Treatment of fistula
From the end of April 2016 to the present, I have undergone three anal fistula operations in more than a year. Because the shadow of the previous two operation failures has been looming over me, before writing this summary, I even went to the bathroom specially, took the mobile phone for three seconds, and took a close-up of the chrysanthemum: the folds are fine and uniform, the skin is dry and smooth, and one line is about The three-centimeter-long scar extends obliquely at 7 o'clock. The scar is healed very well, leaving only a white line. I carefully examined the photos and felt comforted. Since I was a teenager, the external hemorrhoids protruding around my anus have been large and small, and have never been flattened. From the first operation last year to the second after the third operation For ten days, the secretions have been soaking my perianal skin more or less, and it has never been cleaned. This photo tells me that I have recovered and never have to endure the torture of hemorrhoids. How lucky!
In the treatment for more than a year, I have gritted my teeth and waited anxiously. I have prayed countless times and disappointed many times. Many details have not been remembered, but many moments flashed in my mind from time to time. As in sight. Here, I would like to list some unforgettable people and events, leave a memorial for myself, and give some reference to other patients, and also take this opportunity to say thank you to those who have cared about and helped me!
In the Spring Festival of 2016, my stubborn hemorrhoids disease began to attack. I deliberately adjusted my diet and used hemorrhoid ointment every day. My condition was getting worse and worse. Even the severe pain of defecation was difficult to relieve all day long. I went to the anorectal department of a local tertiary hospital for two outpatient visits, and also specifically named the professor. The two professors had different opinions. One said I had a mixed hemorrhoid attack, and the other said I had an anal fissure. But their methods of diagnosis and treatment were the same: I slammed my chrysanthemum with a thick finger, and after some groping, prescribed a bunch of medicines for internal and external use. The treatment effect is also the same: the condition is still getting worse.
Three months later, I was already fidgeting with pain. One night I was even rolling in bed with pain. I immediately contacted a friend who worked in another local tertiary hospital and asked him to take me to the doctor early the next morning. This time I saw a careless general surgeon with a stern and impatient look, as if everything was under his control, and he didn't ask much. However, he was very kind. He only asked me to take off my pants and show him. I didn’t need a finger examination. He could judge hemorrhoids and anal fissures at a glance. He also looked at the face of my friend and was willing to help solve my pain without spending too much money. Money, just administer anesthetics on the outpatient examination table, cut off the hemorrhoids, and take five minutes. However, according to my previous knowledge on the Internet, hemorrhoid surgery is small, but it is troublesome to recover after surgery. Therefore, although the doctor downplayed it, I did not dare to rashly agree, so the surgeon prescribed me some anesthetics and asked me to go home by myself. Rub to relieve pain.
After carrying it for a few days, I found a white spot on the anal margin, like a pustule-like head. At this time, I had trouble walking and fidgeting. During the period of being sick, I found the "Hemorrhoid Abscess and Anal Fistula Surgery Exchange Group" on the Internet. I found that the Niu brother (Xiongniu 618) in the group always answers questions and gives professional guidance to the patients. I put the symptoms in the group. Brother Niu said in detail that Brother Niu judged that it might be a "fistula" and asked me to hurry up and perform the operation. Taking into account the convenience of dressing change and re-examination after surgery, I want to be closer to home. I still choose to go to the local tertiary hospital, but this hospital does not have anorectal department. Only a branch of the general surgery department is related to anal fistula. They treat severely ill patients such as stomach cancer, bowel cancer, and thyroid cancer. Generally, they don't arrange hospitalization for such minor problems. Can only go to friends for help. This time, I was looking for a middle-aged associate professor, who was very young and experienced. He finally diagnosed that it was an anal fistula rather than hemorrhoids that made me feel painful. For the sake of my friend’s face, I was admitted to the hospital immediately, but he could only let me live on the balcony. .
2. The first operation
I was admitted to the famous top three hospitals in the province, and I felt relieved. Although I asked my friends before I was hospitalized, I heard that the Provincial Hospital of Traditional Chinese Medicine performs anal fistula surgery the most, should I go there for a look? But he answered me, your problem is just a pediatric surgery. Now this hospital doesn't know how many bowel cancer surgeries should be done every year. Anal fistula is not a piece of cake. So I honestly followed the preoperative examinations prescribed by the doctor to queue up one by one: blood test, B-ultrasound, chest X-ray, CT, colonoscopy...for four or five days, because it is necessary before colonoscopy. I thoroughly cleaned my intestines and experienced the painful experience of drinking two bottles of liquid laxatives (I don’t remember the name of the drug), filling five liters of mineral water, running the toilet six or seven times until the whole person collapsed, and finally discharged is the painful experience of clean water, plus It was originally a perianal abscess, and it was painful and cramped every time I excreted.
