Could It Be? Last of the Ass Surgery!

Yesterday I went in for ass surgery round four - this time with the new surgeon from Wake Forest. I'll never willingly undergo surgery at Forsyth Medical Center again unless it's my absolute only choice. The difference in how things were handled at the two hospitals was just startling. It started with my pre-op anesthesia appointment. WF does it as a separate event, so I went in at 7am on Monday morning. First appointment of the day was awesome - they tell you it can take up to 2 hours, but I was in and out in just about 45 minutes.

We were told to arrive yesterday at the outpatient surgery center at 1:30pm for a 2:30 procedure. I checked in at the desk and had barely sat down and we were called back. After I was undressed and ready to go on the gurney, the nurse came in and started my IV, the anesthesiology resident and primary anesthesiologist both came in and talked with me, my surgeon came in, and then the OR nurse came in - I really didn't have an opportunity to read more than a page or two in the book I'd brought between visits.

My surgeon suggested that we could do what she needed under sedation rather than full general anesthesia - sedation like you'd have with a colonoscopy. I was a bit anxious about that, but she said recovery is obviously quicker (and having had a colonoscopy I knew this). I said I'd go with it if she assured me that if I had any negative awareness that they'd crank up the drugs. She laughed and said definitely, so we went with that idea.

The plan for the day was to have her take a look around at what was going on, and insert a seton - basically a loop of rubber band like material through the fistula tunnel that would connect externally - rather like an ass ring (oh, that's a painful visual).

They took me back, had me lay prone on the table with several nice foam pieces to keep my head positioned well so I could breathe. The next thing I knew, they were asking me to roll back over onto the gurney, and rolled me out into recovery. They brought the Man back in to see me, and he said the surgeon told him she didn't need to put in the rubber band, and had opened part of the tunnel up to heal on it's own, and the rest had gone away.

I'm still a little confused as to which part was opened and which had closed - the part closest to external was bigger than the internal bit - but I've sent my surgeon a message to clarify, and I have an appointment to see her in 2 weeks (I love Wake Forest's electronic patient access system - you can securely email any care giver, and they will answer promptly).

The Man said she seemed pretty confident that this was over now. Hooray! That means I can make the appointment with our reproductive endocrinologist (also at Wake Forest) and see what we might be able to do about baby making.

Success!

Oh, the indignity

This morning was fun. No, really, very fun. After waiting for two weeks to hear from my surgeon about what kind of scans or xrays he wanted to do (and finally hearing back only after nagging his nurse via voice ail), I was scheduled for a fistulogram bright and early at 8:30am. I arrive on time despite horrible signage for the radiology department, which had you go in through the cancer center - yeah, not an image that was fun. When they finally call me back to get me registered, the clerk starts frowning quite a bit - they can't find the orders from my doctor. Really? I was supposed to be in and out, and back in my home office before 11am when I had a meeting scheduled, plus my team in India would be monitoring a mainframe delete package.

Finally, the manage to get my surgeon's office on the phone and get the orders faxed over - I don't get called back until about 10:15, far later than my scheduled 9am procedure time. So a fistulogram is this: they take a tiny tube and insert it into the external opening of the fistula, shoot contrast solution into it, and then take xrays. The only mildly interesting part of this was that the radiologist looked at things on a monitor I could see before he took the xray snapshots. I have a very interesting pelvic bone.

Anyway - I was pleasantly surprised at the lack of pain of that going into the fistula - which was still there in all its glory, though the bit that actually connected to the rectum is currently nearly microscopic in size. The radiologist then decided he wanted to put more contrast directly into my rectum to make sure I didn't have additional tracts anywhere. So basically I got a contrast enema. That was as fun as it sounded. Nothing extra visible, I get sent to the restroom and then they take one final film after I got rid of much of that contrast, and then I was able to head home - unfortunately now bleeding from the renewed larger opening. Of course I picked today to wear my pretty new undies too. Oxyclean, please work.

