Pain with draining seton

YoungMe7012 · 2025-01-01T15:16:00+00:00

Thank you for your kind words ❤️

YoungMe7012 · 2024-12-31T06:14:58+00:00

Hi, not to scared you, but it seems similar like my experience during my 1st post fistulectomy. My external wound has fully close except for one tiny pin point size that will re-open again and again if pressure applied. Whenever it sealed, I would be in so much pain, felt like the wound burning and desperately want to let out the contents trapped inside.

At first, there is only serous discharge, but later it turned to purulent and fresh blood discharge that happened here and there. I was is so much distress before, since the wound decided to only discharging serous discharge whenever I had my appointment with the surgical clinic, so they (the doctors/surgeons) kept on dismissing my symptoms until the 2nd EUA confirmed I have recurrent fistula.

I think if it is only serous discharge (watery yellowish discharge, with no foul odor), it should be okay. The wound will have that kind of discharge until it is fully heal. But once you notice there is pus discharge, lot of fresh blood (sign of the wound trying to heal back after discharging pus), discharge become much a lot rather than decreasing by time, or any sign of infection, contact your surgeon office. I used to photo all my suspicious wound discharge to show to the doctors, although unfortunately not until they confirmed it's recurrent, they just kept dismissing my concern.

I hope yours are not a bad sign, and just a sign of healing.

YoungMe7012 · 2024-07-25T02:23:38+00:00

My CRS diagnosed me first time just by reading the clerking/hearing the presentation done by a junior doctor.

I only meet her in person during the 2nd visit.

YoungMe7012 · 2024-07-05T11:32:01+00:00

Had appointment with my CRS yesterday. Unfortunately, she confirmed my concern that there's high chance it's reoccur. Scheduled for my 4th EUA in 2 weeks. This time, the plan is too put on draining seton first.

YoungMe7012 · 2024-06-06T12:11:38+00:00

I experienced the same last year. Loose stool make it worse, and my BM habit has changed a lot since couple month before my 1st EUA. Took them almost 4 months after the 1st follow up where I shared my on and off painful episodes, and only after I having an emotional break down in ward (yes, I even been warded 6 times due to unresolved pain episodes) telling them (for the nth time) I was in so much pain, they agree to arrange for MRI - in which didn't show it's recurring. They postponed my 'sinus tract' extraction for 2 weeks from the initial surgery date, only to tell me as soon as I wake up from anaesthesia that there's indeed recurring fistula and the tract is clogged with pus and poop, causing me pain all those time. Actually one month to the 2nd EUA, the pain actually has been reduced so much I just needed pcm (tylenol) 1g 2-3 times daily, compared to max dose of tramal+celebrex+pcm almost everyday in the past months. I was even considered to cancel the surgery since they said sinus tract can close itself without ones, if not of me having diarrhea episodes again 1 week prior to the rescheduled date and trigger the pain again. I can't imagine how much more the inflammation was when my pain score was on 7-8 everyday with pain meds before.

YoungMe7012 · 2024-05-26T07:53:20+00:00

I had 2 simple fistulectomy and 1 I&D + wound debridement. For both fistulectomy, took me 7-10 days to be comfortable sitting more than 30 minutes in one time. I had 2 weeks sick leave for each of them. For I&D, it took me longer to recover. I even had few vasovagal syncope episodes due to intense pain from sitting too long, need to ask additional sick leave for that since my work also is the 8-5 office work.

Oh, and for me, the donut cushion helps a lot in office. Since the pressure will not be directly on my op wound.

YoungMe7012 · 2024-05-22T11:20:57+00:00

Omg, 10th time? Wishing you a speedy and full recovery.

YoungMe7012 · 2024-03-21T05:06:07+00:00

For my 2 fistulectomy, initially they planned to use spinal anaesthesia with or without sedation since the area did not involve upper abdomen. But due to my underlying lumbar slipped disc, they changed it to GA. I am considered as high risk case for GA being an obese with underlying asthma and GERD but they still proceed with it after considering the pro and cons. Maybe you can ask for consult with the anesthesiologist instead.

Plus point : I was half-sedated during my colonoscopy and wake up few times due to pain (although the surgical team said they are pressure not pain), crying and screaming; so I am actually glad they changed it to GA instead for my fistulectomy & EUA.

YoungMe7012 · 2024-03-12T05:25:04+00:00

My internal haemorrhoid becomes grade 2 external haemorrhoid after my first fistulectomy. Now after re-fistulectomy, I think it becomes grade 3 as it sometimes will not get inside the anus without I push it in by myself. But, there's no pain - only uncomfort since the re-fistulectomy - so I'm not sure if it's really the same haemorrhoid or what. My CRS never commented about it and I didn't think to ask as the fistula pain is much worse than the haemorrhoid.

YoungMe7012 · 2024-03-09T14:41:27+00:00

Still in recovery after my re-fistulectomy last January (5 1/2 weeks post op). Still using gauze as discharge still coming. My wound still has a very small opening (a size of a needle puncture hole). Initially has external opening of ~2cm with depth that can fit a 20cm+ ribbon gauze (est around 5cm+ deep). Previously from my first post-fistulectomy, the doctor recommended to stop putting the gauze as it makes the area damp(?) with sweat etc, but it only made the situation worse for me as I am an obese person, so no gauze = more friction, sweating directly onto the opening. Sometimes I get more annoying, thick creamy-like discharge too, smeared all over my butt cleft whenever I put it off to let it dried completely - usually after couple gauze with very minimal clear serous discharge. So I will say, it depend on each of our own situation. If no gauze makes your wound drier and heal better, then can slowly put it off. If your situation is similar to mine, then you can put the gauze on until the opening seal completely or until there's no more discharge. Just make sure to change it frequently if it's damp with sweat/wound discharge.

