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The exploratory surgery on my fistulae and Jpouch yesterday revealed pouchitis. This is the first time, after 5 or 6 pouchoscopies since 2009, that a scope has revealed pouchitis. Normally everything is nice and healthy pink, with just some irritation near the cuff. So, now I'm back on flagyl for 2 weeks (you may recall that I got taken off flagyl just recently because of candida infection, after being on it continually for 2 years). This time, I'm going to limit sugar intake (no bubble gum chewing marathons), and take my VSL#3 diligently to try and keep the bad yeasties away.

Believe it or not, that was the good news.

The bad news is the fistulae.

My right buttock was an extensive cave system of fistulae, 3 with setons and 2 without setons - draining freely. Rather than collagen plugs or leaving the network of interconnected setons in place, the surgeon opted for an extensive fistulotomy. I trust his decision because I trust him implicitly, but it is still an unexpected outcome which I was not prepared for. When I got home last night and removed a thick wad of blood-soaked gauze and looked in a hand-held mirror, it revealed my right buttock has a 3 dimensional diorama of the Grand Canyon carved deeply into it. The sight was so gruesome, I had to look away.

For those of you not familiar with fistulotomy (as I was not until now), the fistulas are cut open and a wide "v" canyon is cut into the tissue so the wound heals from the bottom up, rather than being sutured closed.

When I Binged images of "fistula" the night before surgery to show my partner what a fistula plug was (which is what I was expecting), I saw some photos of the aftermath of fistulotomy surgery and said, "at least I'm not as bad off as these poor bastards." I guess I forgot to knock on wood, 'cause now I am one of those poor bastards.

The recovery instructions call for sitz baths after each BM, but the sitz bath won't fit on my toilet because the Coco bidet is in the way. Any suggestions on solving that would be greatly appreciated. Maybe the sitz bath is more important than the bidet for a while? Don't know.
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I am so sorry David,
I know that any unexpected outcome is a shock but especially when it is this crazy...If you are a good healer then the scars won't be too bad, you can, once they start to close up, pull their edges a bit closed together with steri strips...but not yet...they need to be about 50% healed for that do not need to put the sitz bath on the toilet seat to take one...if you clean out your tub really well you can just fill it partially and do it that way or you can put a basin into the tub...not sure how your bidet works but some have a plug in their drain and you can fill them up like baby bath could do it that way if it works or put some sort of basin into the bidet.
Just keep it all squeaky clean and rest as much as possible...
the good news is that they opened them all up which should mean that they will heal quickly and nicely...and hopefully this will be over soon.
Thanks, Sharon.

My Coco bidet is the seat type, not a stand-alone unit.

I'll try cleaning my bathtub out really well with disinfectant. I just can't picture using it after every BM. But maybe I will get used to it. Hell, I might even enjoy a nice hot bath 20 times a day. There are worse fates.

Turn it into a relaxing event. Candles, incense, a good book. I don't drink, but maybe I could learn to enjoy the taste of wine and turn it into a mini spa experience!

I don't see any silver linings to this fistulotomy, but maybe I can create one. Thanks for the suggestion.

Yes, the bathtub is fine for a sitz bath. You don't haveto sterilize it each time either. This is considered a contaminated wound, and with it open to the air, infection is not a big concern. The soaks will help it stay open, improve circulation, heal faster, and reduce pain. So, the more the better.

Sorry you had to have this done. I've heard people refer to itas being "filleted." I had an abdomnal wound that had to heal this way, and it was about 2 inches deep. It wasn't too bad. But, I didn'thave sit on it!

Jan Smiler
My surgeon, Dr. Frankhouse, just called, and we had a great talk.

He said the bidet is actually the better option to a sitz bath, so not to worry about it, just so long as it effectively cleans the wound.

I feel a lot better about things, after the shock has worn off. I guess it is medically the best procedure to do, although it is tough on the patient for a short period. So, I'm pretty sure if given a choice, I would have chosen long-term good at the cost of short term pain anyway. I told him he had my permission to do whatever he felt was best, and that is what he did. Like I said, I trust him without question.

So, now there is another chapter. Another adventure. Time to fasten the seat belts and see where it goes. Wink


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