6 Weeks Post-Advancement Flap-Tired of this Process

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6 Weeks Post-Advancement Flap-Tired of this Process

Postby tiredjay » 17 Jun 2013, 15:51


While I have been a member of this forum (and frequent lurker) for quite some time, I haven’t posted much. Let me first start by saying that I am 6 weeks post-house advancement flap and curious as to how much longer it should take for me to be “normal” again. Although 99% of the pain from surgery is gone, I still have pain at the incision site where my CRS sutured the flap onto my anus. I still have that sharp pain there where the incision site is when going to the bathroom (my bms are soft and pencil thin) and I’m getting a little concerned that it isn’t going to heal. What makes this all worse is that I this intense burning pain which I discovered is an allergic contact dermitis from Cottenelle wipes that I have been using (I found out that this is actually quite common because the wipes contain a chemical that can cause a severe allergic reaction in certain people). Anyway, I guess I want to know how long it takes for these advancement flaps to heal and if I should be getting worried at this point. I thought this would be a wonder-fix, but it seems like the healing process is taking forever.
 
Here’s my story for a little background:
            I’m a 26 year old gay male with a monogamous committed partner of almost 4 years. I first had my fissure in Nov of 2011 after having a rough bm. While it initially healed by itself within 2 weeks, I kept retearing every 3 weeks or so. I went to my GP in March of 2012 and was prescribed Nifedipine. I was stupid and didn’t fill the prescription until May of 2012 as I felt like I had healed. After trying the Nifedipine without much success I went to my first CRS in June of 2012, who advised me that things looked like they were healing and to keep using the Nifedipine. They also did an anoscope and told me I was not a candidate for surgery because my pressure was normal/low. I returned to the CRS in August as I kept retearing. During that visit they thought I had anal warts (which I informed them was nearly impossible), and they took a biopsy then and there just to be safe. After 2 weeks of healing time, they informed me that they made a mistake and no anal warts (thankfully). In November I went back to the CRS because of re-tears and an intense burning pain (which I just learned was an allergic reaction to the wipes I was learning at the time). The CRS told me that there was basically nothing they could do for me and that “some people just have to learn how to deal with anal fissures.” I was devastated.
            I eventually went to another CRS and have had an incredible experience with him. He has actually spent time with me and was willing to listen to what my concerns/goals were with treatment. He suggested Botox, which I had at the beginning of January 2013. Unfortunately I kept re-tearing with the Botox and did not really have much control of flatulence (luckily my lack of control was never at an inopportune time and the little dignity I have left was spared). The next talk I had with this CRS was surgery. I had concerns with LIS because of the anoscope indicating low pressure and my lack of control with Botox. My CRS said that the anoscope is actually not a good indicator of continence after LIS but he shared my concern about the lack of flatulence control so he agreed to do a house-advancement flap. I had my flap done on May 7th, 2013 and have been in the healing process ever since. The healing has been somewhat uneventful aside from two sutures at the top of the wound coming out 2 weeks after surgery. I had an emergency appointment and my CRS said everything looked fine and was healing nicely. Anyway, I’m terrified that this surgery isn’t the end. I haven’t been able to be intimate with my partner for a year and a half and this whole thing has been taking over my life. Is there a light at the end of the tunnel or am I just being impatient at the moment? Thanks
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Re: 6 Weeks Post-Advancement Flap-Tired of this Process

Postby Savaici » 17 Jun 2013, 17:28

Welcome to the Forum! Thought I would give you a link to those who have had similar surgery and hope it might be of some help.
I know suzyljank, one of our moderators, had a similar surgery done recently, so you might like to see her healing posts.
Good thing you stopped with the wipes! I use wet sterile gauze pads from Johnson & Johnson after a BM to clean, and only ever DAB.
hope the links might help. We are here for you. Hugs!!
http://anal-fissure.org/search?search_keywords=Flap
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Re: 6 Weeks Post-Advancement Flap-Tired of this Process

