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I read my wife what you wrote, and it has helped a lot. We are going to call our GP tomorrow and ask about antidepressants. She has no appitite, and this worries me the most.



You ALL are in our prayers.



God bless, Dad.
Hi Dad, B, Penny and Milesmom,
Dad, welcome to the site. I am very sorry to hear what has happened. My RVF was the result of something called a Bartolin Cyst so I can't help as much as beegirl has done with the post childbirth stuff. I am in the UK, so the first 2 years I went through probably won't apply in the US - however once you get to the right place in our emdical system I think things aren't so different. The problem with this condition is the waiting and also the emotional toll. To have 3 operations where the thing won't heal gets to you - you don't trust your body and you are constantly waiting for the dreaded symptoms to re-appear. So depression is a real risk. I am susceptible anyway and I am seeing a counceller/therapist once a week. Even with that support I nearly went to the Dr to ask for pills recently. Given that after childbirth can lead to depression anyway I'd definitely take your wife to your GP to get some antidepressants. It is better to try and nip it in the bud and not let things get too bad. A lack of appetite is a classic symptom of depression. Also her fear that you may leave may also be related to her feeling down.

I have a long term boyfriend who has stuck by me. It is difficult to provide reassurance but whilst tough it is cope-able with. Please give her my best wishes (and of course to you too). I hope things look up adn best of all that the repair holds.

B - I feel a bit better now. I found the ultrasound traumatic. I now need to wait to get the results - unfortunately, this being the NHS, the clinic date is 29 April. For now though everything is clean and clear and I've not had any urges for a bm recently.

Take care all.

Bea
Hello everyone,
Just as an aside, it's so great to see everyone's responses to someone needing help. I don't see it on every forum and am glad to be a part of this one.
Dad, I'll agree with everything said above. Sometimes the fistula is repaired quickly but even the quick ones requires some time. Others of us have had to wait for a long time and multiple surgeries but either way it can be depressing and anxiety provoking. I'm on medication, too for depression and periodically see a therapist. Early on, before the meds, I had difficulty eating and even being by myself. My poor hubby had to take me everywhere with him. I joined him for trips to the dump, walking the dog, etc. After a bit of that I decided I needed to take charge and the meds and talking to family and friends also helped. It's easy to give in to despair but hearing positive talk from others is a blessing as well as keeping the rest of your life going, shopping, visiting friends, whatever your wife normally does. The baby needs her, too, which in a way is a good destraction. We welcome her here on this site anytime. And I know what helped for me was just hearing from my husband that we were on the path to healing and better times were to come. Reminders that this is temporary and remembering to celebrate the good things in your life all goes a long way.
Bea, sorry to hear your ultrasound was traumatic. I would love to have people doing these tests experience them so they can understand what we have to go through. Everyone should have a training in compassion in addition to running the machines, etc.
B, Glad to hear you're doing well. Miles mom how are you doing?
I'm seeing my Md tomorrow. I'm hoping she has some digestive advice. I had some rough days last week and not sure where to start over.
Take care,
Penny
Hi all!

Thanks for all the inquiries. I am doing alright. I have a number to call for my next doc in Boston. I plan on calling tomorrow as I really can't get to see her before May 10. I took a chance a few weeks ago and auditioned for a lead roll in Guys and Dolls and got it! It's nothing big, just some community theater, but still I am excited about it! I don't think I ever said that about myself, I am a singer. Went to school for vocal performance, but decided that I didn't want to become a professional waitress so I got my education degree, which has worked out well for me. I love teaching and am blessed to be able to teach voice privately and teach the choir at our school.

Anyway, I am a little concerned about being on stage and having the urge to go, but it hasn't happened yet so keep your fingers crossed for me!

