2 days post seton placement — positive experience
22F and I first noticed some tenderness when I pulled the skin near by butthole last November. I went to a GI and was given a lidocaine ointment to treat a fissure. Due to life, work, and a complicated insurance situation, I never followed up despite knowing the fissure wasn’t getting better. End of February the issue started escalating and over a couple of days I began struggling to even walk to the bathroom without immense amounts of pain (8/10). I ended up going to the ER where I got an I&D for a perianal abscess. They gave me antibiotics and packed the wound with gauze and repacked it twice that week. Honestly that was the most painful part of this whole experience. I didn’t feel alive until the packing was gone for good. I followed up with a CRS who told me the wound looked good and told me to come back if I felt it filling up again.
I returned April 23 because it was still leaking blood and every week or so I would have a couple of days were it would get really tender and swollen before it would just drain itself. The CRS did a manual inspection and told me I had a very superficial fistula. She offered doing an MRI but I ended up opting out because I trusted her diagnosis. We scheduled a seton placement for May 8.
The next two weeks were terrifying as I scoured reddit reading people’s experiences. I am a huge hypochondriac, so I convinced myself this was the end of my life. I was very anxious about going under general anesthesia and about all the pain I would feel afterwards. I convinced myself I would either die during the procedure (I know, it’s ridiculous) or be immobilized for months after.
The day of the surgery, I arrived at the hospital at 6am with my mom. I had intake with a nurse and chatted with the anesthesiologist and my CRS. By 7am I was being taken into the operating room. They put me into a deep sedation, not general anesthesia. It was the best nap ever. The seton placement only took 20 minutes. After I woke up they took me to the post-op area where I met up with my mom and waited until the sedation wore off. I felt no pain. I was able to walk home, which was only 15 minutes away. That first day I slept a lot because I stayed up the previous night in fear. At night I started feeling a little achey in the external wound but nothing some ibuprofen couldn‘t help with. I did get oxycodone prescribed but I have already been constipated due to all this anxiety so I am not interested in making it any worse.
Yesterday, I woke up with considerably more pain but really only when I put pressure on the wound and a little when I walk but otherwise I couldn‘t feel it. At its height, the pain is quite comparable to what I felt like post abscess drainage. I was able to go on a 30 minute walk yesterday with no issues. I laid around all afternoon though so as to not push myself. I had my first BM, which I was terrified for, but it did not hurt at all. The sitting on the toilet was more uncomfortable than the actual BM moving through. I used a peri bottle to clean myself and did a sitz bath after.
Today I feel pretty much the same way. The pain is a little annoying when I walk but I’m still going out for Mother’s day to thank my mom for taking care of me in these trying times. I’ve been taking Metamucil and Colace twice a day to deal with this constipation, which seems to be my biggest issue post-op. I’ve been very intentional about taking 600mg of ibuprofen every 6 hours and doing my sitz baths twice a day and after every BM. The most pain I felt so far is when I tried to clean it in the shower. But all in all it is very bearable and if I didn’t get a week off from work, I would go back tomorrow with no issues. I say that knowing I struggle to get the urge to go to the bathroom whenever I am not home so I wouldn’t have to deal with that whole cleaning up routine.
I have a post-op check end of May and will probably get a fistulectomy in August. This long story is all to say that everyone’s body is different and it isn’t worth it to make your life any more difficult by spiraling about this. I feel good and proud of myself for taking this step towards recovery. Living with a seton for three months will be a challenge but now I know that it wasn’t that serious. I will update this post as things develop but to everyone reading, this too shall pass.
UPDATE day 4 post-op: pain still pretty bearable although it definitely increased. it pulses a bit even when i’m not pitting pressure on the wound but it’s mostly just annoying. it is an open wound after all. still only taking ibuprofen and sleeping through the night with no issues. biggest issue continues to be constipation but had my first normal BM today. not painful at all, a little scratchy though.