Advancement Flap Update

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Advancement Flap Update

Postby tiredjay » 14 Oct 2013, 14:47

Just thought I'd quickly write an update as there are not a lot of continued advancement flap posts here. Quick background: I had my fissure since Nov of 2011. I've tried nifedipine, botox, and had a house flap on May 7th of this past year (roughly 5 months ago). Ever since the surgery I have been suffering from an intense burning sensation that usually starts within 30 minutes of waking up and lasts for a couple of days to a week and then goes away for a day or so. I also have a bruising feeling and a feeling like someone is poking the side of my rectum way up there. I literally just got back from an appointment with my CRS. After using a scope to explore up in there he said that everything "looked perfect." He said that there was no evidence of any irritation or any fissure. He did indicate that it is possible that I may be having some pelvic floor issues as a reaction to the surgery and he ordered some tests. Hopefully I'm way down the road to recovery and getting my life back. I, like I'm sure most of you, are sick of worrying about my butt!
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Re: Advancement Flap Update

Postby richibeno » 15 Oct 2013, 15:43

Yes hope you are well on thee road to recovery every day every bm' I think about my but lol'
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Re: Advancement Flap Update

Postby dent1 » 18 Oct 2013, 03:47

Not sure what you mean by "house flap" Sorry you are still having problems. I had a vy advancement flap in April then sentinal piles removed in August plus other surgery. Much better now thoguh has taken a long time to heal and still need movicol.
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Re: Advancement Flap Update

Postby tiredjay » 21 Oct 2013, 16:43

A "house flap" is type of advancement flap that is essentially shaped like a house where the cut is made to look almost like a child's drawing of a house with a little roof and a chimney. The "roof" part is pulled over the area of the fissure and the "chimney" is tucked up into the rectum and sewn in place. Each week seems to be getting slightly better than the last, but it's been a long process. Glad to hear that you seem to be doing better.
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Re: Advancement Flap Update

Postby owmybum » 22 Oct 2013, 08:14

It's always such a long healing process tiredjay, but at least you can see a small, gradual improvement week by week. Hang on in there.... You will get there!

OMB x
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: Advancement Flap Update

Postby dent1 » 22 Oct 2013, 10:33

I have to say I have not had the sort of symptoms you describe. I do wonder if I have another fissure though as 2 sentinal piles were removed and only treated the one fissure and I do get some discomfort still with BM if I forget the movicol for a day or so. Not bad enough to warrant any other treatment for now though.
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Re: Advancement Flap Update

Postby suzyljank » 22 Oct 2013, 15:04

Hi, tiredjay. I had double advancement flaps in april so I'm almost 6 months out now. Some of what you are feeling is normal. It takes up to 2 years for everything to quiet down after surgery. My skin donor sites were left open to heal so that when they did the scar tissue wouldn't pull. It was an uncomfortable recovery but not as bad as the fissure and anal stenosis. I guess technically I still have anal stenosis but it's functional. I have to dilate once a day with 19 mm dilator to keep any scar tissue stretched for at least 2 years. Sometimes I start out smaller if I'm really stressed but it does help me. My incision sites sometimes aches especially if the weather is changing and I get some burning once in a while but it's not bad. If you have any discharge at all this can cause burning on the new skin. Having surgery in that area can also cause pelvic floor spasms too. Physical therapy can help with that. I can always tell when my pelvic floor muscles are tense because I feel like I have to urinate more. I'm glad I had the surgery. I know that each time you have surgery there's a risk but I can have a pretty normal bm now. Before I couldn't pass any stool larger than a spaghetti noodle and I'm not joking, it got that bad. Flap surgery is a pretty invasive surgery in an area that is already very sensitive so give it time. I don't follow any particular diet anymore. I just eat sensibly and make sure I drink enough liquids but I don't go over board on that either. I take less than a dose of miralax at bedtime and if I ache I'll soak in a warm bath or sit on a heating pad. Most of the time I just try to ignore it. I haven't posted in the success stories because I don't want to jinx myself but things are much better than last year at this time. I'm hoping the achiness goes away completely in time. Most of the time it doesn't ache at all but when it does it freaks me out. I felt better when my CRS explained this was all normal though. Try putting some zinc oxide on the outside of your butt. It will protect the skin from any discharge and if the burning goes away you'll know what's causing it. Hang in there, you're not alone. I'll keep you in my thoughts. Suzy
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Re: Advancement Flap Update

Postby tiredjay » 29 Oct 2013, 14:26

I'm totally at my wits end. I just came back from my CSR who performed a manometry test. The whole thing was rather unpleasant but he initially gave me some hope when he diagnosed me with levator ani syndrome and referred me to a physical therapist. He said it was most likely due to the surgery and that the prognosis was good. However, when I got home I noticed a few drops of blood on some tp. Upon inspection, I found a fissure directly underneath where my advancement flap was. I am trying to hold back having a nervous breakdown. This whole journey has been taking place for 23 months and I'm just ready to be done with it.
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Re: Advancement Flap Update

Postby dent1 » 29 Oct 2013, 15:42

Sorry you are having a bad time - especially as it has been going on for so long.
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Re: Advancement Flap Update

Postby owmybum » 30 Oct 2013, 05:02

I'm so sorry to hear things aren't going well for you right now tiredjay. The manomentry test is quite brutal, so I'm not surprised there was some sort of damage left after. Time to baby your butt again, take it as easy as you can for the next few days... Things will start to settle down.

OMB x
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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