Colorectal surgeons appointment tomorrow - concerned

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Colorectal surgeons appointment tomorrow - concerned

Postby over10yearsnow » 08 Jun 2016, 09:21

Hi everyone,

I have a hospital appointment tomorrow morning with the colorectal surgeons. Can anyone tell me what to expect?

i am concerned about them wanting (or needing) to take a look and opening things up.

I had a bad flare up in Feb (hence this referral) but since then having learnt that it's ok to take stool softeners long term I have managed quite well. I've only had one tiny little incident which cleared up within a few days. So have been pretty much pain and bleeding free since around March. I really don't want them starting it all off again, but understand that they can't help or treat unless they know what they are treating.

Any advice? Will they get funny with me if I refuse to let them look? Happy for them to look on the outside but you can't see where the problem is that way.

Thank you, worried!!!
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Re: Colorectal surgeons appointment tomorrow - concerned

Postby chachacha » 08 Jun 2016, 12:52

My guess is that it would really depend on the personality of the CRS. He/she may agree with you that it's not worth disturbing things, and that you should just come back again if things flare up, or he/she could want to take a look tomorrow so that you can both know what you're actually dealing with, even if it does cause some new damage that will need to heal afterward. Some fissures can be seen from the outside though (because that's where they're located), so that might be all that they need to see. Good luck!
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
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Re: Colorectal surgeons appointment tomorrow - concerned

Postby Healingthroughdiet » 08 Jun 2016, 14:49

Hi there tenyears, mine was extra gentle and told me at the first visit the surgeon would only do an inspection externally which was bearable. The actual internal exam happened during the procedure of Botox for which I was knocked out . I believe it revealed 2 fissures and I could have told them that without their exam. It does help them if you are specific in the location of the pain . Think of a round clock and where in the clock you experience the sharp pain, the other thing is to think of a tube and how high or low the pain is . This helps them localize I think. I even drew a small diagram explaining the sites of sharp pain because it was the same spots everyday for me or rather same vertical lines at certain o clock positions if I am making sense. Good luck and don't worry.
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Re: Colorectal surgeons appointment tomorrow - concerned

Postby over10yearsnow » 08 Jun 2016, 16:09

Thanks both of you. Hopefully it will be fine.

I'm currently happy managing things with stool softeners, but over the years my sphincter has become smaller and smaller where it's now impossible to pass a normal sized stool. I can only imagine this will get worse if I keep on the softeners. I was querying at the clinic I went to about self dilation, thinking this would be better and easier than things being forced open when I have a difficult BM, as I can do this slowly and gently over time and hopefully keep things functioning a little better. The clinic initially said they'd ask the advice of the CRS but then emailed to say they thought it better just to refer me direct.
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Re: Colorectal surgeons appointment tomorrow - concerned

Postby over10yearsnow » 13 Jun 2016, 06:29

Well, I'm pleased to report that my appointment went well. The Dr was very understanding and said he didn't want to risk opening anything up again so just had a look from the outside, but yes confirmed that other than a skin tag (which doesn't both me) he couldn't see anything.

He explained things really well, including incontinence due to surgery, as that was what has stopped me seeking help up until now. He said the risks were that up to 10% may find themselves incontinent to gas and only 1% to fecal matter and that what that means isn't that all of a sudden you need a poo and oops you've poo'd yourself but that it's the internal sphincter that is affected and this has a resting pressure that stops us soiling ourselves and farting, but that our external sphincter is unaffected, so if we need the loo we can still hold things just as effectively. But we may get some mild soiling, i.e. skid marks by the end of the day and that's it. Not that we'd have a massive accident. Not ideal, but yeah I see not as bad as I had feared.

Anyway, because I've been managing ok he wants me to go back in 3 months and if things are fine then he'll discharge me, or if not then they'll look at what to try next, probably botox. He was concerned more about the fact that I won't let things 'open up' to go to the loo and suspects my fear of trying this is more me just being nervous than a physical problem. I'm not so sure as I've spent around 12 years opening things up every weeks or so, so I know what I can poo without doing damage. He said that it's easier to correct the fissure than it is abnormal toilet habits (I can't remember what he called this, but it had a name. If anyone knows that would be good???).

In fact just remembered he did say if there were more problems when I go back that the next thing would be an examination under anesthetic. If anyone could share their experiences with this I'd be very grateful. I think yeah great I'm under for it so it won't hurt at the time, but aren't they still likely to damage things and open things up again? I just know how difficult it is to break the vicious circle of pain, spasm and continually needing to poo making this all worse!! :(

The guy was very pleasant and reassuring though and knew his stuff. :)
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