Whoa! Lotta Puss!

Those were the surgical resident's exact words when he sunk the knife
into my perfect hairless ass and the puss geyser shot across the ER
and almost cleared the curtain.

Unfortunately, his next words were "hopefully we won't have to go back in for sphincter
surgery later." After that came the "no riding for 8 weeks."

This was hopefully the end to a long and ugly week. When we left off, the original general surgeon, who I thought was A-OK, had decided to give this a few more days to "come to a head" because it just didn't look like a run of the mill perianal abscess to him, and it still didn't on Wednesday. So Wednesday night I got a pelvic MRI at NEBH, and early Thursday morning I got the call from Doctor B that he thought this might be an intersphincteric abscess, something he didn't want to handle. By now it's growing and I'm barely mobile, but I trucked in, picked up my MRI CD and headed over to the B&W emergency room. I guess in Doctor B and my PCP's pipe dream, a colo-rectal specialist would magically appear and schedule me for surgery that afternoon. Or maybe they just didn't want my blood on their hands.

I spend about five hours waiting in the ER. I can no longer sit down. Finally I am taken out back, and of course everyone back there is pretty pro. But of course there is no colo-rectal specialist surgeon. They have a two month wait for a reason. Instead, I get examined by some doctor whose function I'm not sure of. She comes back with Dr. Z, a slightly older, confident looking dude who introduces himself as the head of the ER. For you out of towners, this is one of the bigger big-city hospitals in a city that is full of big-city hospitals. I'd guess over 50 patients are being treated in the ER at any one time, maybe twice that. They go off to view my MRI while an awesome nurse gets me a bit doped up (but not nearly enough). They come back and he says they can't really tell. It's either the mother of all perianal abscesses, or it's something worse, and I may have to go up to the OR if it is. We wait for a surgical resident, who by now is busy patching up a knife or gunshot wound or something. All I know is that about a dozen police and security guards went out to meet an ambulance, and they broadcast something about "Code Grey" and then they told me the surgeon was tied up with a trauma case.

Eventually Dr. Funk (his real name) shows up. He looks about half my age. Whatever. He says they thought about it, and I have no fever or other symptoms of an intersphincteric abscess. And yes, I got yet another "physical inspection." This was by far the most action I've had in the past two months. They decide to go ahead and treat this like as a perianal abscess and hope for the best. That's the ER way, and this is all I've really wanted all week long. So the female doctor comes back, they do some prep, taping my butt cheeks apart in a move know as the "reverse Emilio" and they go to town. I'm like dude, you going to use any novacaine or something? and he is like "or something, little sting coming up." FUCCCCCKKKKKKKKKK!!! I'm clutching, grabbing, clenching my teeth, and writhing in pain while Ursula the Russian agent doctor pins me down. Of course, I've got no idea what is really going on back there, but he's pretending to be injecting lidocaine. About ten fucking times. Then one right in the coccyx just about made me pass out. I say pretending because I never could tell when the numbing ended and the cutting began. There was no pause in between.

What I did get was Doogie saying "there should be a little puss... WHOOOOOAAAAHHHH, LOTTA PUSS!!!! as the geyser shot across the ER and painted the curtain. Even a set of my good work clothes, carefully hung on the chair in the corner were not spared. Good thing Doogie and Ursula had put on full welding helmet-type facemasks. "You want to see what it looks like?" he says, holding a blood and puss soaked wad of gauze up at my end of the table. When they were done, the table, my johnnie, and even the floor were covered with blood and puss. Nice.

Of course, even with the alleged numbing agent and the world's skimpiest morphine drip going, the instant waterfall of relief that rolled over my beleaguered ass region was worth it. The bad news is we weren't done. The dynamic duo did some more cutting and cleaning, digging a hole over 3 cm deep and 1 cm across, because that's how far down this thing had grown inwards. Once they were satisfied, the "packing" began. Oh my fucking _ _ _ (insert who/what you worship here). I've never had a 3/8 X 2" lag screw run into my butt cheek, but I'm pretty sure that I now know what it feels like. And the best part is I get to go in and do that part again tomorrow, this time without morphine. But I can sit down now.

Not sure about the eight weeks no bike. That might be pessimistic, but this is going to require some rigorous follow up to prevent reoccurence. So looks like a bit of running and a lot of trips into Longwood for various appointments. I'll be on the lookout for JB. Thanks for reading.