Update

October 10, 2013

I figured I should update since it’s been quite a while since my last post and a lot has happened. I’ll try to keep it short though.

For one thing, Crohn’s is the only disease I have as far as anyone knows. There were some ideas that I could have Behçet’s due to the ulcers I had on my skin and eyes, but I guess they were due to severe Crohn’s plus the stress of infection.

In September 2012, I had really hit a breaking point where pain was concerned. It was getting very difficult to walk, stand, sit, or basically do anything but lie down on my side. I basically begged my GI to help me. She sent me to the Johns Hopkins emergency room. The GI team decided to debride my wounds and basically make the two small wounds into one very large wound. After that, they attempted to place a wound vac, but it couldn’t get a good seal, and it just wasn’t working out.

Since the debridement allowed my wound to drain freely, it actually took away some of the pain and the weird symptoms I had been having. I was able to walk a little more freely, but the wound was huge and the inside was still really painful. They started me with pulse lavage treatments to clean out the wound. I feel like they didn’t do much, because there was literally so much drainage that it was a constant flow. They also treated the wound with silver nitrate to get rid of hypergranulation tissue; it hurt like hell, but they gave me some lidocaine beforehand which made it easier.

Most of the time spent between then and now was just doing that and healing very, very slowly. However, the purulent drainage just kept flowing. Eventually, they decided to put me on penicillin, and the drainage just went down to almost nothing. It seemed ridiculous to have waited so long to try antibiotics again; I was told I didn’t need them after I had IV antibiotics in the hospital, because they assumed my wound would be clean after debridement. There were no obvious tracts for drainage, so I guess I can’t blame them. Plus, I had been on antibiotics before with no improvement. This time though, there was a huge improvement.

After starting the penicillin, I just went to the clinic every week for silver nitrate treatments, and the wound started healing better than ever, but still very slowly. I was on penicillin for at least four months. Now, I am off medications and not doing the treatments any longer (or at least that often). However, I STILL have a rectal wound and it STILL has small amounts of drainage. I pack it with gauze every day, and I still have pain. To think, this all started on December 11, 2011, and I STILL have a wound. It’s pretty depressing, and  all I can do is hope that it goes away soon.

The worst thing is that I will no longer be eligible for my health insurance in a few days. I don’t really know what to do besides wait it out and hope I don’t have major problems until I can get something cheaper in a few months.

Also, one thing I didn’t mention was my encounter with a plastic surgeon. After my wound was debrided, they thought they’d give me muscle flap surgery to fast forward the healing process. The plastic surgeon I dealt with was really the worst doctor I ever dealt with. I mean, I’m sure he performed great surgery, but otherwise he was really the worst. Basically, I was jerked around for months without even being scheduled for surgery. I kept calling and his assistant would just tell me she couldn’t schedule my surgery until the paperwork was done; well, the paperwork literally took weeks to get off of his desk (even though my GI surgeon had wanted the muscle flap done while I was still hospitalized). I even had appointments and emails with him where he kept saying he was placing me at number one priority, but after he’d tell me that he would go back to ignoring me for more weeks. I eventually had to just break off contact with him, and my GI surgeon told me I probably didn’t need the flap anymore anyway because it had been so long. I’m glad it didn’t happen, because I’m almost 100% certain it would have failed since the drainage came back full force, but it was still the worst experience I had with a doctor and office. I was really made to feel like I didn’t matter at all, when all of my other doctors were always prompt with callbacks and never left me hanging.

Anyway, that’s basically where I am now. Just waiting and waiting forever for this wound to heal so I can move on with my life.

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Winging It

December 31, 2011

A few days ago, I had another checkup. My deep wound has a good amount of pus boiling inside of it. Awesome. The visit involved a pretty torturous wipe out with gauze. My surgeon recommended I go to physical therapy for “pulse lavage.” When I went, I found out that it’s basically a tube with a little rubber cone on the end where water comes out and shoots into the wound and vacuum suction pulls it back out with the debris to wash to wound. I basically lasted 3-5 whole seconds before I couldn’t take it anymore. I was nervous to begin with, but I was hoping it would be a moderately soothing experience, but I didn’t even really feel the water, just pain. So the guy who was doing it is also a wound care specialist, and he gave me a different packing to put in the wound. I’ve used it before on my stoma; it’s called aquacel and it’s basically a silver dressing that promotes healing and soaks up debris. He also gave me an antiseptic wound spray to spray all up in there. The packing hurts a lot less than stuffing all that gauze in there, but it is also very expensive and not covered by insurance. I’m going back tomorrow to see if we need to make any changes.

