Hey all,

After 7 months of pure hell and agony, I finally decided to do it.
Quick summary of my journey: After an extremely stressful time in my life last year, I developed an AF in Sept 2015. Went through about 5 different gastros & CRS. Misdiagnosed as hemorrhoids at first, then finally treated with Nifedipine and Miralax, which helped but didn't cure fully bc the sharp, splitting, stinging pain came back. Suffered with it for another month before thinking enough is ENOUGH. I did a lot of research for a new CRS and found a reputable board certified chief of colorectal surgery. I made an appointment to see him on 3/29. He did a quick visual exam as I was in too much pain and could see the fissure right away. He said that I am so tight and he can see I'm in pain and he wouldn't have made me go through two treatments of Nifedipine bc it's clearly not working and would've opted for surgery as he could see I was clearly shaking and in agony. He asked when I would like to do the surgery. I said as soon as possible. He called his receptionist and asked her to fit me in as an emergency surgery for the next day. He said he doesn't do this often, but could see I'm in pain so he wanted to relieve it right away. Can't believe how fast it happened.

Surgery prep was just no eating or drinking after midnight the night before. No fleet enema. My surgery was two days ago on Wednesday 3/30. Arrived at the hospital at 7am to fill out registration forms, was gowned, and answered a bunch of pre-op questions with the nurse and anesthesiologist. By 9am, I was off to the operating room. I had the laryngeal mask anesthesia and once the IV was in, I don't remember a thing. I woke up in the recovery room. Was given a codeine pill, biscuits, crackers, juice and water. Was told that I could leave once I was able to urinate. Went and used the bathroom, and saw they put mesh underwear on me and a lot of gauze but no packing. There was blood, but nothing to worry about as this was soon after surgery. I was able to dress myself and walk to the parking lot with my husband afterwards with minor discomfort.

I was prescribed two painkillers - Ketorolac (generic for Toradol) and Hydrocodon-Acetaminophen (generic for vicodin). I was taking this at regular intervals even though my pain wasn't too intense bc I was scared that I would be in a lot of pain if I didn't take it. The first night, all this medication made me super nauseous. Every time I took it, I fell asleep. I ate some dinner, but ended puking it all up due the nausea. Took some miralax and drank tons of water to avoid constipation in fear of first BM.

Day two (3/31): Pain level is not too bad. Managed to go to target in the morning to pick up Colace, apple sauce, fruit cups, and some other things with my husband. He drove, of course and I managed to wobble slowly. Came home and ate some saltine crackers for breakfast. My stomach was still feeling a little off after the night before. Overall, my pain is still the same as the first day. Just some minor discomfort and awareness of the surgery spot but no extreme pain. It's hard to sit and I always have to be on my side. Seems to be easier when I'm standing up. Only really hurts when I sneeze. I stopped taking the hydrocodon and am only taking the Ketorolac 3x a day. Also taking a full dose of Miralax and 3 colace as to not get constipated. Worried all day about my first BM, but it never came. Just a bit gassy. Ate more than the first day.

Day three (today 4/1): Woke up this morning and finally had my first BM. Surprisingly, NO PAIN! I was thinking it might be very painful...bc it still feels somewhat tight down there. There wasn't much that came out, maybe because I haven't been eating much. It did require a little push, but was trying super hard not to strain....I had no stinging pain from the left side where I use to feel the fissure. Patted down with some Tucks pads and then cleaned off with the showerhead with warm water and then took a hot bath. Right now, I don't feel much pain, just some discomfort, and random stinging off and on from the left side where the fissure is, which does scare me a bit.

Currently off work for two weeks! Doctor said I should be able to go back to work on Monday. Um..not sure about that!

I do have a question though for those who have had skin tag removal with LIS. It seems that he cut off the skin tag but there is a huge lump/ball type thing that is bleeding where the skin tag used to be. Is this normal? I thought with the skin tag excision, it would be gone, but there is a swollen, bleeding ball/lump thing where it used to be. Does this mean it's not gone or will this go down in size over time?

It's still early on and I am hopeful but still a little scared. I know the road to recovery has a lot of ups and downs. I am willing to endure it all as long as it permanently fixes it. I really hope this worked bc I don't know what I'd do if it didn't. I just want some peace. This is such a horrible, crippling thing and I pray to God that everyone who suffers from this will be fully cured one day. It stopped my life and I just want it back more than anything. I will continue to update my progress in hopes that this can help people considering surgery. No one deserves this pain. Please feel free to ask me any questions. Praying for you all.

