**WARNING** Graphic images ahead. If you have a queasy stomach I probably wouldn’t click to expand this post.
I’ve had this blog sitting in my drafts since the beginning of the year after I rang in 2015 with a very large, extremely painful, abscess on my butt. I was struggling a lot the last few months of 2014 and the first many months of 2015. It makes sense now looking back – that was right around the time Remicade had stopped working for me and now that I am on a different treatment plan *most* of these issues have resolved.
At the end of last year I wasn’t sleeping very much because I was experiencing a lot of nausea that made it difficult for me to even roll over in bed without the room feeling like it was spinning and wanting to get sick. Walking down the hallway to get to the bathroom was it’s own challenge due to the nausea I was experiencing. On top of the nausea my arthritis was flaring up and was so bad in my shoulders that I couldn’t sleep on my side longer than a couple of hours and the pain was so excruciating I was left wide awake into the early morning hours in tears. I don’t normally cry, and I have a pretty big pain tolerance, but this shoulder pain was intense. I would have just slept on my back but there was an abscess on my butt. The abscess was so big and so painful that I could not put any pressure on my behind so I would prop myself up in weird positions in bed using pillows trying to ease the pain.
Needless to say I wasn’t getting much sleep and the lack of sleep and the constant pain was affecting my mental health. I was unable to concentrate (good ol’ brain fog) and was irritable and depressed.
Below are some of the pictures from abscesses that I have had in the past year. I did not include the bigger more gruesome photos because they are of areas that I will not be sharing with you or the internet. Let me just say though that the one on my butt and the others I have had in my happy places were much more painful and yukky.
I actually can’t remember where this one was located but I think it was my inner thigh. Yum!
Pretty sure this one is the same abscess as the one above. I also want to say that I feel a little silly even talking about my abscess experiences. I am lucky that aside from an intra-abdominal abscess 7 years ago, and a big mouth abscess 6 years ago, I didn’t have any experience with abscesses until this past year. I know so many people who really struggle with abscesses and fistulas and nothing I have been through even compares to how bad it can be.
This one was on my back and this picture was taken awhile after I was put on antibiotics and it had started draining. A week before this was taken this abscess was even bigger and I couldn’t believe the pain it was causing me. It was constant unrelentless pain and I was so happy once it started draining and I started getting some relief.
The same abscess on my back once it had started draining. You can see my PICC line on my left arm which feels strange now because this was such a short time ago but it feels like forever ago.
I don’t remember where this one was located but it sure looks delicious.
Another abscess on another area of my inner thigh after it had already been draining for awhile.
One on my lower abdomen below my semi-colon tattoo on the right side of my body.
A close up of the same one above once it started draining.
So now that I’ve put you through that, let’s continue! The abscesses pictured above sucked but the one’s in my down-below-areas sucked even more because not only did they hurt but they caused me a lot of mental health issues.
WHAT IS AN ABSCESS?
An abscess is a localized collection of pus caused by infection from bacteria. Abscesses can form anywhere – both inside the body and on the surface of the skin. Abscess formation is a way the body defends itself to prevent the spread of the infection to other areas of the body. The abscess contains pus made up of destroyed tissue cells and white blood cells that have been carried to the area to fight the infection. Abscesses are much more common in Crohn’s disease than in ulcerative colitis.
I actually had this huge long blog typed out on types of abscesses, symptoms, treatment + more but it was getting so long that I realized that I needed to break this into two blogs. What I’d really like to talk about in this post is how having abscesses (and fistulas) can really mess up your mental health and your quality of life. Then I’d like to talk about some tips for making life with an abscess more bearable. There is a lot to be said here and this is a very generalized post. Stay tuned to part 2 for more information on types of abscesses in Crohn’s disease.
ABSCESSES AND MENTAL HEALTH.
My situation has been easier than some, but there is a real reason wy I want to talk about mental health here. A lot of patients with Crohn’s disease deal with perianal disease and that can be extremely embarrassing, especially for young patients or patients in relationships. Abscesses and fistulas can contribute to poor body image because of their appearance and their location. A patient with Crohn’s disease who would like to start a relationship and have that intimacy in their lives may put it off and deprive themselves of a happy relationship due to disease taking over their private areas. How do you explain your bloody, pus butt that currently has a drain in it? That’s pretty heavy stuff. For patients already in relationships the physical and emotional aspects of having abscesses can greatly impact a couples sex life.
