Finally had LIS surgery

LIS diary - 36 year old female

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Finally had LIS surgery

Postby Water Bear » 17 Nov 2017, 20:23

Hi everyone,

I finally had my LIS surgery yesterday after suffering chronic AF issues for close to two years. I had tried GTN, it worked well but the fissure returned pretty much as soon as I stopped using it, and had Botox treatment 9 months ago (bought time but really wasn't worth it in the long run). I decided to go with my CRS's advice and have the surgery.

I had to fast from midnight before the operation and head to the hospital at 7 am for the 9 am procedure. They gave me a Fleet enema at the hospital, which was not fun but also necessary given you don't want to have to have a BM right after the op.

As always with surgeries, there was a lot of waiting around and being asked lots of questions before I was wheeled into the theatre and dropped off to sleep.

The surgeon dropped past to see me after I woke up and said the LIS went well and she also removed a little skin tag (surprise!).

I had a rough time with the anaesthetic yesterday, nausea and low blood pressure, but had no pain until this morning, when the nerve block wore off. The pain is probably 3 out of 10, and nothing like the intensity we experience with fissures. I have taken ibuprofen just in case it's thinking about getting worse...

Yesterday I spent the day lying around and trying to walk to the bathroom and kitchen a few times. I was weak and dizzy after the anaesthetic and had a very churny tummy. I felt like I needed to 'go' several times but nothing would happen, and so I managed to hold off until 4 am, when the residue of the enema seemed to trigger a liquid BM. It didn't hurt much and there was only a little blood.

Today I feel much more human, but I am freaked out by the amount of bruising and swelling down there. There are two small burns where the LIS incision was cauterised and where the skin tag was burned off. There seems to be a lot of swelling in one external haemorrhoid, I hope it is not thrombosing... I feel like the bottom belongs on a baboon. My advice if you have this done? DON'T LOOK!!

The hospital sent me home with Benefibre and Rectogesic. My CRS said not to put Rectogesic on there while the wounds were still open, so I haven't used it yet.

I will post more as I recover. I hope this info helps!
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Re: Finally had LIS surgery

Postby Water Bear » 19 Nov 2017, 19:59

72 hours out from the procedure and I'm feeling much better.

The swelling is still pretty nasty and the left side of the bottom is black with bruising. Some cauterised tissue has sloughed off, leaving open pinkish wounds.

I've been told to keep the area clean and dry (dry being *very* important!) - blow-drying the bottom with a hairdryer on a cool setting after every wash.

The pain of BMs so far has been minimal - nothing like what we experience with fissures. The fear of having to go is much worse than any pain when it does actually happen! I'm keeping up with fibre supplements and about 10mL of lactulose at night before sleep.

I have some burning, itching and mild pain. I haven't been able to take any more painkillers as they were upsetting my tummy, but I am coping well without them. I can't sit or walk around for more than a few minutes at a time just yet. My CRS seemed to think I'd only need a few days off work, but there's no way I could return to work tomorrow. No way.

A warm wheat bag placed against the bottom is heavenly. Really relieves the pain and itchy feeling.

For anyone thinking whether to do Botox first, before trying LIS - that's what I did. It's too early for me to confidently compare the two procedures yet, but I will say that after Botox, I had gas incontinence which I have not (not yet, anyway) had following the LIS.
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Re: Finally had LIS surgery

Postby getmylifeback » 20 Nov 2017, 10:31

Hello Water Bear,

I too had my LIS surgery a few days ago with removal of 3 skin tags which was a surprise. I am experiencing similar things as you and the surgery really isnt as bad as i thought it was going to be (not at all). Fissure pain is absolutely worse that this! But its nice to to read that you had the surgery roughly the same time as me, and i think its great because we can talk about the things we are going through at the same time. Little bit over 2 days for me and BMs are only a little discomfort, not like the razor blade feeling. Well I hope us a speedy recovery and on to normal lives. I will be updating my recovery and I hope you will too.
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Re: Finally had LIS surgery

Postby Water Bear » 20 Nov 2017, 19:04

Hi getmylifeback, I hope you are feeling heaps better today too! Take good care of yourself.

I woke up feeling that finally the GA is out of my system.

The bottom was *almost* normal this morning until I had to go to the bathroom, at which point the swelling came right back. BMs have been okay, more stressful because I'm still terrified of going.

Last night I had an intense burning and itching sensation for a couple of hours. I had to take paracetamol + codeine in order to get to sleep. It had gone when I woke up this morning, though. Hopefully it was just the 'healing itch'.

