A patient’s recounts her journey to hell and back….

Things were going well for her. Life was what one could call- stable and fulfilling. She was young, had a full time job as a teacher and was recently married. All in all, life had been kind to her. And then suddenly it wasn’t. It began a small problem, some pain and an embarrassing condition she did not feel comfortable discussing and before long it became a constant, ever-looming companion. She had episodes of pus discharge from the anus, complaints of painful defecation and swelling and tenderness in the anal region for a few months before she realized that she had to gather the guts to visit the doctor. There are thousands of people who have symptoms like her but are too reluctant to visit a doctor. In this way, she was indeed a doctor’s delight- a patient who visits a doctor before the damage becomes permanent but this was just the beginning of a series of failed procedures and dashed hopes for her.

The patient had actually developed a fistula in her rectal region; a fistula is nothing but a connection between two body cavities (between the rectum and the vulva, in this case) or between a body cavity and the skin. A majority of cases of fistulas develop in the genital and anal regions. The causes of their development maybe varied but since these connections are not a normal occurrence, their presence leads of symptoms similar to what this patient was experiencing. Like any other person who is not from a medical background, she too had no awareness of such a condition or its implications. It was her doctor’s responsibility to explain things to her but that unfortunately did not happen, instead she was made to undergo multiple sittings of drainage which provided temporary relief but no permanent solution. She changed doctors but the problem persisted. Finally, she was diagnosed as having a fistula, had been operated upon, but recurrences became more and more common. Her job as a teacher required hours of standing and walking around, a task that seemed impossible now considering there were days she had difficulty even standing or getting out of bed.

After yet another failed procedure, she gave up, put her hands up and accepted that she would live with this pain forever. It had been more than two years of living in shame for her and the physical pain had now become secondary to the mental anguish she had to endure daily.

Her sister mentioned a specialist in Pune- Dr Ashwin Porwal- an internationally trained proctologist whose facility- ‘Healing Hands Clinic’ had made a name for itself in providing quality care in cases like hers. She did not want to travel to Pune but at the insistence of her husband and family, she decided to take one last chance. Today, she says that visiting Healing Hands clinic was the best decision she had ever made.

She remembers that what was different at this facility was that her doctor and his team did not simply just recommend a procedure to her. She was first explained her situation in detail; following examination she was made to understand the she had developed internal openings in the anal region and three external vulval openings which expressed pus. These openings could be repaired by a fistulectomy procedure. She was wary of undergoing surgery again but the condition was now taking a toll on her overall health also. Her hematological tests had shown a rise in white blood cell count.

Dr Porwal conducted a fistulectomy procedure followed by primary rectal repair (to close the internal openings) and primary vulval reconstruction. Postoperatively, the patient had to stay in the hospital for 10 days. Initially there was continuous pustular discharge, and she was put on a course of high antibiotics and NSAIDs. Fortunately, within two weeks she no longer needed the antibiotics and the mucosa around the fistula wound had begun to show health granulation- a sign of healing and repair.

Two months post the surgery, the discharge had totally stopped and so had all the medications. In just half a year, the scar had healed completely and her turmoil of more than two years had finally ended. Today, it has been almost three years since she first developed the symptoms and for the first time she is absolutely pain free. She dreads to think what may have been the case if she had not visited Healing Hands Clinic. According to her, Dr Ashwin Porwal and his team not only provided her the best of care but also helped restore her faith in medical practioners.