Considering LIS

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Considering LIS

Postby SteveR » 08 Dec 2012, 04:04

So - saw the consultant a few weeks ago and whilst I wasn't totally healed was still optimistic but after conversation he suggested that I should have another Botox session under general anesthetic. However after that appointment a few days later for reasons I just can't work out, I suddenly had an opening of my fissure and then spent a week of bleeding pain and cramping. A week on my bleeding has stopped but I still get irritating pain and cramping on a regular basis.
So I wrote to my consultant and said I wanted to be considered for LIS particularly if wheс I have the op it is clear the fissure is not healing. I have had this fissure now for 8 months now, and quite frankly it does affect every part of your life. I really really just need to move on.
Do you think it is right to push for LIS?
I have read that in some cases people wait for a year and a half before they are advised down this route?
Is it too soon?
I am really worried about incontinence - how bad is it?
Do you think now I have told my consultant what I want he would be able to switch from Botox to LIS?
My operation is on 13th December - next week
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Re: Considering LIS

Postby owmybum » 08 Dec 2012, 04:27

Here in the uk the crs's don't seem keen on lis. I have been suffering for nearly 2 years, but still I have to have more tests before they will. Even consider what is the way forward for me. After the test I had yesterday (see post about proctogram) the doc said I was very tight down there but still dismissed lis and said they would prob go down the Botox route.
I am not sure about the risk of incontinence after lis... I have heard a lot of varying statistics on this one... But there is a risk, and everybody is different, so I think you need to get some good advice before you take that step.
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Re: Considering LIS

Postby cherylk » 08 Dec 2012, 06:51

Steve,
I personally would exhaust the Botox route b/4 having LIS. Most people here who had it have been pleased that they took the plunge and did it, however. I think everyone is very different, and each one's outcome is not the same. My Mayo GI doc advised me to not get LIS. I think he knows that I would have a very hard time dealing with incontinence although I really don't know how common that is as a result of LIS. Good luck!!
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Re: Considering LIS

Postby Lauren12 » 08 Dec 2012, 16:59

Hi there
As someone who had the LIS after two years of suffering, I wish I'd had it sooner! First however, surgeons directed me down the route of Diltiazem cream and then two applications of botox, at six monthly intervals. As owmybum says above, many surgeons in the UK seem to want to exhaust conservative methods first.
Your request seems very reasonable to me based on my history! However we're all different, and I'd see what your CRS recommends, based on how you responded to Botox. He may agree with you!
As your procedure is so close, why not find out the contact number for your surgeon or his secretary and ring and leave a message about it, asking for a call back? If you Google his name, there appear to be several websites where surgeons are registered which give telephone contact numbers - unless the hospital provided you with contact details after the botox procedure?
As for incontinence, I think the incidences of this are small and doesn't it refer to gas incontinence, rather than faeces? I haven't suffered incontinence - I can hold things if necessary for ages if I'm not near a toilet, although I'm not comfortable doing so. My husband does wonder how I'd fare if I went to, say, India and suffered something like Delhi belly, but so far, thankfully, such an occurrence hasn't arisen! In all normal circumstances, including diarrhoea in this country (the UK) I haven't had any trouble. I do get, shall we say, 'skid marks' on underwear that I didn't before the op, which seems to occur with wind, but really very modest and only sometimes. Sorry if this is too much information. I'm trying to be reassuring!
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Re: Considering LIS

Postby marg6043 » 08 Dec 2012, 20:26

I am also considering the surgery and have given myself until my next appt, in Feb to see how things go, Like many here have said surgery is not an easy thing to consider, while is wonderful stories about how it have helped many people, and they never regreat it, is also those that their road to recovery has been shaky, we are all so unique.
I have been having this problem "full blown" since August but I have the feeling that is been longer than that, I always blaming the pain on hemorroids.
For the first time after my last flare up two weeks ago, I got the feeling that I can tackle this fissure, perhaps no with a complete cure but learn enough to cope with it. I hope is not wishful thinking.
You are the only person that can make that choice, we only can offer opinios.
Good luck with the decision you take on your problem and know that we are here to be with you regardless of the choice you make.
Just remember even with surgery life is never the same again, you always will have to make sure that you take all the step to keep yourself fissure free.
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Re: Considering LIS

