Diary of a Crohn's Surgery: Incision & Drainage and Seton placement results

Yesterday's surgery started very similarly to my prior 6 fistula surgeries.  They intended to do an incision & drainage of my fistula/abscess and then place a seton in the fistula track to keep it open an allow all infection to drain.

The sedation drug cocktail for this surgery was:

• Demerol
• Fentanyl
• Reglan
• IV NSAID whose name I can't recall
• Zofran they usually also include zofran to help reduce the possibility of vomiting during sedation but a potential drug interaction prevented them from using it on me

The steps for this out-patient surgery were

1. Get weighed (necessary for determine sedation drug amounts)
2. Go to the bathroom (they use a nerve block that prevents you from determining whether your bladder is full so they want your bladder empty)
3. Remove clothes
4. Put on hospital gown and get in the gurney
5. Nurse takes my medical history and checks on drug allergies
6. Anesthesiologist / nurse practitioner anesthetist discusses sedation drugs and checks to ensure they don't case problems
7. Surgeon comes and and briefly discusses surgery (in my case this time, he just smiled and waved - we've done this dance enough we didn't need to discuss anything).
8. Put in IV
9. Anesthesiologist / nurse practitioner anesthetist starts sedation drugs (he started with the IV NSAID)
10. Wheeled me into the operating room
11. Started me on the IV demerol
12. Had me hop from the gurney onto the operating table
13. Started me on the Reglan
14. Started me on the Fentanyl
15. Gave me oxygen and a gas to make me sleepy (the gas smelled strongly of chemicals but I didn't have to smell it for very long)
16. Then I semi-woke up in recovery
17. A nurse asked me how I felt, to which I replied "I'm still very sleepy", and they left me alone
18. A little later I told them I was ready to get up
19. She gave me my clothes, I got dressed, and she walked me out to the car

My post-operative pain and even my pain the next day was minimal and less than I've experience from any previous fistula surgery.

I found out after the surgery that my fistula and abscess contained so much infection and was so inflamed that they were unable to thread the seton through the fistula track.  So they just drained the fistula, packed it, and applied a dressing to the wound.  They left me with instructions for me to unpack the wound at 7 pm (I had the surgery at 2 pm).

The doctor told my wife that he currently plans to place the seton after I complete treatment for the fungal pneumonia (which should be about 5 months from now).  I fear that the fistula will get worse quickly enough that it will require another surgery before that time.

Another issue is that I am forming another fistula, which is much smaller and not abscessed, on the other side of my anus.