So, waiting now for the radiologist report to make it's way to my surgeon, and then hear back from them. I'm pretty sure I'm going to seek a second opinion from Wake Forest before doing any additional surgery - I want whatever is done next to be the LAST on this. Good grief, been dealing with this for 7 months now.

Tonight is my WLS support group meeting, but I'm oozy enough and my back hurts that I just don't wanna go. I'm curled up in the recliner now, and hoping to feel better soon. The Man is going to go get dinner later so I won't have to cook. He's a keeper.

I Just Can't Stop Talking About My Ass

Ugh. Seriously? It's been 16 days now, and while my ooze issues have gotten significantly better, I suddenly have a serious case of constipation - which has made the ooze worse, because nothing else wants to move. I've had plenty of Colace today, and if things don't get moving, I think I'm going to end up with some Miralax tomorrow because, damn, this is uncomfortable.

I made my first recipe with butternut squash tonight, and unfortunately it was a flop. It was a puree of the squash, carrots, and some onion, all simmered in some orange juice. That was pureed and finished off with about 1.5 tbsp of maple syrup. It was too sweet for my taste - but there was some note in there that was just a bit off. Neither the Man nor I could identify it, but we didn't care for it at all. I still have half the squash that I cut into disks and have frozen in a Food Saver bag, maybe I'll try a simple butternut squash soup instead.

Nothing much else exciting going on - can't exercise until I see the surgeon again in about a week, catching up on school work, and starting my next knitting project.

I just want to poop.

This post brought to you by Another Episode of TMI on the Internet.

Surgery - Round 3

I had my third operation on Thursday to try and eradicate this fistula I've had going since May. Recovery this time has been a lot harder than the second round which I'm hoping is an indication that it's actually going to work, where the second one didn't.

If you want the gory details - I had a GORE BIO-A fistula plug inserted. Seeing the pictures on the product site were a little shiver inducing, but hopefully this one will be it - my surgeon said that it was "better" than the product typically stocked by the hospital, so he special ordered it for my procedure.

Thursday was definitely an interesting day - in the outpatient surgery area there are about 16 little alcoves along each side of a hallway - you're only separated from the hall by a curtain. A woman across the hall from me was being questioned by her nurse about her procedure (something they do to make sure everything matches up), and as miserable as I've been with this - sometimes little things you run into make you appreciate what you have. It turns out she was in her mid-30s and was there for a double mastectomy on top of removal of her ovaries and tubes. Yikes.

The surgery itself went well - the surgeon said that the infection had fully overtaken the fistula tract again (not surprising, given the amount of discharge I had been having), but he cleaned it out again and put in the BIO-A plug. I go back to see him in 3 weeks.

My post-op nurse seemed pretty interested in getting me out of there quickly - which I didn't necessarily mind, but I wasn't as clear of the anesthesia as I probably should have been. We went home and tucked me in bed - about 3 hours later I went to the bathroom to try and urinate. I don't know if everyone else experiences this, but it seems like the muscles used to allow urination really have to be kind of told what to do after a surgery like this - it takes concentration, and a bit of "effort" to allow things to relax and get flowing. So I did - several times - to empty my bladder, while the Man was standing just outside chatting with me. Suddenly, I started feeling a little wobbly - and just said "Help, I need help." He took my hands, and tried to guide me to the bed - and the next thing I know, I wake up thinking I'm laying in bed. Except I realize I'm not - my head is resting against the bed mattress, but I'm propped up on one arm and otherwise sprawled out on the floor. The Man helped me up and guided me into bed - I asked him to get my wrist blood pressure cuff - we put it on, and yeah - I was at 88/47 - just a little low. He said I'd been out for 5 to 6 seconds, which is not insignificant for an episode like that.

I have been having low-ish blood pressures for the last month or so - I've had some dizziness on elevation changes like standing up from sitting, or getting out of bed. None-the-less, this scared me enough that I asked the Man to take me to the ER to be checked out.

