Abscess and Fistula Story Part 4: DLPL Surgery

One of the worst things about 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 three abscesses, and a complex, grade 5 fistula.  This is part four of four, read the story from the beginning here.

Part 4: DLPL Surgery in India for Abscess and Fistula

The flight to India was a long, and painful one. I took codeine, and prednisone to help manage the unbearable pain and inflammation from the abscesses.

The day after my arrival, on August 9th I met with Dr. Porwal and his team at Healing Hands Clinic, in Pune India.  During my initial appointment several things blew me away:

• Using a localized numbing spray, and a small camera that he inserted just inside my bum hole.  Ron and I were able to see the hole in my colon on an iPad screen, where the fistula originated from.  No other doctor I’d seen in Canada or Australia were able to locate the hole.

• He explained that I had a fistula, most likely stage 5, and exactly how they were going to treat it.  I was told I would most likely need multiple surgeries.

• When I expressed concerns about taking antibiotics (last time I took them, I pooped blood), he listened!  He told me some intravenous antibiotics were necessary during the surgery.  But I did not have to take the oral ones if I did not want, as long as no infection presented itself.  I cannot express how happy I was to have a doctor actually listen to my concerns.

• I was given his direct contact number.  As well as another specialist doctor, and another surgeon who would be working on my case.  We all connected via Whatsapp, and I was told to contact any of them whenever I had any concerns.  No matter the time of day.

• I was asked if I was ready to receive the surgery, to which I replied yes.  And I was booked in the very next day at 9am to get it done.

After this initial meeting, I felt overwhelming gratitude.  I was brought to tears so many times that night.  Dr. Porwal was 100% confident that he could heal my fistula.  He explained that my Crohn’s may get worse initially for the first 3 weeks.  But afterwards it would be easier to manage.

On August 10th I arrived at Healing Hands Clinic at 9am.  I paid the $8156 USD fee for the initial surgery.  I remember being embarrassed because I had to use multiple cards to pay for it, but everyone was so kind.

I was set up in a luxury, entirely marble room, with my own bathroom and shower.  I would be staying the night, and Ron was encouraged to sleep on one of the comfortable couches.  Which he did.

I was taken into surgery just before noon.  I was given the option, and decided that I wanted to stay awake for the surgery.  It’s the most money that I had ever spent on anything – I wanted to experience it!

I was given local anesthesia, then an epidural.  The epidural in my back was by far the worst part of the entire surgery.  Then I laid back in a comfortable confusion while a team of five plus doctors and surgeons began the surgery.  Dr. Porwal checked in with me before the operation began.  And was there the entire time.

I don’t remember much of the actual surgery.  But there was no pain, or discomfort, and I felt totally at ease.  Like I was being taken care of.

After the surgery I was brought back to my comfortable room, and told not to move much for the next three hours.  I would have to wait until 7pm before I could eat or drink anything.  Which was difficult as I had been asked to fast since 8pm the night before.

I had a restless nights sleep in the hospital.

The next morning I was able to walk around a little bit.  Ron had to hold my arm and support me as I was quite shaky.  A nurse came and cleaned my wounds for me using a small bowl, and gentle shower head.

I had a diaper on which had filled with blood, so the nurse changed that as well.  At this point I took my first look at the surgery wounds.

I was literally shocked.  I had a massive 4cm in diameter wound, along with 4 other smaller, deep wounds around my bum hole.  The big wound was where the abscess had been cut out of me, and it looked like blood and guts were pushing out of it.  I nearly fainted from looking at it.

I quickly sat down.  I almost regretted looking.

Once I was discharged, the doctor in charge of paperwork helped me order a taxi.  But due to heavy rains none were coming.  I was forced to take an “auto” tuk tuk.  Ron was very concerned as the state of the roads were pretty bad.  And with the anesthesia wearing off I was beginning to feel the pain of the wounds.