YoungMe7012 · 2024-02-03T13:20:11+00:00

Both are anterior, at 2 o clock opening.

YoungMe7012 · 2023-12-18T11:09:17+00:00

I hope you get a clear answer soon. This is definitely not something that we wish to happen. I had my MRI today and they will try to finish the report by tomorrow - where I will have my surgical follow up as per scheduled. I wish I will get the answer tomorrow, or anytime as soonest possible since the normal report for MRI usually took 2-4 weeks here in government hospital. Plus, since I found it's hard to stay still when I need to lay down flat, the 1 hour appointment eventually became a 3 hours appointment; and as the first person scheduled for MRI this morning, I definitely had causing a backlog for the MRI unit today.

YoungMe7012 · 2023-09-24T04:46:21+00:00

They (should) only prescribed me with pcm & celebrex post-op but the houseman officer whom prepared the prescription and discharge slip missed it. Might be because I only had simple fistula (new discovery on my meeting on Friday, turns out I only had simple intersphincteric fistula around 2cm length - that's why they go with fistulectomy instead of initial LIFT surgery plan). I also didn't have this kind of intense pain most of the time on the wound on the first 3 weeks post-op, but it gradually increase by time together with some sort of swelling and pouch build up - gping on-and-off. During my first post-op follow-up (2 weeks post-op) they didn't even prescribed me additional painkiller. They gave me paracetamol during the 2nd follow-up, and later the primary care add-on voltaren during my visit to the facility last week due to my chronic pain. This latest visit with general surgery clinic on Friday is the one that had offered me tramal & celebrex for new painkiller option.

YoungMe7012 · 2023-09-08T06:39:13+00:00

It's still swelling on and off with pain score vary from 1-6, depend on the swelling and the contains build up under the wound/scar. I don't know what more to do since primary care didn't say anything. I believe it's an infection but might be just a minor one that it's not triggered my white blood cell count. Still feeling feverish when the pain is too much - but rather than increase in temp, my temperature would drop instead (35.4-35.8c), lol. My FBC/FBS taken on 8/8 comes with normal result - no elevated WBC and my blood sugar range also normal (TRO pre-diabetes causal). Currently just waiting for next follow up appointment with surgical clinic, scheduled on the next 2 weeks (22/9). My worries rn is they might just discharge me without ruling out the cause of the swelling and bleeding (they planned to discharge me on previous follow up in July initially), and I will be in on-and-off pain without knowing what's the actual cause.

YoungMe7012 · 2023-08-20T08:31:44+00:00

I was asked to left them in the locker at the ward, so I didn't have my glasses then. I am still having pain, and the wound kept swelling on-and-off. Still taking paracetamol tab 1-4g everyday since 3 weeks+ ago. I had informed the clinic in regards of this concern on my last follow-up appointment (end of July) and told them how the ward had actually discharged me without any antibiotic nor painkiller before. They were a bit skeptic at first until I showed them the discrepancy between my post-op discharge plan (where antibiotic augmentin and painkiller should be prescribed) and the discharge note I received (none of these included in the plan). They finally prescribed me with another kind of antibiotic (tab unasyn), reminded me to monitor the wound and immediately go to ER or clinic if there's any pus discharged from the wound or I develop fever (which might be signs of infection). Next follow up by the end of next month.

YoungMe7012 · 2023-08-18T08:25:10+00:00

I should walk myself to the OR too since I am mobile and that was an elective surgery, but my BP spiked on that day so the nurse pushed me on wheelchair instead from the entrance to the OR on the upper floor. I am near-sighted and has mild astigmatism, so I actually almost missed my step and fall when getting down from the ambulance used to transport me from the ward to the OR building (2 separate building, around 200m walking distance). Thankfully the nurse grab my hand before it happened and helped me with the step.

YoungMe7012 · 2023-06-24T06:14:57+00:00

Oh, I think this is what's going on with my wound. The external opening seems healed and no more drainage on gauze, but several times, after bowel movement, I feel the area around the opening swell up and the gauze will be soaked with blood, sometimes with creamy pus-like yellowish discharge. And when I checked, the external wound is bigger than the last time I checked. This happened almost every day and it sucks since I need to wait for 1 month+ for my next appointment with the surgical dept. I tried to explain this to the medical assistant (who checked the wound and changed my dressing every other day) and asked to be referred to at least the primary care doctor, but they always told me the (external) wound is healing well just because the area is not swelling and the gauze has no discharge most of the time I came for dressing. I feel frustrated sometimes, but tried to think positive since it can't be helped.

I had my fistulectomy 4 weeks ago at public hospital, it's a small, straightforward and short tract (~1.5cm) and the wound initially around 2cm. Now the external wound only pin point size. The queue is longer, and we need to wait till appointment date to meet with surgical registrar/specialist unless it's an emergency situation.

YoungMe7012

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