Had LIS, minor proctoplasty+skin tag removal May 4, 2012

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Had LIS, minor proctoplasty+skin tag removal May 4, 2012

Postby TryingToLoveMyRearEnd » 19 Jun 2012, 09:35

I have been meaning to post my experience from my surgery but I needed to sit at my computer instead of on my iPad because I can type much more quickly. Reading Pookdodger's story about excessive scarring compelled me to reply post to his/her post. I am reposting some of my post under my own topic. I don't fall into the 95 or so percent of the people who do well after surgery so please if you read this and you are considering surgery just know that my case is definitely in the minority. Most people do so well after surgery that they wonder why they waited so long to have the surgery. So without further ado....here's my experience so far and some information that many of you may never have heard about before:
On May 4, 2012 I had a Lateral Internal Sphincterotomy, skin tag removal and a bit of proctoplasty (surgeon cut an X at the anal opening to give the tissue more elasticity that I had lost due to anal stenosis. A stenosis means a narrowing of a canal.) I had three fissures, one at 12, one at 4 and one at 7 position.
I did well....at first. Of course I had alot of surgical pain but that was to be expected. For a couple of weeks I had no fissure pain which was amazing after having had 7 or 8 years of reoccurring fissure pain, a re-tear in Jan 2012 which resulted in more pain than I had ever had before.
Two weeks after surgery, on May 18, I had a hard BM and I believe I tore the fissure. My surgeon wanted me not to use stool softeners because he wanted the opening to get used to accommodating larger BMs to keep the canal from stenosing down again. The next day was my birthday and I was in so much pain that I just laid on the couch and didn't even want to celebrate my birthday at all. Having fissure pain once again scared and depressed me.
I went back to the surgeon on May 25th and when he examined me it was quite painful and I told him so. He was surprised that it was painful because the first follow up visit I didn't have as much pain. He said everything looked good, that there was no infection and to come back in two weeks. He said "I bet by then you will be feeling much better and having no pain."
I suffered through Memorial Day weekend laying around on the couch and in the bed because I was in so much pain. I was becoming distraught from the severity of the pain. I called my surgeon's office on Tuesday morning and talked to the nurse and she said she would have him call me. I didn't hear from him that day so I called the next day and told the nurse I really needed to speak to the doctor. I finally talked to him that night when I had him paged because he was the doctor on call. He told me that I should be feeling better than I was feeling on Friday but I told him I was in alot of pain. He said that something was wrong for me to be in that much pain and to come see him on Friday morning.
When I saw him on Friday June 1st. I asked him if he would be gentle because I was hurting so bad. I am amazed at how I have to ask for him to be gentle with the exam....they really have no clue how bad an pain can be! He said that I had an infected stitch and that was causing inflammation and pain. He said that my body was taking care of the infection and that I didn't need antibiotics. Just needed to go back soaking in the tub if I had stopped and to start putting Neosporin cream on my incision again. I truly wanted to believe that that was the problem and that when the infection cleared up that I would feel much better but that didn't happen.
I had another follow up visit on June 12th. I forgot to tell my surgeon to be gentle and boy he wrenched my ass open and was pulling and prodding and I was saying "ouch that hurts" but it was like he didn't even hear me. My surgeon told me that the fissure at 4:00 position was not healed yet and that my tissue was very inflamed and irritated. He said that he wanted me to come back in 3 weeks and if I hadn't healed by that point that he would need to do some testing to find out what was going on. Of course he mentioned Crohn's disease and I said I really didn't think I had it because I had no other symptoms. I told him that I had a colonoscopy two years ago and everything was fine. He said that I could be having onset which was presenting peri-anally. He prescribed Flagyl ointment which is what is used for fissures with someone with Crohn's. I guess he wanted to see if that would help the inflammation and would help him make a diagnosis later if need be.
I was in so much pain later that day that at one point I had to urinate and I was sitting in a chair and had such a spasm in my bladder and urethra that for a couple of minutes I couldn't get out of the chair. A couple of days later I discovered the beginnings of skin tags at 12 and 4 position. I called the surgeon's office and spoke with the nurse and she said she would have him call me on Friday but he never called. I have been in tremendous pain since my last exam. I called and spoke to the doctor on call on Saturday night and he told me to take 800 mg of ibuprofen and take as hot a bath as I could stand and to get off my feet. Also to use nefidipine if I had it. Said sometimes people need to have a second surgery. Pretty typical answer from a CRS.
I am a licensed massage therapist specializing in John Barnes Myofascial Release. Knowing what I know about connective tissue which is called fascia I started to think about the fact that my fascia was so restricted and that I had so much scar tissue from previous fissure healings in that past that is what must be causing so much pain.
I called a Physical Therapist friend of mine who also specializes in John Barnes Myofascial Release and in pelvic floor issues. We had a long talk about the fascia and how restrictions can cause the tissue to be so tight that it keeps tearing.
Fascia is the ground substance we live in. We are a three dimensional connected web from the top of our heads to the bottom of our feet. Fascia should be gelatinous (think jello) and move well but when we have stress, trauma, inflammatory processes, postural habits, occupational habit, play habits that ground substance begins to solidify. When this happens the tissue becomes dehydrated and things don't move well. Fascia surrounds and protects everything in the body....bones, muscles, blood vessels, organs, nerves...there is nothing in the body that is not affected by the fascial system. And it's a system that is virtually ignored by traditional western medicine. Most doctors have no awareness because they have not been taught how the fascial system works. Therefore they have no idea how much getting treated by a therapist trained in myofascial release can help a patient make huge changes (sometimes life changing) in the fascia. Fascia has two main components: elastin which gives fascia its elasticity and collagen which gives fascia its strength. Fascia has the tensile strength of upwards of 2000 lbs of pressure per square inch. Which means if you have a fascia restriction it can put that much pressure on sensitive structures causing pain and dysfunction. 2000 lbs is a baby elephant or two full grown horses. You bet that kind of pressure will cause pain and dysfunction. It is so strong it can pull bones out of place. We like to say bones are stupid....they go where the fascia tells them to.
The reason I am writing all of this is to educate you about fascia so that you have an understanding of what is going on with your scar tissue. Scar tissue is fascial tissue. Scarred fascia has the strength but does not have enough elasticity. Too much strength without the elasticity is what makes scar tissue such a problem. With myofasical release we hold the tissue long enough (it takes 3 to 5 mintues) to make a change in the collegen so that that the fascia releases and pain can subside and the tissue becomes more functional.
Fascial tissue is everywhere....yes...including the rectal/anal region as well as the genitals. Scarred tissue in these areas can benefit greatly from myofascial release.
I don't have any kind of agenda to sell anyone on this. I am just trying to educate. I am going to visit my friend and get some much needed internal work because I know that I have major fascial restrictions in my rectal/anal and vaginal tissue. I fly out on Wed June 20th and will be getting intensive myofascial release for several days. I am going to try and update as I go through the process but I may not be until I have returned home. I find typing on my iPad to be time consuming and frustrating and not near as easy as typing on a keyboard. Perhaps I should get a portable keyboard for my iPad!
I am so sorry that some of you are in so much pain. I feel your pain because I am there with you. I feel like my surgeon has the compassion of a brick Image He has no idea what the pain is like, the intensity, the duration....how debilitating and life disrupting fissure/anal issues/pain are or can be. From what I have read on this forum it seems like there are many CRS that don't understand fully how we feel. It saddens me that so many people are suffering and the surgeons don't "get" it. Image
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Re: Had LIS, minor proctoplasty+skin tag removal May 4, 2012

