35th Clinic Visit

The number of visits is a reminder just what a long haul this process is!
Doc still on hols so nurse doing the packing today.  She also applied the oil for the first time.
I'd heard rumours of it being painful but it was fine - quite soothing in fact.

 

Once again in and out very quickly

meds

Interesting observation.  As you may have noticed from previous posts, conventional meds are very cheap out here.
Yesterday I had to buy some more ayurvedic ones and although cheap by UK standards they are more expensive than the conventional ones in Indian terms.

eg these

 

which are Divon + - a fairly standard pain killer here - are 120 rupees for the strip - approx £1.30

This range of ayurvedic ones are 600 rupees each, so the four I needed came to 2400 rupees or about £26.00.  This is my second batch of these - a month's supply.

34th Clinic Visit

Wound packed again today - in and out in 5 minutes.

I am still suffering a bit of pain on lower RHS.  Need to speak to doc when he gets back in January.

I've now been asked to buy some oil to be applied at the clinic daily.  So I'm back to daily visits.

I had to find yet another different pharmacy

 

Literally, 5 mins walk from the clinic.

I bought this oil and having looked it up, it is specifically to enhance healing in conditions such as mine.

Again prices very low circa $2 or £1.50/bottle

32nd and 33rd visit

At the moment I'm now on alternate day visits. Dr is on holiday for a week and nurse is doing wound packing.
Both fairly routine. Today quiet but last one was mobbed. Around 20 waiting. Once again I'm reminded how many this affects.
Feeling a fair bit of pain today. Started last night lower RHS. I assume thread is doing its thing but sitting is difficult!

31st Clinic Visit and thread 7 side A

Well, I didn't have to go to the clinic yesterday!  Felt like a holiday after 30 straight days in a row.
Dr now says every other day, which means the next one will be Christmas day!  Some present.

Anyway, I thought I was in for a routine repacking of the wound today but he surprised me (again) by changing the thread ... without any warning!  He does that.  So another teeth-sucking moment and now it's thread seven. This time after only two days.

He had a word after and said that the large haemorrhoid has shown its head again - literally - and will be an ongoing issue that needs to be addressed.  He can remove it but it might slow things down a little re the fistula.  It would also need another op under anaesthetic.

I've to give it all some thought and get back to him in the New Year when he's back from his vacation.

On a positive note, the partial fistulotomy - done way back at the start - is healing well. Still slightly pink and a little loss of muscle tone but otherwise fine.

29th and 30th Clinic Visits - thread 6 on side A.... and 3 on Side B

Friday was straightforward - in and out in 5 minutes with a nice nurse doing the changes this time.

However, Friday night brought a small surprise when one of my two threads fell out.
I think that's the aim down the road aways, when it's job's done,  but not yet.  It's a good chance to get a look at it anyway.  This is the dummy thread - the one added at the clinic.  I think to keep me sane I'll call it thread B and the other one - the main thread - A!

I Whatsapped the Dr and he said to go in at 9am and he'll sort it!  Oh for service like that in the UK!

Anyway, at 9:00 this morning he puts another in - without anaesthetic which was a bit of a teeth sucking moment.  Getting a thread changed is not so bad as they are tied together as you can see, and one pulls the other through.  When there is no thread there it is a little more difficult involving tools! Hence the <Ouch> moment.

Then when I think he's finished he starts on the other side.... with the quip "Might as well do both today then it only hurts on one day"!

Another (lesser) teeth sucking moment later, and both are done, and as a bonus I'm told every other day for visits now rather than each day.  Progress I hope!

Onwards and Upwards!!

28th Clinic Visit - more Antibiotics

Wound packed very quickly today.  Straight in and out but Doc wants me on some more anti-Bs to "speed up the healing process".  So I was asked to take the culture report in from the last swab.
He then suggested these ones: Trimethoprim and Sulphamethoxazole

But as these were "old medicine"  I had to go to a specific pharmacy to get them.
Despite the "it's a short walk from here" some 25 mins later I finally found it!

Once again as with all drugs around here, they were very cheap - about $1 or 80p for 20!

It's worth pointing out the script annotates when these are to be taken:
so 1-0-1 means one in the morning and one at night and AF is of course after food.

27th clinic visit -thread 5

The doc surprised me with a thread change today (he does that!) but either he's getting better or I'm getting tougher! Barely felt this one. So after 4 changes, I am now on thread 5.  Still on daily visits.