It’s not easy to live with and can seem never ending. My friend Jen put it perfectly in a blog she wrote saying, “For me, abscessing has been a never ending battle that seems to go in circles. The abscess, the pain, the possible drainage, the possible fistula, the possible placement of a seton, the antibiotics, the crazy biologic. It feels better, it comes back the cycle starts again and yet again…”
I said up above that I have been lucky because I have not had to deal with this stuff as extensively as other patients I know. The little experience I do have really took my fragile self-esteem and knocked it down a few notches. The abscesses on my butt and around my genitals made me feel so unattractive and undesirable that I was beating myself up mentally. There was so much negative talk going on inside my head about how gross I was, how undesirable I must be, how I shouldn’t be intimate because this is disgusting, and so on. All this coming from a girl dating a guy with Crohn’s disease who has way more experience with abscesses and fistulas than I do, and I was still embarrassed! I couldn’t have a more understanding partner than the one I have and yet I still thought I had to hide myself away.
P.S. Toward the end of last year between the two of us it was a back and forth abscess party. You’re welcome for the visual!
TIPS FOR LIVING WITH AN ABSCESS:
The above picture I took in the bath while I was at Dan’s house at the start of the year. It took some strong persuasion to get me to take a bath because I hate baths but I knew that it would help, and it did. A bunch of gross bloody skin chunks started floating around. Don’t ya just love me right now for grossing you out so much today!?
- Take a bath – If you’ve had an abscess you probably already know this, but taking a bath not only helps ease the pain but it can help the abscess to start draining. In my experience it has almost always helped the abscess drain on it’s own which greatly relieves the pain. Though it generally takes several days and many baths to get there.
- Use a heating pad – Keep it on the lowest setting and it can help alleviate some of the pain. This was helpful for me with the abscesses on my back and butt and kind of dulled the throbbing. The relief is temporary and only works when using the heating pad but once I stopped using it the pain immediately returned full force. At least it gives you a little break and with how painful abscesses are, a break is worth it!
- Consider a bidet – I used to think bidets were there weirdest thing… until I had an abscess and wiping became difficult. My friends Mal, Jaime, and Beth all have the same fancy bidet in their homes and they swear by them. I even threw up once in Mal’s while I was visiting after a long hospitalization and her heated toilet seat was quite nice for that. #friendswithcrohns A bidet will help keep the area nice and clean and you just pat dry when you are done. It also feels good on the area and can temporarily ease the pain.
- Try the Spray Quick bidet – If you can’t afford an expensive bidet like the one mentioned above, consider a hand held bidet like Spray Quick. Using a bidet on the area can feel soothing and it will help you keep everything clean and help speed up healing.
- Use an irrigation bottle – Same concept as the bidet but cheaper and you can take it everywhere you go! You can also use a hair coloring bottle if you have one around.
- Take a sitz bath – To take a sitz bath you can purchase a shallow basin that fits inside your toilet. Fill the basin with 2-3 inches of warm water and soak your bum for 15-20 minutes to reduce the pain and discomfort of abscesses. The warm water boosts blood flow to the area which could speed up healing, and also help the abscess to start draining. You can use Epsom salt and do this a few times a day to temporarily reduce the pain. Following the bath pat the area dry or use a hair dryer.
- Wet wipes – Using toilet paper can be uncomfortable and little flecks of it can get left in the infection. I prefer using wet wipes but you have to be careful of the ingredients because some ingredients may irritate you even more. Look for wipes with no added scents and the most natural ingredients you can find.
- Consider a pull down shower head – Just like a bidet and shower head can help keep the area clean and can also feel very soothing. I discovered this when I was staying in a hotel for some of the traveling I did as an IBD advocate.
- Get creative with pillows – Sometimes getting comfortable isn’t easy when you can’t put any pressure on your butt. I have had to get creative with pillows to get some good rest. People are sometimes under the impression that you should use donut cushion to help ease the pressure but it actually does the opposite. Apparently this is the cushion to get!
If you have experiences with abscesses and fistulas I would love to hear your tips for dealing with them. Stay tuned for part 2 with more on treatments and abscess info.