Christ.

December 19, 2011

Just FYI, last night’s packing change was a NIGHTMARE. It was soooo painful. There wasn’t any bleeding or anything, but it was probably some of the worst pain I’ve ever felt in my life. I had to tell Rob to stop. I could not tolerate it at all. I literally sobbed after it was finished, and I’ve always thought myself to have a high pain tolerance.

Today, Rob got off the hook, because I had a follow-up appointment with my doctor and she changed the packing. Not as bad as last night, but still very painful. I was very tense and nervous the entire time. She also removed the drain which was no big deal in comparison.

Anyway, I got her to write me a prescription for a stronger pain medication. The percocet just was not cutting it, so she wrote me a prescription for dilaudid. I’m hoping that this helps a lot more, because I do NOT want to go through another packing change like that. Ever.

Phew…

December 18, 2011

I just want to say, tonight’s packing change went much better than last night’s. We did everything the same, but I didn’t bleed all over the place like before. I think the extreme pain from last night was due to the bleeding and the pressure that built up inside from all the blood. So…not that bad. Hopefully, it continues to go more and more smooth from now on.

Slightly Traumatic

December 17, 2011

I spent two nights in the hospital, and I’m home now. The biggest thing to deal with now is wound care and pain management. I still have the penrose drains in until Monday when I have my recheck appointment.

Basically, I have two wounds. I have the smaller wound where the draining tract to my abscess was in the middle of my buttcrack; my surgeon made it a little deeper and scraped out the granulation tissue. Then I have the deeper wound where my rectum and anus were removed. Both need to be packed daily with gauze and “Intrasite” wound gel.

Last night was the first night Rob had to change out the packing. He has been dealing with the smaller wound for a while now, but the deeper one is new. He watched the surgeon do it in the hospital, and it’s a simple task, but it’s still pretty daunting. An entire 4×4 gauze fits into that wound, and it’s a pretty painful experience to go through.

He took out the dressing and I took a shower to clean it off. After I showered, it started bleeding a good amount and didn’t want to stop, which made it difficult to insert the packing. It was just extremely frustrating and slightly scary.

Then, a little while after, the packing became extremely painful. Like, I was shaking painful. It was really awful. I felt like I could hardly move. But then, I adjusted position, and it felt like some more blood came out and I felt immediately more comfortable. I don’t know. It eventually stopped bleeding, but damn.

I’m hoping tonight goes much smoother, but we’ll see.

So, until recently, I have been living pretty uneventfully for a while after surgery. Like I’ve mentioned before, actually having the ileostomy has made my life much better than before. Crohn’s disease doesn’t like to give up though. I still have my rectal stump that was left in after my initial surgery, and I’ve started having some big issues with that.

I noticed there was a huge problem when I was getting a lot of irritation in the crack of my butt. I had a lot of discharge from my rectum, but I just thought that was normal mucus discharge and that the irritation was from moisture. I thought that until I actually had a hole in the crack of my butt. A deep hole. A hole that I couldn’t really see the end of. That was oozing pus. Pretty freaking nasty.

So I went to my doctors (who I love, by the way, because they always take care of me so well), and I was sent to get a CT scan. The results showed that I had an abscess around my rectum. After consulting with my surgeon, she surgically cut the hole open more so that it drained easier, and it’s actually been less painful since then. However, now I have a gaping wound on my butt that I have to keep gauze dressing over.

While I was under anesthesia, she took a look at my remaining rectum with a scope. Apparently, Crohn’s is attacking it so badly, that it basically ruined the closure from my surgery. A little hole must have formed somewhere that is now allowing bacteria from my intestines leak into my pelvic cavity.

My surgeon tells me that I won’t be able to avoid having yet another surgery to remove the remaining part of my rectum and anal sphincter. I’m pretty nervous about it. She told me that she’s not sure she’ll be able to close the wound surgically because of the bad infection. I think having my rectum removed and having another large, gaping wound is what I’m most afraid of. We’re hoping to do the surgery during my break from school, which is pretty soon. So we’ll see how it goes, I guess…

I’m currently on a bunch of antibiotics and keeping up with dressing this really scary looking, draining open wound. I’m pretty nervous about having to go through this yet again. I guess this means it will be gone for good though. Finally.