peri-anal fistula

[MrsPear]

Doug has a peri-anal fistula (I wrote a thread a while ago about his abscess) and needs surgery. Does anyone have any experience of this or surgery in general?

Apparently it should be a day case but will be quite sore for him afterwards and the surgeon says it's not a 'neat' surgery because there will be some guesswork of where to cut. I'm not too worried about the anaesthetics side (don't get me wrong I'm not thrilled but he's otherwise so healthy I know his complication risk is very low and I've seen him have cannulas before so I can cope with that) but I just feel apprehensive about the fasting beforehand (like, is it really awful?) and how he's going to be with bowel movements etc afterwards with his bottom cut open.

Any experiences welcome.

 

[0203]

Hi I think I remember your previous thread. My son had the surgery when he was 6 weeks old. He had a peri-anal abscess which had been caused by the fistula so they drained the abscess and cut the fistula at the same time. He was a bit younger that your son, I don't remember the fasting bothering him (It bothered me big time, I ebf so was extremely uncomfortable) I had to give him a dummy for the first time though and he has had once ever since. The surgery was quite straight forward, I was able to go and get him from recovery after just under 2 hours. I found the after care quite hard, he was given antibiotics and being so young was having very frequent dirty loose nappies, each one would soak the wick and the bandages that were keeping to wound open so it could heal in the right way. This resulted in us having twice daily trips to the hospital to have the dressings changed for a few days then daily for a few days then every other day for a while too. It was very dramatic for both baby and me. They said that it was so hard to keep the dressings right because he was so small. Hopefully with your baby having a bit of a bigger bottom I hope that doesn't happen to you! Once it was all healed then everything was fine, he has a scar but obviously nobody is going to see it.

Good luck xx

 

[MrsPear]

Yes I remember you writing before, thanks for writing again, I was going to pm you but felt a bit shy. So is the fistula fully healed up now? The surgeon said it's less likely to reccur than if it happens to adults. My husband works with some patients with anal fistulas in his job and they can reccur so I was pleased to hear it doesn't normally happen with babies .

I have never used a pushchair with him but I guess I might need to,if his bottom is sore the sling might be a bit tight for him,I'll have to play that by ear I suppose. I do have a pushchair so that's not a problem, I'm just thinking out loud really .

I remember you saying the abscess was fast growing? This one isn't ,it just gets solightly big (ie still small ) then pops and comes back a few days later. So I don't know if that indicates anything (or absolutely nothing) like maybe it is less severe than your little baby's, I'm not sure ,maybe it doesn't make any difference as they have to have general and an incision anyway so perhaps the specific size doesn't matter that much.

The bandages sound like a nightmare! The surgeon said there is an outreach team that come and change bandages but I don't know if that's for everyone or just people who can't get to hospital.

Sorry for this ramble! I'm glad your baby is better. It sounds so dramatic. I think now doug is weaning he only poos once a day so that bit will be easier on us im sure. In the early days when they are constantly pooing that must be so much to deal with.

X

 

[0203]

I was told by one doctor that if it was going to grow back it would be within the first year, a different doctor told me it would be within three years.

Henry's does sound slightly different from your sons. His only appeared once, it grew from a tiny spot (that nobody but me could see) to a huge spot bigger than a 5p and very very swollen. We tried antibiotics and because it actually got worse and didn't pop he had to have the surgery straight away. Poor babies shouldn't have to go through it regardless!

I'm sure they will go through the bandages with you, in the end I was having to do them myself rather than go to the hospital every nappy change (they actually suggested that!!) One kind nurse showed me how to do them and sent me with a whole load of supplies but told me to come back if I ever wanted to. We (I guess yours might be different) had to keep a hole open so the wound would heal from the inside out. The nurse told me that it was quite painful (apparently older patients would be given has an air for the changes- he had to have sugar syrup and paracetamol poor boy) I would suggest to stock up on pain relief, although I am sure you will be given some. Lots of cuddles and distractions also helped. I really hope your son has an easier time with it than Henry did! (Sorry if i am making t sound dramatic) Also I hope that the outreach team can help you. The only reason they couldn't help us was because we were sent to a children's hospital in another town so I had to go to my local hospital myself.

I hope it all goes well

 

[MrsPear]

I was told by one doctor that if it was going to grow back it would be within the first year, a different doctor told me it would be within three years.

Henry's does sound slightly different from your sons. His only appeared once, it grew from a tiny spot (that nobody but me could see) to a huge spot bigger than a 5p and very very swollen. We tried antibiotics and because it actually got worse and didn't pop he had to have the surgery straight away. Poor babies shouldn't have to go through it regardless!

I'm sure they will go through the bandages with you, in the end I was having to do them myself rather than go to the hospital every nappy change (they actually suggested that!!) One kind nurse showed me how to do them and sent me with a whole load of supplies but told me to come back if I ever wanted to. We (I guess yours might be different) had to keep a hole open so the wound would heal from the inside out. The nurse told me that it was quite painful (apparently older patients would be given has an air for the changes- he had to have sugar syrup and paracetamol poor boy) I would suggest to stock up on pain relief, although I am sure you will be given some. Lots of cuddles and distractions also helped. I really hope your son has an easier time with it than Henry did! (Sorry if i am making t sound dramatic) Also I hope that the outreach team can help you. The only reason they couldn't help us was because we were sent to a children's hospital in another town so I had to go to my local hospital myself.

