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Another abscess? Really?

Hi everyone,
I know I've never been super active on the forum and tend to pop in when I'm having a rough time. I think when I'm feeling good I try to put my crohn's problems in the back of my mind. As I've said numerous times on the site, I have issues with perianal crohn's (abscesses and fistulas). I have a seton in that was placed in February of 2010 and it's been great since. I had another abscess and fistula pop up back in October and had a surgery then, February, and April to drain the area, put in a seton, take it out, back in, etc. The surgery in April, my surgeon took out the seton. I saw him 2 weeks later and the pain was still terrible but he said it looked like everything was okay. At this point, both him and my GI brought up nerve damage. They did one final test (rectal ultrasound) to check for a deep abscess and it found nothing. The doctor who performed that test said that while he didn't find anything, I visibly grimaced, moved around, and was groaning while under heavy sedation. It finally made me know that these doctors believed my pain level and that I wasn't overly exaggerating. This doctor also suggested nerve damage. So I was sent to a pain specialist. He put me on a nerve block (neurontin), pain med (vicodin 7.5/750), and muscle relaxer (flexeril) when I saw him in May. This treatment totally changed my life. I was able to function for the first time since last October! It was really amazing! Then out of nowhere, the past few days I've had an increase in pain and have been getting bleeding on my bandage (which I occasionally get when I work out or walk a lot or something but this has been more frequent). I wear a bandage all of the time to catch drainage from the one seton and the place they operated on in April still hasn't healed, which I think is an issue itself. Right? Yesterday it became REALLY bad. Sitting isn't an option right now and walking is becoming difficult. I looked at the area in the mirror earlier this evening and noticed a red bulge right on the spot that's still open from previous surgeries. None of my previous abscesses have been visible to the eye so this is something new and weird for me. It's probably the size of a dime, puffed out, and blood red in color. It feels like someone is constantly stabbing me in that spot with a knife. I'm not running a fever but I'm assuming that's because I've still been taking vicodin even though it hasn't taken much of the pain away. I think I'm going to call my GI and surgeon tomorrow to let them know about this and see what they want to do. I really wanted to get the opinion of people on here too. Like I said, all of my previous abscesses have never came to a head on the skin or were even visible. Does this sound like one though or something else? I really appreciate any opinions!

Thanks so much,

My 20-year-old son is now in hospital recuperating after a perianal abscess was drained. His DID appear at the surface and by the time he allowed me to look at it (probably about 2 weeks after initial symptoms of "something not right down there"), it was bright red/purple, hot and hard to the touch.

After several days on antibiotics and taking warm baths it came to a head, but ended up still having to be cleaned out.

You are doing the right thing to contact your doc.
Thanks so much for your reply! I'm really sorry your son has to deal with this. It's really the least fun thing ever, especially at 20. I'm 24 and having dealing with perianal abscesses since I was 16, so I definitely feel his pain.

I talked to my GI nurse earlier. My GI isn't in the office today so she talked to another one in the clinic. As I expected, he gave me a 14 day round of Cipro and Flagyl. Not my favorite meds but I'm used to their sucky side effects. They did tell me if the pain became unbearable or I started running a fever, head to the ER. At this point I know when that needs to happen so fingers crossed it doesn't get to that. Really hoping these meds and a Remicade infusion on the 25th will kick this before I need another drainage and seton placed.

Sorry you are having these problems, they are all to familiar to me. Let's hope that the antibiotics get things under control. I would have thought that they would not want to go ahead with the Remi if you have an obvious abscess?

At least they believe you about the nerve pain and have given you effective treatment. None of my team want to accept that I have this issue, so I have to put up with pain in my left thigh.

Hope things improve soon.

5 days later..no change

Mark - thanks for bringing up the Remi..I'm going to call them Thursday to ask about it. Have you asked about seeing a pain specialist? It really was a life changer there for me for almost 3 months. Until this happened!

Also, I've taken 5 full days of Cipro and Flagyl doses. I've had no pain relief and the bulging area is still there. Still getting a lot of blood on the bandages but since there's still a bump, I assume that means the abscess hasn't burst? Or maybe it's not an abscess? grrr I don't know. I feel like I would feel better if they would just MRI the thing. Are 5 days of antibiotics enough to see a difference? Should I give it more time or call the surgeon and GI again?

Thanks again everyone.
H Anna,

I will ask to see someone if things don't come under control with the Humira.

