Clark had surgery last Monday to locate and treat a recurring infectious process in his cheek, and to debulk his flap. What was thought to be a possible infection in his jaw turned out to be a fistula between the floor of his mouth and his cheek. The fistula also has a branch that extends to the top of his throat. After surgery, he had significant pain, swelling, and warm, hard, red skin. Drainage in the JP went from clear yellow to cloudy latte color. He could not swallow efficiently or talk at all.

Last night, he had a fever of 101.6. We controlled the fever and pain with Percoset and then saw the surgeon at 11 am. The PS removed the stitches, and the JP drain and left an opening of 1.5 inches to allow the wound to drain and heal on its own. Clark is on Cipro. The bottom line is this: this might work and it might not. Fistulas are difficult to manage and very challenging to close. It requires reaming the the inside tunnel to roughen it up, which the PS did, and then hopefully it closes. But fistulas are known to reform.

In the wake of post radiation, this infection is a lingering side effect. Clark now has Magic Mouthwash to help with the pain since the one opening is near his throat and feels like a large canker sore. Wow, we thought this would be the LAST surgical procedure. The goal was clearly to get to the root of the problem only now we realize that may not be possible. So, he has gauze packing the wound, and whatever happens next is a BIG HUGE GUESS.

No evidence of disease is a wonderful thing to hear. On the flip side, dealing with repeated infection and now more swallowing issues is disheartening to say the least. Clark was going to have a swallow study and get into dysphagia and speech therapy within the next couple of weeks. I still think he will pursue this though at a later date.

Has anyone else had persistent fistula(s)? How are you managing it/them? I am wondering if there is a person out there who specializes in fistula repair in the oral cavity. If you know of someone, please let me know.