Hi Cdaisydo,
I am good, I am what my surgeon describes as a "complex case"
, so struggled with these nasty abscesses and fistula tracts for a while, but am currently in a good place, to the extent that my life is fairly much back to normal other than having a few extra holes:ylol2: (sorry I've developed a bit of dark humour over the years, sometimes it just helps to make a joke of things).
Reading I now have a clearer understanding of where you are at, at the moment, and don't worry you are doing everything right and sounds like treatment is progressing as it should.
Sometimes it's really hard to understand what is going on, especially when often information is given when you are still recovering from anesthetic, but you will get more information after the MRI and when you see your "consultant", who will likely be your colorectal surgeon.
Because you are unsure and nervious about what is happening and why you still have a lump, here is a rundown of where I think you are at, based on what you have said and my personal experience (although please note I am not a doctor, I only mention this to ease your concern over the current lump).
Having developed an abscess, your first surgery was to drain the abscess, and lay a section or all of it open (depending on how much of the tract involves the sphincter muscle, as some muscle can be cut without causing incontinence), the fistula tract is basically the channel between your bowel and where the abscess is, or if it had burst, between the bowel and the outer skin. The idea is to remove all the infection and laying the tract open, hopefully results in the wound healing from the inside out and the tract closing. In some cases this is all that is required, and the wound heals and the person goes back to normality.
From here you could have some swelling or induration (hardening of the surrounding tissue), which could easily be confused for being the existing abscess (which was what I was trying to ascertain last night). Induration will obviously eventually resolve, but my experience after my first surgery was that a second and then 3rd abscess formed, but this was because at that stage I had not been diagnosed with Crohn's and was on no medication. My concern last night was if you were still being seen by a doctor, as an abscess untreated is unlikely to resolve on it's own. Now that I realise someone has looked at it, I am no longer concerned for you.
In cases where the area does not heal, what you get is a tract which remains open, which basically feeds the infection, many will find that the area that was layed open will try to close, and this can cause a pocket or abscess to reform, but this will fill till it eventually finds the point of least resistance and will drain, and it will cycle through this process. This is where you might hear the term 'Complex Fistula' although this term has many meanings, as it can in this case simply mean a fistula that will not close, or can refer to where it tracts through the sphincter muscle, among other meanings.
In your case I assume she meant the tract has not closed, and you are currently experiencing this issue of build and burst cycle (although the lump could also be another seperate abscess, so it is good that you are continuing to see a nurse). From this point you will need the MRI so that the surgeon can best determine what is the best next step.
Sometimes this will involve putting a seton in (basically a silicon band that keeps the tract open and allows things to settle, kind of like an ear ring:ywow
The short of it is to find out why the tract is not closing, resolve any infection, and enable or assist the tract to close. In my case the Crohn's is the reason the tracts will not close, and unfortunately even when I seem to be at my most stable, when the setons are removed the outside heals and another abscess forms, so my setons at the moment stay in place, and we wait and see.
This is the reason I said last night, it's good and bad to read some of the stories on the forums, from the statistics, for every story where the surgery didn't work there are many more where things healed and went back to normal. Hopefully this will be the case for you, once the MRI is done and a plan is put in place to fix the problem. Also it might be frustrating having to wait for the MRI, but my understanding is you need to heal a bit in order for the MRI to show the full tract, so some waiting may be necessary.
The next few months will likely be hard and you will have a lot of questions, and things will be confusing. If I could go back in time, the things I would suggest to myself, would be, have someone you trust go to your appointment with your specialist. Buy a diary and put in the diary any changes or symptoms, as this will help your doctors. Write any questions you may have down, and take the questions to your appointment.
I wish you all the best, hope some of this information has been helpful. Again remember I am not a doctor, I am simply sharing my experience and information based on what you have said to try and help you understand what is happening. If your symptoms worsen, or you develop a fever, you need to ensure you see a doctor or return to the hospital. The key is not to panic, but also don't ignor symptoms.
Cheers,
Camo