Also, I just want to say thank you to everyone on this forum, but in particular CanadaBum, who has been so kind and supportive. Whenever I am most down, I reread everyone's advices and kind words and it has helped me through this more than words can ever say! THANK YOU. <3

First of all - CONGRATS! It was very brave of you to go through with the surgery, even though you were suffering so much beforehand.

I had LIS about 14 months ago, and I was also surprised by what happened in the anal area after the surgery, but many, many people on this forum experienced the same thing. I had one tag before the surgery, and the doctor did not remove it. Afterwards though, I ended up with 3 or 4 more and in the days following surgery, they were VERY large. Over the next few weeks they diminished in size, but never went away completely. My doctor told me that they will be with me for life, but they don't cause me any pain, so I'm okay with that (it was more than a fair trade off, considering the agony I experienced with the fissure for years).

Did your doctor not instruct you to have several sitz baths a day for the first couple of weeks after surgery? Mine did, and it seems to be the norm for most forum posters here too. I opted for tub baths though, and soaked for 20 minutes, 3 times a day, plus a showerhead rinse and then a bath after each bowel movement.

Good luck with your healing, and I hope that it moves along very quickly.

SD-- wow...awesome news for you. I too wish you a fast and easy recovery with no whammies!!

I am so glad for you that you have been able to take this incredibly huge step towards a full recovery and healing -- the freakin' pain of an AF is enough to drive us all mad -- simply incredible that you found your solution.

I have not had the procedure but would imagine that it will take some time to feel 100%...so still make sure you take it a day at a time, keep it clean, keep yourself hydrated and healthy -- and please let us know how you are doing.

Your last note was very kind -- you too have been a great voice on these boards for people...as I have said, we are all here for each other.

Have a great wknd!!!.....and congrats!

Canadabum

(I will toast you with some prune juice tonight....lol)

Chachacha - Yes, like you, I have also opted for tub baths for 20 minutes a day, 3x a day with the showerhead rinse after a BM! Thank you so much for the well wishes!! Would you say that you are fully healed now 14 months later? I hope you are and things continue to go smoothly ;)

Canadabum - Toasting with prune juice!! Hahaha. Thank you thank you, CB! I know this isn't over yet, but I am hoping for a fast and easy recovery as well. I definitely think I have PTSD due to this whole AF ordeal. I still worry a lot about the healing process and whether or not I will heal fully. It scares me to see a lot of people on this forum still having problems after LIS. Or re-tearing shortly after LIS.... I guess it just boggles my mind a bit that LIS has such a high effective rate at curing fissures and yet a lot of people seem to still have issues with it afterwards. Gosh darn this crazy thing. Anywho, I hope you've been doing very well and pain free!! Are you still taking a tiny bit of miralax and metamucil as the magic combo to keep things at bay?

UPDATE

Day 4: BMs seem to be back on track now. Still had discomfort sitting down on my butt, so mostly spent the day on my side. Walked around the house a lot more. I stopped taking the hydrocodone (vicodin) and just taking Keterolac, Colace, and Miralax.

Day 5/6: Minimal discomfort but virtually no pain. I'd say about 1/10 on the pain scale. Still feel somewhat uncomfortable sitting for long periods of time. But otherwise, all good. Been taking 2-3 baths a day, and rinsing off with a showerhead after each BM. BMs have been painless and quick. I do still have some minor discomfort/somewhat of a tight feeling temporarily afterwards but this seems to go away quick. Took my last dose of Keterolac, my anti-inflammatory/painkillers. I was only given enough for five days. Now I'm just on Colace 2-3 a day and 3/4 dose of Miralax.

Day 7: OFFICIALLY ONE WEEK POST OP. I'm still off work for now. I can walk and sit for a lot longer now (although I really try not to sit for more than an hour straight). You see, I still have that lump. And today is the first day I'm starting to get worried about it. I had LIS and a skin tag removed. I don't know if the lump is just swelling from the LIS (which I hear is considered normal???) or from the skin tag site. I thought after the skin tag was removed, it would just be gone....so I don't know what this lump is. I've had it since the surgery. However, I am having some discharge today!!! It was bleeding a bit the first few days of surgery and it slowed down. But now, I have somewhat thick, white mucus-y (maybe yellowish) type of discharge coming from the lump. And I'm really scared that it's a sign of infection. It has and still is tender to the touch since surgery. Is this an abscess? I always thought abscesses looked more like pimples. This one looks kinda like a skin tag (a lump) but IDK. I called my doctor but he's in surgery and the nurse practitioner is supposed to call me back. When I talked to the post-op nurse the other day when she called to see how I was doing, she told me a lump was normal after surgery and that it should go away within a few weeks. However, now I have discharge and I don't know what the heck is happening. Of course, being the stupid worry wart that I am...I'm driving myself nuts over this.

