6 months...what to do??

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Re: 6 months...what to do??

Postby Canadabum » 12 Aug 2015, 22:26

Thanks Msimon for the feedback. I thought I remembered that a Dr you consulted warned against long term use as it might cause dependence -- that it may prevent the muscles down there to function properly and may not keep the skin toned the way it needed to be for normal bowel movements. Honestly, as I write this I am not sure why I remember this...am I completely off base?
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Re: 6 months...what to do??

Postby msimon » 13 Aug 2015, 02:10

No, you do remember correctly. This was my CRS. I do not however put a lot of value in his opinion on this matter though as I have had others tell me otherwise, particularly because it is non-stimulating. There have been many on here too that have been told it is safe for life-long use. Of course it's not ideal My CRS has also been surprisingly wrong on some other things that have made me take what he says with a grain of salt. Great surgeon but...I actually had to prod him on asking about the sphincter not stretching enough etc. I do see this to be a potential problem for me in the future (especially if I need to be scoped again, and given my history with roids it's only a matter of time) but I do also believe that the new skin needs upwards of a year to reach a decent enough strength to be stressed. Since I had such a large patch of skin removed I am not taking any chances. Ultimately, we each have to do what works for us as we are all so different in what we need. It can be very difficult to know what that is sometimes too. Ideally, I would not be on the stool softener forever but until I get my pelvic floor to settle down, that is how it will have to be. Sorry this got to be way too long! lol.
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3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
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Re: 6 months...what to do??

Postby Canadabum » 15 Sep 2015, 20:04

Hi all...it's been a little while since I have checked in. My tag line should now read "11 months...what to do". I am clearly not a newbie so may start another thread in the diary section after tomorrow.

I am doing ok...no blood for a while and minimal pain...just discomfort from time to time. I am using Restoralax (miralax) in the morning and evening...probably a total of one third to half a dose a day. Without it I would be worried of injuring myself again.

So my news is that I have an appointment with a well regarded general surgeon who does lots of anal/rectal work. I am prepping for the appt. by taking dulcalax suppositories tonight and tomorrow morning. The one tonight burned a bit going in...hmmmm.

I am hoping to find out where I stand in terms of my healing, I will ask how long I can be on restoralax safely, what my best next steps are...if there is anything else you think I should ask please let me know.

While things have been pretty good for me I am scared of potential bad news, potential re-tear on the table...basically I am just nervous. Like so many of you - for me it has been a long and challenging battle and I have no interest in traumatizing myself more than I have been.

I will keep you posted -- and as always...a huge thank you to all you awesome posters...your advice is always appreciated. Msimon...you in particular have really stepped up your game,..pretty soon you will be THE Canadian expert on these matters...your advice and caring are exceptional....thank you from me and all of us.

Here's looking forward to someone's finger in my butt tomorrow...lol!

All best - Canadabum
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Re: 6 months...what to do??

Postby hopefull » 16 Sep 2015, 03:07

Good luck for tomorrow. From what I have read, discomfort from time to time is common for a year after healing but I imagine it will be reassuring to have it assessed by the general surgeon.
I'd be interested to hear what they will say about long term use of the restoralax as I am currently taking high doses everyday but then the doctor didn't seem worried about it.
Hoping for good news for you :)
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Re: 6 months...what to do??

Postby msimon » 16 Sep 2015, 03:34

Best wishes for your appointment! Thanks for the kind words. You are quite the asset on here as well ;)

Let us know how it goes. Fingers crossed here!
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: 6 months...what to do??

Postby Canadabum » 16 Sep 2015, 16:26

So here is the update....i must say, I sort of feel sheepish even writing this because I myself have a hard time believing this...but apparently....the fissure has healed!?!?! Did I just write that....it is actually healed.

I say this with !?! after the word healed for a couple reasons: 1. I am thrilled that I am healed 2. I am confused because I still have some sensitivity, and 3. I feel like i am pretty vulnerable to tearing it open if I do not keep things really controlled and generally soft....so still scared and a bit anxious about my state of healing.

I know that in the scheme of things I should be shouting joy from the rafters...but I am feeling a bit cautious still. I would love to hear from others who have healed and how long they felt sensations and a general sense of vulnerability down there for...

So here is what happened -- first of all, the Dr. was fantastic. He did a very thorough digital exam and then did a rigid-sigmoidoscopy exam. He said he could feel the scar tissue and a small bump (i think it is called a papilla) where the fissure was. He did not see any fissure...but saw where it was. I was told that I have a very robust sphincter muscle (too bad i cant show it off...like a six pack...lol) and a long passage...he thought that the very strong muscle may have contributed to the problem in the first place.

