I have an op date...

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I have an op date...

Postby Fissurefrustration » 31 Mar 2015, 12:57

Well, I have an op date for the 17th of April for my EUA +/- fissurectomy/Botox/hemorrhoid removal

I'm actually bricking myself - I'm so scared.

What do I ask him to do? its basically an EUA to start and then he will decide what to do from there on in. Shall I ask him not to do LIS and just deal with my hemorrhoids and fissure? I have a feeling that I have to be very specific with what I want otherwise he will just have a field day.

I also have a nasty skin tag that's always a problem - should I get that removed?

I'm shaking with nerves now - I know I need something done as it's been over 2 years now and I'm so fed up of being in pain every single day. it's not a type of pain that stops me from working or living however it's always there.

J x
Suffering since June 2013 :(

Methods tried:
Sitz Baths
GTN cream - awful migraines!
Manuka Honey / Coconut oil / Aloe
Vitamin E suppositories
Tablets (Fiber, Cod liver oil with vit A+D, Multi vits)my + tag excision X 2
Dilatiazem - so far so good.
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Re: I have an op date...

Postby msimon » 31 Mar 2015, 16:10

This is great news FF! Finally you can work on a resolution to your problems. If you want my opinion, I would go with the least work necessary. As you probably know, many on here have not had success with botox long-term so I would think that given all the success stories, LIS would be the best choice for a chronic fissure. This is hard for me to recommend given my experience but I can't use myself as an example as I have complex issues down there.

Do you feel that you have spasms? Has your Doctor ever evaluated your tone down there? How much do you trust this Doctor? Are they a CRS? Can you take the time off to recover from surgery? Has this Doctor done many LIS surgeries?

As for the skin tag and hemmies, the more you remove, the more risk of complications such as infection, stenosis and longer recovery time. The hemmies may well calm down after LIS as the spasm will no longer prevent them from healing. I had my sentinel tag removed and that is the standard protocol of surgeons here as they consider them scar tissue and will impair healing of the fissure. I did not have anything done to my fissure (it did not have scar tissue). I would be reluctant to recommend having just a fissurectomy or hemmie work done without something that will ameliorate the sphincter spasms that will follow, such as LIS or botox. LIS gives immediate results, whereas botox will take 2-4 weeks for relief that may or may not come. Botox is less invasive, temporary and has a shorted recovery time.

It's a lot to think about. There is a lot of information on here as I am sure you know. It was a very difficult decision for me to make too and I tried the botox first. I actually think the results from that were better for me as I think it spread to my spastic external sphincter too.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: I have an op date...

Postby Fissurefrustration » 31 Mar 2015, 16:25

Thanks for the input Msimon :) yeah it's petrifying. Well my CRS I wanted couldn't see me until june but I don't think I can wait that long so they have re-booked me to see a general surgeon with an interest in colorectal surgery: http://www.circlehealth.co.uk/consultants/paul-durdey

I havn't bled in so long so don't think its my fissure causing the problems anymore - I think it's either the scar tissue, hemmis, or the tag? I get some spasms after a BM however not as bad as they used to be. I feel like I'm so close to healing but I just can't get there so need someone to have a look, and just do what they need to?

*sigh* I'm just so nervous! I could live with this but it's just stopping me from enjoying my life!
Suffering since June 2013 :(

Methods tried:
Sitz Baths
GTN cream - awful migraines!
Manuka Honey / Coconut oil / Aloe
Vitamin E suppositories
Tablets (Fiber, Cod liver oil with vit A+D, Multi vits)my + tag excision X 2
Dilatiazem - so far so good.
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Fissurefrustration
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Re: I have an op date...

Postby msimon » 31 Mar 2015, 17:10

I know what you mean about the nerves. I cried all the way to the OR and thought right up until they put the mask on my face to put me out that I was going to change my mind. I had even cancelled my surgery date twice before. These 'elective' surgeries can be very difficult to decide on.

Just to let you know, not bleeding does not mean your fissure is healed and also does not mean that it is not causing you pain. My fissure rarely bled. I have heard that they often don't bleed and this is actually an indication of chronicity. It can indicate poor blood flow, likely from scar tissue that results from the repeated tearing and healing. Even if your pain does not seem to come from the fissure it could be referred pain that you feel somewhere else, but nearby, such as a skin tag. I often thought that my sentinel tag was the real problem but later realized it was when the fissure acted up that it would hurt.

Have you met this Doctor? People on here are very cautious about only getting a very experienced CRS to do LIS. I wouldn't be so concerned with botox, or just an EUA.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
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Re: I have an op date...

Postby Fissurefrustration » 31 Mar 2015, 17:13

Never met this surgeon so no idea what he's like. He shares the same medical secretary as my first consultant I saw and she said he was lovely. I think in the first instance I should ask him just for an eua and to band any hemmis that look bad maybe trial Botox but if I need LIS I will be seen by a crs at another date - does that sound logical?
Suffering since June 2013 :(

Methods tried:
Sitz Baths
GTN cream - awful migraines!
Manuka Honey / Coconut oil / Aloe
Vitamin E suppositories
Tablets (Fiber, Cod liver oil with vit A+D, Multi vits)my + tag excision X 2
Dilatiazem - so far so good.
User avatar
Fissurefrustration
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Re: I have an op date...

Postby msimon » 31 Mar 2015, 17:22

Sounds logical to me. Especially if you think you are healing and maybe just need one last push in that direction. There is definitely nothing wrong with being more conservative first.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
Moderator
 
Posts: 1343
Topics: 64
Joined: 08 Aug 2014, 19:38
Has thanked: 76 times
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Gender: Female


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