Abscess and Fistula Story – Part 1 Abscess at Sea

One of the worst things with IBD, is the complications that can arise as a result of the disease. When you have chronic inflammation in your gut, strictures, abscess, and fistulas may occur.

This is my story of dealing with, and healing 3 abscesses, and a complex, grade 5 fistula. This is a four part story, so stay tuned!

Read part 2 here, part 3 here, and part 4 here,

Background 

 

In 2019-2020 Ron and I were sailing around the Caribbean on our 46’ sailing yacht. We visited some amazing places all over the Southern Caribbean.

We made lifelong friends on other yachts. We spent our days snorkeling, hiking, and socializing. Most of this socializing was done with sunset drinks. BBQ dinners, and late-night parties.

I was having the time of my life; and completely disregarding my health.

 

During this entire period, I was never in remission. I had symptoms almost every single day.  These symptoms would vary in intensity based on the quality of my diet, and how much I had been drinking that week.

I don’t think that I had a solid stool during this entire period.

At the same time my symptoms were never ‘bad enough’ that I was willing to make any major changes. I was already eating 100% dairy free, and about 80% gluten free. I thought that these sacrifices were enough to keep me well.

Or at least keep me well enough that I was able to continue my hazardous life style.

We left the Caribbean islands, and began to approach Panama in March 2020. We were making preparations to enter a new ocean, and begin our Pacific crossing. During this time a little-known virus appeared in the news: coronavirus. As word of this virus spread, my stress levels increased.  And my symptoms worsened.

We spent three months in Panama. For the first two months my Crohn’s symptoms worsened.  I began to poop blood, I had almost no control over my bowels and was having bowel movements 15+ times per day.

My mental health was at the worst it had ever been in my whole life. I felt trapped. Trapped inside my sick body, trapped on my boat during quarantine.  And trapped by the pandemic.  My mental health was at its worst.   It was dark, horrible time for me.

Once we were poised and ready to begin our Pacific crossing, I was actually beginning to feel a bit better. We knew it would take us 3-5 weeks to sail from Panama to French Polynesia.

 

We were under pressure to cross during the right season.  And as a result, we made a hasty decision to begin our trip.

 

I don’t think that I knew how sick I was for our departure. I was under the mindset that I was just ‘always sick’.  I had been experiencing symptoms for so long, that it became my normal. I was a sick person and that’s how my life was going to be.

Once out at sea my health deteriorated again. My sleep schedule was completely out of whack because of the night watches. My diet changed to more canned, and less fresh food. The constant, never ending movement of the boat put my body and mind under further stress.

The entire crossing took us 26 days. 26 days at sea without seeing land at all.

On about day 16 I began to experience a pain in my left bum cheek. It felt like a bruise, and I figured it was from sitting and bracing myself during the long crossing. I tried to sit in different positions or sit on a pillow to relieve the pain.

By day 18 the pain had escalated. I no longer thought it was a bruise. We had no internet connection at all. So I had no way to research what could be causing this growing pain in my bum.

Using our satellite communicator, I text another yachtie friend of ours who is a nurse. I told her my symptoms.  She already knew my history of Crohn’s disease.

She replied that she thought that I may have an abscess. She told me that I needed medical attention straight away. I did not know much about abscesses, but I knew that this was not good news. She told me that I could have complications, like blood poisoning.

 

She said that if the pain grew much more. I would have to contact a cargo ship to see if I could receive medical attention aboard their vessel.

At this point I was still able to stand, walk around, and do most tasks. I was still doing my night watches, cooking, and functioning mostly per normal. I was pushing through the pain, and trying to ignore it.

 

By day 22 I was in agony. And I mean agony. I could not stand up, I could not eat anything.  I was vomiting from the pain, and spent all of my time lying in bed.

The pain had gotten to be unbearable.

Ron was forced to sail the boat on his own. He raised all of the sails and pushed the boat to sail as fast as possible towards our destination. We did not see any other ships to make contact with during this time.

Looking back, I know that I made some mistakes. I should have taken some oral antibiotics that we had onboard. I did not realize how serious an abscess could be at this point. And I am very anti, anti-biotics because of how they destroy our gut microbiota.

I also should have taken some injectable pain killers that we had in our first aid kit. But we had always reserved those for a serious medical emergency, and again I didn’t realize that this was one. Also, neither of us had ever injected a needle before, so the idea seemed daunting.