The security guard helped me get into the tuk tuk.  He explained to the driver that I had had surgery, and he needed to drive slowly.  The driver was very accommodating, even when other drivers beeped at his slow speed.  We paid him extra for his efforts.

Immediately after the surgery I was fairly bed ridden, although I could make it to the toilet and back.  My pain levels were bad, but they were a lot less than when I had the abscess.  I remember saying multiple times, that it was the least amount of paid I’d had since May.  But it was still quite a bit of pain.

Over the next three weeks I slept a lot.  Like 14-16 hours a day.  I just could not keep my eyes open. 

After ‘longer’ activities like a short walk outside, or gentle yoga, I would have to have a nap from exhaustion.

I had regular appointments with Dr. Porwal and his team of doctors every 3 days or so.  I would travel to the clinic, wait to get into the small surgery room.  Then I would have my wounds examined, and “cleaned” which was a very painful experience.

I was told many times that the most important factor in success is that the wounds heal from the inside out.  It would take at least three weeks for the wound in my colon to completely heal.  And after that the pain would lessen significantly.

To ensure that the wounds would heal from the inside out.  I had a 15cm long “balloon” or catheter inserted into the wound and fistula tract to hold it open during the initial surgery.  This would prevent the tracts from healing too quickly, and give the hole in my colon time to heal first.

This balloon caused me a lot of pain and discomfort during the first two weeks.  I could feel it inside of me, and twice it stuck out of the wound.  Dr. Porwal had to push it back in during the cleanings.  No anesthesia was given for this, and it was very painful.

On week two I had a second surgery to have the balloon removed, and check general progress.  Dr. Porwal said he was happy so far.  And after a few days of recovery post surgery, my pain levels went down.

But it wasn’t until about week 6 that I could sit without much pain.

And at this point I had to receive a third surgery.  One of the wounds in particular was healing too fast on the outside, and would have to be re-opened.

I was told that it was a minor surgery, but I think this information misled me.  During the procedure they opened all of the 4 wounds to allow better draining of the infection.  The wound openings were almost 50% bigger after this.  And it took me a whole week to “recover” from this surgery.

On September 5th I began to notice that less infection was draining from the wounds.  After the third (and final) surgery the wounds began to leak a lot more again.  Which I was told was a good thing.  If any infection remained trapped inside of me, it would re-abscess.

And slowly, the leaking began to slow again.  By week 8 all leaking had stopped.  At this point I was told that I was around 80% healed. 

The last two weeks in India were hard mentally.  I was so ready to go back home, and get back to my normal life.  Our finances were dwindling, and we had to ask a friend for a $2000 loan to tide us over.

But we knew that the best way to guarantee full healing was to stay until I was 100% healed.  And I was fully committed to the procedure.  The doctors’ persistent after care is what makes the DLPL surgery so successful.

On October 17th, just over 10 weeks since the first surgery.  I was told by Dr. Porwal that I was 100% completely healed from fistula disease. I remember crying on the table, trying to thank everyone involved with my whole entire heart.

They held a “fully healed” party for me with all the doctors, nurses involved in my procedure.  As well as other international patients who I had become quite close with. 

This party has become quite the tradition at Healing Hands Clinic.  Usually a cake is provided, but I asked for 100% juice for everyone as I don’t eat cake.

Of course they accommodated me without question. Another example of the amazing service that I received the entire time at Healing Hands Clinic.

Although I experienced a lot of pain, and discomfort as a result of the multiple surgeries I got in Pune, India.  I know that they were all necessary for my complete healing.  And now it has been almost 6 months since my surgery, and I am living my life – fistula free!

I know that I have been a part of a healing miracle.

I cried many times writing this post.  I encourage anyone who has a complex fistula to look into Healing Hands Clinic in Pune India.  And Dr. Ashwin Porwal.

I feel as if I have had a second chance at my life because of this procedure.

Please feel free to reach out to me if you have any concerns, questions, or just want more details.

In good health,

Kyla