u/debaser00

Hey all,

I've posted a few times about my journey but I guess as we all know, its an ongoing saga. I've had 2 drainage surgeries and a seton put in after a perianal abscess. The last surgery was now 5 weeks ago. Apparently I'm generally healing well. I feel a lot better than I did overall even if some days are worse than others. There was a point last week where I almost felt 100% for a few days and I wish I could have captured that feeling! I still have a lump on the inner left butt cheek, right up against the anus. I was scared this was another abscess forming but I've had 2 different doctors now be pretty sure it's not and that its more likely post-surgery trauma, more like a blister. It bleeds a bit and is what causes the most pain now, but apparently it's ok.

I was meant to have an ultrasound last week to determine what type of fistula closing surgery I am to have but I couldn't have it done - it was still a bit too painful so they want to try again in 3 weeks. Giving it more time to heal and drain. Apparently the main 2 options they're considering are the MAFFS and LIFT surgeries but given its quite a complex fistula and deep they want an ultrasound done over any other type of scan as well as a muscle strength test where I have to squeeze a balloon thing with my butt.

I guess what makes me nervous is the success rate of the surgeries. The doctor said no matter which we go with, the success rate is still at about 60% and if it fails then we will basically be starting the whole process all over again and next time we are back at this point it'll be less than 60% since apparently your best shot at getting it done right is the first shot. I know 60% is more than half the chance, and there's things working in my favour - I don't smoke, I'm not obese, I'm not diabetic etc... but still a 40% fail rate is scary.

I don't really know what im typing this for, I don't really have any questions as they said theres nothing much I can do now but keep on keeping on and giving it time. And that time for it to keep draining and maturing is better than rushing into it. I guess I just wanted to get this out somehow and people here seem to be ones that will understand the frustration/fear/anxiety of what's ahead.

I have a new-found level of empathy for anyone going through this. I didn't even know it was a thing until it started a couple of months ago but it's just brought my entire life to a stand-still and is so debilitating.

Hey all

So I've posted a couple of times along my journey but things have been relatively stable for a bit, but I feel like I've hit a bit of a cross-roads. I had a perianal abscess and then had a surgery for that and a seton put in about 6 weeks ago. 2 weeks after that I was back in the ER with intense pain, had another surgery - they found a pocket of infection missed the first time - no new seton but just readjusted the existing one to accommodate.

So that was a month ago and since then things have been going reasonably ok. It's still painful and uncomfortable, but nowhere near what it was. I have far more freedom of movement, im still draining. In general I think I'm tending in the right direction. Then about 4-5 days ago i noticed when bathing feeling a familiar lump on my inner left cheek near my anus. Same area as previously there has been the abscess. Towards the end of the day for the past few days it had been bleeding a little too - not from the fistula or anus I believe, but from the swollen external lump. Not crazy bleeding, just a little on wet wipes when cleaning up at the end of the day. But I think the bleeding, while probably not ideal, might also be keeping the lump kind of less painful? Like, its relieving it a little?

Anyways, things just didn't quite seem right, so I went back to the ER today. I explained all the above and they said from what they could see it looked pretty good and they think the bleeding and painful lump area might be more of a blister, potentially caused by the seton and scar tissue from where they had cut and drained before.

But I've come home and I'm just not sure. Its true that I am in nowhere near as much pain as last time. I don't have that same intense pain when theres pressure or certain movements. But it is sore, it is a definite lump, it is in same place as the previous external abscesses. So I'm wondering if they got it wrong. Could it be a regrouping of the abscess but maybe, hopefully, it just isn't as deep this time? Maybe just localised to that outside area rather than another pocket deeper?

What I'm not sure about is what to do next. I could go back to the ER and get a second opinion. But I also have an ultrasound booked for next thursday with a colorectal surgeon. But the thing is, I just don't know at this point whether I'd even be able to do that. While I'm not in as much pain, I think putting an ultrasound probe in just feels like it wouldn't be possible. The ultrasound appointment also costs $250 and money is tight. I'm not sure if I should just hold out until Thursday, and maybe instead of the ultrasound, try to ask the doctor his opinion on what I should do - maybe another surgery - but that's not what I have the appointment booked for. I don't know if I can just change it on the fly like that? I don't know if I should just go back to the ER and get another opinion - albeit, it's just a doctor, not a colorectal specialist.

I mean, I'd *like* to avoid another surgery. However, I also don't know how any of them would really know for sure what it is and whether it is just a blister, an infected isolated pocket, or leads to something else without going under and doing another investigative surgery. I hope that if it is something that because its less painful that if its another setback then it is at least a smaller setback than the previous two. But if it is another regrouping abscess, i want to find out why it keeps coming to that same spot if it is isolated.

Anyways, point being. I don't know if I should hold out until Thursday with the colorectal guy and spring it on him at the last minute that I don't think i can do the ultrasound and to get him to advise me further. Or, if I should just go back to the ER and push the issue sooner. I don't know how much time is a factor in these things. I guess there is still the possibility the diagnosis today was correct and it is a blister and an inflamed area due to the seton and all the trauma the area has been through ... but there's just something telling me it isn't. While the seton protrudes, I'm not even sure if it protrudes that far to irritate that area.