Dad, I think it is wonderful that you are so active in your wife's recovery. I too had a repair right after the birth, but it fell apart. Be sure to report any pain immediately. I felt like my stitches were pulling apart and we had it checked out at one of Miles' appointments. Being aware of depression is key to avoiding it, but make sure that you're not overly paranoid either. There comes a point when you just have to say to yourself "This sucks, but there are people out there who are dealing with much worse stuff than me" and remember that God only hands out what we can handle. I know that sounds awful, but it is how I get through the day. I think to myself, I must be really strong if He thinks I can handle this! And then I move on. There are always things that can be done! Especially with a newborn! I know how it feels to be 28, I am too, and have this breathing down your neck! It totally sucks! However, it can be corrected and while it may be a long process, I just have to believe it will all be done soon! Just some info that my doc gave me after my repair. It can take awhile to heal, so really follow the guidelines that they gave you after leaving the hospital. Report any pain or gas passing, and keep looking at that amazing baby! Is it a boy or a girl? Miles is the only thing that has really kept me sane! Let us know how it goes!

Penny, B, and Bea- keep your heads up, and good luck to all of you!

Karin
Congrats on the lead role!



What kind of pain should we be concerned with? She has a fair amount of pain during BM's, but they subside within a half hour or so to just being sore. here is no gas, only a little BM passing through. She had more pain a few days ago, and the doc said that the stitches looked good.



What about laxatives (Milk of Magnesia)? Do they make it better, or worse. She says her BM's are pretty firm despite the stool softners.



Thanks to all the ladies who have gave me support. I appreciate it more than you know.



God bless, Dad.
I delivered my son Dec. 11, 2008 with a 4th degree tear (induced with pitocin, forceps used to assist delivery of 7 lb 9 oz healthy baby boy) For the past few weeks, I'm passing gas via my vagina, no stool at this time. My obgyn ordered a barium enema to help diagnose a possible fistula. I am having it done monday.

Please advise which tests anyone has had that successfully showed small rvf formation.

Also, if rvf is found, who do I go to see next? Colerectal specialist or gynourologist?

I am a wreck emotionally about the possibilities. Any helpful advice would be wonderful.
Hello, hope all is well.

I have another question.

My wife has been having a little greenish discharge the past 2 days with no other sympyoms other than a little soreness (which I assume is normal for her proceedure). Is this a sure sign of infection, or possibly just part of the healing process? The Dr. said the only thing to look out for is bleeding, or excessive pain. She has neither. She is taking a course of Macrobid, but that ends today.

Any help would be appreciated, Dad.
Hello, hope all is well.

I have another question.

My wife has been having a little greenish discharge the past 2 days with no other sympyoms other than a little soreness (which I assume is normal for her proceedure). Is this a sure sign of infection, or possibly just part of the healing process? The Dr. said the only thing to look out for is bleeding, or excessive pain. She has neither. She is taking a course of Macrobid, but that ends today.

Any help would be appreciated, thanks.
Hi Drews mom - welcome to the site - sorry that you may have an RVF. A barium anama is a good way to diagnose an RVF I think. The only issue is how thick the liquid is. When I had mine they diluted the 'normal' fluid by at least the same volume of water again. It needs to be a thin liquid - especially as it sounds as though yours may be small - so that it will flow into any small hole and show it up. Other than that an endo anal ultrasound is good - my consultant's preference. Another test can be putting dye in the rectum and a tampon in the vagina and see if the dye comes through on the tampon. If yours is small it may be difficult to prove. AA colonoscopy may also be suggested. Once diagnosed you need a colorectal surgeon (If not before, for the diagnosis) as any surgery has greatest risk to the rectum and sphincter muscles - not to the vagina. And it is the bowel end which is difficult to heal - so that is where you need the expertise.

Hi New Dad,
Re your first question you don't want to use laxatives and make the stools too liquid as this increases the chance if it getting into the wound. Stool softener should help make passing bm less painful. I was actually on immodium for a while as in general firm stool just pass by the hole and don't get squeezed into it.

