LIS and anal advancement flap, My experiences

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LIS and anal advancement flap, My experiences

Postby Maciej » 22 Sep 2011, 08:09

Where to start...
Day 6
Last night was quite good yet terribly annoying! I went to the toilet 5 times, not much pain thought. My diet is quite terrible at the moment...
I am terrified of food after the first night after the op when i went to the loo and thought my stiches will not hold the pressure... Loads of pain which felt like the old experiences with my AF.
All I had was a bowl of liquidized veg soup and one cooked potato... Passing it felt like passing a brick... When I could no longer stand it I drunk a sachet of movicol and the rest of the night was quite ok.
The last night was far more pain less :) during the day I had 3 skinned plums, half a banana, half a pear, 200ml of fortified milkshake (do not remember the brand but it is sold in cans) and a glass of prune juice before going to bed about 450-550 calories in total... That is far too less but at the moment i simply can not imagine to pass more... The other thing is that after this day's diet i took a sachet of movicol and the poo came out as liquid, thankfully it was not irritating it took me 5 trips to the toilet to finally purge my system. Still not much of the pain after each BM and only slight feeling of spasms. Now i feel quite painless Image
The biggest worry is that I have been using up to four sachets of movicol for the last half a year so I am a bit afraid that my anal canal is somewhat not responsive, and not as flexible as it should be... I am afraid that even if it heal up I will still have problems with passing anything thicker than a mountain dew...
I cut down the movicol to two sachets a day one in the morning and one in the evening, plus I am slowly trying to introduce fruity fibers in to my diet... I stopped eating meat, cheese and bread... I will stick to fruits and later on some soft cooked veg...
My Surgeon said that my Fissure was far too deep and long to heal on its own even with LIS in mind. He classified it as a deep chronic posterior AF.
That is why he performed the Anal Advancement flap and LIS. Whole last year was pure hell, thankfully I am starting to believe that things will improve.
I am sure it is still far to early to say it was succesful or not but if I manage to balance my fibre to movicol ratio things will be brilliant!
Tha task in hand is quite hard as i will need to standarize all I eat and drink to produce that perfect runny but not liquified poo
I will try to eat a whole banana instead of just half, and maybe an additional plum plus maybe try to mix my fortified milk drink with fybrogel and see if things improve at all...
Lets hope for the best
Last edited by Maciej on 23 Sep 2011, 03:09, edited 2 times in total.
Reason: Wrong title, i will write here daily on my progress :)
Maciej
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Re: LIS and anal advancement flap, My experiences

Postby val » 22 Sep 2011, 08:55

Hey Macie,
cutting down on movicol 6 days out of surgery doesn't sound like a good idea Image
If it were me, I would go to your GP and see what he says - my opinion is that you could bulk up on fibre to make the stools bigger, but take the movicol so that they remain soft. If you suddenly cut it out and get constipated, that's the last thing on earth you need right now!
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Re: LIS and anal advancement flap, My experiences

Postby Maciej » 22 Sep 2011, 09:33

Well did you read how little i eat :) if i would take four movicols to acompany a banana, few plumes and a milkshake i would start to permanently dwell in the toilet Image I am on the liquidised diet so ther is no sense in flushing my bowels with half a litre (a pint :) ) of movicol.
about making stools bigger I can not pass anything bigger than my small finger yet, and that with pain...
My CRS left me in charge of my laxatives... I used 4 movicols after 4 days of hospital diet when I finally came back home after 4 long days in the hospital and it worked great, but now I eat just enough to sustain healing processes, and I have no physical activities, as I can not even sit...
besides i took two yesterday and it worked brilliantly.
Thank you for your concern Val.
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Re: LIS and anal advancement flap, My experiences

Postby Maciej » 23 Sep 2011, 03:26

Day 7
First night when i did not needed to wake up to the toilet every two hours...
Just 3 trips so far
Passing liquid is quite pleasent but it can be irritating to the whole area of the operation, I need to find a good ratio of food to movicol.
I will try to take some fibregel with my morning vitamin milkshake to see if it would actually stop my poo beeing super runny, I will take half a sachet to see if there will be any difference...
Today's bm was not so bad, which is great! just a bit of eatching, and discomfort afterwards... every day seems to be a little bit better.
I just really need to standarize my diet, and find a good ratio of laxatives to consumed food...
It sometimes feel like rocket science...
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Re: LIS and anal advancement flap, My experiences

Postby Maciej » 26 Sep 2011, 11:42

Nights number 8 and 9 were a bit terrifyin!
I ate only fruits and that in tiny amounts, and even thought i had a really painfull BM... Yesterday I decided to try liquified diet, no hard foods at all just fruit juices and fortified milkshakes, plus ice cream... It does not sound healthy and it probably is not but the number two is simply out of my grasp at the moment... When I go I feel that my stitches are stretched to their limits and the whole area feels troumatised and really closed up... Maybe my surgeon sitched me to tightly, hard to say...
Well this night will decide if I will stay off normal food for another week and then start to introduce some fruits by the end of week two.
Doctors are care less, in a way that I was given no advice whatsoever about anything post-op...
I hope todays night will pass painless...
................................................................................
Todays diet:
freshly squezzed carrot juice
a jug of fortified milkshake mixed with vanilla ice cream
freshly squezzed apple and pear juice with no bits
2 litres of water
1 small glass of prune juice
1 movicol (just in case if I still had something in my bowels)
loads of pain killers
................................................................................
a quick update:
I was in the toilet minutes ago :)
I have passed not much more than a bit of water, not irritating as well which is always a good sign :)
I am currious how many more times will i go to the toilet during the night... maybe just once if yes than I am sorted for the next week or two, as long as I keep the callories intake above 600 cal...
Well lets wait for tomorrow and see how things are...
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Re: LIS and anal advancement flap, My experiences

Postby Guest » 26 Sep 2011, 11:50

Aww Macie,
I have read a few posts on this procedure. It seems to be pretty darn painful! I think with time, this will all get better. I'm so sorry and hope things get better for you soon!
I'll look into the older threads and post the link here. I remember reading one that you may find helpful to compare your experience with.
http://anal-fissure.org/t1136p15-advancement-flap-surgery#39733
http://anal-fissure.org/t2275-advancement-flap-surgery-my-experience#49397
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Re: LIS and anal advancement flap, My experiences

Postby Maciej » 13 Oct 2011, 08:02

Thanks for the links I read all of them.
I am 27 days after the op and there is a slight improvment. My CRS told me that I should recover in about 3 months... I could not believe how long it will take :( I am still bleeding quite a lot but all the discharge from the infection cleared. I had a major infection which started two weeks ago and ended last week. Antibiotics made me run to the toilet like mad, diarrohea every day made me so weak that I could barely stand. It is a bit better now, the pain during the bowel movement is still quite bad, and the opening feels not as big as it should be.
I still can not sit down for any period of time and my CRS said that I should be able to sit down in 4-8 weeks...
My diet is still quite crazy...
At least 3 litres of water a day, one small meal (a little side bowl) consisting in 70% of overcooked soft vegetables(no potatoes), cup of clear soup, cup of prune juice, and depending on how I feel 1 or 2 ssachets of movicol and 3*15ml of lactulose.
addition of Lactulose changed a lot it produce softness so even if things are not as good as they should it passes without much straining.
Oh and if I am really running to the toilet like mad I eat 2-3 chocolate pralines so my energy levels are a bit better and the cocoa in the choc helps to stop the awful run.
I am still waiting for a referal to a dietician, my CRS promised to help me to loose weight and regulate my eating habits, that alone should help me to fight that stupid illness.
All the best to other AF-sufferers
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