20.9.12

My story: downhills


I will pick up were I left off..

The open wound

When visiting hour was over the nurse came to my bed to take a look at the open wound. It was wrapt with a lot of bandages and a drain was sticking out that was tied to a plastic bag and that bag was tied to my hospitalbed. There was a lot of blood and pink smelly fluid when the nurse removed the bandages. That was the first time I smelt pus. And let me tell you, it's not a pleasant smell. The nurse told me it was a very deep large open wound about 3 cm away from my ano. She also told me they were going to clean the wound twice a day. I thought she was talking about the outside of the wound, but when she came back with catheters and all I started to suspect it was going to be inside the wound. She told me to lay on my side and she started to stick a catheter inside the open wound, next to the drain that was already there, and started to spray water through the cathether into the wound. OMG that hurt!!! I just screamed and grabbed the side of my bed and was holding it so tight untill she was finished. I never scream, so it was so weird that sound was coming out of my own mouth. Then she told me she was going to put gauze into the wound. I just grabbed my bed in advance and she started pushing the gauze in. That was even worse! I was bagging her to please stop. But she told me it was absolutely necesarry and I had to try to lay still. Ones the gauze was in I was given very charming panties and a large sanitary towel..hmm.. My hospitalroomies asked if I was oké and they felt sorry for me I had to go through that twice a day.

My most critical moment

I was feeling very sorry for myself too:( Besides the pain of the wound terror I also started to feel the after surgery pain, so the nurse gave me some painkillers, that helped a little bit. I was really tired after all of this and just wanted to sleep. Maybe the pain would be better the next morning. During that night I started to get really cold, so I asked the nurse for an extra blanket. That didn't help so I asked for another one because I was shivering. I tried to sleep again and I woke up feeling so warm and just not well. I pushed the red button again to call a nurse. She took my temperature and it was extremely high. They called the doctor in and he wanted to check my blood. So my blood was checked and they came back about an hour later to tell me it was going dowhill with me. From what I can remember I made some kind of joke and the doctor told me there was nothing to joke about because I was having a sepsis and I could die.. I remember they were drawing blood from me every half hour. I was beeing checked and monitored constantly and given antibiotics and more liquids through my IV. My mom told me that I had called her to say I could die, and that's it, but that's the only thing I can remember. I guess I was to sick to really comprehend what situation I was in.
The following days are very blurry to me. I'am told I was sleeping a lot. The good part is that the antiobiotics did what it was suppose to do, and in the following days my temperature and bloodlevels started to decrease. Yeeeeh!:) A nurse showed me my bloodresults a week later from the night I had the sepsis. I guess she still had the feeling I was so calm about it, I was just babbling with my roomies and didn't get that I could have died that night. My CRP level was 370, normally they are between the 0-10, when you're not feeling to well they are about 20. Also my leukocytes(white blood cells) were sky high. I guess it's when she showed me this I came to realize I had been very lucky.

The aftershock

Till today I still can't really be sad, scared, mad or extremely happy about it. I think it's because I was sort of 'away' when it al happend and I wouldn't be the one to know it if I had died, because I would be the one who was dead.. It did scare the shit out of my family and friends. My mom told me she had made a phonecall to the doctors office who had let me walk around with my symptoms for more than a month. She told them crying and angry that I could die because of their incompetence. If they would have just believed me.. That's so not like my mom, but I'm so proud of her! She and my dad switched to another doctors office soon after.
I was feeling really weak and couldn't walk without help, or I would just fell over or faint. I was overwhelmed with flowers and presents and good luck cards, so sweet. I do take life somewhat more relaxed now. I think that's due to this experience and also because of me being sick for more than a year now. The things that you normally dont't even think about are not so normal to me anymore. I can be very happy when doing my own groceries or just sit on a sofa instead of lying on my side all day.

Perianal fistula's

As I explained earlier what a perianal abscess and a fistula is, I'm now gonna show you the types of perianal fistula's. Yes you've read it good, there are also types in this kind of fistula's. The types depend on the place they're in your butt and whether or not they cross or go through your sphincters. Ruffly speaking there are 4 types of perianal fistula's as seen on the picture below:


The percentages in the picture stand for how often this type of fistula occurs. What's not shown in this picture is that the placement of a fistula can be higher and lower. A high fistula is more close to the bowel.

In cases where the fistula is still cousing absesses an abscess will develop from the track of the fistula.

My fistula is a high Trans-sphincteric fistula. That means it's beginning is high up in my rectum, goes through both sphincters and ends up in my butt. My fistula track has developed some side-tracks and started to create abscesses here and there, those are the red dots in the drawing below. It shows just how a fistula can develop.


Because of the placing of a perianal fistula it's not just a matter of cutting it out and that's it. You see, when they would cut out the fistula they will have to go through your sphincters and that means incontinence problems. That's why the surgical treatment of perianal fistula's are limited.
 
When a fistula is not treated infections will keep running through it and sooner or later will pile up and develop an(other) abscess.
 
I will talk more about the treatment of perianal fistula's in another post.
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