Story of my fissure treatment at Hyderabad

Somewhere in 2018, I felt some puss sort of discharge from rectum area. This symptom was intermittent which used to last for few weeks and then go away on its own.

After some research on internet, decided to meet one surgeon at Care Hospital Banjara hospital. Deciding a doctor is also difficult task as I got to know much later that we should consult a Proctologist for any issue in ano area. Doctor is very experienced and renowned one, did some physical examination around the anal area, suggested ultrasound for rectum area as he has doubt for Fissure in Ano. Ultrasound didn't show anything and since nothing came up from test, I stopped the further treatment. On my own I tried "Pilex" cream from Himalya and it stopped the pus discharge for almost 6 months.

This issue of discharge used to come and go, applying Pilex will suppress the symptoms for sometime but again it will surface after 5 to 6 months.

In 2023 end, I decided to start the treatment again and after lot of research and videos, I understood that I should consult a Proctologist. Consulted one renowned proctologist at Apollo Jublee Hills, his initial physical examination suggested that it could be fistula in ano. Suggested a scan where a camera sort of thing was inserted in rectum area and did investigation. It was confirmed that its fistula in ano and outer opening as well as inner openings are clearly visible. Surgery is the only treatment option and might cost around 1 to 1.5 lac.

After consultation, did lot of research on how surgery is done, tons of video is available with real surgery videos. After reading blogs, patients experience, I was only worried about renal incontinence issue post surgery, although its rare but possibility can't be ruled out.

During the internet research, a "Khsar Sutra"  procedure also kept coming in my search results but didn't pay attention much.

Research paper :https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296345/ made me think about this procedure.

Khsar Sutra is basically Ayurvedic treatment where a thread is placed in the canal and left the wound to heal on its own. Its safer with respect to bowel incontinence issue.

Tried to find a good Ayurvedic doctor  in Hyderabad and it seems there are many, but found one Hitam at JNTU which offers ayurvedic treatment of issues related to rectum area including fissure. 

Consulted a senior doctor here, he also did one physical examination and he clearly showed the opening inside the canal and its outer opening in an screen. I was very impressed with infrastructure and expertise of the doctor. This diagnosis was much better and convincing then Apollo one. He suggested for Khsar Sutra and as my fissure was around 5 cm, will need 4 to 5 times change of sutra which is done every week. So in my cases , treatment will last for a month. Cost of treatment almost one third of allopathy surgery.

I opted for this treatment, went of procedure on 26th March 2024 at 7 AM ( clinic starts very early in the morning at 6.45 am). At around 8 am , procedure started, gave local anesthesia, in around 20 minutes, Senior doctor said that my procedure is done. I couldn't feel what was done, but it seems some minor cut was done and a thread was tied.

They put cotton gauge around the treated area, got a bed in the clinic and waited there till 11.30 am. Finally I was given antibiotics, pain killers, liquid for sitz bath, bunch of cotton gauge as white discharge will be there for next few days.

Other than dietary restriction to avoid constipation, I was asked to do all activities. I couldn't sit for longer hours due to minor pain and whitish discharge.

Week1( 2nd April): This week I didn't have much problem except for white and red discharge. I had to change gauge 5-6 times in a day. Try to get bulk of guage with absorbent wool cotton considering that you might need it for next 6-8 weeks.

I wasn't able to sit for a long hours , more than 2 hours in one stretch. On 2nd April my thread got changed. Doctor advised Ayurvedic antibiotics "Grab" as I was having stomach upset issue with alopathy antibiotics.

Week2 ( 9th April) ; This week discharge continued(with smell) and color has changed to yellowish with less redness. Thread was changed again and absolutely no pain during thread change. I was able to sit comfortably for long hours around 3 hours but used to take break after that. Ayurvedic medicines was continued.

Week 3(16th April): This week discharge continued (with strong smell) but amount has reduced significantly. This time I had slight pain during thread change and doctor said its due to track hole becoming narrow due to healing. I almost resumed all my normal routines. Kept taking rest after 3-4 hours of sitting. Minor intermittent pain , I think due to thread.

Till now I have been taking sitz bath after passing motion and also before going to bed.

Papikondalu Night Stay Trip

We planned for a night stay trip for Papikondalu in the month of Dec 2018. It was an awesome experience to be very close to nature, although there were some minor discomforts.

