So, the short version: I’m scheduled for LIS in 5 days.

The long version: I’ve lurked a bit on the forum for a while and first posted back in July or so, about my trouble finding a Dr. who would prescribe nitro. My fissure started back in May 2014, and would retear every few weeks, even though I was fastidious with my diet, drank tons of water, and was taking Colace. Things got a lot better when I finally got on nitro and Miralax in August. I stayed on the nitro until December, so nearly 4 months, and much of that was pain-free except the odd twinge/stab now and then. When I retore about 3 weeks after weaning off the nitro, I was pretty “bummed,” needless to say (har har). It was just incredibly disappointing to feel that old pain after I had been feeling like I had finally healed it up once and for all, especially so because I was still taking Miralax, Colace, and being careful with my diet! I decided that it might be time to reconsider LIS (which had been recommended to me in July, but I wanted to try nitro first).

I met with my (new) CRS three weeks ago (first guy retired, but this new one is so much more patient and really took his time talking with me) and scheduled surgery, with the option of cancelling if I felt like another course of the prescription cream was doing me good before that point. Up until today I was considering cancelling the LIS because the nitro had healed me up again and I was pretty much pain free—until it struck once again this morning. L While I’m lucky not have ever really had the all-day, debilitating spasms folks talk about on here, this problem just does seem to be able to go away for me permanently with the nitro alone at this point. I’m guessing that my first few days after LIS will be more painful than my fissure has been, but that after a few days it will become more equivalent and then eventually better, hopefully permanently…

I suppose I’m mostly writing this to get my own thoughts out, but I guess I do have a few questions. I know that recovery times vary, but given that I’m in my late 20s, and quite healthy and fit, would it be reasonable to try to go back to work after 10 days? I’m a grad student and my LIS is right before spring break, so luckily I have that many days of built-in time off, essentially. “Work” is a mix of sitting and standing (grad school, student and TA, etc.), so I’m hoping it will be doable after 10 days. And a related recovery-time question: I have a 5-week trip to the UK in July ( ). My CRS I says I should be back to completely normal well before them--does that sound right to everyone? Because I'm going on that trip (research related, expenses paid!) no matter what my dang butt is doing!

And another question (awkward, I’m sorry)—has anyone given themselves an enema with a fissure? I’m supposed to do one at home, to be completed within 30 minutes of coming in the hospital. I’m such a tight-ass (surprise) that even applying the nitro much at all past the surface can be difficult—how on earth are you supposed to ram that thing up there, by yourself, when you have an active fissure? Or is it really not that bad and I’m just overthinking it? Call me crazy but I’m almost more terrified of giving myself an enema than the surgery itself! (I know this is not rational, but still!!).

Thoughts and advice are welcome—and thank you so much for participating in this forum. It has meant a lot to me to have this place as a resource for this hard-to-discuss problem. <3

I'm sorry to hear that you've been suffering, but at least you seem to have found a good CRS who you feel comfortable with. I would say that chances are very good that you'll have no trouble with a trip as far off as July, because most people heal within a few weeks (from what I've read on here anyway).

I had to do an enema 30 minutes before leaving for the hospital too, but thought that I should have it an hour ahead of time instead, in case I was still expelling stool for a longer period. I had no trouble with the enema bottle and the nozzle went in easily and caused no pain. I must stress that everyone is different on this front though, and suspect that the location of the fissure could be the determining factor as to whether or not it will be painful or not. Is there any way to contact your CRS beforehand, to ask if you should continue with the process if you're experiencing pain while inserting the nozzle?

Good luck to you next week and I hope that more forum members chime in with their experiences too.

10 days should be plenty, I think most people are back to normal in less than a week.

I called my doc about the enema because they were also in my pre op instructions and I had no idea how I'd get through it. They said if it didn't work then it was ok to go without it because the doc does one right before surgery anyway. I tried and failed and they never said anything about it. My surgery was a good experience. Good luck and congrats on taking the next step towards healing!

Good luck I'm 2 days out from mine

Hi Tigerbutt.

It is very difficult to predict the outcome of this surgery. While most people do very well and recover very quickly, there can be complications. I am a case in point and just wanted to let you know, in case you are one of the unfortunate few. I developed a sinus (area that healed improperly and formed a pouch) where my LIS site was and this went on to get infected. I had 3 weeks of antibiotics off an on until the CRS decided to go back in for another surgery and lay the whole area open. I am 4 months into that now and am still bleeding and have pain, although it is healing. It does seem the infection is gone, however. One could also develop incontinence but this is very rare in the hands of an experienced surgeon. So, most likely you will fare very well, but just in case, you can make an informed decision ;)

If you are concerned about the enema I would call the Doctor's office and see it this is really necessary. I didn't have one for either of my surgeries. I was also so tight I couldn't even get the tip up there! Hope all goes well for you. Keep us posted.

How are you doing Jteller?

Thanks so much for the replies everyone! I appreciate it. I am calling my Dr.'s office tomorrow morning with a couple questions anyway, so I'll ask them about the enema. I'm going to give it a try, but I think it really depends on the next few days. Right now it hurts just to touch externally applying my nitro :/ Jteller, I hope you are doing well! We'll have to keep each other posted on our progress!

The tiger, I've been home for about 4 hours now surgery was a breeze. I was pretty nervous before hand. I'm laying on the couch ATM just have a slight pain down there, nothing crazy yet thank God. I only had the LIS done and the crs wants to see me in3 to 4 weeks. Well see how I am by then lol

Wishing you a good recovery. All the best!

Thanks Bailey! Jteller, I'm glad to hear it's going well so far! My surgery too felt like a breeze, thank goodness. No problems with the enema at home after all, and the sedative (I had general) passed me out instantly. I'm just laying on the couch now, and not really feeling any pain. I did notice than earlier, about 15 minutes before my next percoset, I was having some mild ache but then the next dose kicked in within 20-30 and it feels good now. I took just 1 perc with 2 ibuprofen, and I'll probably do 2 perc during the night. I'm hoping I can wean off it and just do ibuprofen in a day or two (to avoid constipation). I'm keeping my fingers crossed for tomorrow's bm as that will be the real test of course!

Things are still going fairly well here, I have managed since about 12:30pm on just 2 ibuprofen and no percocet. I still have some aching but it's manageable, and I want to avoid too much percocet as I haven't had my first BM yet. Not sure if I should be worried about that or not yet at this point, as today is my first full day after surgery. I may drink some prune juice before bed tonight if it still hasn't happened and maybe take a full Miralax dose (usually I do half a dose in the morning and evening). But I don't want to give myself the runs either. :/ Is not going until the second full day pretty common? Here's to hoping! Jteller, hope you are still doing well!