Anal Fistulas, Abscesses and Despair: The History of The Eye of Sauron

For the past 7 months, I've been dealing with a complex horseshoe fistula. I've had four surgeries (AND COUNTING!) and have spent thousands of dollars on medical bills, medications, gauze and flush-able wipes; yet, but no monetary amount can describe the emotional toll this has taken on me. Over the years, I've started to call my anus the Eye of Sauron (as I will continue to call it in this blog) because it's like a flaming eyeball reining over evil causing trauma and despair. If you're one of the few 200,000 yearly cases unlucky enough to be diagnosed with an anal fistula and stumbled on this blog through a Google search, I hope that my posts will help to make you feel not so alone.

I decided to start this blog because I feel like the online resources regarding anal fistulas are few and far in between. Doctors will give you blanket statements from medical textbooks but they haven't lived through it, medical reports are a fucking bore and message boards, while helpful, don't always outline personal experiences. 

So for my first post, I decided to provide a history of the events that lead up to my first surgery in May 2017. 

November 2008

I had a closed pilonidal cyst surgery. That's right, I've had literally every possible butt cysts you can have! While this may be unrelated to my fistula, it also may be... who knows! Those sinus tracts are tricky little fuckers. 

February 2016

I call this moment my very own Dol Guldur, the moment when The Eye of Sauron took shape. I'll never forget the Superbowl 2016 because I felt like an anal fissure was going to kill me. I've suffered from hemorrhoids and small fissures before, but I've never had a fissure that felt like it was tearing me open with a searing knife. This pesky fissure became chronic and bugged me for over a year. During this time, no amount of steroid foam, pain killers (not recommended!) could heal my anus - the only thing that provided some relief is a high-fiber diet, stool softeners, sitz baths and fiber pills. While I don't know if the fissure caused the fistula, I think it's a possibility. 

March 2017

After over a year of dealing with a chronic anal fissure, I started to feel better. I took a trip to Thailand and on the last few days I started to feel some discomfort and tenderness around my lower butt cheek/taint area. After a long plane ride home, the discomfort turned into major pain - I could feel a hard lump. I was scared that it was a botfly that I got in Thailand (not possible)... ugh... I wish it was a botfly.

On my first day back from vacation, I visited an urgent care clinic. The doctor said it was a "dermal cyst" and prescribed an antibiotic. Although the antibiotics helped with the swelling, I could still feel the lump, so I decided to go see a dermatologist. The dermatologist felt the lump and said it was "too deep" and recommended me to a Colo-Rectal Surgeon (CRS).

My first visit with the CRS was with a physician's assistant. She felt the cyst and did a rectal exam (THIS IS VERY UNPLEASANT) and ordered an MRI to check for a fistula. At this point, I didn't have much detail as to what is happening, but I had Googled enough to know that I had a perianal abscess. I've been a relatively healthy person, so getting an MRI was a first for me. I was already shocked by the specialist copay but getting an MRI bill shook me to the core. I knew that in order to get a better understanding of what was happening to me, this needed to happen, but god damn this shit is expensive. A brief side note, that despite having to pay over $1000 for an MRI (with insurance) they only had FREE Pandora with ads available to listen to in the machine. 

April 2017

The CRS physician's assistant called me with the results from my MRI and stating that I had a perianal abscess and fistula and referred me to my CRS. At this point, I felt like I kept on taking steps back every time I heard news of my condition. I didn't think it could keep getting worse... I WAS WRONG. 

Upon my first visit with my CRS, I learned that not only do I have a perianal abscess and fistula, but it's a complex horseshoe shaped fistula. The CRS told me that this is the most difficult case to treat (yay!) that it could take 6-12 months to be healed (I'm beyond the six month period with no end in sight) and that the success rate is 60-80%. Essentially, the horseshoe shaped fistula is a little tract that likely stemmed from the fissure in my rectum, latched itself internally to the outside of my rectum like a horsehoe, up my butt crack and also down to create an abscess. 

I think it looked like this:

My surgeon scheduled a surgery for the end of May and I'm hopeful that I will only need one or maybe two surgeries and this shit will be over with by Fall. I'm also bitter as hell and experiencing "WHY ME" moments and so disappointed that I won't be able to swim all summer. On my next post, I'll talk about my first surgery.