I should mention too - I've had "the lump" that a lot of people on this forum mention after LIS. It is just a hard, pea-sized, red blob at 6 o'clock. It was very sore and angry on day 2 and 3 but has been decreasing in size and redness.

I got the bill from my surgeon this morning and finally know exactly what she did! Each part of the procedure is itemised and billed! So now I know she not only did the LIS but also removed the sentinel tag and cut away the fissure. I had two pudendal nerve blocks, which explains why I was completely numb down below for over 24 hours after the operation.

I have not been up to anything more than pottering around the house. There is no way I could've gone back to work today. I took a load of washing downstairs this morning and changed the bedclothes, and then had to lie down with my bum in the air for a good ten minutes to get the swelling to go down! Gotta laugh.

I wear a Fitbit and have gone from doing nearly 20,000 steps a day to practically none at all on the day of surgery, a few hundred the next day, and yesterday managed 3,000. I'm aiming for 4,000 today but will be guided by my body. I'm discovering how terrible daytime free-to-air TV is here...
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Re: Finally had LIS surgery

Postby getmylifeback » 21 Nov 2017, 16:41

I hope you are feeling better and progressing today, I totally get the terrible daytime tv! I actually prepared a nice week of entertainment with Netflix and other shows I planned on binge watching, i figured having things such as tv shows to look forward to can make the time fly! I am on day 4 post OP and the process has been A LOT easier and not scary at all, the pain is not even close to my bad fissure days!

I think its good to get the blood flowing and moving around, I will be going on my first walk outside today since the OP!
But since we are here, i do have a question to ask. Do you get some sore of discharge from the incision site? something like a combination of blood and other fluids.
I think my recovery has been good so far, I was just wondering if you were getting the same thing.
Other than that, hop on that netflix and watch a series like stranger things and itll really make the day fly by! Cheers
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Re: Finally had LIS surgery

Postby Water Bear » 21 Nov 2017, 16:57

Hi there, I agree it's important to get up and moving! Good luck with the walk outside - let us know how it goes!

Yes - I am getting a slight discharge. My CRS recommended wearing a sanitary pad but so far there hasn't been enough of it to get onto the pad. It is like clear serous fluid with a bit of old, brown blood in it from time to time. My CRS said to expect this and it is a good thing, it means the body is cleaning the wound as it heals. We only need to worry if the discharge becomes more like pus or develops a really foul odour.

That said - my wounds did stink for the first couple of days. Like burned flesh (which they were!). That has gone now though.

I had a bad time this morning with some fresh blood and pain which was enough to have me almost fainting in the shower! I hope this doesn't mean my healing has been set back.

This is the morning of Day 5 post-op for me and the swelling has gone down a lot. The bruising is pretty horrible still and extends across the left side and up to the lady-parts.

Thanks for the tip re Netflix - that's on my agenda today!
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Re: Finally had LIS surgery

Postby Finally81 » 22 Nov 2017, 17:16

Good afternoon all! I too have had surgery 11/16/17(LIS and 2 fissures removed). I have had the same discharge-with dark blood.Pain is minimal, but there- usually sharp pains when not sitting correctly. Any issues with bm consistency? My doctor has me on just fiber. I am having issues with discomfort and blood at the beginning of a bm.

I am following your thread. Happy healing!
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Re: Finally had LIS surgery

Postby Water Bear » 22 Nov 2017, 22:44

Welcome, Finally81! Sounds like we are all experiencing very much the same things!

It seems like surgery and the intravenous antibiotics they pump in while you're asleep can really upset the system and change bowel habits.

I understand we're supposed to be aiming for soft but bulky BMs that can stretch things out a bit without scraping. Lactulose and Benefibre are great for achieving 'soft' - but not 'bulky'.

I'd really like to know how to create the perfect post-op BM! Anyone out there who knows how to achieve this?
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Re: Finally had LIS surgery

Postby Water Bear » 24 Nov 2017, 00:55

One week out from my surgery and I'm feeling 80% recovered. I reckon I could go back to work on Monday.

Still some tenderness and slight swelling from time to time. I'm able to walk around normally but wouldn't risk exercising quite yet.

I started applying the NTG ointment last night now that the skin wounds seem to have sealed over. It definitely helps - just relieves those little pangs that start up after using the bathroom.

I'm actually amazed at the result... Why didn't I do this sooner?!
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Re: Finally had LIS surgery

Postby Marko » 24 Nov 2017, 06:37

Please can you tell me before operation was your fissure open all the time or sometimes healed and came back after large stool? How long do you have fissure?
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