Our family ( me, wife, elder daughter 11 years and younger daughter 4 years) planned for this trip from Hyderabad. we had two options to start trip either from 1. Bhadrachalam or from 2. Rajahmundry.

we preferred from Rajahmundry primarily due to factor that railway station from city is a bit far from city.
Booked train ticket from Hyderabad in Simhachalan express, that reaches Rajahmundry at around 6 am. We had a plan for one night stay at Rajahmundry as we wanted to explore the city and next day  for one night stay trip to Papikondalu.

For day 1 , I booked a non ac retiring room at station at reasonable price of Rs 190 through online as our hotel check in time for Aditya Palace near Kotipalli bus stand was at 12 PM.
After quick fresh up and breakfast , we went for ISKON temple and Gautami ghat at around 9 am, took an auto from station to ISKON for Rs 60 and is around 3-4 km distance. Spent around an hour at temple and then went to Gautami ghat which is next to Temple. Gautami ghat is very calm place and peaceful environment makes you relaxed. Our kids enjoyed at ghat playing with water, spotting small fish. We had an option to go for boat ride for 20 minutes for Rs 300 but didn't opt as next day anyway we will be on boat. After an hour or so we came back to retiring room and headed for hotel for check-in. Railway retiring room was  ok for quick fresh-up, had spacious room and bathroom. Checked in to hotel and took rest until evening after having delicious Andhra meal in nearby restaurant.

In the evening we went to Pushkar ghat, just missed the aarti as we reached at around 7 pm. Pushkar ghat is around 2 from Aditya palace hotel and auto charged me Rs 50. Spent around 1 hour and then came by walk through the crowded market. Google map showed me a distance of 1.5 km to hotel via market route.

Next day our tour operator Godavari Holidays asked us to report at Kotipally bus stand at 8.15 am. we reached there and paid the rest of tour package amount Rs 7k in cash. he gave two slips one for boat and other one for hut and asked us to board a bus that would take us to boat launch station which is around 1.5 hours journey from Rajahmundry.

Selecting a tour operator and choice of place to stay out of Shivaka and Kolluru hut stay was a difficult task. I had to go through blogs/ reviews to make a decision between Sivaka and Kolluru. I found Sivaka huts better by comparing online photos posted by reviewers, hence decided to go for it. Now coming to tour operator, I was looking for AP Tourism package but it didn't have for night stay package but have for a day tour package. Telangana tourism has night stay package from Bhadrachalam but not from Rajahmundry. Now I was left of option for private tour operators. After going through reviews and website I considered Punnami and Godavari holidays. I was able to connect better with Godavari holidays guys who promised for one separate hut for 4 family members. We settled for deal of Rs 2700 per person and Rs 900 for 4 years child, total Rs 9k. Paid advance amount 2K through online bank transfer and remaining to be paid before tour starts strictly via cash.

After making advance payment, I had to collect written confirmation of tour details, amount agreed etc through email. It was quite evident that tour operator was reluctant to provide anything in writing, However he sent details from one gmail account of Godavari holidays after insistence.

Our bus started at 8.50 am   reached to boat ride point at around 10.30 am. after getting down from bus, we need to walk to the bank of river where multiple boats are waiting. Our boat name was written on receipt as "Mayuri -2", had some challenges in locating it but ultimately found and boarded it. Boat started very soon and served breakfast of idly and upma and it was good. We then moved to first floor of boat in anticipation of wider view of nature.

There were big soundbox , music was being played on the first floor. then one person from boat crew member started entertaining the tourists by dancing, engaging in some kind of dance activity with kids, adults. these activity was somewhat deterrent in enjoying the natural beauty. for all entertainment activity and announcements were made in telugu so i need to rely on fellow passengers so that i do miss important information. somewhat i wasn't comfortable with dance program and loud music being played. at the end of dance program i was forced to pay service tip of Rs 100 to the dance crew.

