12 Years of Fissure Pain and 12 days after LIS

A fissure journey across 3 continents...

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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12 Years of Fissure Pain and 12 days after LIS

Postby SnChem » 07 Feb 2018, 17:43

Fair warning, this is gonna be a long post... I don't ever write reviews or blogs, but I've gained so much insight in this forum, I think I owe the platform my experiences. And hopefully it can resonate someone out there that is still struggling, and seeking salvation!
If you only want to know you should do LIS or not, go straight to Chapter V :)

Chapter I: China, The Beginning...
It all started 12 years ago, 1st year in college. You thought you are invincible, terrible diet, life style, and excessive drinking and computer games. It resulted chronic constipation and caused pretty bad external hemorrhoids and multiple fissure.
I was blasting blood every BM, like full on period for a whole year... I don't know why I think that was acceptable for that long...
Anyways, on my 18th Birthday, I decided to see a butt doctor as my b-day gift. I know, stupid..
Btw, this was in China. The doctors didn't explain any to me, just said, oh it's hemorrhoids, we'll cut it. They gave me some local anesthesia, and then just started cutting!
Through out the 1 hour hell like experience, my ass got pulled inside out and there were cutting, pulling and skin burning. The worst part, is I felt like I was gonna poop the whole time during the surgery, while i can smell my ass burning.
The Post op, omg. Idk what kind of messed up 1850 technology they used, there is some gauze dressing and stitches were embedded in my anus, and it had to be taken out a week later. it felt like waxing but inside of my anus.
In conclusion, DO NOT do surgeries in China in early 2000s... Hopefully that has been improved.

After about 2 months of post Ops. I pretty went back to exactly were it started. The hemorrhoids were removed, but the fissures were not.

For the rest of my college years, I basically just kept bleeding everyday. I had zero confidence in any of the doctors there. Every day, they comes after BM, and clears up by about 10 pm, and start all over gain. It's kind of a miracle I graduated top of the class and got full ride to do my PhD in the US... I think part of me was aiming to finally land a good doctor to fix my ass, so I had to come to the US.

Chapter II: U.S.A., The First Salvation
After coming to U.S., I was like, omg, there will be a good doctor to fix me!
Then I encountered something called U.S. Health Insurance. For the ones are not in the US, you don't understand how expensive it can be to be out of the network, and the whole thing is just too expensive for a stupid.
My only insurance is some basic co-pay plan at the school clinic, there is nothing then can do to my anal fissure.. They actually recommended to take hydrocodone everyday for pain management.. WTF.

But, God Bless Web MD.

Note, I've been bleeding for 4 years, and I still didn't know the basic Anal Fissure management.
This is the first time, I learnt about High Fiber Diet, Sitz bath, Laxative, NitroGlycerin Cream.
And Nitro cream is not FDA approved in the US yet, but I bought some on line from Australia for like $20.
And I was 'FIXED'!
about 4 weeks into the nitro glycerin, I was first time ever since i was 17 to be able to poop with no pain.
managing the diet and exercise regularly I was about 90% of the days no pain. 10% of days can be managed.

I thought that was my salvation! and my life can be recovered!
Lies....

Chapter III: Italy, is Not Your Friend...
After a 'sweet' 2 years of 90% good days, I took my mom to Italy for a dream vacation.
Who would ever though, cheese and gluten is so violently devious to your anus....
On the first day, I felt like I gave birth through my anus.... I passed out on the floor in blood in a small hotel of Rome.
It was the best and the worst trip of my life. Italy is beautiful, I was just in pain the whole time...
After the trip, this giant fissure on my left side just not going away, despite all the management I used to do. I'm downgraded back to 10% good day and 90% bad days.

Chapter IV: Specialist, the incompetent one.

This is the very first time, I started thinking about LIS. Because I'm so sick and tired of the fissure.
But all the incontinence possibility and infections ppl get are scaring me away. I've been reading, researching, and contemplating for 2 more years.
I finally decided to see a specialist, and see how it goes.
First of all, the inspection, he ripped my fissure more than it was already.
Second, all he can offer were more creams, different creams.
Thirdly, whatever creams he gave me, FUCKED me over. I had 6 Thrombosis Hemorrhoids in the course of 3 months. 2 of the 6 had to be excised.
How many thrombosis I had in the past 10 years of anal fissure? NONE!
That made me so angry, and I was in so much pain, during the thrombosis and post ops of excision.
If you ever had a thrombosis, you would understand, it felt like you got shot by a bullet in your ass, and that bullet is shooting from inside out. and it takes 3 months to go away....
And after all that BS, I still had my fissures...
This time I did a lot of research, and find a very highly rated specialist.