On the green discharge - might be best to get a medical opinion if you can but it is true that pain is the best indiciator of infection. Some bleeding is OK and in fact other discharge too as it is the wound healing and draining - better out than in. However green does sound a strange colour so might be best to get it checked it out - even a phone call may help - i did that once when I was concerned.

Hope you both are OK - being new to this whole problem takes a bit of adjusting and do use this site to say how you feel as you can't always talk freely to friends about some of the details.
Take care both and to PEnny, B and Milesmom,
BEa
Hello-

I have had a recto-vaginal fistula since the birth of my son 6 years ago. I had a 3rd degree episotomy and foreceps used. This sounds weird, but I didn't realize that I had a fistula until 2 yers after his birth. The only symptom I had was gas, which I thought was just air because I didn't think it was possilbe for gas to come through my vagina. My doctor said it was normal for me to feel air through my vagina when I told him that's what I thought was happening. I just thought it was part of giving birth and would go away.

When my son turned two, I got pregnant with my second child. Around that time I also got a really bad stomach virus with vomit and diarreha ( i can't spell that ). I had stool passing through my vagina and realized something was wrong because that had never happened before. I did some researach on line and realized that I must have a recto vaginal fistula based on my symptoms. I called my doctor and he had me come in. He agreed that I must have a fistula, however he said he never saw one when he did exams after my son's birth. This doctor resigned half way through my second pregnancy and I began seeing a new doctor.

We debated if I should have a c-section for this delivery because of the fistula. Let me remind you that both doctors still could never actually find the fistula, but knew I must have one based on my symptoms. We decided to go ahead and do a vaginal delivery and see if it could be repaired during the delivery.

I ended up having another episotomy (4th degree) and my OB said he saw the fistula and he tried his best to fix it. I was very pleased! After 6 weeks though I had gas coming through. This was all 3 years ago as my daughter just turned 3.

My OB has told me that if I have more children that he could try to fix it again. I have been debating what to do because I wasn't sure about having more children. My husband does not want anymore children and I am beginning to feel the same way and that I should just get this problem taken care of. I called my OB and he told me to make an appointment with a colon rectal doctor and that is what I did. I have an appointment in 2 weeks. I am absolutely terrified because of all the horror stories I have heard. I have never had any pain from my fistula, and I rarely ever have stool pass. My only real symptom is the gas which only happens depending on how I could be standing or sitting. I pray that mine is not bad and can be easily fixed. I just don't want it to get any worse since it isn't so bad compared to what some of you had. I am terrified of the exam because I don't even like regular gym exams.

If you have any advice for me please let me know!

Thank you,
Guest
Drew's mom, the barium enima showed mine... good luck.

