2x botox, 2x LIS and Fistulotomy Diary

Was:Interesting comment from the treating surgeon

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2x botox, 2x LIS and Fistulotomy Diary

Postby AnalFizz » 01 Sep 2017, 12:10

Some Background: My fight with the fissure started Christmas 2016 with urgent pain after BM. I had some precursors before that like blood in toilet paper and tight Sphincter. First I got the usual Hemorrhoid diagnose from work generalist doctor. Then after symptoms got worse (probably due to all the cortisone) was referred to a Specialist CRS who identified the AF. this was followed by 6 months of Diltiazem treatments and two botox shots. These treatments calmed the pain to almost zero and left only the discomfort and the actual fissure. Next step was LIS but for that I had to go the public route, meaning up to a 6 months waiting line (maximum by law in Finland). They managed to close my referral by accident which postponed the op even more. Last weeks Wednesday I got a call that they were setting up a queue shortening evening for this monday. The surgery was done uneventfully on Monday evening and I was home by night.

Now to the curious comments:
Yesterday I got Spasms to end all spasms after first BM and basically from 4AM to 11PM I was in constant pain and twiching from the shocks.
I called the hospital today and the doctor commented via a nurse that the spasms are good thing meaning that the muscle is working. I was dumbfounded. From earlier doctors and reading here, I though the whole point was to minimize the tightness downstairs. She told to continue with showering the area and eating my over the counter pain meds... Asked also about continuing Diltiazem but the doctor didn't say anything about it according to the nurse. All the specialist doctors and surgeons I've spoken to have been trying to get me out of the room as quickly as possible.

Fortunately today has been easier...
Last edited by AnalFizz on 16 Mar 2018, 17:22, edited 4 times in total.
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Re: Interesting comment from the treating surgeon

Postby LemonMan » 01 Sep 2017, 15:32

Hi AnalFizz (great name!)
Sounds like it is early days for you at the moment. given you have just had the Op. I have read from a number of cases where things are rough for some for the first couple of weeks or so. Odd thing to say about your spasms, but I guess he could be right in that, even if the muscle is cut your sphincter is still working kind of normally. It's a shame no-one is giving you time to go through your concerns properly. I can understand how that can be super frustrating, but glad to hear you are doing better today.
I would be interested to know how you get on, so please do continue to post.
Best, LM
Aug 14: Anal Abscess diagnosed
Dec 15: Anterior Anal Fissure diagnosed
Jan 16: Anoheal - Thought was healed end of Jan
Apr 16: Anoheal - Thought was healed end of May
Sep 16: Fissure back. Started Anoheal again
May 17: Botox and banding - fingers crossed
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Re: Interesting comment from the treating surgeon

Postby AnalFizz » 01 Sep 2017, 16:05

thanks, yeah it's early just didn't expect the sledge hammer to the groin. Second time I've cried from the pain this year.

Like I said today has been better, although I'm running through the wife's pantyliner stock at a pretty quick pace.

About them doctors: It feels that at some point in the doctor education/career the patients turn into lists of symptoms of their specialty to treat.
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Re: Interesting comment from the treating surgeon

Postby LemonMan » 01 Sep 2017, 16:24

Yeah I know what you mean. That "bedside manner" thing is somewhat yesteryear. I think it just purely the amount of pressure they are under. I imagine they just have to default to what the accepted process is and turn off to the concerns of the patient. Sign of the times to a certain extent. I'm sure things will get better for you.
Aug 14: Anal Abscess diagnosed
Dec 15: Anterior Anal Fissure diagnosed
Jan 16: Anoheal - Thought was healed end of Jan
Apr 16: Anoheal - Thought was healed end of May
Sep 16: Fissure back. Started Anoheal again
May 17: Botox and banding - fingers crossed
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Re: Interesting comment from the treating surgeon

Postby AnalFizz » 06 Sep 2017, 08:13

9 days since the cut. Still bleeding from stich site(they've melted already). Had a look downstairs. Place looks like a bed of colourful cauliflowers(there's a mental image for you). Almost all of the follicles from the surgery hair trimming are raw and sore from not being able to keep a gauze there during spasms.

