Had hemorrhoidectomy, need surgery for fistula and skin tag removal

Background info- Very active 31 year old mother of two.  Never had any major health problems.  Developed large external hemorrhoid with first pregnancy.  After vaginally delivering two beautiful babies, my hemorrhoids were bad- burning, itching, and bleeding a lot.  I was 31 years old, constantly worried about my butt, and it was very embarressing.  But I have the most amazing children and I would go through this all again for them.  Bare with me as I get into what I call my butt problems.  :)  

My OBGYN sent me to see a gastro who did a colonoscopy to see if banding would help any internal problems, but he said my problem was mostly external and my only option was hemorrhoid surgery.  He referred me to a colorectal surgeon.    

After putting it off for about a year and a half out of fear, I had the hemorrhoidectomy done.  My whole experience has been pretty bad.  I came out of the procedure pretty sick from the anesthia.  I had zero appetite and when I would force myself to eat anything it made me want to vomit.  The aides my doctor had me taking to make sure I didn't get constipated actually made me have too frequent of bowel movements so that was pretty painful just coming out of surgery.  Saw my doctor a few days after surgery, she said my sutures still looked good, adjusted my meds a little and sent me home.    

7 days post op I wound up back in my surgeon's office with extreme pain and swelling.  Turns out I had an infected suture that needed to be removed right away in her office.  I had just taken my last prescribed antibiotic from the surgery (flagyl), so she said it was still in my system and I didn't need any more at this point.  After that I had several days of draining mucus and blood.  But things seemed to settle down and the major pain went away.  She had me applying diaper rash cream to the external area to help heal my skin.  

The affected area had always looked kind of swollen, like the external hemorrhoid was still there, but my doc assured me that this type of swelling was common and would subside.  Two weeks post op it still wasn't going away and the surgeon told me they were skin tags and not anything to worry about.  

At about the 4 week mark, the swelling was still there and I started experiencing severe itching and burning all around my anal area and even close to my vagina since this is the area where the hemorrhoid was removed.  Saw my doctor again, and she said I must have very sensitive skin as it was extremely irritated.  She said I was most likely having a bad reaction to the diaper rash creams.  She prescribed a hydrocortisone type of cream.  This helped with the itching.  Went back a week later and she said everything looked good.  She did a thorough in-office examination using a scope to see internally as well and said things were healing very well.          

Two days later, I swell up huge out of no where while grocery shopping with both my kids.  In tremendous pain and hardly able to walk, I somehow drive home and get into the bathtub.  It felt like something finally popped, and blood and puss started draining out.  My doctor told me to come to her office immediately, so I rush in with both my kids.  The office manager had to watch them while waiting for my husband to get there (he had to drop everything at his desk and drive 40 min to get to us).  Meanwhile I'm on the exam table, and the doctor tells me I've developed a severe infection.  She says she needs to cut open one of the skin tags and drain it right now.  After 4 numbing injections both internal and external, she cuts and drains it.  Most awful experience of my life and now I have to face my little kids in the lobby who want to know why mommy is crying.  That was worse than the procdure.  I was put on a stong antibiotic.  This was at the 7 week mark.  We had a trip scheduled out of state for a family wedding and my kids were both in the bridal party.  I was told it was okay to travel, but to see her as soon as I got back.    

After this procedure, things felt better but still have not gotten to a place where I feel healed.  Was at least able to have a nice family trip, came back and saw my doctor again.  Looks like the infection is still draining, but now she says I've probably developed a fistula somewhere underneath the skin tags or internally somewhere in the scar tissue from the intial surgery.  According to her, this issue I've had with swelling, infection, and the need to drain will be recurring unless I do something about it.  She was right.  I swelled up again this week, but at least things were still able to drain from the opening she made recently.  

My doctor wants to do a second out patient surgery to remove the skin tags and clear out the fistula.  Since I had such a bad reaction to the anesthia the first time, she wants to use an epidural and other medication to sedate me but not put me out completely.  This time there would be no sutures, just open wounds to drain.  That sounds so painful and scary.  Given the fact that I've had so many complications already, I can't even begin to conceive the side effects of this.  It seems like I'd be even more prone to infection to have things left open in the dirtiest area of the body.  

I did seek other opinions this week because surgery is not something I take lightly.  I talked with my family doctor who I highly trust.  She seemed to think that I need the second surgery, but she also referred me to a general surgeon who pretty much told me the same thing.  He suggested giving my body more time to heal, then doing an examination under anesthia to pinpoint the exact probelm, and then going through with surgery to correct it.  To me, that would just prolong things though.  We have other big family events this summer which I need to be better for.    

Has anyone ever had an experience like this?  My doctor says she's flabbergasted that a person my age who's active and fit has had it so rough.  From what I've read online, what I'm experiencing only happens to 1% of the people who have hemorrhoidectomenies.  I can't help but ask why me?  Does anyone have any advice for me regarding the second the surgery?  Basically I've come to terms with it now in the sense that I know it's inevitable, but I still have so many fears about it.  I'm really scared that I'm starting over again from square one and maybe this won't help either.  I want to be sure that I know what all the possible outcomes of this could be.          

[Dr. Kokil Mathur]

Hi!
I am sorry to hear all that you had to go through. Yes, as you know, this is a rare complication. It is more common in people with diabetes, fungal infection, dermatitis or due to poor personal hygiene (may not be true in your case). Hence, apart from surgery all these other causes will need to be ruled out. And, yes, surgery appears to be the only option.  Take care!