First visit with CRS today, and wanted to do surgery Friday?

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First visit with CRS today, and wanted to do surgery Friday?

Postby Juls814 » 27 Mar 2013, 14:12

Hello everyone,
I'm very new to this forum as a member, and I have some questions about the LIS procedure.
I have had an anal fissure with terrible spasms for about two months- the spasms only more recently within the month. After my GI diagnosed the fissure and prescribed nifedipine, I started to feel somewhat better, but then had so much trouble passing stool and could never get it soft enough. Im sure as you all know how painful that is..anyway, the past few days have been even worse- even with three Ducolax a day I cant seem to get it out?? I really thought that maybe overuse of Advil contributed, so the past two days I have been trying to live without it.
Today I was in my " spasmodic" sate when I had my appt, and was kind of shocked that the Dr said surgery- " we can get you in Friday".. he was very honest, told me the risks and said it was up to me but he could see the pain that I was having. When I asked about conservative measures, they said to try adding metamucil, use Colace 3X a day and sitz baths with Epsom Salts ( The GI told discouraged those saying I am a woman and risk of UTI) I did them anyway- I needed relief.
I would like opinion (s) on the Dr suggesting the surgery so quickly- he said that he doesn't normally do that but judging from the fact that I have had this two months, been unable to work, it was a thought. He is the Director of Colo-Rectal Surgery at the hospital near my house here in NY, and I don't know him, but haven't heard anything bad about him either..I'm very confused. Would love your opinions please.
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Re: First visit with CRS today, and wanted to do surgery Friday?

Postby marg6043 » 27 Mar 2013, 18:12

Juls814 hi there, you know is all up to you and how you feel, if you think that you can not cope with the pain and suffering of the fissure, spams and think that is taking away from your quality of life, then surgery is for you.
But if you have the time to see if the fissure heals on its own then you still have that option.
Surgery should always be the last thing to try because is none reversible.
Is many good success stories from surgery here in this site, but also is stories in which people didn't get what they were expecting.
I hope you make your own decision and it be what you want and nobody else.
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Re: First visit with CRS today, and wanted to do surgery Friday?

Postby Jessjess » 27 Mar 2013, 21:05

Hi Juls,
If it is a chronic re-occuring fissure, it will most likely not heal on it's own. That is probably why he suggested surgery. If it is chronic, then the internal muscle spasms and your body can not heal the tear. My doctor said that surgery was my only option.
If you are more comfortable trying the conservative measures, then that is what is best for you. Just understand that the pain only gets worse over time. If you have been out of work for a while for this pain, then I would suggest the surgery as your best option for pain relief and healing and no more fissures.
Best of luck to you! BTW, prunes are the best source of stool softener that you can get. Eat about 5 of them and drink lots of water and your digestive system will do it's thing! :D I was actually taking Percoset/Motrin, stool softeners, Mirilax, prunes, water, apples, lettuce, etc with healthy BM after coffee every morning.
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Re: First visit with CRS today, and wanted to do surgery Friday?

Postby Juls814 » 28 Mar 2013, 04:20

Thank you both for your advice. The thing is, this is the first fissure I have had- I never had this before, or at least can't remember it, and judging from this experience and pain, I think I would have known. I do always have constipation, even know with stool softeners it seems like I just cant go in one sitting and it is still so hard to pass. I just started taking Metamucil yesterday. The other thing that frightens me is that I haven't been able to produce soft stools and if I go in for surgery, how will I be able to after that? The constipation is what started this all..this is so depressing. I am thankful to have found this site, I felt very alone :(
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Re: First visit with CRS today, and wanted to do surgery Friday?

Postby suzyljank » 28 Mar 2013, 06:00

Hi, so sorry you're having such a hard time. Are your stools very thin? If you're spasming they tend to be thin and difficult to pass. You said you tend to be constipated all the time, have you ever been checked for pelvic floor issues? They can cause spasming also. I use miralax to keep things soft and I like that you can adjust the dosage up or down to your needs. As far as surgery goes LIS I a relatively simple procedure. It works great for most people. It might not be a bad idea to get another opinion and then make up your mind though. All the best Suzy.
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Re: First visit with CRS today, and wanted to do surgery Friday?

