Question for Jan Dollar

They rarely heal on their own.

I have a fistula. When the abscess stated doing what you're saying, a sitz bath, as hot as I could stand it, helped it drain. If it's draining on its own, might not need cut. Mine developed the fistula; they say at least 50% do.

I have a seton in my fistula now, which stops the process of cycling and trying to abscess (healing over, filling with mucus/blood, bursting), and it lets it settle down and drain continually. My fistula doesn't involve my pouch... was diagnosed by MRI (something you can ask for; with a J pouch, they may ok one, since you're rigged differently, and they might want to look closely before proceeding further), it's low and intrasphincteric. I saw my old J pouch surgeon for mine, and his first step before proceeding was an MRI. Then it was an exploratory under anesthesia to find the fistula and place the seton.

The seton isn't great, but manageable, and stops 95% of the pain. It's still a bit tender at times, and I do sitz baths about every other day, for comfort. It'll likely be in there for a time, maybe a long time. No plans for anything else at this point.

Thank you for the reply.....I think I will ask for an MRI when I go in. It still seems to be draining pretty good today and not near as painful as it has been. If there is a fistula then it will just reoccur correct? If I can get all this abscess stuff healed up I would feel great as the pouch is functioning well.

Yeah the cycle comes from the fistula. I hope you don't get one.

Rachel, thanks for replying since I was not able to quickly reply.

But, yeah, in a nutshell, abscesses need draining. Sometimes, once they come to a head, burst and drain, that is all they need. But, if this is a deep, perirectal abscess, they need a wider drain and possible exploration. Setons may not be required, but at the very least, you will need to do hot soaks a few times a day to keep it open and draining until it completely heals from the inside.

Hope there is no fistula. It is not a given that it is the case.

Jan

Hi Jan,
Had my colon and j pouch done about 15 years ago. Not alot of problems during that time. Starting getting infections in j pouch alot about 3 years ago. Had the usual scope and antibiotics and finally sent to cleveland clinic. Scoped an was told that the j pouch due to infections has become very sensative and was having spasms which by the time i got to cleveland clinic had lost most of my bowel control and was in pain alot. I have been on opium/belladonna which has really helped gain control again. Changed my life totally had to stop working. Saw my regular doctor and she put me on lexapro and klonipin for my depresstion which was very bad. Working my whole life to not working and dealing with that and lose of my income threw me in a tail spin. Lexapro was not working she changed me to 150 of effor. I am in therepy and it has helped but over the last year i have gained 40 pounds. I work out and eat correctly most of the time. I do not eat red meat. I just gain and gain. Dont know what to do and will do anything to lose the weight and feel healthy again. I have looked 100 times about side effects and nothing big on weight gain. I was 165 a year ago and now 212 and i am 5 foot 10. Dealing with alot emotionally but feel i am getting better but the weight thing i just dont know what to do anymore. Please please any advice?
Thanks for your time.
Frances

Sure, sometimes unintended weight gain is a side effect of some medications, but it is too easy to try to pin it on that. So, I think you are smart to look at others factors.

Depression alone can lead to weight gain and there are multiple factors. It leads to emotional eating, which often is empty, snack food calories. Plus, not working drastically reduces your activity levels. And pile onto that, the fact that the stress and anxiety associated with finances, employment, your health, your weight, etc. alters your metabolism.

My weight gain was gradual, age related, and simply due to eating too much. "Eating right" and exercising didn't work for me. I actually gained more! Over 20 years I went from 130 to 235, and I'm only 5'5". I went through a medical weight loss program, and there was no "secret." It all boiled down to eating less, a LOT less, and staying active. I lost 65 pounds that way, but gained back 25-30 pounds over the past few years. Avoiding sweet, salty, and fatty foods was important, as these food types stimulate the brain to eat more.

So, I am unsure if you can tackle your weight while are dealing with other health problems. But, maybe shedding a few pounds would improve your mood? It does help to ave a diet buddy. My husband and I didthe weight loss program together.

Good luck. I know how difficult this is.

Jan

I cant thank you enough for just saying you know how difficult this must be. It has been the hardest year of my life. I am not looking for a magic pill just want to be healthy and loose the weight. I am thankful that i have a medicine that keeps everything under 90% under control. I have a wonderful family that has been great. I thank god for them. I just feel like a salmon swimming up stream with every step foward i go two back.
I will not give up i cant but i just want my hard work to pay off on the scale.
I have been through alot and i will figure it out but it sure is nice to here your kind words. I dont have any friends besides my family and they all work outside the home.
I hope you have a wonderful day you have made my day a little lighter.
Frances

Frances,

Hopefully you are discussing the weight thing in your therapy sessions. Since I know nothing about you personally, I may be all wet in my thinking. But, for me, I needed to be OK with an imperfect outcome (I am not going to be a fashion model or wear a bikini). I do not hang my happiness on my weight, and I know I will always be a little chubby (more to love?).

Perhaps if you joined something like Weight Watchers you could get the motivation you need. Once you lose 10 pounds, you'll begin to feel more like a success.

Jan