Guest, u can go back and read my posts...if you are thinking about a repaor get many opinions, ask many questions. I have a rvf, from the birth of my daughter, had one failed repair, which made my (not so big) fistula huge...so, if you can life with it, the way it is, and it is not causing you major issues, that can be an option....all surgery has risks, obviously. In december, I had a second repair with an ileostomy...I am still waiting for the repair to heal. Good luck to you...go see a crs....not a gyn. B
Guest
Just wanted to mention that by the sound of your fistula you do have the option of fixing it or not. After many months and my last surgery my MD talked about 'dealing' with it if it was still there. It was kind of mind blowing at the time. I had surgeries, tests and an ostomy all to get rid of it and then I heard 'dealing' with it. I was not happy. But I guess she felt if it only passed gas and maybe fluid when I had diahrea I could live with it. I'm not sure if that was going to be true but luckily it was no longer there. I think you have to get all the info you can and then make the decision. You could always wait until or if it got worse you could deal with it more aggressively then. I had a flap repair by a colorectal person first but that didn't work and I was due to have a gynocologist repair it vaginally when they saw it had healed so I think either one might work depending on where it is or who had the best experience. Take care.
Bea, B and Milesmom, how are you all doing? Any new news? Hope we're all feeling better with the extra warm sun. My goal this year is to do some bicycling. Something I haven't done in decades. Looking for a soft seat, though! You're all in my thoughts,
Penny
I know my symptoms don't seem so bad since I really just deal with the gas... and maybe I could live with it, however, I worry if I live to be 80 I might have other bowel or bladder issues and this fistula problem will only make things worse. I can somewhat control the gas not coming through my vagina with my muscles, however what if I can't control it when I am older. I am only 32 right now. It's really just embarassing when you can't control it coming out of the wrong place. UGH... this is so frustrating. As mentioned, I do have an appointment coming up with a colon rectal surgeon, so I guess I should just see if he can even find it and ask him what the risks are to having surgery and not having surgery. I am afraid he won't be able to find it because my OB never could during an exam. Like I said in my first post, I really don't like these kinds of exams so it scares me to think of what he will need to do to find it. Also, for those of you that have had surgeries to fix this, did your insurance cover it? I have been a little concerned about that too since I have been living with this problem for a few years now. I am assuming that my fistula must not be very big since my OB can't find it and I have minimal symptoms. How long is the recovery for a surgery for a fistula?
Guest- I guess it depends upon what kind of procedure you have. I guess they can "plug" up the fistula now, they can do a flap repair, or they can do a sphincteroplasty or layered repair. I had that done in October and it took about 2 weeks to really be able to be up and around again. After that you aren't supposed to lift anything heavy for 8 weeks, and forget about sex for a long long time, and when you do begin to have sex again, it's totally painful! Remember that this surgery can also cause fistula (it caused mine). I have also been told that the "plug" from the plug method, can just pop out!

I worry too about the long term effects from this, but I don't know whether it's worth all the pain, and efforts of the surgery! I had to have this surgery because I was just one giant hole after the birth of my baby. I was also told that I can never have another baby vaginally again, so if you are going to have another baby and want to do it vaginally, I would do that first.

Dad- I know that I could tell that my repair was falling apart when I had intense pain, so bad I doubled over and felt like my insides were actually tearing apart. It truly is almost indescribable. I could take two percocet and it wouldn't even touch the pain (but I think that might just be the way I handle percocet). As far as the discharge, I would get it checked by the doctor. Green is not an indicator of good things usually, but with your wife already on an antibiotic, I really don't know how an infection could be there. I would get it checked though.

Penny, B, and Bea- Hope you are doing well. Hope there were no more leaks and unpleasant news from your doctors. I am doing alright. My husband and I are trying to get our sex life back, but it hurts so much! Any ideas on that front? I worry about using the lidocane jelly because I don't want to have no sensation...I am also really rethinking the whole trying to get this fistula fixed thing. I don't think I can take another surgery, and as far as the plug goes...I hate the idea of the unknown. It totally sucks to feel like I am going to pass gas through my vagina forever, but I really don't see another way. What are your thoughts? I still have stool passing occasionally, and I really want to be done with this, but I don't know what to do! I am getting depressed, and feeling a little hopeless.

Karin
Guest,

as far as length of time of recovery after surgery-it depends on the procedure and your body... my flap-failed in a week..., so I didn't have to continue not lifting.... my ileo and last repair- 2-3 mos. then I could lift my daughter. I went back to work in two weeks. but I am still recovering and have to tak eit easy...

insurance-not sure, mine covered it as i repaired after my daughter's birth...

whatever decision you make is up to you... and i am sure you will do what works the best for your needs... i can understand your fears of the future, but surgery can also cause further problems (just something to think about) I wish you well and ask away!

Bea and Penny-hey ladies, hope you guys are good. i go back sometime this month for my next appointmnet, so i will keep you posted...

Penny-great goal-my goal is to get back in shape this summer and to have a garden with my daughter... and to write, as always.

Bea-how r u feeling? any more problems, bleeding???? thinking healing thoughts 4 u?

Be good ladies. b