As for the antibiotics, it's difficult to say. For me, Cipro is a slow burn and wouldn't expect to see much improvement for 5/7 days. Flagyl is quicker, typically 2/4 days. As a combination I would have thought that you would have started to see some benefit by now, but everyone is different. If it is an abscess, they sometimes do not respond well to oral antibiotics. In the past I've been in Hospital on IV antibiotics for 10 days before there was much improvement and they let me out. If you don't see any improvement in a day or two or things start to get worse I'd get back to your Doctors.

Hope you are feeling better soon.

Bad news and good news

I'm here today with some bad news but also some good news. I ended up having to have surgery (number 6 since nov. 2009) yesterday to drain the stupid abscess and put seton #2 back in...for the third time. I really wasn't feeling too bad until Wednesday of this week. I actually had a phone call from my surgeon on Tuesday (I'll add this on to my reasons of why I'm lucky to have him; personal calls to check up on me) and I told him how things were just okay. I had an appointment scheduled for Monday with my GI and the plan was to see him and get an MRI then decide what to do. Well Wednesday I woke up with pain 100 times worse. I tried thinking it was just because I did so much sitting on Tuesday but I broke out into a cold sweat all night and just felt overall crappy. Called both the surgeon and GI on Thursday and they couldn't see me in their offices so told me to head to the ER. My surgeon sent some residents down to see me who said it def looked like an abscess. He scheduled surgery for Friday morning and they admitted me over night for pain control. I lucked out with a gigantic private room that they were testing as a "smart room". The stuff they're coming up with to help with care is amazing! My nurse was kind of a jagoff that night. I told him the pain med he gave me did nothing and he said he had flexeril on order for me. Uhh that doesn't help with abscess pain. After I got it through his thick skull I needed something stronger, it was 1 AM before he had me okayed for something stronger and I could fall asleep. 2 different wake ups for blood work. 5 am antibiotic being put up. Then 6:45 was woke up by literally 8 people from my surgeons team standing there above my bed. I went down for surgery right after. He drained the abscess and put the seton in. Fingers crossed this keeps everything okay for a while. Him and I told each other we're sick of seeing one another. haha

Now for the good news. I was approved for disability! On the first time I filed! As I said, this is my 6th surgery for abscesses and fistulas in the past year and a half. Sitting or standing for a job just wasn't a possibility for me, even now. After surgery number 5 in April, I applied. I had my PCP, GI, surgeon, and then in May after they found nerve damage my pain management doctor, all being very supportive and helpful with the process. My family and I were totally prepared to get an attorney and fight because we always heard, no one gets approved the first time around. I got a letter this week though that I did. I won't be reviewed for 3 years. The monthly payment I'm given is really miniscule though because I haven't had the opportunity to work a full time job yet. Luckily my parents are super supportive so I know I always have a place with them. This will allow me to at least pay for my co-pays, prescriptions, and help them out though. Such a relief and happy news to get during such a crappy week!
Hi Anna,

I was wondering how you were getting on. It's not good to clock-up another surgery, but lets hope that this really makes things more comfortable for you. You're catching me up!

I don't think that I'd ever qualify for disability in the UK. Fortunately my employer has been very supportive, I just hope they continue to be so!

Wishing you well.

This was number 7 for me overall so I really am catching up to you! I just really hope you'll keep the higher total for a while now :)

I'm feeling okay today. The pain is a little better. I'm still having some major cold sweats when the pain meds wear off so I look forward to being able to wean off of them sooner rather than later.

Thanks for your thoughts!


Your Story Forum Monitor
I am so sorry to hear about your recent issues and surgery. I hope you have a speedy recovery!

And that is terrific news on the disability. After 6 surgeries in 3 years, you deserve it!
Hey Anna!

It's good to hear atleast you got some relief.

The red thing you're talking about, is it granulation tissue? I've got the same kinda issue, with the not healing (I'm heading into humira, hoping it'll help), and I've got some really red, puffy granulation tissue. It's like, what your body does before it creates skin and scar tissue, and it hurts like HELL to touch... Feel like a big bubble of pain. If you go to your doc, they'll probably tell you they want to cauterize it. I'll be honest: This hurts like a b****. They take sticks of silver nitrate and chemically burn it. It does help, after it stops burning, but it is awful painful. Next time I have to do it, I'm buying my own Emla (a lidocaine cream) and applying it beforehand.

I could be wrong, and it could be something else, but it sounds like some heavy gran. tissue to me, especially with the "not healing" bit and all. Good luck, and keep us updated :)