I had this odd phase for about an hour where my arms and legs were shaking, but not because I was cold. They took a series of blood pressure readings - laying down, sitting up, standing up, etc. The first series I had the dizziness and they were pretty low (under 100/60). They gave me some fluids, put me on a heart monitor, and drew some blood to check all of that. Took about 3 hours to get the blood results back - at which point my anesthesia had totally worn off, and I'd missed the time for when I could have taken vicodin and the pain was really ramping up.

They came back and did another series of BP readings which were slightly better - and finally gave me a percocet and decided that what happened was a vasovagal response brought on by still having some anesthesia on board, the history of low-ish blood pressure, and exerting some effort to urinate.

Not very satisfying - especially since I was worried about it happening again, but they sent us home after about 5 hours.

I've been on the vicodin pretty much every 4 hours since we got back - and draining enough that I've had to use chux pads to protect our mattress and my recliner. So much fun (really - super fun. really.)

I'm thankful that I have Monday off as an Evil Banker since it's Columbus Day, it's been a bit easier to sit for longer periods in the recliner, but any activity up and about in the house has really kicked in the pain. I suspect I'll be working from the recliner for the rest of the week, as I can't see my ass putting up with my Aero chair for 8 hours at a time.

I'm trying to keep my fluids up, though the best I've done is 40oz. Protein has been a struggle too - I probably ought to just have a shake while the Man is at work and let him feed me when he gets home, which I may consider for tomorrow.

No exercise until my 3-week follow-up appointment, which while frustrating, I'm willing to do if it means this thing will actually heal!!

Hopefully by next weekend I'll feel like cooking again, and have a little more to say here than "damn, my ass hurts and I'm still oozing like crazy."

So that ends today's issue of Too Much Information on the Internet.

Surgery Day

Today was the day - the follow-up surgery to why my incision from the original rectal abscess surgery wasn't healing. The doctor suspected I might have a fistula (internal pocket of infection) that had connected to the incision site and was draining from there. I was getting a little worried, as after I saw him and the surgery was scheduled (for 4 weeks later), that the oozing had let up a bit. I had visions of getting put under anesthesia and being brought right back out and having him say that there was nothing more he could do.

I was told to report at 10:15, and we got there right on time. Nearly 2 hours of sit in a consult room and have various people come in and out and ask for information, take vitals, etc. Finally got taken back to the pre-op area about 11:30, waited for more visits - anesthesia, my surgeon, and then got my IV started, etc. It was nearly 1pm by the time I was actually wheeled back to the OR.

I next became aware of time and place at about 2:45 in the first recovery room. Pain wasn't too bad, maxed out at about a 6 before they got the Dilaudid on board. Surgeon stopped by very briefly and said he did find a fistula, that it was very deep behind muscle, so they didn't want to cut through that, and put a plug in it that will eventually dissolve.

After about an hour in initial recovery, they moved me into post-op monitoring, gave me peanut butter crackers to eat so I could take a Percocet and allowed the Man to come back. He told me the surgeon told him the fistula was 5 inches long/deep and contained a very nasty infection. Lovely! I was given IV Cipro and Flagyl, and sent home with prescriptions for an oral round of both antibiotics (plus some hydrocodone for pain management).

Finally, at a little before 5pm, I was discharged. We dropped the prescriptions off at the pharmacy on the way home, and the Man went out a little while later to pick them up.

I'm definitely feeling spacy as is usually the case on Percocet/hydrocodone, and I can tell I'll definitely be hurting for a few days. I scheduled tomorrow off as well, and again I'm thankful I work from home, so if I'm not up to par on Wednesday I can work from my recliner if needed.

I truly hope that this finally ends the saga of the never ending oozing ass incision. I just want to be able to sit normally, exercise without worrying about angering it, and stop having my clothes stick to me. Not  much to ask, is it?