Postby Juls814 » 28 Mar 2013, 09:05

Hi Suzy, thank you. On the contrary, my stools are extremely hard and bulky and have always been hard to pass. I used to joke that it was like having a baby through my rectum. Not so funny anymore :(. And for a while the stool softeners made a difference and now its similar, except I cannot evacuate all at once for fear of straining, so it's like many trips to the bathroom throughout the day, a sudden urge and then a tiny ball, which feels like the size of a tennis ball. I'm so frustrated. I asked both Drs if Advil could constipate and they said no. Yet everything I look up says that could be a side effect. I have been taking them daily for two months and just stopped about two or three days ago- I am hoping to see a difference. In the meanwhile, I took off from work ( dont care if I get fired at this point) just so I could be home and use other means for pain like ice packs, sitz baths and heating pads. How could a Dr want to perform surgery without even knowing my history? I don't get it..
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Re: First visit with CRS today, and wanted to do surgery Friday?

Postby Rachael 1984 » 28 Mar 2013, 09:52

Juls814, could you get a second opinion? Different CRS have different views and ideas. Maybe if you don't want surgery now you could go for another option?
Are you in US? They do seem to go straight in there, which sometimes is a good thing if you are in so much pain day in day out...like in my case, but my CRS is doing Botox first, I am in the UK, so they are a little more conservative.
You need to do what is best for you. Maybe find out some past info on this CRS, how many times he does LIS, success rates etc... ? Just an idea xx
Hem Banding sept 2012
2Fissures
Nitro- Effective short term
April 2013-Botox-Effective short term
Diltazem-No effect, developed Rash
July 2014-Diagnosed High Resting Pressure
LIS performed on 17.9.14
Ongoing pain/re-tears. Awaiting pressure test results.
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Re: First visit with CRS today, and wanted to do surgery Friday?

Postby Juls814 » 28 Mar 2013, 10:00

Thank you Rachael- I agree. Although I really am suffering, its bearable, more so being home, it was very hard getting to work. The thing is this is the first time I experienced this, so shouldn't I try other stuff first? If I could just soften my stools, I am hoping the metamucil makes a difference. I am not completely opposed to surgery, just wondering why he would just take a quick look and not ask too much about any history. I know my GI doc said that he wouldn't want me to have surgery without a colonoscopy first, to make sure everything else is ok. And stopping the spasms with surgery wont stop my constipation, I am so confused.
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Re: First visit with CRS today, and wanted to do surgery Friday?

Postby Savaici » 28 Mar 2013, 12:20

Hi Juls,
I would not worry about the Sitz bath causing a UTI. I use one and could not survive without it. It could happen, but I have heard nobody on here say they got one. You just have to be careful that it is your rear in the water and not the female parts of you.
I use the Metamucil biscuits - cinnamon flavour - and they are easy to eat. As I don't have a big appetite, I only take one and a half of them, and drink an 8oz glass of warm water with this. I even dampen the biscuits.
My diet is very basic, and it does not change much from day to day. It is what makes me life easier, so I do not change it. Would be interesting to hear what you eat to get an idea if anything might be causing the constipation??
I also do dilation - plenty on here about that on a few posts. It has helped me a lot.
I can't advise on the surgery. You fissure is barely chronic, and might just heal with GTN. Suggest this to the surgeon.
All the best to you.
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Re: First visit with CRS today, and wanted to do surgery Friday?

Postby Juls814 » 28 Mar 2013, 15:18

Hi Savaici, thank you, it is so reassuring to hear from people with actual experience and who can give me some insight and real advice.
As far as my diet, lately it has been very simple and small ( I have lost about 10 pounds in the past 2 1/2 weeks). I have a piece of toast with some peanut or cashew butter on 12 grain bread, a piece of fruit, either an apple or over ripe banana. I may have a half a sandwich ( tuna) for lunch, or small salad- past few days I have been having a baked yam. Another piece of fruit after that. For dinner usually salad, maybe a small piece of chicken and a baked potato. I tend to snack on pecans or baked sweet potato chips, but not much at all. I have about two-three cups of decaf coffee a day, I alternate between coconut milk in it or actual light cream. A few years ago I went to a nutritionist- I have always had stomach issues, and she suggested I go gluten/dairy free. I will admit that I felt very good, but eventually I went back to eating breads, not really dairy, other than cream in coffee. Rarely ate cheese, unless we were having pizza (hard not to, I'm in New York). During this episode, I cut out the bread for a few days, but it is my most fiber at one sitting since I have really lost my appetite. I'm praying that the Metamucil softens me up. Anything I eat I am measuring fiber, and wont eat it if it doesnt have any. It was pretty hard making chicken cutlet parmigiana for my family yesterday- I have even gone so far as chewing some foods and spitting them out, cause I miss the taste so much. What exactly is GTN? I am reading about the dilation, and would like to try that after this soreness heals up. The CRS said that none of the creams ( nitro, nifedipine) work. But then again, the insurance company would pay him about $ 8000 for a ten minute job.
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