On another note, a long term stay here involves many things you might not think of. Today I took the plunge and went for a haircut!
10 mins walk away and very enthusiastic followed by a great head massage (wish they did that at home). All for 70 rupees which is about $1 or 75p in £.

Even giving him double it was less than half I'd pay back home. It's a strange land this one. Full of many contrasts!
 
Update!
Once again I felt a bit under the weather in the afternoon.  I slept straight through from 2 - 6:30.
 Not sure what's behind it at this stage.  Perhaps just the whole experience getting to me.

26th Clinic Visit

Well, today's visit seemed routine.  Literally, I was in and out in 10 minutes with the nurse doing the necessary wound packing.

However, after getting back to the hotel I felt totally worn out.

I don't know if it's the meds kicking in or some form of stress (which I am not transparently feeling) or if it's some side effect of the threads etc.  Whatever -  I slept for 5 hours straight.




Feeling slightly better now but even though it's not late I am still tired.  I will see what tomorrow brings.

23rd 24th and 25th visits to clinic

These have all been pretty routine.  In, wound packed and out again. 23rd/24th by the nurse.
But today was Dr. B again and a bit uncomfortable, as he did another "deep examination".  However, this only lasts a minute or two.
He also asked for another look at my scans which I took in for him and he subsequently copied.
Presumably to have a look at later.

His initial thoughts were two weeks of daily visits and then 2 months of weekly ones, but we are now almost up to four weeks of daily packing.  Obviously, this is a flexible estimate  Today he suggested probably one more week but we shall see!



The doc is on holiday from the 24th for a week so hopefully, he will do the thread changes before then.

Looking at the stats here each blog post is getting between 30 and 50 views so I hope this is all of value to some out there!
If anyone has any questions at all about what's going on feel free to post them in the comments section and I will try to answer them.

21st and 22nd clinic visits thread 4 and 2!

So yesterday was pretty routine and on the good news front the doc reckons he can work around the issue in the last blog post.
Today was a bit more traumatic when I had not one but two threads changed!
On one side it's now the 4th thread, on the other, the 2nd.

There was no anaesthetic during this so it was a bit painful especially for the main thread. However as before the pain is a fleeting thing and I see every day as one step nearer the end result.
Onwards and upwards!

19th and 20th clinic visits

So yesterday was pretty routine visit. In and out in 5 mins. Today less so 😢

Another "thorough examination " which frankly hurts! Even more today than last time. I needed to rest for 10 mins after.

Sadly a large haemorrhoid has appeared right where the thread needs to be 😞

The dr is contemplating another full surgery to remove it. I hope not as it will put things back a bit but we will see what he says tomorrow.

17th and 18th visit. Op no 2

So yesterday was routine visit but today less so!
Dr decided I needed a second thread fitted in a new area and some skin cut. So op 2!
This time it was done in the small hospital where he holds his daily clinic. In the small operating theatre next to his office.
Done under local anaesthetic so 5/6 injections into a very tender area!
This was the most painful bit.
The smell of your own flesh being cauterised is a bit traumatic too!

I needed a 20 minute lie down after but it was all so simple compared with the UK. No form filling no wait two hours after. No discharge letter...Sadly no tea and toast either!
Back to room for a sleep but three hours after I am  feeling better.
There is a lovely wee shrine in the side room and folk seem to come and add flowers ..... even as you're lying there 🙏

14th 15th 16th clinic visits

Falling into a routine here. At clinic for 10:00. Somedays quiet some busy.
Wound packed and out again. Some days dr. Some days nurse. She needs to work on her bedside manner a little!
Today was a "thorough examination of wounds" which was a bit painful. Fiona said I was grey when I came out.
Dr talking of a possible second thread to be fitted Monday.😏

11th/12th and 13th Clinic Visit - Thread three!

11th and 12th went well - just more packing of wound so in and out quite quickly although the queue in the clinic is building up!
We were over an hour waiting yesterday.  What strikes me about that is how many of us suffer from this damn thing.
We are an eclectic mix from many countries including the USA, Israel, India, Australia and of course Scotland!

13th visit was a bit more dramatic!  Big crowd again but time for my second thread change in only 5 days.  This is a painful but necessary part of the treatment.  Again the pain only lasts for a few minutes.
This time there was some "burning" sensation for a good while afterwards - just the thread at work I guess - and Dr Bhat suggested I take it easy today.
Uber back to hotel for a lie down.