I finally waited for the doctor's notice that the operation could be arranged the next day, and the preparations for colonoscopy were done again that evening.
Just like most operations, I was nervous when I entered the operating room. I didn't know anything when I took the anesthetic. When I was awake, I was already lying on the cart and sent to the ward. The doctor happily told me that the operation went well and the inner mouth was found quickly. I don’t worry about asking, have my hemorrhoids been taken care of? The doctor said that he had done a few ligation of internal hemorrhoids, but no external hemorrhoids were found. My heart sighed, no external hemorrhoids?
The postoperative pain was a little bit painful and I could bear it. The doctor took a special photo of me during the rounds. The anus was knotted with a yellow plastic flat thread, but there was a swollen external hemorrhoid, which protruded from the outside. I can't see any wounds. This is very different from what I expected. I am a little worried, but I can't say it clearly. The hanging thread fell off on the fifth day. The doctor said that I recovered quickly and could be discharged from the hospital. He prescribed diosmin tablets for oral use and Taining suppository for external use, and instructed to use potassium permanganate for a daily bath. After returning home, the swelling pain gradually disappeared, but there was always a tingling sensation during defecation, and there was a dark yellow discharge every day, and a granulation grew on the hole where the thread was hanging, which became bigger and harder. Half a month, one month, one and a half months, two months...I go for a review every two weeks. The doctor always looks outside and says that I am recovering well, but after two months, my symptoms are not at all No change, I couldn't help but ask him, what's the matter with this fleshy pull and yellow discharge? When will bowel movements stop pain? He vaguely said, maybe this is the case, I don't know.
Looking at his awkward expression, I knew that my first operation failed.
Third, the second surgery
With a fluke, I insisted on plugging various hemorrhoid plugs. I dragged on for another three months, but there was no turning point in my condition. During this period, a summer passed. Because of the high temperature, the secretions from the anus mixed with sweat made the perianal eczema, and the pain added itching. By the end of September, I was determined to go to the Provincial Hospital of Traditional Chinese Medicine for a second operation.
The Provincial Hospital of Traditional Chinese Medicine is known as an authority on anorectal technology in the province, but its hardware facilities are rudimentary. The ward is located in an old building. The yellowed walls are covered with dirty marks. I don’t know how many patient’s fingerprints, sweat and blood are mixed; the bathrooms are full. Dirt, for many years, the traditional Chinese medicine from the patient’s bath was poured in the toilet, and the medicine residue that was not cleaned in time settled on the wall of the toilet, forming a helmet; at the end of the corridor are the dressing room and the operating room. There are three in the dressing room. The dressing table is symbolically separated by a curtain in the middle. When it is time for dressing change, there is a doctor sitting in front of each table, and his patients line up behind him, taking turns on the stage. The new patients are a little embarrassed. Old patients can pull their trousers down and lie on their sides on the table for the doctor to change the dressing, and also for other patients to observe. A new female patient was preparing to go through the hospitalization procedures. Passing the door of the dressing room, she saw a white buttocks, all with blood and blood wounds. Sometimes she heard a patient screaming out of pain and she was immediately scared. Fainted, this is true! The operating room is next to the ward, and the conditions are better than the ward. There is one less dressing station and two more instruments. That's it.
The operation was very fast, but the postoperative recovery was difficult.
After the first operation, I urinate very easily, so I did not ask the doctor to insert a catheter for me this time. I did not expect that I would suffer more pain than an abscess. There are a lot of infusions after the Chinese Medicine Hospital. Seven or eight bottles of various sizes have been infused for four to five hours, but I did not urinate all night. The various liquids in those large and small bottles passed through my The blood vessels, kidneys, and urethra were all blocked in the urethra. It seemed that there were thousands of troops gathered under the city gate. With all my strength, I could only open a small gap in the city gate and let out some pawns sporadically. Those who can't get out are rampaged in my lower abdomen. I clearly remember that all night, I was constantly rubbing my stomach, running to the toilet, and then returning to spend it without success. It was not until noon the next day that I emptied my bladder intermittently. I don't know if it has anything to do with the anesthesia method. The first time I was under general anesthesia, the second time was spinal anesthesia.