At around 12.30 pm, lunch was served on boat, it has rice, sambhar, daal, veg curry, pickle and curd. it was good and enjoyed it. it then reached to a place at 1.40 pm and were given 40 minutes to explore. after visit of this temple like place boat returned and dropped few passengers at Kolluru hut. Also picked up few passengers who were supposed to return back from yesterdays trip.

after 15 minutes of ride, we were dropped at Sivaka hut. i had to do followup with boat crew just to make sure that i will be getting down at right place. it was more of your consciousness , crew member wasn't paying any individual attention to passengers. i could imagine, if i am waiting crew member to come and tell me that your destination has come, i would have never landed to my destination, and quite possible i might have gone back to Rajahmundry. Also language barrier was a big challenge as they were not versed with english or hindi.

Now at Sivaka hut, I followed to the crowd for hut allotment, a small reception like place. it was full of chaos as large number of tourist were making request without following any queue. also these reception people had a challenge in understanding english/ hindi, After 15-20 minutes of my wait, they allotted me a hut C33, after collecting my hut receipt, mobile number and pan card details. i saw lot of arguments going on between tourists and reception guys over number of huts allotted, sharing of hut along with other family etc. Overall I felt you need to be lucky enough to get a hut at your terms which you agreed with tour operator. As your operator isn't reachable ( no mobile network), and you are at mercy of reception guys, they aren't polite ones.

One reception boy showed me my hut, it was very close to a row of huts primarily meant for bachelors. i could think of possible nuisances from bachelor group, but consoled myself that there were instruction that alcohol is strictly not allowed.

We kept our luggage, first reaction from family members weren't that great after looking inside hut. hut had around four mattress, two blankets, one light and a fan. somehow family settled. soon we saw tea is being served, grabbed 2 cups of tea , sat Infront of hut and had a sip of tea in calm place. Evening snacks was also served at hut and slightly family started liking the place. I went in search of bathroom and was a bit down after seeing the condition, it wasn't better than the ones maintained at railway stations. Anyway embraced the situation and prepared family as well for it. Roamed in the little colony of our huts, bought one mineral water for Rs 30 from canteen. took some snaps. It was awesome evening, very calm, nice view of mountains, river, liked a lot. Slowly at dawn, temperature was going down, took our jackets. Camp had a nice arrangement of drinking water, street lights, public announcements through loudspeaker( in telugu only). at around 6.30 or so they started selling bamboo chicken Rs 250/ half kg, bought one for family, it was good and there was huge rush to buy it.

Diner was served at 7.30 with chicken and egg curry, two veg curries. We enjoyed the food, also saw people carrying bottles of alcohols towards bachelor lane, got worried but accepted the situation. In the night i felt the entire bachelor lane of around 50 people were drunk, making loud noises among themselves, not a good scene, but refrained if coming out of hut. didn't feel good on overall atmosphere, although they didn't trouble us at all.

Next day got up early in the morning at around 5 am, went for a walk, felt good at it was engulfed in fog, sunrise was good, took lot of photographs. finished daily chores and had cup of tea being served since 6 am.
it was announced that breakfast will be served at 7.30 am, followed by a trekking to water flow, lunch will be served at 12 pm. those opting for Bhadrachalam drop should be ready by 12.30 as Krishna boat will be coming and for Rajahmundry, we should be ready by 1.30.

We had a nice breakfast of idly, chutney and upma. then started for water flow which was around 1 km from camp and had a slight climbing. in the rout saw orange trees with fruits tried to pluck one, got one. shared among our family, it was awesome. reached the waterflow at 10 am, it was very clean although not deep, hardly 2 feet , i couldn't resist of taking bath. enjoyed a lot . Came back to camp around 11 am, packed our baggage and proceeded for lunch. it was good lunch with chicken and fish.

Bhadrachalam boat came at 1.30 pm. camp guys asked to vacate the hut and wait near boat point. they didn't mention boat name, but said boat crew member will announce you name and tour operator name. again i need to be watchful not to miss my boat. at 3 pm, 3 boats came and one them were announcing my name, identified the boat, made our way through crowds. In the boat again there were entertainment program, dancing, they served tea and light snack. asked for service tip at the end. return journey on boat was completed in 1 hour 45 minutes. i asked crew member about the bus for return to Rajahmundry, but didn't got firm answer. moved to bus parking area, followed crowd, kept asking drivers mentioning my tour operator after some anxious moment, found my bus. my Idea , Jio didn't had network so couldn't contact tour operator.  Started bus journey and reached Rajahmundry Kotipally bus stand at around 7 pm.

Overall It was a pleasant experience.