The exam was not horrible...but not pleasant. I used no drugs etc before the procedure. Deep breathing and a sense that it would soon be over got me through it. The awesome thing is that when he slid his finger around where the fissure was and would be...NO PAIN!! The last two times that happened...lets just say the patients in the waiting room must have thought that the Dr. was torturing me.

He did not suggest surgery and said i should manage this medically with (you guessed it my fellow fissure friends....) Sitz Baths, Fibre and Ointment......(as an aside, dont you wish you could tell someone to to the aforementioned and charge them $300 for the brilliant suggestion...). The baths are to be done on an as needed basis...in case of a flare up. The ointment also as needed...i was prescribed niphedepine this time. He told me is maintains its efficacy for about 6 months. The Fibre is something to be done every day until I take my final rest in a pine box. He highly suggested psyllium, metamucil and bran buds. I will give these a whirl....i remember that in my early days of fissure when everything was raw, open and pulsing with pain that fibre sucked as it made everything bulky...but perhaps now it will be ok.

So I also asked about Restoralax (Miralax) -- I told him that I take about a quarter dose in the morning and a quarter dose in the evening. His first words to me were....who put you on that. I told him that I put myself on it. He said that he does not recommend it for his "younger" patients (i am 43) and that he uses it for constipation in his older and elderly patients. His feeling was that it is not exactly a stool softener and it is more or a gentle laxative. He told me he would cut it out. I said that I was reluctant to cut it out because it has been so helpful. I then asked him that if I chose to continue using this for say another full year every day...would it cause any harm or be a problem...his answer was a clear no...no problem to continue to use, however he does not recommend.

So there you have it....I will continue to let you know how I progress and what is going on with me. There should be a section on this site for people who are reluctantly healed or sceptically healed...that is where i would post my next thread. I am really thrilled that i was given some great news today...perhaps the reason I am not jumping up and down is because i am a bit shocked and also a bit sceptical. When it sinks in i will let you know.

I cant thank all of you enough for your help, feedback and support...without a doubt it has helped in my healing process...so thank you all..specially the administrators and moderators who do such a great job for all of us by keeping this forum humming. This is not the last you will hear from me...no doubt I will have more questions, there will likely be a twist and a turn of events at some point...and I will certainly be there when i can to shed some light from my experience.
Best to all,
Canadabum
(apologies for the long and somewhat rambling note!)
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Re: 6 months...what to do??

Postby felix » 16 Sep 2015, 16:51

Best news ever! You must be so relieved and as for strange sensations, I think they must be really common after healing as scar tissue and nerves feel strange after healing. Also muscle spasms can occur for ages after healing so could be a bit of that going on too?
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Re: 6 months...what to do??

Postby hopefull » 16 Sep 2015, 17:28

YAY! So glad to hear your good news :) Keep up the good work, it has worked!
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Taking: Lax-sachets, flaxseed oil, Mg
Topical: Diltiazem, Sudocrem
Circulation: Warm wheat bag, relax, short walks
Tried: Rectogesic, slippery elm, Lactulose
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Re: 6 months...what to do??

Postby msimon » 17 Sep 2015, 02:12

So glad to hear of your great news. I am in the same boat (sceptically healed is a great term). I have yet to post that I am healed, although I was told the incision and fissures have been healed for months now. I have been working very hard at undoing the damage done to the rest of my body from this whole ordeal (stress, lying around causing muscle wasting, etc), especially to my pelvic floor. I haven't even been able to work on the sphincter muscles themselves yet. I wonder if that is where your pain still resides (given the strength of your sphincter-as you mentioned).
Interesting about the Miralax. Funny how Doctor's differ so much in their opinions. I certainly have never gotten a stimulation effect from it. Certainly nothing like Magnesium. I am have not had to increase my dosage across the years I have taken it daily. This indicates to me that it will not make a lazy bowel (at least not for me), as with stimulant laxatives, they stop working after a while (unlike Miralax for me anyway). I agree it's not ideal, but for now...it's the least of my worries. I am rambling....thanks for the info. Keep on keeping on...and hopefully you will feel some peace about the whole thing soon. I am still not there yet either.....I totally get it!
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: 6 months...what to do??

Postby Canadabum » 17 Sep 2015, 21:13

Msimon- I too am "reawakening" these days....physically and emotionally. I dropped many things over the last year that I want to get back to slowly but surely...including my working out etc.

As for Restoralax...I too never found it to stimulate, just acted as a softener. So I would agree with you in terms of it likely not causing a lazy bowel. I also never found I needed to increase dosage because I was getting accustomed to it. I will continue to use it sparingly and reduce to once a day over the next week and see how it goes. Bottom line...I am very comfortable using this as needed for as long as needed.
Thanks again for all your kind words.

All best - C.B.
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