Sorry this is very rambly and wordy, just trying to get my thoughts out! Has anyone been through similar? Has anyone actually had a situation where the seton was the culprit causing blister-type lumps??

Hey all

I'm currently pretty close to the start of my journey so I'm still trying to figure out what is what. I had a perianal abscess for which I had drainage done and a seton put in. Recovery started ok for about a week and a half then the pain suddenly ramped up to the point I couldn't stand it and then ended up having another surgery exactly 2 weeks after the first one. Apparently there was a pocket of infection that was missed, so they drained it and readjusted the seton accordingly. That was a week ago.

So I'm 1 week post second surgery. And I think things are going better this time, but I'm absolutely paranoid of the cycle repeating. For the most part the pain is better. I can still feel a little hardened lump area on the inner left cheek right near my hole where the abscess has been twice. I'm trying to tell myself its normal for it to be there, its all inflamed after surgery and its still draining, doesn't mean its coming back there etc... But its hard not to be scared, especially when thats where the bulk of my pain is.

Anyways, what I'm wondering is people's experience after a bowel movement. Did you find that was the most painful? The actual BM itself isn't too bad. Stings a little sometimes, but im taking metamucil and a stool softener so its mostly fine. But the 2-3hrs after a BM is really painful. Everything just feels, for lack of a better term, "angry" down there. Like its irritated, super sensitive, between the cheeks almost feels like nappy rash at times.

Is this basically just "normal"? I guess as bad as it is, I can put up with it if I know its just normal and you just go through it even though things are progressing well. Does it basically always feel like this after a BM during the 6-8 weeks before the seton is supposed to be removed, or is there usually a point where it stops being so bad? It feels like I'm basically house-bound because of this because I can't risk being out and suddenly needing to use the bathroom away from my shower/bath.

I shower after BM, then usually 30-45mins later I have to re-wipe with wet wipes as i tend to have leakage. Sometimes it feels like I've not wiped at all after the BM. Then I have a bath after I've cleaned up. But yeah, for the next few hours after it's really painful.

Hey all

I have just had my second drainage/seton operation nearly a week ago (first one was 3 weeks ago but they didn't get all the infection so needed to be redone).

What I noticed between the two surgeries is that after the first surgery the little shoelace type end of the seton tube was protruding far more than after this last surgery. The latest surgery was done by an actual colorectal team whereas the first was done by the emergency surgery team - so I assume this second one is a lot more "proper".

The thing I'm wondering though is how much the seton should protrude and whether it can shift in/out a bit. I feel like while the first surgery it may have been out too much, this one started off feeling better but it feels like it's gone kind of too far in? Just in the last few hours or so it feels like it's not as protruding as it was for the first few days. It's still protruding from my anus, just a tip, but is it normal for it to shift in and out a bit? I don't want it to go too far in and not come out and then start draining inside or just onto the anus tissue itself. But I also might just be overthinking and paranoid - after the first surgery failed it's been really hard not jumping at shadows of anything that might go wrong and cause another relapse.

Hey all

Sorry for another post ... i'm still in the really early stages and have so many first time questions I'm encountering along the way.

I just had my second drainage/seton insertion (only 1 seton in me), the first was 2 weeks ago but they didn't catch a pocket of infection the first time.

I just had my first bowel movement post-surgery after coming home and when I went to the shower to clean up I noticed i had some soft non-woven gauze packed into my anus. I don't know whether that is something i was meant to remove or would have fallen out on its own and I should have left it, or whether it was supposed to wrap the seton or what. I gave it a few tugs and it came out because i got worried that maybe it was blocking the seton from draining .. but now I'm not sure if I should have removed it, or at least removed it yet.

After my first surgery I didn't have anything packed in there like this. So I'm wondering if anyone else had this and whether its ok to come out and just have the seton protruding on its own? I should stress this gauze wasn't just placed between the cheeks, it was properly packed into my anus, kind of between the seton and the inner cheek where an incision was made to drain from the outside.

Thanks all!

Hey all!

I posted a few days ago about being 2 weeks post-seton insertion surgery and how I was still in a lot of pain. Turns out I went back to emergency and had the same operation again, this time with an actual colorectal team. Turns out there was a second pocket of infection which was either missed or had formed after. So I've had a proper clean out now and the surgeon said she felt more confident I should have a normal recovery now ... fingers crossed!

I did have a question for the brains trust here regarding baths. Sadly the sitz bath I got that's meant to fit in the toilet just doesn't fit. So I have been taking actual baths and just kind of kneeling down until I'm submerged in them. What I'm wondering about is the use of salt. I have been putting in half a cup of regular sea salt into a half full bath tub. But towards the end of last week I had a new kind of pain where it felt the inner cheeks area was kind of chafed, tender, almost like nappy rash or something. I'm wondering if maybe I should skip the salt baths and just have regular warm water baths, as it could be drying me out too much, has anyone got any insight? Or maybe have 1 salt bath and 1 normal bath a day or something?