I also did not know about sitz baths, nor have any Epsom salts onboard.  But that definitely would have helped.

Finally, we arrived in the Marquesas, French Polynesia. I was unbelievably weak and unwell.  I had lost 4 kgs off my already thin frame.

When we arrived to the small remote island of Nuku Hiva it was about 8am. We turned on our VHF radio and heard the daily cruisers net. Ron made a call immediately to say that we had a medical emergency and we needed help right away.

We were told that we would have to receive special permission to go to shore, because of COVID-19 protocol. Ron and I were in disbelief. We had spent the last three and a half weeks at sea, completely alone without any outside contact at all. There was literally no way that we could have COVID.

 

Hospitalization and Surgery

Finally, at 1pm we were contacted via our VHF radio. They told us that a doctor was ready and waiting for us on the shore. Due to COVID restrictions, only I was allowed to go to shore.  Ron would have to drop me off by dinghy, then go back out to our boat.

The doctor was there in a full head to toe hazmat suit. He had a clip board and immediately started to ask me questions. “Do you have a fever, cough or sore throat? Have you made contact with anyone since you left Panama?”

I was on my hands and knees crawling towards the nearby ambulance van. I had tears streaming down my face from the pain. All I could answer back was, “Can I please lay down in the ambulance while you ask me these questions? I am in so much pain.”

I was rushed to the nearby hospital, where the doctor confirmed that I had an abscess.  And I would have surgery later that day to have it removed.

I was wheeled into a completely metal room, which was the operating theatre. The surgeon was a kind man from France. Most of the nurses were from Tahiti, and a few of them were from France as well. Most of them did not speak much English, so I tried to communicate using my broken French.

They washed my whole naked body in betadine. I needed help to stay standing while they washed me. I gave myself over completely to the procedure.

I did exactly as they asked, and let them help me as much as they could. I was in too much pain to function, or make any decisions. I just wanted this thing out of me.  I just wanted to feel relief.  I felt like I was dying.

My legs were put in the stirrups, exposing my whole bum and vagina area to the surgeons. I had to sit up while they gave me the horrible epidural needle in my back.

Soon I couldn’t feel anything below my waist, and I smiled because finally, the pain was gone. I laid back on the bed and tried to relax.

The surgery took about two hours. I was awake the whole time.  I tried to watch what was happening in the reflective metal walls. Twice I heard the surgeon comment, in French, about how big the abscess was.

After the procedure, I was quite dazed from the epidural. I remember the surgeon telling me that he removed an abscess the size of his fist from my body. HIS FIST! No wonder I was in so much pain.

He told me that the abscess had just burst inside of me. I was lucky to receive medical treatment when I did. Before I suffered even more serious consequences.

Ron still wasn’t allowed to come to shore so I spent that first night alone, and a bit scared in the hospital room. I couldn’t tell yet if I had relief from the pain because of all the anesthesia.

I would spend the next 7 days and nights in the hospital. I had to get a second surgery to remove the rest of the abscess a few days later.

 

It had been weeks since I had had a full, proper meal. And I looked like it. I was shocked to see that my weight had dropped to 42kgs (I am 170cm tall). My collar bones and ribs stuck out at odd angles. I was so weak; I could not stand without assistance.

The doctor would not release me due to my weak, malnourished, condition. I still had not regained my appetite at this point, and had eaten almost nothing since being in the hospital. I knew that I had to eat, but I just felt so sick.

It was decided that I would go on TPN food.  For the next four days I was constantly attached to an IV.  Through which a thick, white liquid dripping into my veins. It wasn’t exactly pleasant, but I felt so relieved to know that I was getting some nutrition into my starving body.

After day two my veins started to hurt, but I was told that I had to finish the four-day program.

By the time I left the hospital I was feeling a lot better. I did not feel sick all of the time. My unbearable abscess pain had subsided. Although I did still have pain from the four drainage wounds that had been cut.

I was still too weak to walk much, but I could now stand on my own.

I would have cleaning appointments every day for the next week. Then the appointments would taper off until my wounds were healed.

I was blown away with the caring service that I received at this hospital. My life improved greatly, not only from the life saving surgery that I received. But from every caring action of the staff in the Nuku Hiva hospital.

Looking back now, and seeing the shocking photos of myself, I can see that I was so close to death. The staff and surgery literally saved my life, and I am forever grateful.