25 year old male - 4 days post LIS

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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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25 year old male - 4 days post LIS

Postby Buttpalsteven » 26 Aug 2016, 19:39

Hi everyone, this forum has provided me great support for preparing for and dealing with LIS surgery. This board has a lot of varying stories and different circumstances so I thought I would share my own in case it can provide relief to others more similar to myself.

I do not suffer from any other known issues (Crohn's disease, IBS, etc..). I am a gay man (relevant as I am a receptive partner). I believe I developed an anal fissure about 5 years ago. For me, I never felt pain on a regular basis. I only endured pain when passing a bowel movement (BM) and generally the pain would stop after. Hemorrhoids (or what is believed to be hemorrhoids) runs in my family (my dad and his dad) so I thought that was my issue. I began the regimen of prep H, tucks, sitz baths, etc.. and had minor relief. The pain during BM only occurred sometimes (maybe have a bad spell for two unrelated months each year) and although it hurt it wasn't insanely painful for me so I dealt with it for a few years.

As a gay man and entering my 20s I decided to see a doctor about my butt as I did suffer some pain (only in certain positions) during anal intercourse as well. The doctor was just a general doctor/provider and in his late 60s or 70s. He joked and said it was hemorrhoids and told me to keep up with hemorrhoid creams and to eat more fiber. Btw, I generally have a BM once a day. Sometimes less/more but 1 a day is pretty standard for me. I tried his advice knowing the option wasn't going to work. About a year later I went to a different doctor (general practitioner). I told the nurse I believe I have a fissure - she honestly didn't know what that was. Fortunately, the doctor knew and said yes I have a large fissure and told me to get zinc oxide. I tried that. No success. 3 years later, age 25 (I'm a student - grad school now working towards a doctorate degree) I finally decided to schedule an appointment with a colorectal surgeon(crs). I put this off for the same reason many of you reading this probably have. 1 - it's so darn expensive 2 - my pain is tough sometimes but I'm managing life okay 3 - sort of embarrassing. Well my CRS is a younger man (40s?) And was truly empathetic as I explained my situation. He went ahead to gave me an anal examination but after just starting to open my cheeks he stopped and said wow I don't want to open you any further - you have a really bad fissure. And said if I'm interested, the only option to heal is LIS. I went ahead and scheduled for a few weeks after that appointment.

I had my surgery on Monday 8/22. I did not have to prep ( I know some of you are asked too with an enema). The operation was rather quick, I was put under with a general anesthetic and woke up 50 minutes later. The first hour after waking up I had absolutely zero pain and was excited as I had heard horror stories after waking up. The person in the bed next to mine was in pain and he had a similar operation done. I was wheeled to my own private room. After time went by my anesthetic must have worn off and my butt felt like it was on fire (to be more specific, like a lighter was lit just inside my rectum). I called the nurse and she got me pain meds (hydrocodone and Tylenol - 5/325) and the first nurse gave me a large bag of ice. Another nurse came over who saw that I was distraught and she went and filled up a glove (the plastic/nylon gloves) with ice. Much easier to stick between the cheeks lol. So if you are going to have the surgery - know a glove can be a life saver! You can stick the fingers of the glove in your Crack to alleviate the burn. I went home once I was more bearable. Reading on here, everyone's pain is very different. For me, I could not sit. I wanted to stand but the staff was nervous since I was still freshly off of my anesthetic. I found some relief by laying on my side. Before my surgery, the doctor explained he was going to be stuffing me with lots of padding. I was to leave the padding inside of me until the following morning unless I was unable to pass gas or if I had to have a BM.
That first day was my worst day. Constant pain. I only had the burning pain I described earlier for 2 hours. After the burning pain it felt like constant heavy pressure and throbbing in my bum. I set my alarm for every 3.5-4 hours during the night to take my medication. It was sort of weird because I was able to sleep. But I'd wake up on my own from time to time and when I did, my external sphincter (the one we have control over) would clamp down really hard for a few seconds. It is rather painful.

