u/Alternative_Delay319

I currently have a seton for a low perineal fistula. There was minimal external muscle involvement but just enough my surgeon wasn't comfortable with a fistulotomy. Hence, the seton. Had my 6 week f/u today and everything is going on. Have some hypergranulation tissue but watching it for a week or two before they decide on silver nitrate. Overall seton is bearable for now.

The issue at hand is when to have the next surgery. He said he doesn't know if I'll get to have a fistulotomy, lift or flap until day of, which I know is normal. He confirmed there will be no risk to sphincter involvement. He is comfortable performing this surgery near the end of June but I have a trip planned for Colorado August 6-10. Some light hiking (it's more walking than an actual hike tbh). He said it's my choice to have the surgery in June OR I can wait to have it after my trip in August and keep the seton till then. He thinks I could be okay with having the surgery in June but know if I have the flap, I could risk cancelling the trip :(

What would you do?? :(

31 days post partial fistulotomy/ Seton placement and I just gotta say I hate this shit right now. My incision is only about 5cm but it feels like it could just split me wide open. Week 3 was so much easier. I was walking around more. Less pain. This last week and a half has been hell. Back to semi waddling. I guess since it's healing from the inside out, the new tissue building has finally started to reach the incision. Its not hypergranulated but the new tissue is visible. It feels raw, tight, everything burns it - water, air, changing gauze (yes I'm using nonstick). Only thing that helps rn is an ice pack. And calmoseptine ointment around the edges. I hope things take a turn this coming week because the thought of them examining it at my 6 week appointment makes my stomach hurt :(