19 Months Post - LIS - Pain

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19 Months Post - LIS - Pain

Postby queenofpain » 30 May 2013, 15:02

I'm 19 months post-LIS, and am experiencing a bad bout with pain (I had surgery after conservative treatments for five years). From month to month, I've been doing well, with the exception of milder pain a number of days per month. Occasionally, I experience pain equal to that of pre-LIS, i.e., bad pain. For the past three days, I've been in a lot of pain. I'm not sure if I irritated the scar tissue, or what. I continue to take a capful of Miralax, and a TBS of M.O.M. (down from 2 TBS), as I don't feel I can handle a normal stool yet. My CRS (haven't seen him since February 2012) told me he cut enough, and that I should give the healing 18 months (that was probably a random number he threw out). It's been 19 months now.
Bottom line is I feel discouraged. I hate to go through a second LIS, as I experienced pain/spasm for 6 weeks afterward. The CRS prescribed cyclobenzaprine for spasms, which I never took. Because I'm very sensitive to medications, I'm afraid of the side effect of nausea. As bad as the pain is - and it's bad, I'd rather deal with pain than sickness. Two questions: 1) Should I give the healing more time? The fissures (2 of them) were healed pre-surgery, and the surgical site was healed within 6 weeks (or so I'm told), but I don't know if the scar tissue is still healing 2) Does cyclobenzaprine cause nausea as readily as a narcotic?
Thanks!
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Re: 19 Months Post - LIS - Pain

Postby Jojo1 » 04 Jun 2013, 10:00

I'm afraid I don't know what to tell you. I've not experienced this particular issue. My fissure occurred in July 2011 and I had LIS in November after close monitoring by my CRS who could tell (no duh) that it was not healing with treatment. I've not had any problems beyond minor irritation if I indulge in too much of something sinful and I'm at 17 months. I can tell you that gone are the days when we can blindly follow what a doctor tells us and you have to really take charge of your care. I would work closely with him and push the envelope to find out what's going on and how to address it and if you're not getting the results you need, be open to going to another doctor. I truly hope this issue gets resolved for you.
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Re: 19 Months Post - LIS - Pain

Postby queenofpain » 04 Jun 2013, 10:11

Thanks for the reply, Jojo. This is my 7th day in pain, and the longest setback I've had since surgery. All I did was have more formed stools, though very soft, and I ended up in pain. I haven't been eating as much the past week, as I'm afraid. I called my surgeon for an appointment just before you wrote, and he's out on sick leave until at least July. His fellow might be able to see me, but she won't have the years of experience. I read on this site recently that someone read an article that states that a conservative cut (I was cut conservatively, but he insists he cut enough) can result in the sphincter compensating by going into spasm. Not sure how accurate this is, but it's enough to discourage. If only someone would weigh in that took more than a year and a half to heal, I'd see light at the end of the tunnel. Thanks again.
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Re: 19 Months Post - LIS - Pain

Postby 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.
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Re: 19 Months Post - LIS - Pain

Postby Aliaa » 30 Oct 2016, 10:45

Hey queesnofpain, how are you doing now?!!
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