Surgery: 12.05.06
The quick summary
My second surgery was a lot better than the first. I came away with a scar very similar to the first one although perhaps slightly longer, about 10cm which extended a little lower than the first and again had a small area about 1cm long at the base which was not stitched closed for drainage. I didn’t have as much pain as the first time around, and the aftercare process was a lot less problematic, I’d sussed the system at my GP’s surgery by this time and was well known by all the nursing staff. Eventually with the help of antibiotics, a steroid ointment not licensed for use in the UK and a lot of time the wound did heal in January 2007. However that wasn’t the end and a few months later I had a recurrence a new sinus had formed along with a lot of pain and cursing from me. It’s unclear to me whether this recurrence was a really a new incidence of the disease or just the original infection which was temporarily knocked back. I have a strong suspicion it was the later.
The detailed account
So on to the second surgery which was essentially a repeat of the first one. By this time I had formed the opinion that my first surgery had failed because part of the infected tissue from the original surgical site was missed at the first surgery. It seemed to me that where it hurt most at the top of the cleft of my buttocks was where the suture line started and I was concerned that the area they removed there couldn’t have been wide enough. So although the sinus had been removed the underlying infection was still present and eventually worked its way down through the recently healed scar tissue formed after the first operation. I stress that this is only my opinion and may not be true at all, but it seemed to fit to me as a theory. The only other thing I could think of was that the area at the base which was not stitched closed could have provided a good entry point for hair and bacteria to get into the wound but my consultant insisted that it was necessary and that it shouldn’t have caused a problem. A third factor which also was in contention was that I had previously had a reaction to the stitches used inside the wound. One of the nurses at my surgery put this forward as an idea after I also had to have a couple of moles on my back removed during the time the first surgery was (not) healing. The wounds I had from this which were only small and were stitched with dissolving stitches also did not heal well, one of them became infected and the stitches didn’t seem to rot as they should have done. For this reason my consultant claimed he had used different stitches for this second surgery, to be on the safe side.
This time around I took the laxatives right from the start. It was a lot less painful, and sitting on the toilet wasn’t nearly as painful as after the first surgery. I had high hopes. Again I stayed off the area, sleeping on my side, lying or kneeling instead of sitting and generally being careful. I tried to eat very healthy as I had done the first time around, as I was told that a high protein diet with lots of fruit and veg would really speed up the healing process.
By now I was savvy in the art of booking ahead for appointments with the nurses at my GP’s surgery who all knew me well since I’d spent the last 5 months seeing them pretty much every other day. They were great, always cheerful and professional, and they made me laugh which wasn’t easy at that time, I was pretty miserable on the whole. So I went in for my dressing changes and things were going well. I had my stitches out after two weeks, with no real dramas and very little bleeding compared to the first time. However as time went on and the general pain and discomfort subsided I couldn’t help feeling that it still didn’t feel right to me and sitting was still uncomfortable. I noticed the familiar pain at the top of the wound return and again. The area at the base of the suture line was still open and refusing to heal up. I had a couple of courses of antibiotics in case there was a lingering infection which was preventing the site healing, but in the end to no avail. Incidentally I am now a relative expert in the use and consumption of commonly prescribed broad spectrum antibiotics and some of the narrow spectrum ones as well! It scares me how many I have had and I wouldn’t be surprised if I’m now harbouring some bugs with some pretty impressive immunity.
So after about 3 months my consultant told me that he had spoken to a colleague of his who suggested using a particular steroid ointment around the area to try to encourage it to heal up. This ointment wasn’t licensed for use in the UK but nevertheless they were happy to prescribe it to me and so I went away with this, and sure enough it did seem to speed up the healing quite a bit, eventually to the point where it stopped draining. However I still had the feeling that all was not well, and a couple of weeks later it began to start discharging again. At this point I think my consultant at that time gave up with me, he’d done all he could think of and so he referred me to his colleague who had suggested the steroid ointment. A plastic surgeon who I was told could perform a flap surgery which would likely sort out the problem.
My new consultant was reticent, he explained that the flap surgery was quite invasive and my case was pretty mild compared to most that he saw. He wanted to wait and see what happened. I agreed though I can’t say I held out much hope and agreed that I would see him again in three months time. The three months went by and I have to say that for once I was quite surprised. It did seem to have improved and I’d had no discharge for a long time. I started to feel that perhaps I would be ok and for a period of time, my life was the most normal it had been since probably the end of 2004. Although I never quite got rid of the slight pain I felt whenever I sat down on a sofa or did anything vaguely strenuous, again it was the site of the original infection that concerned me which from the outside looked fine but never quite felt right. Still I was pronounced healed in January 2007, just over six months after surgery No.2
However this was obviously not the end, or this blogsite would not exist. About three months later the honeymoon was over and by early June I was back in the office of the Plastic surgeon discussing the next move, which was to be the originally proposed z-plasty flap reconstruction surgery…
