Hey all,
After suffering with a fissure for 4 years and waiting for the op for the last year (bloody NHS waiting lists!), I finally had it today. I'd never had surgery before so was really quite anxious. I went under general anaesthetic at around 10am UK time and was awake again by 11am. There was some soreness and pain for the first hour after surgery, even that was really minimal (less than what I usually have after a BM), but since then then I am in absolutely no pain! Didn't get given any painkillers at the hospital, which worries me a bit but given I've had my fissure for so long I think I'm well equipped to deal with any pain that does arise! Ibuprofen will be my friend :)
I'm worried about the upcoming BM though. I didn't have one yesterday, probably due to nerves so I'm worried it my be a little hard. I kinda feel like I'll have to go shortly, but not sure if it's too early since it's only been 6 hours since surgery? Can anyone advise on this? I'm taking stool softener, so that should help, but is it is generally advised to wait a day before going? Obviously if nature does call I wouldn't like to forcibly hold it in, but is it worth avoiding if i can?
What about baths? I asked at the hospital about this, as baths have helped with my pain in the past, but the doc said to avoid for today, and maybe start tomorrow? Does that sound about right to everyone? Also, what about topical creams? Is it too early to be applying, or should i start with them straight away? I'm going to get an appointment with the GP tomorrow and stock up.
I'm so glad I plucked up the courage to do this, I feel really positive about the next few weeks (worries about BM's aside). It's taken up so much mental energy, planning when I can go to the toilet so i'm not in agony, always considering what I'm eating and what effect it'll have on my stools. I'm going to stick to a high fibre diet mind, but just feel likes some weight has been lifted :)
Finally, is there anything else I should be aware of, or proven tips people have to help with healing? Should i be expecting leakage for a while? The doc said I might have problem with containing wind, but so far nothing, just had my first angel gas and it was entirely voluntary haha.
You guys are awesome, this forum kicks ass, I love the internet for this reason.
Thanks

Hi SoreBum,
Congratulations with your LIS op.
This will be the start of your new life, I am sure :)
I have not had my LIS op yet, so can't give you any advice about that.
I know what you talk about when writing about planing your hole day after BM, but that will soon have an end for you, after your LIS today :)
keep your spirits high, you are almost the winner of this battle already
Kind regards

Thanks DAF :) if you've got any apprehensions put them aside and just do it. I was terrified, last week I was frantically thinking of excuses that might allow me to back out of the surgery. But I told myself to man-up, accept what's coming and to realise that it might be the path to a happy ass again!
Despite it being my first ever surgery of any kind, it was a complete breeze, over before I knew it and little-to-no pain so far. Just had my first proper meal - chicken dinner with carrot, swede, brocolli and parsnips. That should result in a nice soft BM tomorrow :)
Would love for someone post-LIS to answer my questions above.

Hello SoreBum,

Let me just say congrats on biting the bullet and putting an end to your suffering. I love your positive attitude!
I'm 4 days post LIS and can tell you what I've done so far. First of all, do not ignore the call of nature. If you have to go, go. It may not be pleasant, but holding it in may make things worse.
Anyway, the things that have really helped me thus far are sitz baths, stool softeners, and ibuprofen (to reduce the swelling). Although my BMs have been soft due to my diet and the stool softeners, it has been very difficult for them to exit because of so much swelling in the anal area. The swelling has gone down considerably today. I can actually sit upright for the first time. My CRS told me the first 3 days would be the worst, and she was right. The BMs were the roughest part for me. I haven't yet had one today, but I'm curious to see if it will be any easier since the swelling has gone down so much.
I had a skin tag removed, so I have some drainage from that, but no other leakage. I keep the area dry by inserting a piece of gauze between my 'cheeks'. Like you, I can control the gas, etc. My dr told me to begin using zinc oxide cream on the skin tag wound after 1 week, but no creams or anything for the LIS wound...since it's up inside.
What else? My dr told me no wiping and no soap on the anal area. So, I shower after each BM, and I use the sitz bath at least 3 times per day to keep things clean. I dry off with a hair dryer on a cool setting. It seems weird not to use soap, but it really hasn't been an issue.
That's all I can really think of for now. I wish you a soft and smooth recovery! Also, I'd be happy to answer any questions you may have. :D

