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.

Process - 1st & 2nd Clinic Visits

So what was done at this stage was a partial fistulotomy where part of the wound is cut open to the air - but only where this does not interfere with any muscle tissue.  At the same time the first thread was inserted.
The wound is "packed" in a similar manner to the UK.  At home "aquacell was used"

Where it all happens...

Out here it is slightly different but no doubt as effective.

Day 1



This is then what has to be changed initially on a daily basis...





So after a day's rest at the hotel I was back into the clinic to see the man once more.  Literally in and out in 15 mins.... Just to get fresh packing.

Day 2

The Op at Shoba Hospital

On Wednesday having seen Dr Bhat in the morning, at night I was admitted to Shoba Hospital.

The standards here are different in many ways to the NHS in UK but the speed and the quality of care were excellent.  The waiting area has these in it.

I was checked in having had Chest X-ray, Blood tests and blood pressure in 20 mins, and placed in a private room.  With ECG a little later.  Most patients have a "companion" to help out and there is a bed for them too.

There is little/no bedding and no towel!
There was also no food or drink supplied so make sure these are taken with you if you go.


To be honest I didn't sleep much - I never do in hospitals, but that was Ok.

Next morning I was awoken at 6:30 AM for a quick shave ... and not of my face!
There was also an enema just to round things off.

I was delighted to get a visit from Haim and another fellow sufferer(?)  just before theatre.  This cheered me up a great deal.  The support group out here of fellow sufferers is very strong! It's also multi National... with over 15 countries now on the listed of "treated"

However the op was scheduled for 9am and at 8:50 I was duly taken to the theatre!
Again standards are different but there were 5/6 staff there and I was sedated with a spinal anaesthetic while the op took place.  It was strange for me to be awake throughout as I have had very many ops in the UK but always under a general anaesthetic.
However, there was no pain whatsoever and I was soon back in the room.
What was a little alarming is that I had no control at all of my body from the waist down for some 8 hours or so!  That was certainly disconcerting.
However my wife Fiona came in to sit with me most of the day and all was well.  Dr Bhat came in at night to explain what had been done, what was to be done and to say "due my age!!" I was to stay another night in hospital.
Next morning bright and early I was discharged and the Dr's own driver brought me back to the hotel.

Dr Bhat

Saw the man himself today.

He's a great character. Very upbeat and positive.There is much more about him on his web page 

It's also worth saying you might need a diet change whilst here!  The doc strongly recommends NO meat and NO alcohol during the treatment.  One more burden for some perhaps.....

Hospital tonight.... op tomorrow under spinal anaesthetic.

Stay until next day then daily wound dressing for two weeks. Then weekly for two and a half months. 

Current seton doing nothing!

Partial degradation of sphincter but confident he can sort fistula. 

Relieved but nervous!

Onwards and upwards. 

For the doubters or who need family convinced watch this video.  The main man is a cardiologist in the USA!
Threads of Hope

Scans

The green is the fistula.  The red is the existing seton

These are TRUS scans. I have no idea why the UK doesn't make use of them.  They are fairly non-invasive and very clearly show what is going on.

Unfortunately, you can clearly see on the bottom of the left scan that some of my inner muscle tissue has disappeared!  (the incomplete ellipse) This is probably the result of some of the many treatments I have had in the UK  and weakens the sphincter power.  Luckily at this time, it is not affecting me but who knows what the future will hold in this regard.

Scan time

Went for TRUS scan today. 

Not much fun but very friendly and efficient. I don't understand why this technique isn't used in U.K.  

Very revealing fairly fast and uncomfortable but not painful.

Wee tip... I was asked if I had any existing scans with me.

Here's another chance to see the explanation of the scan...
TRUS

E Visa

One of the issues travelling to India is that you must apply for a Visa in advance.  The choices are many but the simplest is a tourist E-Visa which if you're applying from UK is valid for 1 year with a maximum stay of 6 months each visit.
There are many "false" websites online which will overcharge you for this.  If you use the official Indian Govt one it will be cheaper.  I paid only$40.
Visa application site

Phones!
UK roaming costs are very high in India.  The obvious solution seems to be to get an Indian SIM.
However!  This is not so easy.
First make sure your phone is unlocked...

Then.... you need your passport, a passport photo and a "permanent" address in India.
We trailed around 3 shops today before anyone was prepared to offer "Foreign Nationals" a sim card.
All credit to our driver Sumil who steered us in the right direction, albeit the wrong way up dual carriageways, car abandoned in the road etc etc (Indian driving is a whole new concept!
However we now have got the Sims and await activation.  Costs are great - approx £8 for 3 MONTHS unlimited calls/data.
cf with £1.80/minute on UK plan or £6.00/day roaming charge.

Fistula and what causes it

Warning!  This blog will be graphic in a medical sense!
Don't read it if you are sensitive!


It is designed as a hope for others suffering the same.
I seek to explain the issue and how it might be cured!
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.

Hi all.  My name is Kevin Thompson and this is a record of an epic medical journey.  There was much soul-searching before I undertook it but I needed a cure and Western Science could not provide it!  So I find myself in India 

Read on for the whys and wherefors....

What's It All About
An anal fistula is not fun!  It needs constant attention.

One explanation of what a fistula is, is given at this link:

Fistula explained

Having suffered from this for some 6 years now, I have had almost 20 surgeries.
Due to the position of the fistula - wrapped around the sphincter muscle, traditional operative cures cannot be used as they would cause incontinence.  Fistulae can be simple or complex.  Sadly mine is the latter.

The result has meant a long-drawn-out process of operations under regular general anesthetic to clean out the wound and replace the seton.

A seton is simply a special thread inserted and tied off which allows the wound to drain.

 

Actual seton in place

Having felt worn out with the longevity of this I started seeking alternative treatments about a year ago.
As I said, sadly Western Medicine does not offer any in my case.

However Eastern medicine does offer a chance using a technique called Kshar Sutra. 

See here for explanation  Kshar Sutra explained.  If that website is down try here https://www.pristyncare.com/blog/kshar-sutra-treatment-pc0113/

There is even a FaceBook group of the same name which is how I came across it.
see Kshar Sutra For Fistulas
The downside of this is that only one country in the world offers it - India!

So after much soul-searching this week I head off to Bangalore to seek a cure.

This is not a short term win and may require several months of treatment but hopefully the results will be worthwhile.

Watch this space.