The second tribulation is changing the dressing. The Hospital of Traditional Chinese Medicine requires patients to change their dressings every day after the operation until they are healed. One patient who lives in a neighboring city has a large wound. He drove more than an hour a day to change the dressing for more than two months after the operation. There are many surprises in the dressing change process. Some patients need to tighten the thread. Every time a patient tightens the thread, the entire ward can hear the screams of wailing. It is creepy. Some patients need to trim the wound. If the doctor says the wound is growing up Now, that's the patient's nightmare, the thin skin and tender flesh that has grown a bit anxiously, the scissors are running across, and the blood is dripping. At this time, the onlookers turn their heads and cannot bear to look directly.This time, the thread I hung fell off on the seventh day, and I didn’t have to suffer from the tightening of the thread, but the pain of trimming the wound made me feel lingering afterwards. The doctor said that my physique is special and the inner mouth always grows granulation, so in addition to trimming the outer mouth, I have to trim the inner mouth. Every time the inner mouth is trimmed, it is a technical test for the doctor to change the medicine for other patients. Often graduate students do it for me, and the dressing must be changed by the female professor himself. She first used an anal expander to expand the anus, rinsed the wound inside with a metronid file, and then used tweezers to reach in, so that the stubborn one would not be burned by wildfire. Exhausted granulation is clamped off, and finally the drainage strip is pressed up. The action should be fast, accurate, and ruthless, otherwise it will be difficult to operate after the blood flows out. I was lying on the dressing table with my mouth wide open, taking deep breaths one by one, trying my best not to hum, and I felt sorry for the doctor, although this special treatment was not what I wanted.
When the dressing was changed to 70 days, the female professor gave up, saying that the inner mouth had grown up, and there was still a protrusion, but that was because of my special physique and there was no way, but fortunately, it did not affect the recovery. I was worried that there was no better way. I had also consulted the director who performed the operation before. He did not come to a conclusion on my condition, but the treatment measures adopted were the same as the female professor. I am anxiously watching the changes in my body every day, a small amount of secretions have been flowing, the position of the inner mouth is always a little swollen and painful, there is a small hole at the six o'clock position of the anal margin, which can’t be closed, and whenever diarrhea or When you are in an emergency, there will be unbearable loose stools flowing out of that small opening. I went to the director for review and raised all my doubts. This time he told me frankly that the position of the thread was a little lower and the upper end of the fistula was not hooked up, so the internal mouth would have hyperplasia and a little inflammatory secretion. It is recommended that I have another operation in a few months to completely remove the remaining fistula.
The director is an authority in the province. He does not evade his own mistakes. From his calm face, I can see the hidden apologies. I know that the second operation has failed.
Fourth, the third operation
After a digital examination and anal B-ultrasound examination, Director Zheng thought that I had a high anal fistula remaining, and it would not be too much of a problem without surgery for the time being, but this is a time bomb and may go wrong at any time. I asked her if she would hurt her sphincter after another operation, and she said no. I asked her how many days it would take to change the dressing after the operation. She said that there was no need to change the dressing. She had a good effect on the drainage of the virtual and actual thread, and just a bath. I asked her how long I would stay in Beijing when I was out of town. She said that after the operation, she felt good and could go home. The stitches would be removed in 20 days. I asked her if the operation hurts, and she said it did not hurt. Director Zheng always smiled when he spoke, but his tone was firm and confident, which made people feel very at ease. I decided to let Director Zheng perform the third operation on me.
The preparations before surgery in China and Japan are also very simple. After going through the admission procedures in the morning and doing some routine examinations, the surgery can be done in the afternoon. Do not enema, just defecate naturally.
Director Zheng is really a fairy!
Although my postoperative pain is a bit heavier than ordinary patients, especially on the sixth and seventh days, the anus swelled like a piece of iron embedded in the flesh, and I wanted to dig it out, but the postoperative recovery was normal and very normal. smoothly. After the operation, the medicine was changed twice in the hospital. The Chinese-Japanese medicine change is different from our local Chinese medicine hospital. The Chinese medicine hospital puts the coated gauze strip into the anus for drainage, and then covers the outer mouth. Put a clean gauze on. The dressing change in the Chinese-Japanese Hospital only needs to clean the outer mouth, and then apply the medicine to seal the gauze. The hanging thread has drainage effect, so there is no need to insert the gauze strip in. This kind of dressing can be changed at home. Trouble with the doctor, so I decided to go home on the eighth day after the operation. Before going home, I asked Xiangu a question I was most worried about. What if the granulation grows? The Chinese Medicine Hospital cut me scared. Xiangu still smiled and said, okay! The tone is firm. So I went home with confidence.
There is another important reason for being able to go home with confidence, that is, Brother Niu said, this time I will follow up with you throughout the whole process. If you have any questions, please feel free to tell me.
After returning home, rest assured, take a bath in the morning and evening, and change the dressing on time. During that period, the most important thing every day was to get up in the morning to defecate, wash the sitz bath, take pictures for Niu, and then change the dressing. Brother Niu told me to drink more water, sleep more, and move around more. I did the same. Brother Niu emphasized that eating is not important. I just eat normally. I don’t specifically supplement chicken, duck and fish, nor only eat vegetables and fruits. I don’t have a stool every day. Not thin, just in shape. The wound healed quickly. After 15 or 6 days, the external mouth was almost closed and the secretion was greatly reduced, but the swelling pain lasted until 50 days before there was basically no feeling.