Postby suzyljank » 17 Jun 2013, 18:35

Hi tiredjay. I had double advancement flaps 7 weeks ago. My donor sites were left open to heal so they wouldn't put tension on the flaps. I had a scary episode with bleeding a few weeks in but got it under control. I was instructed to rinse with warm water after a BM and to use a hair dryer to dry. No wipes at all. I had to use gauze for packing too. It's a long recovery. So much to sort out. How to sit, how much miralax, getting into a BM routine. It just takes time. My CRS told me 6-8 weeks for the initial recovery but 6-12 months to get as close to normal as I'm going to get. Because I had a double flap I have to dilate daily right now to keep the muscle stretching. I'm no doctor but I would imagine it would be a while before you could be intimate again with your partner. Give yourself time to fully heal. It's frustrating but in the end it will be worth it. My friend had the house advancement flap and she said it took her 5 months before she felt normal again. You sound like you're doing we'll so I hope you continue to heal. And god bless your partner, you are very lucky to have someone who care enough to be patient. All the best Suzy.
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Re: 6 Weeks Post-Advancement Flap-Tired of this Process

Postby pinpin » 18 Jun 2013, 00:02

Hi,
From my experience, if you have very narrow BM you are either in serious spasm or in stenosis.
Most likely first thing. As you had surgery down there and I believe pain for 6 weeks, muscle tends to shrink. But you will get it released since wounds will be healed.
I am not a doctor, so better to confirm this with him, but only my personal experience. The pain you still get most likely again is from unhealed places, like suture places.
Do you have post BM spasms/incing/burning?
07.02.2013 - got open hemorrhoidectomy, leaded to slow healing wound. Link to story
11.12.2013 - LIS surgery
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Re: 6 Weeks Post-Advancement Flap-Tired of this Process

Postby tiredjay » 20 Jun 2013, 15:46


Thanks everyone for the replies. Savaici: the link was definitely helpful. My initial search on advancement flaps before posting did not pull up all of the posts on this procedure like the link you provided did. Thank you.
 
Suzyljank: I have actually been following your story over the past several weeks and am glad to hear that you are recovering (albeit slowly). Your patience is certainly admirable.  Hearing that it took your friend 5 months to feel normal again makes me feel a bit better. My biggest concern is that one of the incision sites has not completely healed and still hurts when I go to the bathroom. I’m just worried that this will turn into a non-healing wound like my fissure was. As for being lucky for having an understanding partner, you are most certainly correct. He has been there through and through and has been incredibly patient as I complain about these issues to him. While I have been very appreciative of him your post reminded me that this is also something that is difficult for him in a way and that I should express my gratitude more often instead of focusing on how uncomfortable I am. I hope that you continue to recover and beat this thing!
 
Igrik1986: Thanks for your post. I think that you are right and that the pain may be in spasm from the incision site not being completely healed. I also think part of it has to do with my allergic reaction to the wipes, which apparently takes a couple of weeks to heal. To respond to your question, my burning/pain is not really associated with my BM. While I do have some sharp pain at the incision site while going to the bathroom, the burning pain starts within an hour of when I wake up and remains throughout the day (it doesn’t get worse or really die down after I go to the bathroom). So, I think you’re initial point of it being a muscle spasm due to the incision site may be correct. I have my post-surgical follow-up appointment with my CRS on Monday so hopefully I’ll have some answers to relieve my anxiety at that point. Thanks again!
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Re: 6 Weeks Post-Advancement Flap-Tired of this Process

Postby tiredjay » 24 Jun 2013, 13:35

Just wanted to update everyone:
Last night I was in quite a bit of pain and it felt like my muscles were tightening up and refusing to relax. I purchased a heating pad last week, which seems to help when I feel this way. Anyway, I had my appointment with my CRS today and told him of my concerns with a tearing/pulling feeling when I go to the bathroom along with the muscle tightness, skinny stools, and burning. Upon inspection he told me that all of the wounds were closed and there was no sign of a fissure (he inserted his finger to get a better view and there was no pain!). He said that the tearing/pulling feeling was most likely scar tissue and that the remainder of the symptoms were most likely due to all the trauma the area has gone through over the last year and a half. He prescribed my Anusol HC suppositories to help with the pruitis and the spasm and he said that his patients have had a lot of success with these (I'm supposed to use 1 in the morning and 1 at night for 7 days). Regarding the skinny stools: I told him that I had started Miralax right after surgery and that I did not have skinny stools prior to surgery. He said that it was most likely due to the Miralax, which could also be causing the burning. All in all, it was a good day. I'm still sore/spasming, but knowing that this is not abnormal is making me feel worlds better.
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