and they are cheap. Also, I don't think anyone mentioned, but after the surgery, it helps to have a 4x4 or 3x3 (depending on how big the whole they make is) and keep it in between you cheeks. It makes things alot more comfortable, and it collects the stuff the drains out. I still use then daily and will until I get the repair surgery.
03-27-2014, 07:49 AM   #11
lgpcarter
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I use gauze daily as well. I get it at Target for $2 for a box of 10 Pads. I fold them in half and stick them in my crack. Also a pad to collect any extra that might escape.
03-27-2014, 07:55 AM   #12
Emily626
 
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Thanks! I am adding that to my list for the store tonight!
03-27-2014, 08:47 AM   #13
justbreathe8
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This is gonna sound crazy, but I buy the gauze $10 for 1,000 at a time. They are 3x3 cotton pads and I change them every time I go pee because Im worried again about bacteria getting in there if I don't change it after I use the bathroom. I was buying the boxes of 10 or 25 but it was costing a fortune. So again I went to ebay lol (I'm obsessed with ebay as you can tell) You will probably use them the whole 2-3 months you have the seton in, so it can get quite expensive.
03-27-2014, 09:26 AM   #14
Emily626
 
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Thanks for the tip! I just purchased 1200 pads on amazon. (I am an Amazon girl myself ) I also went ahead and bought a couple of peri bottles. Just in case.
03-27-2014, 09:28 AM   #15
justbreathe8
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Then you should be all set!! lol
03-30-2014, 01:25 PM   #16
justbreathe8
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How did your surgery go? How do you feel?
03-31-2014, 07:09 AM   #17
Emily626
 
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Everything went well, better than expected. My surgeon said that the seton went in very easily and she expects my 2nd surgery to be completed at the 2 month mark instead of 3 months. Today I am feeling pretty good. Sitting for long periods of time is still uncomfortable, so I am working from bed today. The seton placement was never really "painful" for me, just more uncomfortable because of the feeling of pressure all the time. There have been times I have moved or sat in a way that gives a burning or pinching feeling, so I have to re-adjust or be careful when I move. I have been changing out my gauze every time I go to the bathroom and the area is definitely draining. Sitz baths are the best thing ever!

All in all, the surgery was not too terribly bad. I have had much worse surgeries that had me down for 4-6 weeks. It is the fistulotomy/LIFT (no confirmation yet on which one, I will find out during my follow up appt. this week) that is coming next that is concerning me now.

Thanks everyone for all the suggestions/support. It really helped me properly prepare and feel confident going into surgery.
03-31-2014, 09:09 AM   #18
justbreathe8
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Thats great news! It will be nice to get it out earlier then expected! Please let me know when you get the lift! Mine will be in August or september, so I would like whatever advice you can offer!!
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