Chapter V: LIS
To answer the big question, should I do it or not. The answer is YES! F**k YES!
Go find a good doctor in your area. I currently locate in Oregon, US. Colorectal Health Northwest, is the best in the region. I had Dr. Scott Browning. It was the best decision I made.

I went in for a consult, he listened my long and whinny 12 years of journey. Did a very gentle inspection. He told me, it was a clear chronic fissure, visible scar tissue around the fissure. Even worse, from the Chinese doctor, i had anal stenosis, so the anal canal is extremely narrow, plus the spasm from inner sphincter with the fissure. This is pretty much impossible for me to heal anymore.

Dr. Browning offered me LIS as first line of option, he explained that he is using enclosed technique. and partially tailored LIS.
The enclosed technique is he insert a 11 blade under the Inner Sphincter, rotate inwards and cut the muscle. This technique is harder to do, much faster in recovery compare to open technique, where the Dr. makes an incision, pull the muscle out, then cut it and stitch up the incision.
The partial LIS is a game changer. He explained, back in the days, LIS invovels cutting the full length of the Inner Sphincter muscle, and cut in 3 and 9 oclock. That's why it involves so much incontinence rate in some studies. Now Dr.s only cut 1 side, and tailor to the length of your fissure. The incontinence rate is essentially 0. Only issue with the vulnerable patients (elderly, or had traumatic birth) might be temporary flatulent incontinence. Full on losing bowel control is pretty much impossible.

That visit gave me insane amount of hope and determination to do the LIS. And get a new asshole for good. I scheduled the surgery right away.

The surgery itself was very straightfoward, they gave me local anesthesia, and sedation.
i was in the OR for about 30 mins, I didn't remember a thing. It did take some effort to pee for the first time, but nothing was bugging me on the first day.

Well, here is the only down side of LIS. The first 48 hrs Post Op.
It mother f***ing hurt.
Take that Oxycodone before the anesthesia wears off, trust me. And take Miralax with it for 2 days. I waited too long to take pain meds. I was woken up by the pain at 4 am. It felt like glass shards exploded inside of me and is poking my anus.

I'd say the pain level was dropping from 10/10 to 5/10 in 24 hrs. After 48 hrs, I was able to live off Ibuprofen, no opiods needed.
But now comes the drainage. This is very confusing, because it is normal to have some amount of drainage, and it is not gonna smell good. it's like a sweating shit constantly permeating through your ass....
The Dr. will warn you to call the office right away if you have foul smelling drainage, since about 1-3% might have infection. So i was panicking... However, the smell was going down on its own, and the drainage was very clear. So I held off, and didn't do anything.

At day 5, the bleeding and foul smell comes to a contrallable manner. I still do sitz bath like 10 times a day, and keep the area dry and clean. and eat like a rabbit everyday, but no laxitive anymore.

At day 7, pooping doesn't hurt anymore. You will go through a little mental debate: Omg, is this real!? Am I fixed for good!? No way! It will hurt again tomorrow!

At day 8, it still didn't hurt... And my poop were huge. They were used to be pinky size in girth, now they are like my wrist size... and it DOESN'T HURT!!!!

Day 9-10, no differences, still doesn't hurt. But it still bleeds after BM, and everytime it comes out, it felt itchy not pain. however, any discomfort disappear in the next 5 mins.
For the very first time in 12 years, I stopped worrying for my anus for just 1 full day.

Now I'm at day 12 post LIS. I have never been this happy, I feel like a new born.
The area is still a bit tender, and small amount of bleed after BM. But No pain, no worries.
I can carry on with my life, and plan the future.


Chapter VI: The Conclusion.
Thank you for scrolling down so long to get to this point. Here is a simple play book for your anal fissure.
1. If you are first timer, and acute fissure.
Change your diet, get fiber supplement, do stiz batch, get stool softener.
get some Nitro glycerin creams, it works better than calcium channel blocker.
2. If you are chronic, means it lasted more than 6 months, or repeated multiple times over the years.
Go find a great specialist in your area. and do the LIS! Don't waste your time, and be like me to struggle 12 years. It will be painful for 2 days after surgery, but it will be the best decision you ever make in your life. And again, a great doctor is the key, it will mitigate complications and speed up recoveries base on the doctors.
Google doctor ratings in your area, and you can also tell how good they are base on their manner and knowledge when describing the surgery.

Thank you all so much for spend the time reading this, and hopefully my journey can help one or two out there. And let me know if you have any questions or concerns. I probably had it all, I'm glad to answer your questions.
Best!
SnChem
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Re: 12 Years of Fissure Pain and 12 days after LIS

Postby Vishal » 07 Feb 2018, 20:56

Wow what an amazing story. Hope you are still better.
Vishal
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