Twenty days later, I went to Beijing again and asked Director Zheng to remove the stitches. Before the stitches were removed, I asked Director Zheng, did it hurt? Director Zheng still smiled and said that it doesn't hurt. The tone was still very firm, I still believed, but this time she lied to me. After the stitches were removed, I came out of the clinic. I told a patient who came from Tianjin to remove the stitches unkindly. It hurt me to death. I used the anal expander to expand my anus, and then I took the scissors to cut the stitches. Blood, you are mentally prepared. But then I asked the patient, he said that his thread just pulled out from the outside, and it didn't feel at all. He doesn't even hurt! It can be seen that some experiences cannot be copied. When the stitches were removed, the director asked me to check again in fifty days and gave me a stress test by the way. She said that if the stress test proves that my anal function is normal, it means that our surgical level is already leading the world. Up. And You Rong Yan.
After removing the stitches, I stopped taking baths, changing dressings, and taking medicines, but according to the director and Brother Niu’s instructions, I put a little Chuangyining on the Taining suppository every day, and took it into the anus by the way. When Yuning is used up, use Jingwanhong or Moist Burn Ointment instead. The pain is relieved very slowly, sometimes the whole right buttock is numb and sour, and there is always blood in the stool, which always makes me suspicious. Niu said that soreness is normal, and bleeding is a good thing, because bleeding grows flesh. , No bleeding is troublesome, I just relax a little bit.
I went for a review after fifty days. It was Labor Day, so I went to Beijing a few days in advance and decided to take a good stroll around the few scenic spots that I had never visited. Beijing is my blessed place, and Xiangu is my noble person. I often sigh. Before I went to Beijing, my butt was still sore. The next day I arrived in Beijing, I went violently across the city. When I came back at night, it was nearly 20,000 steps. I thought it was my own death. Go to the toilet to take pictures and observe the secretions. Net, very cute! Even more amazing is that when I wake up from sleep, my numbness and soreness are greatly relieved. On the third day there was another rampage, from Dongzhimen to 798, from 798 to the Old Summer Palace, from the Summer Palace to the Summer Palace, from the Summer Palace to the Drum Tower, and then from the Drum Tower to Dongzhimen. After one day, the numbness and swelling were hardly felt. I went to see the clinic on May 2nd, Xiangu gently touched her finger and told me that she had grown better, but her skin was still a little thin, and it would be completely better in ten days. Then I went to the Western District to do a stress test and anal B-ultrasound, but no problems were found.
This time, looking at Xiangu's relaxed smile, I knew I was saved.
After more than a year of seeking medical treatment, I tortured my body and tempered my mind. After this disaster, my understanding of many things has changed.
After returning from Beijing, I told the students that you feel that it is hard to study now, and sometimes it is almost dark. I sympathize with you, because when I was sick, I also felt that the light is really far away, and every day I suffer. But if you take a long-term perspective and believe that time will not fail people who work hard, assuming that you have stepped out of the darkness at this moment, looking back at this point of training, it really doesn't matter. I have undergone three surgeries. Whenever the pain is hard to endure or I lose my confidence, I think, I can’t die from this disease anyway, and I can overcome it if I die. What I have to do now is to take good care of it according to the doctor’s requirements. Take a good rest, time will definitely return me a healthy body. There is always an end to your studies. When you feel tired and hard, don't think about things that are too long. Just study hard according to the teacher's requirements. Time will definitely give you a bright future. Thinking about it carefully, how many things in life are based on this principle?
However, just bear it blindly, you have to learn to choose in life. There are many factors that influence our choice, but it is often unimportant factors that determine our choice. For example, under the premise that economic conditions permit, what should be the first consideration for treatment? Of course it is to find a good doctor. The first time I went to a local tertiary hospital was because it was close to home and convenient for family members to take care of, but I didn't consider their lack of experience in anal fistula surgery. The reason why I went to the Provincial Hospital of Traditional Chinese Medicine for the second time, finally took the medical skills into consideration, but ignored that my first operation failed, and the second operation became much more difficult. Maybe they have nothing to do. In fact, the proximity to home and the high reimbursement ratio were considered. What if I go to Beijing for the first time? I have to suffer less. At least the second time, I should go to Beijing decisively.
Yesterday a parent told me that his child is determined to be a doctor and relieve the suffering of the world. After hearing this, I was very moved. Quack doctors harm people, good doctors save people. The value of a good doctor is by no means measurable by their income, so I told the parents that your child is amazing and he has a real sense of saving the world. Of course, Ji Shi does not necessarily have to be a doctor. People in any profession, as long as they do their best to do well, it is Ji Shi. Therefore, as a teacher, after more than a year of ups and downs, I suddenly added a sense of awe to my job. I often remind myself that maybe you can't be a good teacher, but you must not mislead others.
June 5, 2017