Hey Bumpkin,
Thanks for the response, it's comforting to speak to someone only a few days ahead of me. You can be my yard by which I measure my recovery
Yeah don't worry, I'm not in the market for avoiding nature's call, just haven't had that "OMG I need a crap like now!" feeling yet, and I don't want to force anything so have just left it for today.
Yeah sitz baths have always helped me in my fissure suffering. The real problem at the moment is that I do not have a bath in my current dwellings, only a shower :( Is there some way I can fashion some kind of small sitz bath, big enough for me to plonk my bum into? I didn't think about using ibuprofen purely for the swelling, I was going to use it purely for pain relief, but clearly the anti-inflammatory properties are just as desirable at this point. Is it strange that I've been able to tolerate sitting down since a few hours after the op? Not that I've been spending much time in that position, but I did eat my dinner at the table and beyond some slight awareness that my bum is tender, it didn't hurt in the slightest. Maybe I'm just not that swollen, perhaps because I didn't have the skin tag removed as well? I definitely have a skin tag, what's the benefit of having that removed as well? I just thought it was a pretty inconsequential symptom of a chronic fissure.
They didn't give me any gauze at the hospital, to be honest all they did give me was stool softener. I plan to visit my GP tomorrow and amongst other things, I'll try to get some gauze off them, hopefully some silver coated stuff to stave off infection. If not can I just buy some gauze, or does it have to be some special medial-grade stuff? As for the softener, I have lactulose. Is it recommended by the peeps here, or is there a better alternative? Movicol, perhaps (is that the UK or US brand name?)?
No wiping eh? Hmm I don't like the idea of purely showering as I don't want to be bending down giving my shower a good clean! Is dabbing tissue OK to get the bulk mopped up and then shower to finish the job? Haha, a slight tangent, but there's probably nowhere else on the web where you can exchange bum wiping tips in the open!! What do you think of applying a bit of petroleum jelly prior to BM to lubricate the cogs, so to speak?
Thanks

Hello guys,
Firstly well done for going ahead with LIS and welcome to the other side - hopefully it will be one of the best decisions you have ever made.
So a few tips....
I was given pain killing medication by the hospital after my surgery but they told me to avoid Ibuprofen and instead take Paracetamol should it be required.
Baths - have lots of them, maybe 3 a day - not only do they help relieve pain but they also help prevent infection. I used to take my ipad in the bathroom and watch TV programmes or films during my bath visits.
BM - Sometimes the first one can take a while coming this is because the hospital usually give you an enema before surgery which effectively empties your bowels altogether. Also pain killers can cause a certain element of constipation so dont worry if you go a few days without having the need to go. When you eventually do go you may be surprised as most people expect the worst only to find its one of most painless BM's they have had in a long time. Just make sure you relax and dont strain - you are not in a rush after all !!!!
Cleaning after a BM - Start with a baby wipe and gently dab away as much as you can then use a shower head above a bath for a good clean up. I used to also use another baby wipe after the shower and dab dry with regular toilet paper afterwards. (it is very important to keep the area as dry as possible)
Make sure you stick to your fissure diet until you get the all clear from your GP or CRS and then it is always advisable to continue with a healthy fibre diet to ensure good bowel health.
Also during the recovery phase...
Dont strain!!!! And i dont just mean during a BM, so no heavy lifting, no straining to remove lids from jam jars, no lifting children (if possible) - any strain on any part of the body will have an impact on your (recovering) fissure.
Exercise - this will improve your healing time as it helps the blood flow around the body. So try not to stay laid up, as soon as you feel fit to do so go for a leisurely walk, take the dog to the park, pop to the shops and just get your body moving again.
Wind - it should be expected in the first few weeks following surgery - normally its silent but dont let it worry you - just blame the dog :D
Soiling - Some people experience an element of soiling certainly in the first 4 weeks. It is important to note though that sepage from the wound can sometimes be confused with soiling so dont worry if you see some brown/yellow staining in your underwear for a little while yet.
Granulation tissue - in a few weeks time things sometimes start to look a bit worse down there - this could be granulation tissue. It will look all red & swollen and may be leaking a little - this is the bodies natural way of healing and is body tissue filling the gap where the scalpel incision/fissure initially were. This eventually goes away and the skin heals over but dont worry if you see sore looking red skin protruding from the wound.
You can either use lactulose or Movicol (UK equivalent of Miralax) - if one is working for you then i wouldnt bother changing to the other. In the UK there is a chocolate version of movicol which can be ordered from Boots the chemist - it tastes way nicer than the lemon & lime one (in my opinion)
Infection - The main risk following LIS is infection (and certainly not incontinence) so i cant reiterate how important it is to stay clean and dry. The signs you should look out for though are an INCREASED level of bleeding or if you find things were improving pain wise and all of a sudden they take a turn and start getting worse again - If this happens return to your GP/CRS as soon as you can.
Finally dont apply petroleum jelly or anything else for that matter, just keep it clean and dry down there.
I hope that helps
Davo