Also, for those that have had LIS - could you see your surgical incision? I have no idea which side the LIS incision was made? Therefore, when I feel a slight pinch or discomfort from my left side (where my fissure is), I don't know if it's coming from the healing fissure or from the incision itself.

Just really, really praying every day for a full recovery. Pain is exhausting. But being scared and worried all the time is even more exhausting.

Thanks guys for reading and always keeping you guys in my prayers <3

I am completely and totally recovered now and so terribly glad to have bitten the bullet and had the surgery.

Some surgeons stretch your bum hole open and go in and do the surgery through the hole, and some (like mine) actually make a slice about a half inch to the side of the hole and go up through that new hole. The slice was so tiny though, that even just a few days later, my husband could barely see where it had been. So I had a cut on the outside and then the inner sphincter was cut too.

I think that you should get in touch with your surgeon again, so that he can tell you whether or not the discharge is a problem or not.

Keep us posted and good luck with the rest of your healing. It sounds like you're doing very well, other than the discharge.

I wish you a strong swift recovery. I really hope there is nothing to worry about with the lump. I hope you had an answer from your surgeon before the day was over. This has to be so stressful for you. I know what you mean about the PTSD from the fissure <3 It is hard for me to see food as quite the same anymore... It all looks like knives on a plate to me, heh...

You seem to be handling this like a champion! I can't even sit down in a car at the moment without excruciating spasming pain. I have to have the front passenger seat down, with my bum up, pillows stuffed under my stomach and chin, with pillows on the sides for my elbows.. I am most afraid of getting a ticket while on the way to a Dr's appointment. I've never been in trouble with the law. My case worker says that with the cops around here, they won't care if I am in excruciating pain and only leaving my house for Dr. appointments. That they would ticket me anyways >.>

What kind of questions did you ask your surgeon in order to determine that he was -the one you could trust-?
I'm about to start the hunt for a colorectal surgeon tomorrow and I don't know how to determine if he is qualified or how to go about asking. I've decided I am not going to move forward with a general surgeon like I was referred to.

Keep us posted about the lump and your recovery <3 I am wishing you the best <3

PC - I completely understand how you feel!! Before this, I was a fairly healthy eater in general but I really, really loved spaghetti and all things pasta, which is something that I haven't really had since this whole thing started. You look at food, and the first thing you think to yourself is...will I pay for this tomorrow? is it worth it? I really hope that notion goes away for us as we heal. As far as questions for the surgeon, ask him/her how many of these surgeries he has performed. If any of his patients have ever been found incontinent, and if so, was it only transient incontinence or permanent? Check for patient reviews on vitals.com and check to see how many years of experience they have as a colorectal surgeon. Make sure that he/she is board certified! I went through 2 gastros and 3 surgeons before choosing my final one. I chose the one that showed the most empathy and had the most experience. Thank you so much for your kind words and wishes. And I really hope you find a good colorectal surgeon soon so that you can start healing!

Update!
So I talked to my doctor on the phone and he said it's nothing worrisome for now since a little lump is pretty common after LIS and skin tag removal as it is just swelling from the surgery. When I asked about the discharge, he said that some drainage during this stage is normal because the wound is still healing. As long as I don't have a fever and the pain is not getting worse, I should be ok, but to call him if anything changes so I can come in. Otherwise, I'll see him in about a month for my first post-op visit. So for now, I'm keeping up with the cleanliness and baths, and keeping an eye on it!

Today is 9 days post op for me and I am doing pretty well. It scares me to say that!! It scares me to say I'm doing well in fear that I'll jinx myself and I'll have a retear. Idk why but this fear is extremely real. Darn, PTSD...I'm telling you. I am able to walk and go out and am still having pain-free BMs. However, I am still continuously taking 3/4 dose of miralax and 1 colace a day plus plenty of water. I also soak in a warm bath after a BM and am taking little mini baths 2-3x a day. I will probably continue to do so until I'm fully healed. I know I am not out of the woods yet!!!! I have to go back to work next Tuesday (which will be 13 days post op). I am a little nervous about that because sitting on a chair for 8 hours a day plus commute might be uncomfortable and I really don't want to put any strain on the healing process.

