Thursday, 23 August 2012
Pain In The Butt
Once I’d established I was one of the 27% of Crohn’s patients who have their anuses sewn up and take ages to heal, you’d think I’d have let it go at that. And maybe I would have, if the healing had followed the traditional pattern one expects such things to follow – ie gradual improvement. Even if this improvement came in the smallest of massively spaced out increments, I’d have been happy. I’d have kept swallowing the pethidine on a three times a day basis, but I’d have been aware, at least, that things were on the mend. Getting better. I’d have believed that some day this would all be over and my Barbie Butt would be the complete, sealed, happy and non-bothery thing I’d been expecting it to be all along. The surgeon did warn me about the 27%. He even pointed out that things often went wrong for me, and that I would probably be one of them, but I never believed him. Looking back, I realise I never do believe the worst will happen, not right up until the moment that it does. Probably later, actually; at the moment it happens, I usually assume it’s something else, something lesser; only when there is unequivocal evidence, over a protracted period, that the worst has actually already happened, do I start to accept that perhaps it has. As I’ve said before, my glass is a strange kind of thing that persists in trying to convince me it is half full, no matter how much evidence there is to the contrary.
Which is why it took me a long while to accept that the pain in my butt wound was getting worse. It was bleeding a lot, it was weeping copiously, and it hurt. Wow, it hurt. The pain was extraordinary. When I was a small child, I sat on a cactus whilst wearing a bikini, which was extraordinarily painful; I remember lying on a sunbed in the back garden as my mother pulled the spikes out of bum, one at a time, and to add insult to that injury, I remember the mortification I felt as she chatted to the man next door over the garden fence while she extracted said spikes. This pain was worse than all of that. It was constant, for a start, and while the pressure cushion helped, I still felt like I was sitting on a bed of burning rusty nails that took it in turns to adjust themselves, each one sticking further into my sewn up anus than the last. Like there were tiny evil nymphs running around between those burning, rusty nails, swivelling and pulling them into bent and twisted positions as they penetrated my poor, sad, battered wound, drawing yet more blood and nasty serous fluid to the surface. I tried to ignore it, but it only got worse. Each day, I woke up earlier, and in more pain, and finally it occurred to me that I should see the surgeon. And not just for a regular check-up as I was supposed to, but sooner, specifically to tell him just how bad it was.
And so I found myself sitting next to husband, opposite my surgeon, perched on the edge of the chair on just one buttock (I’d left the pressure cushion in the car), wincing as I told him I thought the pain might be a little bit worse than it was meant to be by now. He agreed that even if the wound wasn’t going to heal for ages, if at all (If at all??? I wasn’t even going to think about that), it should have stopped hurting by now. He smiled his warm, reassuring smile as he said, ‘Let’s take a look.’ Without really thinking, I got up from the edge of the chair and went to the examination bed/table thing as he pulled the curtain around me, leaving husband sitting on the other side.
There are many indignities one has to suffer with Inflammatory Bowel Diseases, but having my anus sewn up meant a few of them were no longer applicable. No more colonoscopies, for a start. If I’d kept my rectum and functioning anus, I’d have had to have one of those every year because the chances of my getting bowel cancer would have been raised. Another thing I thought must surely be a thing of the past was the rectal exam. One of the highest things on my list of pros when I was considering whether or not to have the proctectomy was that never again would I have to hear those immortal words, ‘Just lay on your side with your knees up to your chest,’ uttered with the accompanying snap of a latex glove. Turns out I was wrong about that. At least, it wasn’t the case yet. Because that’s what happened as I got on the bed, quickly realising I was about to be subjected at least one more time to a lot of prodding and poking. Oh, if only that were all it had been.
He said he could see ‘pockets’ that might be infection, or might be little blockages – he would just open them up, he said, as though what he was about to do was a benign, gentle little action. When what he really was about to do – what he did – was hack into those ‘pockets’ with a scalpel and no anaesthetic. If I’d thought I was in pain before, I’d been a fool. A blissfully ignorant dope of the first order. He did check that I was up to date with my pethidine, but that was it for pain prevention. He cut and hacked for what felt like hours, as I tried to banter with him and make reassuring jokes for my husband to hear behind the curtain, when really what I wanted to do was cry and scream and offer him money and my first (only) born child, if he’d only, please, just stop. It reminded me, oddly, of the first time I’d had my legs waxed, when I’d wanted to do something similar and run out with only one hairless leg. I stayed ‘til the end then, and of course I had to stay ‘til the end of this, too. Every time I thought he’d got the last one, hacked into the last pocket of pus or whatever it was, there was just one more, then another, until finally, eventually, sometime just before the world must surely have ended, it was over, and all I’d done to give myself away was let out the occasional unbidden gasp. I think I might even have been so impressive that he didn’t think it had hurt at all, though he did suggest I take a few breaths before I joined him and husband back at his desk. I looked at my watch and was amazed to find the whole thing had taken just five minutes. Five minutes that had felt like fourteen lifetimes.
Back at his desk, he told me that if this worked, if the pain was significantly lessened after his quick intervention, then I could pop in once a week at the end of clinic and he’d happily do it again for me. Every week. I said I’d let him know when I’d seen how things were over the next few days.
One of the ways I handle bad things happening to me is to talk to my friends about whatever it is that I’ve just been through. I phoned three of them on the way home, while husband listened to me repeat my tale of anal woe – using the exact same words, with little variation each time, apparently; which makes it quite dull for the person sitting next to you, husband says. It was less boring for me, because I got different responses. At least, with different words; the responses were much the same in that everyone was appalled that I could’ve undergone such a thing without even being offered some local anaesthetic. I laughed it off; what would I need local anaesthetic for, I asked; he only took five minutes, somehow forgetting how hideously, unendingly long those five minutes had seemed just half an hour or so earlier.
Whilst still in the car, I called my GP because I needed some more pethidine and we agreed to stop off at her surgery on the way home. She took me into her consulting room and I told her what had just happened and, like my non-medical friends, she was quite surprised that he hadn’t used any anaesthesia. I generally put unquestioning trust in my surgeon, but I do in my GP as well, so now I had to look at it properly, rather than just ‘bravely’ laughing it off. I didn’t want my surgeon to be wrong, and I didn’t want my GP to be angry at him, and I suppose really I should just have been thinking about me, but who knows what would happen if I did that for too long … and I realised as I tried to jump to his defence that I did agree with him. That if I’d had local anaesthetic, I’d have had to have countless injections around the anal area, which would have hurt like hell on their own, then I’d have had to wait for them to work, during which time I’d probably have been sent back out into the waiting room while he saw a couple of other patients which would have meant I was there for goodness knows how long, and all manner of other interruptions he’d had to deal with would have dragged that out, and all the time I’d have been feeling nervous and scared about what he was going to do to me that had required painful anaesthetic injections, and how bad it was going to be. In the end, five minutes – and it was just five minutes, however much longer it had felt at the time – of agony and torture was far preferable to all of that. The GP thought that was a fair point, as long as I was happy with it, and I was, so we went off home, me clutching my prescription for more pain relief and husband eager to get me back to my usual place of recovery so he didn’t have to listen to the story of the surgeon ever again.
You’re probably wondering if the procedure did work; if it did significantly relieve the pain. I’ll tell you this – I never felt the need to go back and let him do it again. Which isn’t exactly the answer to that question, but it’s all I’m saying.