Day 2 (1 day after the surgery) in the morning I began taking my padding out. It was extremely difficult and painful. I spent about 30 minutes tugging and got about 8 inches out. I then stopped to give myself a break. Had breakfast, did some personal odds and ends (phone calls, emails). Then took more pain pills and got back to work. It wouldn't budge. I hadn't done any sitz baths since the surgery, I know many people on here swear by them. My doc didn't mention them.. just said on day 2 I could shower like normal. Well I was scared with the difficulty for the removal of the padding so I hopped in the bath tub hoping it would loosen the padding (i assume pad was stuck in my wound or dried blood was sticking it to me). Anyway I don't know if it was easier to pull out in the tub but it was less painful. I literally had to use all of the force I had to yank it out. There was a clear slime hanging off of the end. No fresh blood. After the padding was removed my pain cut in half. So in retrospect, I would have pulled the padding out earlier (the night before). The pressure the pad puts on the cut was just completely awful for me. Reading on here, some people were more comfortable with the pad in. So seems really case dependent based on how you get stuffed with padding! I didn't take pain meds for the rest of the day until that night.

That night of day 2 (day after the surgery) I had my first bowel movement. It hurt, but not much more than when I had a bad day with my fissure. The pressure from the BM was intense but it didn't feel like I was passing glass like some BM before the surgery. I did bleed a little. I knew I had a BM coming before I passed it, so I took a pain killer about 15 minutes before it happened and got a sitz bath ready. Honestly the sitz baths don't help me much, maybe I'm doing it wrong. By sitz bath I actually mean just a warm bath. Fully immersed. Read online that a proper sitz bath is hanging the legs over the side of the tub etc.. maybe others can weigh in on this? A warm bath just felt nice in general though.

I think the pain of your BM post-LIS mostly depends on how bad your fissure was before the surgery. If it wasn't too bad then post-surgery your pain will feel much worse. But if your pain was immense before, it's possible you will have relief with your new decrease in internal pressure and increase in blood flow. I apologize if this is TMI but my first bowel movement consisted of a few little balls and one medium sized one (pre surgery I have normally 2-3 long stools with each BM). As I said, the BM pressure was intense. I try to sit to pass my BM, but it was moving slow. So I stood up and if I bounce a little it speeds up the process (great visual, eh?). In fact, I found it easier and less painful to pass the BM standing up. I try to be seated but sitting while not pooping is already painful so I preferred to stand as is. So I passed my first BM standing. I used baby wipes to clean up after. Blood was present but it wasn't dripping or anything, just came off with the wipe.

I did not take any more pain meds and slept mostly through the second night. Again, whenever I would wake up my external sphincter (I'm assuming it is my external sphincter anyway) would clamp really hard for a second. The clamping is quite painful but fortunately passes quickly. I don't know why this occurs but it's obnoxious. It wakes me up.
Day 3 I went to school. I know I shouldn't have but as a graduate student I just didn't want to fall further behind. I over did it though, so had some throbbing for the rest of the day. Took my second BM that night. It was a small BM but was glad to pass it (just little balls this time - I assume the pain killers have decreased the size of what I release during a BM). As the night before, having a BM is scary as you feel the pressure of the BM coming and as you pass it but you will survive it. It isn't all that painful (for me) just terrifying because it's normal/healthy to somewhat slow and squeeze the sphincter as you pass a BM.. so trying to not do anything at all as it comes is a difficult challenge. I bounce between laughing at myself and shaking from the pressure of the BM.

