From my experience, there’s these great gauze pads on Amazon that you can just tuck up there between the cheeks, no cutting required. Those have worked great for me. Link: gauze pads
In terms of diet, I would highly recommend taking a fiber supplement, it makes the BM much easier, very consistent, no squeezing, no pain. The stuff I use from Amazon (I use 1 table spoon in cold water): fiber supplement
I use these gauze pads and yes, kinda stick them in between the cheeks, and also try to wrap the on either side of the seton.
Sitz baths, heating pad, ice packs, put as little pressure on it as possible (a wound care specialist told me those donut pillows actually are not ideal for anal wounds like fistulas and instead to use something like this if you have to sit https://www.amazon.com/dp/B01DOILL2A/ref=cm_sw_r_cp_apa_glt_fabc_2F94ANRPDJHZMKK0ATZQ), pain killers (narcotics if you have any), anti-spasmofics, weed if you're able to help with pain, and if none of that works in my worst moments I try meditating for pain relief (headspace has some good series).
I'd recommend seeing a CRS asap bc you don't want to let an abscess sit actively as it can really wreak havoc on your rectum. Good luck!
Maaaaybe a week will be enough for the fissure to get a little better. But I’m also wondering if you can reschedule for just 1 month later or something. Most fissures heal in 2-4 weeks. Only saying this because splashing bile on an open wound while experiencing agonizing stomach cramps from the ultra strength laxative is a special kind of hell. It won’t kill you, but you might wish you were dead. I’m just thinking that you might want to give it time to heal, now that you have the proper diet that won’t cause your fissure to reopen chronically.
Also, I wanted to recommend this supplement instead of a stool softener:
If you take just 1 capsule (the reduced dose for maintenance) at bedtime with a glass of water instead of 3-5 capsules (dose for full-on colon cleanse that dumps out everything overnight but very gently with low acidity), then it can help you maintain softer stools, especially if you lacked fiber during the day.
I just kept my portions of problem foods small (like steak and pizza) and paired them with high-fiber vegetables and a teaspoon of Metamucil in water. Like steak can constitute only like 1/4 to 1/3 of the meal. When I eat too much meat, I’ll end up with a fissure. Maybe you can start modestly and check what your limit is. Also, if I’m eating out and there’s not a vegetable in sight, I’ll be like “fuck it” and eat whatever but take a MagO7 with water at bedtime that’ll prevent it from becoming too solid. It says the dose is 3 capsules on the bottle (for a total colon cleanse) but I’ve experimented and 1 capsule works for my purposes of just keeping things soft.
I wanted to share the link of the one I bought my husband but it was acting a bit funny. See if this works for ya.. https://www.amazon.com/gp/product/B07HD8B9SP/ref=ppx_od_dt_b_asin_title_s00?ie=UTF8&th=1
If not its a cushion on amazon by a brand called 5 star united. My husband had a simple fistulotomy three weeks ago and was using this cushion to sit at the dinner table by day 3. We take it everywhere including today, his first day back at work, which is all labor work but he used it in his truck to drive. He really believes it has helped him and worth the $50 or so that I paid.
FYI his farts also seemed to slip out at first. We are just over 3 weeks out and this isn't really the case anymore. His fistula involved no muscle for reference.
> Do you know roughly how big, big can be?
Unfortunately, the "crater" will be as deep as needed to be to fully drain the abscess that has formed and to open up the wound and get to the fistula tract causing the issue.
> With pain, how bad would you say it was?
Pain following surgery isn't too bad with proper medication; I received Exparel which masked the first 1-2 days following surgery. You will likely be prescribed opioids like macdow mentioned, and you can see if you have any success with OTC tylenol.
> And do you have any recommendations for recovery?
Depending on how the fistula tract goes, it may hurt when having bowel movements. Highly recommend increasing your fiber intake and if necessary, take a stool softener like Coalasce as well. I personally have been incorporating metamucil into my diet.
As for additional items for recovery:
You will likely have to cover the area with gauze to catch drainage while you heal. In addition to standard 4x4 gauze, I enjoy silicon gauze when venturing outside my home. Panty pads are also helpful for catching drainage and blood in general.
Get non stick gauzes. I tried different stuff but this one is really good. Just place it between your butt cheeks.
The bidet will change your life and is great even after youll be healed. I have this one from Amazon DIHAF Toilet Bidet With Dual... https://www.amazon.com/dp/B09GNF2GHK?ref=ppx_pop_mob_ap_share and also you might want to get a squatty potty too.
This non woven gauze. I cut each piece in half (into squares), then fold it (twice lengthwise) and tuck it between my cheeks and go.
Heavy flow period underwear are going to be your best option. They do make incontinence underwear for men as well, however I am not sure if the layout of them has pad that goes all the way back that would catch drainage.
Here are some disposable pad specifically for the backside:
B-Sure Anal Leakage Pads, Box/24 Pads https://www.amazon.com/dp/B005GDTWOG/ref=cm_sw_r_cp_api_i_NZ959SD7FMDX5CWW780K
Here are some reusable pads I hear great things about:
Lilind® 10 Pack Interlabial Pads, Reusable Organic cloth, Washable Menstrual Pads, Zero Waste 100% Cotton Random Flowers https://www.amazon.com/dp/B088T3SNCJ/ref=cm_sw_r_cp_api_i_T101W85SY4CYH1KD8VKR
Only during the first week or so after surgery.
Due to the swelling caused by the surgery.
I would highly suggest getting a portable Bidet with warm water options.