OK so the good news: I just had my first BM, it wasn't particularly big, but it's a start :) and the sponge came out as well. My heart was pounding and I was shaking with fear that it's going to be agony, but I'm happy to report it was pretty painless, a little discomfort more than anything, but a bath relieved that. That's the first hurdle cleared! As an aside, the sponge was a lot smaller than I imagined it would be. Unless I didn't pass it all? Who knows? I'm sure i'll find out tomorrow!
Cheers Davo, I'm feeling so positive about the future now, wish I could fast forward 6 months to be where you are, but I'm OK with the journey ahead. It'll be hard work and require commitment but everything will be for the best :D
I'm going to invest in some baby wipes today at your advice, i guess i should be looking for wipes with zero perfume etc?
As for baths, this is where I have an issue - I don't have a bath in my house. I'm at my mother's at the moment so was able to have one, but I'll be going home today. I think i'll just try sitting in a basin or something? That'll be a sight to behold!
Wind-wise, Im farting like there's no tomorrow! Completely not silent, but thankfully, completely voluntary. This will annoy my girlfriend to no end, which will amuse me to no end :)
The hospital only gave me 10 days worth of lactulose, I guess i'll be needing more than that, so i'll stock up. Movicol is something I can buy over the counter at boots, is it? No prescription necessary?
I'm not worried about soiling/leakage for now. I had a thrombosed haemorrhoid a few years back which then ruptured, resulting in brown discharge for a good few days (it does look like faeces doesn't it!). So I'm alright with the discharge for now, unless it's still going strong after a few weeks I'll not worry.
I'll definitely ensure to get some daily exercise, a swift walk around the block, perhaps walk up here to my mother's for a bath daily as well. Though i'll make sure to take it easy and not overdo it.
Thanks again Davo for imparting some of your encyclopaedic knowledge of LIS recovery :)

Hi,
Fragrance free baby wipes are the future my friend, you dont need any fancy brands and you can pick own brand packs up for around a pound.
If you dont have a bath at home just use the shower head a few times a day to ensure you stay clean. You can buy a Sitz bath if you feel you need one however a shower should be fine - Just ensure you are fully patted dry afterwards.
Movicol is available over the counter (Pharmacy section) in Boots and Superdrug without prescription but you wont find it on the shelves. The standard flavour is Lemon & Lime but if you dont like the flavour they can get the chocolate variety in within a day or so.
"Encyclopaedic knowledge of LIS recovery" :D I am the font of all ass knowledge :)
Davo

Wow, didn't realise Sitz baths were an actual product you could buy, thought it was just the name given to the appraoch of soaking in a bath. Will definitely be ordering one of those, it's a bit awkward in the shower. Plus i think the pressure of the shower, despite being good for cleaning, is not as good for soothing like a long soak in the bath is. Am going to buy now! Seems that amazon(.co.uk) only stocks a single one, and it's marketed as a bidet. Will see if i can find anywhere else.
I'll go and buy some movicol tomorrow, will make for a good walk, 15 mins there and back. I hate having to go and buy embarrassing products from the pharmacy. A few weeks back I had to get thrush cream. The lady was like "is this for you?", "uhhhh...... no?". I don't think she believed me :)
Thanks again Davo

Sorry I never replied after my initial reply! I've been trying to navigate my rollercoaster of a recovery! I see Davo did an excellent job of responding.
I just wanted to add that the sitz bath has been a lifesaver for me. It's like a spa for your butt. I see that Amazon-US has several different brands...not sure about Amazon-UK though. I got mine at a pharmacy.