Alternatively, if people don't think the salt baths could be a problem or contributing factor .. any idea what could cause this? I have been wiping up discharge as regularly as I can, but wondering if the fluid sitting there at times can contribute? Or is it maybe the seton protruding that is causing irritation?

I know some people recommended a barrier-type cream but my doctor recommended against that. She seemed to think that even if I'm careful with application it still runs the risk of potentially blocking something there that it shouldnt - like maybe some gets on the end of the seton or something - again, any insights?

Sorry for all the questions, I'm a first-timer so I'm learning on the go at the moment! I have the utmost sympathy and empathy for anyone going through this at the moment or in the past so hoping you're all hanging in there too!

Hey all!

I have been browsing this subreddit the past few days and really appreciate so many different insights and stories. It seems we are all relatively connected by the same thing but there are so many variations on it. I feel like I may have read too much and scared myself by some of the things I've read .. I know someone here mentioned that generally people who have things just go well for them either don't tend to post or stick around - so there is hopefully a heck of a lot of success stories out there that just aren't being shared. But yeah...

As for my situation. I'm 40M and in Australia. About a month ago I had a really bad flu, I was coughing violently and continuously. It got to the point where I noticed when I coughed I had a little pain in my rectum. I ignored it at first as it only happened when I coughed and I figured I strained a muscle or something. Then it started getting sore when not coughing too. The flu subsided but the anal pain continued. My doctor believed it was thrombosed hemmorhoids brought on by the continued pressure of coughing. She gave me some scheriproct cream and suppository and I thought that would clear it up. I'm still not entirely sure if I ever had hemmorhoids or if it was an abscess to begin with. One doctor thought I never had them, another doctor said I may have and through them getting infected was how the abscess came about since there was initially blood and such when I went to the toilet.

Either way, about a week after seeing my doctor I noticed pus when wiping and thought this just wasn't right. So i went to the emergency department. It was a long 5hr wait there but when I saw a doctor they thought it was a perianal abscess. I was booked in for an investigative surgery the next morning. I had the surgery and when I woke up they said they drained the abscess and put a seton in for drainage. The plan then was for 6-8 weeks of having the seton in before an MRI to decide what to do next. They mentioned another small surgery to remove the seton but there was never any talk of things like FLAP or LIFT procedures - I learned all that from here.

So that was about a week and a half ago. Since then it's been ... uncomfortable, depressing, sore. Some days are better than others. I had no idea the seton was meant to protrude from my anus at first - I rang the hospital after my first shower thinking something was wrong. I feel my best the longer I've been laying on my side with no pressure and the further away from having a bowel movement I have been. Having a bowel movement generally doesn't hurt too much - i have been taking movicol and metamucil to help. But the next 2-3 hours after a bowel movement are the worst. It feels like the whole area gets inflamed or irritated. I shower immediately after any bowel movement to make sure I'm clean but I find that I usually need a second shower an hour later. Usually within 30mins after the first shower I have some fecal incontinence ... it's such humbling/undignifying stuff. I'm also having 2 baths a day, one with just warm water and another as a salt bath.

I'm scared I'm making slow progress. Lots of people seem to say they are "relatively" back to normal after a week or so, but I still feel like I'm hobbling around and can't return to normal life. I'm still draining. The hard thing is that nothing ever seems the same. I am in pain, then I'm not. I can move relatively freely, then I'm hobbling, the pain is a sting, the pain is a dull throb/zing, sometimes it feels like the area is just rubbed red raw/sensitive ... I can't say i feel any one way for too long before it's totally different. I'm scared of any cough or sneeze I need to do because of either pain or unexpected incontinence. And I'm paranoid of another abscess forming. Sometimes it feels like it is, the pain becomes similar to before my first surgery, theres a little raised lump in the same spot. Then it subsides, so maybe its just the same area being a little backed up and then draining or something? Even draining isn't consistent. One day I'll have very little drainage, the next day i'm constantly cleaning up/changing pads.

Then I got reading about the issues people have had with needing multiple secondary surgeries to repair the fistula after the seton is removed and how it can drag on for months and I just feel so despondent. I've never felt like life has come this much to a standstill before as besides suffering from a mildish chronic fatigue syndrome, I've been relatively healthy. I feel like I can't leave the house because needing to have a bowel movement away from home would be a disaster. Not to mention the pain moving around.

I guess I don't really have any questions in particular, just venting frustration and the overall situation. I've never really had an issue that hasn't had a relatively linear recovery and I think that's whats really messing me up as well as being paranoid about additional abscesses or failed surgeries.

Hey all

I've been wanting to set up automatic shoutouts for people who raid. I think I have most of it set up right but I am not sure if it's completely correct yet. I have the trigger set up as add: twitch > raid > raid, and then min/max left as blank.

For the sub-action, I already have nightbot set up to respond to a !so command that will display the person's ttv link plus show what their last played game was. So all I want streamerbot to do is do a !so command for the raider and then let nightbot do the rest.

The thing is, I'm not sure what variable to use. Is it as simple as "!so %userName%" will %userName% capture the right data of who raids? Or is there something else I need to do to make sure it's getting the right person?

Cheers :)