Day 4 - I slept the entire day. I think from overdoing it the day before.. and I havnt slept through a full night so lots of napping today. I'm still having my external sphincter clamp hard sometimes as I sleep which wakes me up. It's very strange. I had my third BM last night. To be honest, I have been standing up to pass my BM. I don't know if that is bad (eg maybe it causes it to heal the wrong way or prevents healing? Hopefully it's completely acceptable?) All I know is my pain is a lot less as I stand. I try to sit though but as the pain and pressure increases I end up standing and holding on to the wall. I have been taking stool softeners every day as prescribed (doc-q-lace 100 mg twice daily). I apologize for the details here.. I had 3 little stools come out. They were similar to my first two BM. But the pressure became intense and I was standing but whatever was coming next wouldn't come. So I finally gave a push.. and I had a very long one stool as well as lots of mush come out after. I mean a lot came out of me. Mind you, I was standing as all of this came flying out. Huge sigh of relief after and took another bath. My butt was very tender after this so I took my first pain pill of the day and grabbed another glove full of ice to relax. Few hours of throbbing have gone by and I'm now in bed feeling the best I have since the surgery. I slept well last night.

Day 5- Had aching pains much of the day but I went pain pill free. Nothing exciting to report today so far.
I did not anticipate the amount of pain I was going to have from the surgery. Obviously the procedure involves creating a cut but I assumed it would be more similar to the pain from my fissure. Instead it has been a constant throbbing pain. However I'm glad I had the surgery and as each day gets easier to get through I'm excited for the prospects of having a normal life once I'm healed.

So I guess my closing comments are:
1.) If you are struggling with a fissure - you have the opportunity to get help with this procedure. It's relatively safe - incontinence is a true concern but if you have the surgery with a CRS your odds of incontinence are extremely extremely rare.
2.) If you have the procedure, know it's not a walk in the park. I thought it would be, I'm a young healthy male with a self-determined high pain tolerance but it has been a rough week.
3.) Gloves filled with ice are life savers. Also, it's okay to take your pain pills. If you don't need them - great. But if you need them, take care of your pain. It's okay.
4.) Your BM after surgery might be rough but don't be afraid of them! Take your stool softeners. Many on here recommend fiber. Know how you handle fiber before the surgery. Fiber is a great nutrient - it makes stool more firm (sort of acts like glue, brings your poo together) and leaves less behind (in fact, when I take fiber, I rarely need toilet paper - I'm clean as a whistle after) however fiber can also cause constipation. So know your body before hand. I chose not to take fiber post surgery as I know it decreases the frequency of my BM.
5.) You will learn things about yourself. For me, for example, standing up to poop is gross but easier. Also I use my butt muscle to do everything. To bend over or pee or step on the break peddle - always squeezing the butt. (Avoid driving if your butt muscle hurts to squeeze - or else you are gonna have one painful drive lol).
6.) Day by day - things get better.

I have my follow up in a week and a half. I will post details if I have any interesting news. I'm happy to answer questions if you have any. Even if you just wanna talk - I know how isolated you might feel about this.
Also, as weird as it is - I have a picture of the padding hanging out of me. I was yanking it out in pain and decided I wanted to see what was going on before I continued yanking. So if you wanna see it let me know to get an idea of what you might look like down there. It might be useful to see, there is bruising where I assume the prongs were placed to hold the anus open, some redness from the pressure, etc. Don't be embarrassed to ask questions to your doc or the people on this board. Take care of yourselves and good luck with your butts!

Your butt pal,
Steven
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Re: 25 year old male - 4 days post LIS

Postby Savaici » 26 Aug 2016, 21:32

Great post! Things sound like they're proceeding well. I use a sitz bath every day (from rite aid, and it fits over the loo, and I just fill it/empty it using warm water). Love it!!

If you put a pic up with ... Etc, just put it under a spoiler. You will find the spoiler button far right when you put Full Editor on. Then people can look - or not!

Let us know how you continue to do. :huggies:
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Re: 25 year old male - 4 days post LIS

