Fistula Repair with Gracilis Muscle - One Week Out

[DCCrohns]

Anyone here recently had fistula surgery utilizing gracious muscle?

I had a temporary loop ileostomy back in July (http://www.crohnsforum.com/showthread.php?p=946570#post946570), and I am eight days out from gracilis surgery. This one is a different type of rough but I am so happy to have the drain out and to be able to shower again as of today.

Would love to compare stories/progress if anyone is in the same boat...or to share my thoughts/experiences if it at help you!

~~~~~~~~~~

Diagnosed with Multiple Fistulas: 2000
Diagnosed with Crohn's: 2002
Past Meds: Pentasa, Remicade, Cimzia, Asacol, Cipro, Flagyl, Lialda, VSL#3
Current Meds: Humira (40mg weekly)
Surgeries: Gall Bladder Removal (1997); Fistulotomies & Seton Placements/Adjustments (September 2011, January 2013 & August 2013); Advancement Flap (December 2013); Temporary Loop Ileostomy (July 2016); Fistula Repair with Gracilis Muscle (September 2016)

 

[jhendrix]

First let me wish you well with your recovery. I am very interested in following your progress as I may be undergoing the same surgery (rectovaginal vaginal fistula likely caused by undetected abscess after j pouch procedure). I had an unsuccessful flap advancement followed by a diverting ostomy. The next plan will be another flap or perhaps the gracilis surgery. How was the surgery? How is recovery? Can you guage it's success yet?

 

[DCCrohns]

Thanks for the well wishes, and happy to share what I can so far...

I'm five weeks out today and closer to my normal activity level; however, I don't have the final followup with both my CRS and the plastic surgeon for two more weeks. It's hard to tell if it's healing, due to where things are and the fact that I am still having discharge. My doctor wasn't concerned with discharge and I know it can take a while for things to heal...but I still hate the waiting game! We did, however, go ahead and schedule my reversal for mid-December hoping the followup is as expected.

In terms of recovery, it is by far the most challenging of the surgeries I have had. The rear feels the same as with my previous flap surgery (although easier there not having to worry about BMs with the ileo). The thigh has been a pain, as I have about a 2-inch incision on the interior-rear of my leg just above the knee crease, a wound from the drain an inch or so above that, and then an 8-inch or so incision further up to the groin. Everything was closed with dissolvable stitches or glue, but I had some irritation around the larger incision -- complicated by chaffing (since they warn you to walk with your legs together for the first week or so - no abduction of either leg). And the drain was probably the hardest part early on, but I felt much better once it was out (at post op appt) and started to heal over.

I was given the okay at my one-week post op to move more, but I am still not able to have a full range of motion with the leg the graft was taken from (I stop when I start to feel tension or potential movement of the graft inside).

I only used prescription meds for about five days when I was home, but I did need Tylenol to help and I still do periodically (feeling more sore when I have an especially active day). I also am doing sitz baths daily to help soothe things and promote healing (was only required to do them until my first followup and was told I could discontinue if I cleaned gently in shower).

I think that's most of it, but feel free to ask questions and I'll update (hopefully with good news on healing) in a few weeks.

All the best to you on your journey!

 

[DCCrohns]

A quick update for those considering or going through the same treatment course...

Returned to see my CRS and plastic surgeon in early November and healing was still in progress but looking good.

We went ahead and scheduled surgery for today, but the surgeon wanted to start with an EUA to see if things were fully healed and he thought we could proceed with the reversal. It was unsettling going under and not know whether I would be saying goodbye to my stoma (and being admitted) or not.

In the end, after an EUA, he ended up doing an interior repair so I have to wait a bit longer before reversal. Bummer (pun intended) but lucky to have a great surgeon committed to getting it right and giving me the best chance at success. Now back to laying down and my drowsiness.

 

[bmmilward]

I was extremely excited to find this thread. I will be having a fistulotomy w/gracilis flap repair on 1/18. I am excited and nervous all at the same time. I've had on going issues with a high transphincteric fistula for three years. After multiple failed plugs and countless surgeries I am looking forward to being seton free I've previously had a colectomy with ileostomy that was taken down to a J-Pouch. So one of my main concerns is having bowel movements post op since we are not temporarily diverting.
I love my CRS and I met with the plastic surgeon last week and he seems great. its been a long three years to get to this point but I am so ready to finally take care of this problem so I can get back to being myself!!
I hope that you are continuing to improve!

 

[DCCrohns]

Glad it could be of some help, bmmilward! You've certainly had your share of it, so here's hoping the repair does the trick! I go back for a followup with my CRS in a few weeks. Have had some indications the last repair hasn't healed...but hoping my body & time will take care of that!