I hope it all goes well

Well i think it does sound different in that Doug's is really not painful at the moment, he's had it weeks (can't even remember when I wrote my first thread), he couldn't care less. So I don't know if that will affect it post surgery (presumably it will be painful from the surgery itself though). It gets as big as a pea then pops and builds up again, but it never seems to hurt.

I don't know whether that will be the same as ours with the healing process. They are going to completely open the fistula up and let it heal so probably similar. When I've packed abscesses in my job, yes people often do need gas and air, at least for the first couple of days. In Doug's case the abscess itself is really very small (and looks quite superficial to me), so I don't really have experience of that.

The surgeon seemed to think it could be a bit 'messy' because they might cut in the wrong place if they can't get through the fistula with a probe (if it is blocked too much). But we'll see. I'm not going to worry about that because I'm sure it'll be as neat as possible.

Sorry for my rambling. Thank you again for your input. x

eta- go for dressing changes at every nappy change? That's madness! The hospital is about five miles from here, maybe 40 minutes door to door. So that's not a huge distance but if we had to go every nappy change, that would be a lot of time on the road, that's crazy they wanted you to do that! x

 

[0203]

When I think about It I think some of the doctors made quite a big deal over it for Henry. I hope that doesn't come across as cold Hearted, He was seen by 7 different doctors in the space of 7 hours, I wonder if it was because he was still very very little, some of the doctors didn't know what it was, some wanted him to go via ambulance to the nearest children's hospital. In the end the doctor that had the final say delayed the surgery by a week and we tried the antibiotics to see if we could get the abscess ( which grew to the size of a cherry) down. But like you said Doug's doesn't seem to bother him where as Henry spent the week on antibiotics and then after the surgery screaming a lot!

One other thing is that they can't have baths, well Henry couldn't anyway, in think that lasted about 2 weeks. It was very fun to give him his first Bath after and he really enjoyed it.

It wasn't ever explained to be that it would be a messy surgery. They explained all about the probe and cutting the fistula. Anyway Henry has a purple patch of skin and a little dimple of a scar which I'm sure will fade....not that anybody is going to see a scar on your bottom!

X

 

[MrsPear]

When I think about It I think some of the doctors made quite a big deal over it for Henry. I hope that doesn't come across as cold Hearted, He was seen by 7 different doctors in the space of 7 hours, I wonder if it was because he was still very very little, some of the doctors didn't know what it was, some wanted him to go via ambulance to the nearest children's hospital. In the end the doctor that had the final say delayed the surgery by a week and we tried the antibiotics to see if we could get the abscess ( which grew to the size of a cherry) down. But like you said Doug's doesn't seem to bother him where as Henry spent the week on antibiotics and then after the surgery screaming a lot!

One other thing is that they can't have baths, well Henry couldn't anyway, in think that lasted about 2 weeks. It was very fun to give him his first Bath after and he really enjoyed it.

It wasn't ever explained to be that it would be a messy surgery. They explained all about the probe and cutting the fistula. Anyway Henry has a purple patch of skin and a little dimple of a scar which I'm sure will fade....not that anybody is going to see a scar on your bottom!

X

I love the name Henry BTW.

Maybe because Doug's keeps popping it isn't so much of a concern. The doctor did say they want to do it sooner rather than later, but that since he is over three months it doesn't need to be done immediately. All in all it sounds like Doug's is not as serious but I suppose the surgery will be pretty much the same anyway. They didn't mention antibiotics afterwards but I should think it's quite likely as the risk of infection must be high .

Thank you for telling me your experiences ,it is very helpful x

 

[minties]

I know it's not the same thing, as my abscess was higher up and nothing to do with my anus or a fistula. But I had a large pilonidal abscess removed from my natal cleft about 10.5 weeks ago and they had to dig around a lot to find it all. The pain in the week afterwards was very intense. Worse than my 2 c-sections and gallbladder removal.

However that was only if any pressure went on thet area, so definitely no sitting or anyone touching it firmly. Lying on my side was fine and walking was fine. I couldn't lie on my back for at least a week. I imagine being in a carrier would be excruciating but mine was right on the tailbone so maybe be different around the anus. I was able to sit very carefully at 2 weeks past the surgery.

It's really hard to keep germs away when it's a wound in your bum. You will have lots of great advice from your nurses etc for your son, but saline washes were my best friend when it came to cleaning. Antibiotics all gave me horrible diarrhea.

 

[MrsPear]

Your abscess sounded so painful, Minties I think you really suffered with it.

Yeah the more I think the more I reckon slings are definitely out, there's no way to make it so the bum doesn't get any pressure I don't think. I might see if we can borrow a double buggy or a buggy with a buggy board for a couple of weeks. Surely someone we know will have one. Otherwise I'm going to struggle to transport both kids to the hospital, Joni isn't very reliable at walking. Still going to be bad for him though because he can't lie on his side in a pushchair can he? Be so good if the outreach team can come to us. Best thing would be if someone can come over and look after Joni so that Doug can just leave the house for his dressing changes, and then spend the rest of time at home in a comfy position. Someone will need to take Joni for a few hours though, she won't cope well with too many days at home x