Postby Buttpalsteven » 22 Sep 2016, 00:56

Hi everyone,
I've had a few e-mails so figured I'd post an update on here. Some of the details have gotten fuzzy of my immediate days following this post.. but I remember that it wasn't until around day 8 that I began feeling like myself again (energetic, pain-free) and was soon comfortable and able to walk distances (my campus is large - takes steep walks to get anywhere). I tried to avoid stairs as much as possible the first week, they weren't comfortable for me.
Soon began the intense itching. Mostly in the mornings right after a shower and the evenings after a long day. I washed myself with an anti-bacterial body wash between the cheeks. I know the science is out on using anti-bacterial soap for home purposes but I'm glad I was able to use it (Dial Wash - Spring Water) as it made me feel like I was keeping my wound clean. Psychology does the body well it seems! I also used my bedroom fan to dry my arse lol. After 1.5 weeks or so, I felt comfortable drying myself with a towel. For those who are curious if when it's time to switch over, I think you just instinctly know. You will feel more comfortable spreading your cheeks open when its time!
Around 11 days post-surgery, I was getting antsy and went to the gym. You should follow your docs orders, mine said to atleast wait for my check up (2 weeks) but I couldn't help it.. obviously no leg day! I just did minimal activity. If you decide to go to the gym but arn't sure what is recommended.. anything that involves you sitting or laying down is mostly okay (i.e. biceps or chest). Carrying the dumbbells resulted in a tingling sensation so I called it quits and tried again in a few days and was fine.
I had my post-op check up 2 weeks and 2 days after my surgery. Doc was impressed with my healing speed. Said my stitches had fallen out already and that my incision site was all but healed - just waiting on the most outer layer of skin to grow in. Doc gave me the okay to do gym things but said to save leg day and any other heavy lifting for at least 2 more weeks (4 weeks post-surgery).
I am now 4 weeks and 2 days post surgery.. havn't done any leg workouts yet :P but honestly, I'm healing really well. I'm really fortunate and feel that I was with a wonderful physician. I feel 100% normal during the day and exercising.. but I still feel some pressure with about every other other BM.
I quit taking my stool softener at week 4. I noticed that while on the stool softener, my size and frequency of BM has greatly decreased since life pre-surgery. I havn't noticably changed my diet so I'm not sure why I have such different stools now. I've been off the stool softeners for two days now so I will let you know if my BM return to a normal size and frequency. Fingers crossed! If anyone has tips or suggestions, I'm all ears! I was taking a fiber supplement too, but I went cold turkey on that 2 days ago as well.
There seems to be a few posts of people asking about this on the forums so - My doc recommended at least 6 weeks before returning to anal sex. His advice was that anal sex is no more annoyance to the arse than a BM as long as your use ample lubricant.. so I shouldn't be too concerned about returning to intimacy with my partner but that I should obviously be mindful as I'm still healing. I am going to wait this period (6 weeks, probably 8.. will see if 99% of my BM feel normal) as it is not worth the risk of harming a productive healing process. Fortunately, I have a supportive partner in all of this so this waiting period has been good for me and my health.
I will post an update if anything changes.. feel free to email me from here anytime (or post on here). I will try to respond in a timely manner. Thanks for your support across the boards, I'm really glad this forum was here to help me through the process. I was definitely scared my first few days after the surgery - I hadn't seen many posts of people describing the intensity of the pain on here so when I was virtually bedridden I thought something was seriously wrong with me@ I'm doing really well now and couldn't be more appreciative of having the operation done!
Best,
Steven
P.S. Sorry I didn't post this post under diaries, when I first joined the forums I only saw the "main thread" tab, didn't realize there were other forums to post on.

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Re: 25 year old male - 4 days post LIS

Postby Buttpalsteven » 12 Nov 2017, 21:39

Hard to believe I had this 15 months ago! This surgery really turned my life around. The first few months after surgery weren't perfect. I would have a good spell and then randomly have a BM that reminded me I had this surgery. However, I consider myself perfectly healed now. I'm grateful for my surgeon and for all of the people here who offered compassion and understanding when I was scared. I hope all of you are well and have happy healthy butts!
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Re: 25 year old male - 4 days post LIS

Postby Mypoorbutt » 13 Nov 2017, 04:34

Glad your recovery went so well and that your now totally healed, it really is great to hear success stories
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Re: 25 year old male - 4 days post LIS

Postby yenrac » 16 Nov 2017, 22:31

Thanks for posting your experience. I'm so afraid of surgery but I've literally tried everything else. I've lost 20 lbs because of my diet and being afraid to eat.
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