Postby ryrylou » 08 Dec 2012, 23:08

I had my LIS 2 days ago and am doing well. I haven't had any incontinence so far, and the doc told me I would most likely have some gas incontinence the first 2 weeks, but that hasn't even been a problem.
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Re: Considering LIS

Postby SteveR » 10 Dec 2012, 00:01

Thank you guys. I have contacted the consultant about this and he has said he would discuss it with me at the consultation before he op. this doesn't mean he will do it, just that this is when he will answer me. I just want this to be over. 8 months of living with it is enough
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Re: Considering LIS

Postby cherylk » 10 Dec 2012, 01:17

Steve,
Do you guys have pretty good doctors through your NHS?? Good luck with your op!!
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Second opinion?

Postby Sorew5 » 10 Dec 2012, 02:19

Im from the uk but living in australia. My surgeon here let me choose between botox and lis. If you aren't comfortae getting another round of botox maybe just speak to him but don't get it done. You could ask for a second opinion as he may just prefer botox. I had LIS in mid nov and havent had any incontinence issues whatsoever. I suffered my fissure for about three yrs (would have been in uk when i got it but never went to dr til this yr!).
It is completely your decision. Not ours and not your surgeons. Do alot of research and reading and decide on what makes you feel happy. Thats what i did. I skipped botox when i read the success rate was low whilst LIS was 95%.. But that doesn't mean botox doesn't work!! They wouldn't use it if it didnt and its probably a lot less trauma to your bottom Image my bum hates me right now after LIS!!!
Otherwise just give it one more try and see what happens. Seems annoying to have to go through a general for botox though. Do they not do it by local? I know its in your bottom but the general made me feel rubbish for days and that and the painkillers caused constipation big time.
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Re: Considering LIS

Postby Lauren12 » 10 Dec 2012, 08:43

Hi again
I don't think I'd have botox under local Sorew :) I was glad I had it done under general! As for the painkillers, as botox on its own is a relatively minor procedure, I asked not to have painkillers containing opiates because I didn't want to get constipated. I think the second time I had Botox, the only pain relief I had in the hospital afterwards was intravenous paracetemol (it's more powerful given that way I think). I did take painkillers at home afterwards - prescription NSAID's and over the counter paracetemol, but again, was careful to avoid painkillers which were constipating. The GA itself can contribute to constipation of course, because I think your digestive tract comes to a standstill whilst you're unconscious. But I wouldn't be surprised if a local anaesthetic wouldn't be constipating either (although I'd have to check that out). The GA didn't have the effect on me it had on you - I felt out of sorts for the rest of the day, but OK the following day.
Even when I had the LIS, I asked the anaesthetist not to prescribe constipating painkillers to send me home with!
@ Steve R - I had the LIS op only 3 months after my second botox procedure. I'd gone to a different Consultant (my third) and he said it was clear that Botox wasn't working for me, having already had two applications and still being in pain, so we went for the LIS. I thought the Botox took four or so months to wear off, and thought we'd have to wait until it had worn off before doing the LIS - but he said no, and was able to do the LIS at the earliest opportunity after my consultation with him.
As Sorew5 says, do your research - and only you can decide in consultation with your surgeon which is the best route. It sounds as though you've redamaged again after your last lot of Botox, although only the surgeon can confirm what your actual condition is on examination. As you're seeing him immediately before your procedure, it sounds as if he won't be taking a look until you're actually under anaesthetic. I suppose you want to know, therefore, whether LIS is going to be a more effective route for you to prevent and eliminate these kinds of setbacks. When I had the LIS, I formed minor fissures for a while afterwards - the tissue in the anus was swollen after the op, making the anus tighter, making it more likely to damage with bowel movements. However the surgeon I saw said that I wouldn't get another major fissure and eventually, I wouldn't get these minor fissures either - which has proven to be the case. I'm 20 months post LIS now and back to normal.
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