Bidet Sprayer for Toilet, Handheld Bidet Spray water Kit, Bathroom Hand Shower for Self Cleaning – reduce Toilet Paper Waste – Premium Stainless Steel https://www.amazon.com/dp/B087DZW5H7/ref=cm_sw_r_cp_api_glt_i_ZM0K3YHZY1AKPXQJTQ7Y
Something like this?
Organic Psyllium Husk Powder (24 oz) - Psyllium Husk Fiber Powder for Baking Keto Bread, Easy Mixing Gluten-Free Fiber Supplements for Promoting Regularity, Finely Ground and Non-GMO https://www.amazon.com/dp/B011QGTRG4/ref=cm_sw_r_apan_glt_i_Y131D1H93H0ZCBG886X9
I’m in love with these underwear - they are super comfy, pretty cute, and much cheaper than thinx - I literally replaced all my underwear with them. Great for shitty drainage. Bambody Absorbent Panty: Period Panties/Maternity & Postpartum Underwear https://smile.amazon.com/dp/B08D8Q1ZJ9/ref=cm_sw_r_cp_api_glt_i_2GGX6QPXH69Z9TMJTD9J?_encoding=UTF8&psc=1
I use these ones, which I buy at my grocery store and I cut them in half. I'm going through them so fast (probably change it three times a day) that I just ordered these, though I can't give my review of those yet.
This is a tough time while you wait for your appointment. I agree with a lot of the previous comments:
1.) Avoid spicy / sugar-ey foods.
2.) Don't over-eat. I find that if I ate till I'm super full (think buffet-style) I would be more constipated which would lead to more pain, more swelling
3.) Exercise but more like just walking. I tried lifting when I had my fistula and I found that since I clench my butt while doing heavy lifting, this was probably bad for my healing. I stick mostly to light cardio until I know I am fully healed.
4.) Do Sitz Baths
Have you done this? This is the most soothing thing that helps in my opinion. I use this sitz bath:
and I put in some Dr. Teal's Epsom Salt.
Like others I use non woven swobs, but larger ones, fold ed in half. They last me 2/3 of the day before changing out.
Premier 3 X Non-Sterile Non-Woven Swabs 4 Ply 10 cm x 10 cm White Paper Packs (Pack of 200) https://www.amazon.co.uk/dp/B08G1RBZQN/ref=cm_sw_r_apan_glt_fabc_XQ8DT757VVPMX8MJDE4K?_encoding=UTF8&psc=1
Been using this gauze for 2 years for my fistula. I layer 2 pieces together.
Dynarex Non-Sterile Non Woven Sponge, 4x4 Inch, 800 Count https://www.amazon.com/dp/B0785FH5H7/ref=cm_sw_r_apan_glt_fabc_S26AAG9B4CE1PKA0FPPW?_encoding=UTF8&psc=1
I personally wouldn't out tea tree or coconut oil on the wound. I have done silver gel or prescribed, compounded lidocaine ointments. I use a bidet to keep things clean.
There is some discharge and pain, but lot less than what I expected. I’m only using Tylenol and ibuprofen after the surgery day, because the opiud drugs give you constipation. Also see if your hospital has exparel - this is a non opiud injection, that keeps the surgery area numb for 24-48 hrs. Mine didn’t have that, also get this cushion - Donut Pillow Tailbone Pain Relief... https://www.amazon.com/dp/B07KF9P5FZ?ref=ppx_pop_mob_ap_share
It was helpful Pre op but post op it didn’t fit me much, I liked the bed better.
What are you using as sitz bath? I use something like this: https://www.amazon.ca/dp/B07V1V6G83/ref=cm_sw_r_apan_glt_i_MKHQN4Q8RQD3XXWR0S6R
I agree no wet wipe nonsense gets it clean enough without hurting so I sitz after BM.
There is a link for the one i use. It can be a little messy and a pain to get organized if you're in a rush. But it is still so so so worth it for when you need it.
SmarterFresh Faucet Bidet Sprayer for Toilet - Warm Water Handheld Sprayer with Sink Hose Attachment for Bathroom… (Stainless Steel) https://www.amazon.com/dp/B01E4H7DTA/ref=cm_sw_r_cp_api_glt_fabc_8XMC7005AY8CM8RWS2NF?_encoding=UTF8&psc=1
SmarterFresh Faucet Bidet Sprayer for Toilet - Warm Water Handheld Sprayer with Sink Hose Attachment for Bathroom… (Stainless Steel) https://www.amazon.com/dp/B01E4H7DTA/ref=cm_sw_r_cp_api_glt_fabc_XB4CF60ZJCTYEPXJHS95?_encoding=UTF8&psc=1
It’s normal for the first few weeks. Use a bidet but not on full force. It will help clean after BM.
SmarterFresh Faucet Bidet Sprayer for Toilet - Warm Water Handheld Sprayer with Sink Hose Attachment for Bathroom… (Stainless Steel) https://www.amazon.com/dp/B01E4H7DTA/ref=cm_sw_r_cp_api_glt_fabc_ZP96D7YYYJB9X3WYX9HF?_encoding=UTF8&psc=1
There are anecdotal references to healing without surgery. I’m wondering about this myself. There’s stuff on the web on wheatgrass, diet and hygiene regimen and others. See this below too. Let’s keep talking.
I'd recommend this product more- you can take it with you wherever you 'go'.
SmarterFresh Faucet Bidet Sprayer for Toilet - Warm Water Handheld Sprayer with Sink Hose Attachment for Bathroom… (Stainless Steel) https://www.amazon.com/dp/B01E4H7DTA/ref=cm_sw_r_cp_api_fab_PWYDFbAVM5N3W