Something that I've been worrying about is my period this month. My surgery was right after my last cycle ended so I didn't have much to worry about for that, but it seems that I tend to get a bit tight/constipated around my cycle especially a few days after ovulation through my period. So although things feel pretty good right now, I guess the real challenge will be in about two weeks. I am really praying that everything will be okay and that healing will continue towards a full recovery with no hiccups. Once you've been through this, everything scares you. I wonder if I'll ever be able to live without fear of this. The mental part of this whole ordeal has been equally as challenging as the physical part of it...if not more. I wish I was stronger mentally!

But I'm hanging in there! Hope you all are as well. Have a lovely day, my friends <3

chachacha - so glad to hear you are completely recovered! you're so sweet, always helping people out on this forum especially after you've healed! People like you and Canadabum are kinda like superheroes :) Thank you guys for all you do.

When I spoke to my surgeon the other day I actually asked him which side the incision was made...he said it was on the left (I believe my fissure was on the left side). Not sure if it's normal for them to make an incision on the same side as the fissure? But that's what he said! I still don't see the actual incision but it might just be because the little lump is still there...I just gotta have faith that things will be okay.

Wew, glad to hear that what you are experiencing is normal.

When you soak in the bath, is your bum able to touch the bottom and do you experience any pain if you do? That has been my problem with the bathtub. We just got an inflatable cushion that I am going totry in the bath tub. I miss my baths lol! That PTSD is for real. Have you had any spasms since your surgery?

I'm taking 2 doses of Miralax a day in prune juice. I had to stop the grape juice with it because it started to make all my teeth sensitive Water and prune juice is all I'm drinking. I officially stopped drinking pop 2 months ago because of this pain in my bum :) A positive side effect. I think I am going to be on this Miralax for the rest of my life in fear of this ever occurring again. I wonder if the Miralax ever stops working? If I forget to take it for a day I retear. I even got a new fissure on the left last Friday One in the back and one on the left now. I tried to move something yesterday, then sat down and I felt a really deep tear occur on my left side in the new fissure. I shouted so loud the cat took off lol. I just laid completely still until I fell asleep after that... Everything seems to be fine... I'm sitting on my bed, the only place my butt will let me sit...but I am refraining from moving anything until I am completely healed now.

Oh my, that has to be frightening going back to work so soon... is there anyway your job can 'reasonably accommodate' you such as letting you stand every 15 minute intervals? Is there a 'light work' option? Can you bring a blow up mattress in with you with some pillows? Does your Dr have any advice for coping?

Yeah, I read hormones effect constipation. Maybe try sneaking in another Miralax dose on those days? Or adding foods that won't contribute to constipation? I hope you have smooth sailing <3 Have you found a max limit on your daily Miralax intake? I think mine is 5.... but I'm not sure if my vomiting was due to the barium swallow for that CT scan... gag!

Canadabum recommended this book to me: http://www.amazon.com/You-Are-Your-Pain ... ge_o05_s00 It also comes with a CD. I am going to start reading it this weekend. I've been in chronic pain for over 10 years and I still had not purchased a book like this. I have nosed through it and it looks very helpful. It talks about the 2nd part of the pain that we experience which is the mental and emotional pain, the PTSD from the pain. Also a good book on PTSD in general is Invisible Heroes Survivors of Trauma and How They Heal
from Belleruth Naparstek. She also has some wonderful guided meditations.

Living in fear of re injuring yourself is a real complication of chronic pain. Light cleaning has become terrifying for me now because gently moving around doing a few things caused a pop then a spasm inside my rectum which made me bed ridden for so long. My mind is afraid of doing so many things because the price to pay is so high Hopefully this mindfulness meditation helps me. Maybe it can help you too. Thanks again Canadabum!

You're so brave in such overwhelming circumstances, Severelydepressed! I am trying to work up the bravery just to call the colorectal surgeon XD I'm getting there though thanks to your answers and story! Talk to you soon! Take care <3

When my surgeon first described the procedure to me, he said that he would take a sliver of sphincter out "across from the fissure", so I was surprised that my external surgical site was on the left, like my fissure. I realized afterward though, that maybe he meant "top" and "bottom". If you picture the sphincter as a donut, my fissure may have been on the top part, where the icing is, and he cut directly below that on the bottom (and non-iced) part? Just a guess, but it kind of makes sense, because then the loosest part of the post-op sphincter would be near the fissure, allowing it to get more blood and heal.

And if he went up through your hole and did the surgery that way, you wouldn't see the incision at all.

I hope that you continue to heal well and quickly!