Introduction

Tonight is the fourth night after my combination fistulotomy/hemorrhoidectomy and I thought with everything going on inside my bottom and in my mind, I should jot some of it down.

The procedure was done by Dr. Kambiz Jahadi at St. David's Round Rock Medical Center on Thursday, June 11, 10 days before I turn 31. Tonight is Monday night.

I realized a year and a half ago, maybe two, that something was wrong. But I had never heard of a fistula before and knew I had hemorrhoids. After more than a year of dealing with that hemorrhoid that seemed to be worse than the others, I finally decided enough was enough and to go in for the procedure. But I had spent countless hours researching it, all of its symptoms, what is a fistula, how they are formed, what they mean and most importantly, why I had one at 30.

I'll spare you the gruesome details and if you would like to know more about a fistula, google it. It's basically a tunnel from the rectum to another part of the body, commonly the vagina or the anus and is formed by infection eating its way through muscle and issue. They commonly end in an abscess, which appears as a very painful bump on the outside of the rectal cavity. They resemble a hemorrhoid if you don't know just exactly what you are looking for.

In October of '08, I found Dr. Jahadi by googling proctologists in the Austin area. He first diagnosed me with hemorrhoids but I knew something else was up and so researched it and asked him about a fistula. He agreed, pulled out the probe, and confirmed it.

In March, I had a colonoscopy to rule out Crohn's, UC or colon cancer. The news that I needed a c-scope was enough to scare the hell out of me. But after I talked to Mom and then my big brother and realized he'd had a colonoscopy at my age, I thought, oh, ok, it's ok then! Scheduled it, got time off work, drank the absolutely awful 'alien snot' as I call it, went in for it, and it was over. Major nausea as the anesthesia was wearing off though. Chucked the grape juice on my front stoop before making it in the door. Was glad I'd never have to drink the alien snot "MoviPrep" ever again. A week later, I phoned Dr. Jahadi to proceed with fistula treatment. Met with him and thought it was a go UNTIL he wrote a note for 2 weeks off work. TWO WEEKS?!, I thought? So I met with the boss that day and he said to do it. But my trip home to Columbus was coming up within a month and I thought "no, let's wait". So, wait, we did.

June rolled around and I decided it was time. The company was very gracious to activate short-term disability and off we went. Wednesday before the surgery, roommate and I went for a meal. I was worried sick about what lie in store. The next day, I reported promptly to the hospital. Time for prep. She was sweet, but the pre-op nurse was pretty inept. She had to ask three times when was the last time I had urinated, twice when I ate last, and she had a devil of a time with my IV. Got into the OR, we had agreed on spinal anesthesia, they put the needle in there, I lay face down on the gurney, and out I went. I woke up just before the surgery was over, though, and could feel nothing, back there. I was overheating and was ready to chuck. Then I fell back to sleep. Woke up again in the holding room and my waist- down- was numb. That began wearing off, and they wheeled me to my room. The nurse told me I would be staying overnight, doctor's orders.

The pain at the time was nil. I was so numbed by the spinal that I felt nothing. They also had me on Percocet. Afternoon drifted to evening, I had the room to myself, and aside from the cords coming off me, I was ok. By 8 or 9, it was storming and they activated a tornado warning for Williamson County, and they evacuated us to the hall. Nothing like a little "we're all gonna die!!!" excitement right after the doc chisels a chunk from your ass. That was soon over and we were back to normal, no tornado. That night was long. Sleeping was tough. The cords hanging off me, the IV, the bed. Ugh. The confinement and lack of independence, the occasional pain, though nothing ferocious.

The next morning came news of the sitz bath. They did not teach me how to use it until Friday afternoon, which I thought was pretty bogus. The care was really good, but the wait for juice, pills and the like was way too long.

Got home at 5:30ish and they say I can eat solids, just high fiber and no spicy food. I decided solids would be a bad idea, so I remained on liquids. Went down to Walgreen's and picked up my prescription for Hydrocodone and came home. A couple of days went by and I decided the swelling had to go, so I looked up "NSAIDs" and researched it a bit. Asked the pharmacist at Walgreens if they would counteract, got the go-ahead and picked up some OTC ibuprofen, store brand.

It's Monday night. Yesterday, I craigslisted for a TV for this room. I've insisted on no TV in the bedroom -- until now! I also decided it might be time to switch to solid foods, so I ate two small homemade cheeseburgers, no spice. Yesterday or the day before, I super-glued the clear sitz bath feeder tube into its two-finger slot in the bottom because it kept flipping around and coming un-done. Six times in a row of trying to make that thing stay gave me a headache. Yesterday morning, I woke up with a nasty sting between my perineum and the anus. I figured I'd developed a chafe, but I let it pass.

First bowel movement after surgery came last night. I forced it, mostly because my muscle has been healing and adjusting, and lot allowing for much movement in that regard. Well, lo and behold, the good ole' chafe had to join. STING! Yeah, didn't need that so much. I'm not sure I'd been able to go through with the BM if I hadn't tapped some Calmoseptine cream on there first. I'm pretty sure the raw tissue of the fistulotomy would have been cruel and unusual punishment, but the cream pretty much shielded it all.

Today, I went to Wal-Mart and picked up some yogurt, protein drink and other supplies to stay off solids for a while longer. Got home and put the stuff away, and back to bed I went. Went to do a sitz bath and realized that second sting was being a troublemaker, but decided to let it go. I put some Calmoseptine cream on it too, after I took care of the fistulotomy job. Several hours later, the chafe was hurting worse than the surgery, so I decided enough's enough. I also felt a BM coming on, and that damn chafe was making it next to impossible. I did my business, which took no less than 2o minutes, then I had to use my laptop and webcam to examine back there, and the chafe had grown to about a pea size. No wonder it stung! Out came the triple-antibiotic ointment. I think that qualifies as a "complication".

We'll see what tomorrow brings, and I'll keep the blog running daily from now on.