Postby lilbopper88 » 21 Jan 2014, 17:25

Hello Tryingtolove,

I am suffering with 3 anal fissures and facing a LIS. I have had these fissures for many, many years, but in the past couple of months have gotten so bad that I am on my knees in tears after BMs. I have fibromyalgia and am familiar with Myofascial and John Barnes. I was wondering how it went for you? Were you able to get relief? I have had external work done but no internal work. Please let me know how you are doing. I hope this finds you healed and living life again. :)
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Re: Had LIS, minor proctoplasty+skin tag removal May 4, 2012

Postby Scientist2516 » 21 Jan 2014, 18:01

Hi Tryingto Love,
I'm curious about myofascial release. I had never heard of it, so I looked on Wikipedia. It sounds a bit like massage and stretching. How do you apply it to the anal area? (My anus is cringing as I write!). A few people here have tried anal dilitation. Is that a form of myofascial release?
If you had it done, has it helped? Was it very painful while you had it done? Do the results generally last for ever, or does it need to be re-done as tension builds up again in the area?

I just looked at the date of your post, and see it was a long time ago. So maybe you aren't here any more. If you are, or if anyone else here knows about this, I'd love to hear about it. Thanks!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: Had LIS, minor proctoplasty+skin tag removal May 4, 2012

Postby owmybum » 22 Jan 2014, 13:37

Me too!
I was wondering if it would be a lot like anal dilation. That stretches the skin out.

Hope someone knows!
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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