Hey guys,
Just wanted to tell that I will not be regular this much after the Easter , so if you have any questions for me - just "shoot" them now :D !!!!
Hope that by next March all of you will be healed and well

Ok not fissure related (not this particular question anyway :)) but where are you headed Fiss? Will you be gone until next March? If it's personal, then no worries, but just curious since you're so helpful around here. Hope things are okay.
I will try to think up some more questions to pester you with before you take your break :)

Aaaawe NP : ))) !!! Nope - LOL, I am "all dressed up, and nowhere to go" LOL Well, OK, I will probably travel July to see my Mom after almost 4 years : )), but the thing is - I am not very regular on this forum. I come sometimes , once in a blue moon, to see if I can give some quick advice , but I am not here often except March and April when I come to the forum every single day to help, as a little "thanksgiving" . Most major contributors are gone now for good since everybody healed and try to recover emotionally from all of this anguish and that is absolutely understandable !!!!!
Thanks for asking, though

What causes a fistula to form? Is it an already existing fissure???

Oh Cheryl, you are so cute ; ), I am not a big expert on all of the butt problems , but will try to answer your question.
Fistula is a small tract (tunnel, tube like) path which always starts from the point of infection - abscess. Bacteria starts to grow in a small space between butt muscles (internal and external sphincters) and than has no place to "drain". Body tries to get rid of the puss and tracts form :( . Little tunnel can have different size, length and direction of where it goes and where it drains. In women it can even drain into the vagina or bladder :( :( :( , and you can imagine extent of that surgery and possible complications .
Patients with Chron's disease very often can develop fistulas and they usually start deeper and further up the colon and than drain by the anus . Positioning and shape of the fistula can sometimes help the doctor to determine if there is a possibility of a Chron's being present.
So, basically, whenever there is an infection (abscess) trapped in the tissue it than forms a tract to the surface of the skin to drain.
Now - if the fissure is present for a long time, or it does not heal correctly (inside-out) - than it can heal on the surface but still have some "space" beneath the surface that did not close up.
When that happens, that "space" is the perfect place for bacteria to collect and start growing
forming the abscess. If it is not discovered on time and surgically drained , than body forms a tract (fistula) to drain it.
That said - fissure can cause abscess and later fistula to form , but infection in the rectum and fistulas can also be formed without fissure ever being present.
Hope I answered your question

Thanks for the explanation. I was always fearful of developing a fistula and honestly was thinking about Dazzy and the times he had to have the packing.

You are welcome Cheryl !!!
OK - time for me to gooo... : ))) !!!
Happy Easter everybody !!!!
Wishing you all the best of luck with healing

Hey Fiss, not sure if you're still around or not, but if you are, do you recall how many follow-up appointments you had after LIS? And what did they do at those appointments -- anuscopies, taking out stitches, or just general office visits?
I may (not 100% decided but leaning that way) get LIS from the same CRS you did and was just curious as to what to expect after the surgery itself. As you know it's a decent drive to get up there for me so I'm trying to anticipate what kind of logistics would be involved.
Hope you enjoy your "time off" and thanks again!

I had no stitching. I had none first time either. Many CRSs think that it is just additional trauma for a butt , so they keep it open. It also drains better open - blood and lymph - cleaning out the wound !!! So infection is less likely :roll: At least I was told that and it did work great. "Wound" is really 5 mm long LOL so bleeding is minimal , if any... I had almost
none blood from the second day on both times, but I was never a "bleeder" to begin with. My fissures bled only once or twice . Than I had some yellowish/pinkish discharge for couple of days that could be found on the cotton gaze or pad - absolutely in the minimal amount. I needed to "look for it" to see it ; )
I had, I think , 2 appointments . I had one after 2 weeks , I think and than one soon after since I had a question about my skin-tag wound - but that was because I wanted exam. Than I had one at 8 weeks and was supposed to have one at 4 months , but canceled the last one since I was feeling great LOL and did not need it :D .
All exams post-op with mine second surgeon were outside observation only - no inside scopes or "finger" or anything.
Just to put you at ease - after my first LIS (with another CRS) I developed skin-tag and wanted CRS to check it and he wanted to do internal exam which I refused on the spot !!! So - you always have a right to say :"no thank you, but NO" - but he was an idiot and exception and I do not think that the second CRS that I recommended would suggest something like that a week post op anyway. Also, after 4 weeks my skin-tag was still bothering me and I went to SF CRS . She did internal exam with a finger and it was NOT painful at all !!! So, once that crazy sphincter is relaxed and if there is no infection - there is very little discomfort during the exam even if one has not yet fully healed !
Now - regarding driving there - I would suggest that for the first post op you ask a friend or take a taxi or limo LOL. Even though I had 7 wounds - I had no trouble sitting , but I would have trouble concentrating on driving due to worry and such. You will basically need somebody giving you a ride to the surgery and than for the FIRST post-op and later it would be up to you - if you wanted a company or not
Best of luck NP with whatever you decide !!!!!
You will be OK - you will see
And.. I might "drop in" lol... you never know ; )

Excellent, thanks Fiss! That gives me a good idea of what to expect.
Thanks A BUNCH once again and hope to see ya around :)