On a positive note - one of the guys - Haim from Israel - was declared Fistual Free this week!  Almost on his birthday as it happens.  A definite time for celebration.

He was one who visited me in hospital when I was in for op.  So I am doubly delighted to see him at the end stage of a long and painful journey!

10th Clinic Visit

Nothing much different today.  Visit for packing of wound.  In and out in minutes.

Quick Uber back to hotel with no ill effects.

9th clinic visit - Thread two

First thread change today so was I a little nervous!
Two minutes of pain but much less than I've been through over the last five years, such as a colonoscopy 😏
I had a painkiller beforehand which may have taken the edge off!
Now waiting to see how the pain is with the thread in place doing its job.

On a totally different note, I have sussed out Amazon India with three packages delivered in two days including the wonderfully named "Billy Bum" cloths

 

I also now have my very own Sitz Bath!
It is strongly recommended that these are used twice a day.  They sit in the loo and you fill them with warm water.  A great way to soak and wash those important little places.

 

As before prices are very minimal.

8th Clinic Visit and tackling the laundry

So that's a full week passed.  Back today for more of the same packing although once more it was quite painful for a good half hour afterward.

On a positive note, we collected our laundry!  All done to a reasonable standard. It's a thought if you're out here for a long time how to address the clothes washing issue.
Here at the hotel, it would have cost about £40 for 10 days washing.  Instead, we went to a  branch of "The Laundry Basket".  About 20 mins away by Uber.  Costs were around £3.50 for the same load, all done for us and pressed, folded and bagged!

Seventh Clinic Visit and some Antibiotics

More packing in wound today. Slight discomfort as before but otherwise ok.

 However, over the last five years or so I've had a low-level underlying infection in the fistula tract. Some days it would flare up and need antibiotics. Probably a dozen times in the last few years. 

It always gives me sweats and a great lack of energy. 

It seems the treatment has set that off again so to add to the other 5 pills I have twice a day I now have amoxicillin!

As before costs are low so approximately £2 at local pharmacy for the course. 

Transport

The traffic here is horrendous!  The sixth worst city in the world according to surveys

 I am not going to drive here but the popular way to get around is by Uber

or failing that Ola - a similar service.  The costs are minimal.  It's been around $1 per trip so far or less than £1!  The service is pretty good on the ground but!......

Make sure you have a card that works with them before you travel!  We have spent two weeks trying to add a credit card as one expired and it is simply not possible to add a UK card to an account with an Indian phone number.  To make matters worse Uber is almost impossible to contact.  There is no phone number and no email.  It can only be done through the app and the response is terrible.

Luckily I have another card in place but my wife has not so.... we have only one phone which can access the service.  More than a bit frustrating.

5/6th Clinic Visits

Lot of pain after visit 5. 24 hours of discomfort. Visit 6 dr saw some swelling and inflammation. Prescription for some pain killers
Divon + and tramet p.
Costs minimal.

Fourth Clinic Visit

This was a little less traumatic than the last one.  More discomfort than pain.
I woke up to pretty heavy bleeding which took a while to stop.
However, Dr Bhat assured me this is a normal part of the process and it calmed down through the day.

Perhaps worth mentioning another (small) hidden cost.  He took a culture today and there is a fee of 700 IRP (approx £7.50) to have it analyzed.

There may be more of these as time goes on.

Third clinic visit

Back at the clinic third day in a row and.... today the pain kicked in!
Whatever the open wound was treated with, burnt like mad for about 10-15 minutes.
Indeed I had to walk it off.  It also made sitting down a little challenging for the rest of the morning.
I guess this is the start of the real healing process!

I keep thinking "No Pain - No Gain"

It is worth pointing out that keeping this whole area totally clean is really important during the process. Considering what its used for, this is a challenge!
However many of the bathrooms in India - even public ones - are equipped with these, right beside the loo..  and with a drain below.  They give a fairly high-pressure jet of (cold!) water which does the job!
Locally referred to as "bum guns"!

Meds

Got meds prescription today. Lots of pills! Eventually found an Ayurvedic pharmacy too!

 

Ayurvedic  kendra 161 dhanalakshmi complex bangalore

These are not what you would call "traditional" medications but rather more akin to herbs or extracts you would get in a health food shop. They aid bowel and digestive issues, among other things.
The doses are quite high at 4 a day of each - 2 morning - 2 evening - for at least a month.

Wound was repacked too but otherwise little change from yesterday.