Advancement Flap Surgery - My experience

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Re: Advancement Flap Surgery - My experience

Postby Elfkin » 09 Jun 2010, 12:50

OK quick update.
I need to see the practice nurse every day at the moment to apply a special anti-bacterial dressing. None of the medical professionals seem to think the wound is actually infected and this is to be on the safe side really.
The wound is still discharging quite a bit (i guess a couple of tablespoons of liquid per day). It isn't particularly painful but I am bored of it not healing properly. Still it is only 12 days since the surgery hopefully it will heal soon.
The actual flap of skin sown over the fissure seems to be healing fine. I am having problems with the site that the doctor cut the skin flap from.
I am recording this because hopefully it will help someone else who is going through similar surgery one day.
One other thing is that as part if the op the doctor also gave me botox. This means that when I need to go to the toilet it is very urgent! I have about 10 secs to get to the toilet before things become super urgent! No accidents yet but it feels like there could be! Has anyone else experienced similar with botox?
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Re: Advancement Flap Surgery - My experience

Postby Fissulyna » 09 Jun 2010, 16:39

Thanks Elfkin for posting !!!! Image
I had a very "nice" chunk of anus cut off together with my skin tag so yes - that little "hole" which I called "black hole" LMAO did need more time to close than anything else in that area.
Wishing you super-fast continuation of the healing
I think it needed about 6 weeks in my case :roll: - but was definitely most likely much smaller hole than yours !!!! Image Image
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Re: Advancement Flap Surgery - My experience

Postby Elfkin » 25 Jun 2010, 11:38

Oh well.
The point of my posting was that I hoped to provide some positive feedback about this procedure but unfortunately I now don't think that's going to be possible.
About 5 days ago my sphincter suddenly tightened up. I don't know if the botox wore off but that doesn't seem likely as it was only a month ago that I had it.
Anyway doing a BM become a real struggle and it also hurt. Not agony but it was painful for the first time since surgery. Today it hurt a bit more and I had the dreaded blood on my toilet paper :( The pain level is fairly low to be honest its mainly my anxiety thats the problem!
I feel worse off than when I had the operation as it feels much tighter now (and the botox hasn't even fully worn off). Plus I guess my fissure is back or at least a new one.
As the NHS is a bit of nightmare I haven't been able to see a CRS yet (despite trying to get to see one via A&E). I've seen my GP and she prescribed Diltiazem and told me to up my Movicol dosage.
I've used GTN (rectogesic) for years but without sucess so I guess Diltiazem is worth a try. How has everyone else got on with it?
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Re: Advancement Flap Surgery - My experience

Postby Fissulyna » 25 Jun 2010, 15:23

I am so terribly sorry to hear that Elfkin :( !!!!
You know, anybody here who ever had a flap done (as far as I know) also had a LIS performed at the same time and they had permanent good results Image . I really do not understand why your CRS relied on a temporary fix with a Botox Image , especially after so many years of suffering with chronic fissure :( . My only guess is that he is not comfortable doing LIS and maybe had some bed results (read cutting too much) and is now scared to do it :roll: . So, my advice would be to go private if you can and find a top notch CRS who has great success rate with the LIS.
If you are absolutely terrified of a LIS , than use creams or get another Botox ASAP !!!! Maybe he did not give enough of toxin or did not hit the right muscle with a needle Image . You kow - tha whole ting with a Botox is still in "investigative phase" - they still do not have one universal protocol !!!!!
Regarding creams - I liked Nifedipine cream the most . It did not gave me headaches nor itching and burning. I recently tried Dilit. as a preemptive measure since I had some minor butt irritation and it caused such burning sensation that I used it only ONCE !!!
But, we are all different :roll:
Wishing you the best of luck with it all Image Image Image
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Re: Advancement Flap Surgery - My experience

Postby Elfkin » 29 Jun 2010, 12:29

OK quick update.
I have increased my Movicol intake to 1 sachet in the morning and 1 at night. Also following a tip from Cherylk I also take 2 teaspoons if Benefiber at about 6pm.
(Figures crossed) This has really helped no straining or stretching as everything is so soft. Whilst the fissure/ripped stitches or whatever hasn't gone yet I think it is improving. I have had no blood on toilet paper for instance and only fairly minor soreness/burning in the bum area e.g. not serious fissure like pain.
I am also using Rectogesic night and day. Not sure this is necessary but keeping it up for a week just in case.
I am a bit frustrated as I hoped the operation would 'cure' me but hopefully I can limit the damage and I will still heal.
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Re: Advancement Flap Surgery - My experience

Postby StevePain » 29 Jun 2010, 15:20

Diltiazem is good unless you get the dreaded itch (like me), I stopped using because of it, although, when I have bad days I tend to apply a very small amount which reduces the itching reaction, overall I think it's far better than Rectogesic and does a fantastic job of slackening the sphincter, oh yeah, and the burning sensation that Fissy mentioned wears off after a while..
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Re: Advancement Flap Surgery - My experience

Postby Elfkin » 21 Jul 2010, 12:38

Ok quick update as I saw my CRS today.
As i mentioned in my previous post i upped my Movicol to 2 sachets and I am still getting soreness but no bleeding and certainlyno trouble when going to the loo (2 sachets certainly makes things loose!).
Anyway I saw the CRS today and he examined me and accordingly to him everything has healed perfectly. I have some blisters which are causing the sorenes and bleeding a bit. This is due to me rubbing too hard with TP/wipes apparently.
He has suggested that I use Metanium (a baby's nappy rash cream!) and wash rather than wipe.
He has also suggested that I stop taking Movicol all together as wet stools can irritate the skin.
I think what happened 3 weeks ago is that some of my stitches (Or the area that was stitched) popped open. In the intervening time this has obviously healed.
I am a bit dubious about stopping Movicol all together so I am going to cut down slowly to one sachet and see how I get on.
I will post how things are going so people who are considering the same surgery have an idea of the success or otherwise of this procedure.
Still this is positive news but I am not completely convinced I can stop taking Movicol and everything will be fine.
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Re: Advancement Flap Surgery - My experience

Postby StevePain » 12 Jan 2011, 04:22

Hey Elf, I'm just wondering how you are now, are you healed, I would certainly hope so anyway.
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Re: Advancement Flap Surgery - My experience

Postby Elfkin » 12 Jan 2011, 12:39

Hi Steve
Thanks for posting and reminding me that I left my thread on a bit of a cliffhanger!
Like your post on your thread I would say that the fissure is 99% healed but I still get discomfort from time to time when doing a BM.
Until very recently I have had sore skin around my anus and at the fissure site (I think). It is this i think that was making BM's uncomfortable rather than fissure issues.
I am still on movicol. I haven't had the courage yet to stop it as I am afraid the fissure will come back. But in a month or two if things settle down I think I will try cutting down (I take 1 sachet a day atm).
Anyway the soreness seems to be abating I have been using barrier cream and it appears to be clearing up.
I would recommend the surgery to anyone whos CRS feels they would benefit from it. As I have had very few complications (apart from me panicking with hindsight).
Best and healing wishes to all
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Re: Advancement Flap Surgery - My experience

Postby StevePain » 12 Jan 2011, 14:11

Good news Elf, I'm glad your pretty much healed, I too have very sore skin around the anus but am using chamomile ointment to try and combat that, the Movicol (for me) is producing far too many BM's which cause lots of pain from the fissure site so am in the process of switching back to Fybogel to bulk up stool.
I know what you mean about panicking!
Best wishes and continued healing!
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