Called the doctor and she said that without puss, I should just keep on washing and keeping it dry.

I just wished there was a short cut to this.
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Re: Interesting comment from the treating surgeon

Postby dmcff » 06 Sep 2017, 11:59

LemonMan wrote: I imagine they just have to default to what the accepted process is and turn off to the concerns of the patient.


If that's really the case, they are letting their patients down badly, I would say.

David
2014 Anal fissure
2015 CAT scan, EUA and sigmoidoscopy, 2 MRI scans - 4 hospital stays, severe pain until August, then moderate to low pain
2016 Anal fissure - pain severe then moderate to low
2017 Return of moderate pain
2018 Now in biofeedback treatment
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Re: Interesting comment from the treating surgeon

Postby LemonMan » 06 Sep 2017, 14:32

On reflection probably an unfair comment. Most Doctors I have met have shown a great deal of concern, even if they are under pressure. I certainly wouldn't want to be in their position. Must be pretty difficult.
Best LM
Aug 14: Anal Abscess diagnosed
Dec 15: Anterior Anal Fissure diagnosed
Jan 16: Anoheal - Thought was healed end of Jan
Apr 16: Anoheal - Thought was healed end of May
Sep 16: Fissure back. Started Anoheal again
May 17: Botox and banding - fingers crossed
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Re: Interesting comment from the treating surgeon

Postby AnalFizz » 09 Sep 2017, 12:43

day 13.

Couple days a go I went to the private CRS who diagnosed me originally in Feb. I said earlier to my wife that I would never go to him again, but he had a free time the same day. I've had some white excrete in the gauzes, so I though it was the quickest way to get some peace of mind.

He looked and everything looked to be going ok, only some irritation and a hemathoma(? blood clot from the muscle cut. It dropped a day later with a BM). Also he reminded me to be patient with the progress... He prescribed me antibiotics (he said that I don't need it but still instructed to take them) and Diatsepam (I complained about the panic I get from the postBM pain)

Biggest thing about this visit was that it really helped me on the mental side. Now that I know that there is nothing big brewing in the cellar; I can just concentrate on the pain management. Haven't needed to take the 'Pams, just used some breathing techniques and a face down ass up position (don't ask) which seems to help.

Bleeding has reduced in the past days. I think that the postBM pain is also lessening. There is no major pain anymore, only major irritation and burning for multiple hours. So looks we are moving in right direction. I'm so waiting to get back to swimming and getting fit again.
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Re: Interesting comment from the treating surgeon

Postby AnalFizz » 16 Sep 2017, 07:03

Day 19. Bleeding is now totally gone. The surgery site is healing now nicely. I have a tendency for scar tissue, but hopefully it will stay manageable. Minimal marks in the undies looking like some liquid comming from released air.

Still have issues with post BM irritation. burning and general bad feeling for upto 6 hours. It feels really tight again down there and you could play guitar with the perineum. Sitz and diltiazem don't feel like helping. I've tried some stretching poses for it and they seem to give relief for that moment.

On Monday I'll be back at work. Hopefully it will help to think something else than have been for the past tree weeks.
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Re: Interesting comment from the treating surgeon

Postby AnalFizz » 27 Sep 2017, 15:08

4 weeks +2 days after the cut. Looking at the back end, Surgery scar is now almost gone only small discomfort when putting pressure on it. The Sentinel tag is as big as it's been for past half year. Otherwise it looks almost normal down there, the earlier hypertrophied papillae have disappeared back to their hiding place.

Daily post BM still creates discomfort and once in a while moderate pain. I'm taking Paracetamol and Ibuprofen combo to make sure that the pain won't increase.

On Monday I was so tired of this shit that I was silently sobbing in the office toilet. Then again the pain subsided few hours later and I was like nothing had happened. Funny how the mind works. Work stress is currently high, because I need to basically catch up on the missed three weeks.

One thing I've now noticed is the almost total inability to fart without sitting on the toilet. In the morning when I sit on the toilet with slight muscle release the farts come. Sitting on a chair does not cause this release. Wonder what causes that?

Now I'm basically waiting if this goes away in next 6 weeks.
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