by queenofpain » 24 Jun 2013, 12:57
Here's an update to my post dated May 30. I've been in pain since May 28 with few borderline days each week, and because my surgeon (I saw him last February 2012) is out on leave until July at least, I decided to seek a second opinion. I found a colorectal surgeon with 27+ years of experience, who has won an award, and is sensitive and meticulous. I, surprisingly, was able to get an appointment right away. He even took my paper with my questions to see what else I wanted to ask. Unbeknownst to me, he was trained by my surgeon who has 44+ years experience. He told me my surgeon has written books on LIS-related topics, and that if he did my surgery, I can be confident it was done right. So, it seems like I'm in good hands.
To cut to the chase, I asked why I'm experiencing so much pain now, 20 months after LIS, and he agreed it could be scar tissue. He said sometimes a neuroma develops (a nerve gets trapped in the scar tissue), but I think that would be more obvious. This feels like pre-LIS pain. I asked whether I would require a second LIS, because my surgeon cut conservatively, but he didn't think so. He said usually a second LIS is required when a person goes to a general surgeon who hasn't cut enough. He then said matter-of-factly, "But, we (colorectal surgeons) are experts." I told him my surgeon said in so many words that I could expect pain through 18 months. He responded to the effect that I shouldn't take a time frame literally. My surgeon could really have meant 24 or 26 months. The exchange was encouraging, but it doesn't resolve my pain!
This surgeon had wanted to do an internal (digital) exam or to use a microscope, since he was, of course, limited without it. I told him, however, I was afraid of being torn. My other CRS never thought I'd be able to tolerate it, although he had done a digital once or twice in the weeks following LIS to make sure I healed. This second-opinion CRS did an external exam, and said everything looked good on the outside. There was scar tissue, but not much. I said I would probably have to return and allow him to examine me internally if the pain doesn't go away. He wasn't even sure if spasm was causing the pain, and asked if I ever used hydrocortosone suppositories to help the pain. He said that with spasm I should feel an opening or closing. I'm not sure if that should be the case, though. It's hard for a CRS to relate to spasm when they themselves aren't experiencing it, but maybe he's right. At any rate, I told him I wasn't able to get suppositories into me (prior to surgery; I haven't had experience with them post-surgery). His comment about spasm was interesting, though, because I'm not able to differentiate spasm from other pain well, and wouldn't have known about it without reading about it, or having it assumed by the other CRS. I'm not sure if my muscle relaxant works well enough (cyclobenzaprine - 5mg; he said he never heard of using 10mg), so again, maybe the pain is not related to spasm.
At any rate, here are my questions: 1) How painful is it if they use a scope? Does it take long? I told him I might need medication for the exam, and he said we can talk about that. 2) How do you differentiate the pain of hemorroid from fissure or LIS-related pain? I'm wondering if something else is going on, but it feels like there's a stretchy, scarry feeling, and something's sore on the right-hand side by the LIS site, that's possibly leading to the bad pain. 3) Is there anything good for pain that is not a narcotic or muscle relaxant? I'll leave it at that. Thanks.