16 days post-op
- Ok, so after hurting yesterday due to Thursday's step class, basketball fall, and my stubborn straining, I didn't have a BM for quite some time.
- To make sure I didn't get constipated, I had Tons of Water, tea, coffee, prunes, flax, Colace, constant eating of soft fruits, healthy fats, protein, etc. This triggered a soft high volume BM just now and the pain seems to be a lot less than yesterday. I'm soaking in the tub and hoping that I won't have moderate pain and discomfort for hours after this (like yesterday).

17 days post-op
- no real pain last night
- thick BM this morning (had been about 20 hours since last one)
- a little pain, but its fading after about 1 hour and a tub soak
- CRS follow-up visit tomorrow!

Good luck on your follow-up visit tomorrow. I doubt the CRS will stick a scope upwards into your healing butt!!

cherylk wrote:Good luck on your follow-up visit tomorrow. I doubt the CRS will stick a scope upwards into your healing butt!!

I hope not! How long after the operation do they usually wait to use a scope to see how you are progressing?

Hopefully, not for a long while. That area needs to HEAL, instead of having more trauma!!

18 days post-op update
- Had a thick (but soft) BM yesterday (4-5 pencils) followed by 20 minutes of heavy pain. Wasn't fun. Pain went away totally after a hour. Feeling fine today
- First follow-up Dr. appointment is this evening. Not sure what to expect yet.

Ok, so my Doctor visit is actually tomorrow. I guess in my medicated post-op state, I got confused and wrote down the wrong day.

Now you are making us wait an additional day to learn about your results! :)

Yeah. I leave in a hour to go to the appointment! I'll post an update when I get back.

FOLLOW-UP WITH DOCTOR
19 Days Post-op --- ~2.5 Weeks after surgery
Ok, so I got my 12v heating pad out and drove across the city to the Doctors office. I brought my question list (and my differential equations book) . Here is what happened:
* before the visit, I tried to plan a BM about 3 hours before. This is because I find that the sphincter remains tight after a BM for quite some time. I read anya's comments about the area being too tight to do a good exam. So, I figured I would try to make sure it was as relaxed as possible. Now, I'm not sure, But I think that after about 2 hours after a BM AND if I use heat or a warm sitz bath, it starts to loosen up down there. I am pretty sure of this this because when I wipe, I can clean a bit better once it looser. It really feels more relaxed. It doesn't hurt. And I can clean (easily and carefully) a bit deeper. This strategy seemed to work well as he was able to do the exam without any issue.
* The doctor came in and asked me how I was doing. I explained that overall, I thought I was healing well. I mentioned the setbacks with thick BM, exercise, and post-BM pain. He said that 2-weeks post op is still very early and it is normal. Right away, he wanted to take a look.
- He did not use the big scopes this time. He had a couple of devices or tools or some sort. One of them looked kind of like a salad tong made of aluminum. I bent over. It didn't hurt to much as he pried things apart gently and took a look. He said, wow- you are healing great. That is really good. I was very happy. I explained that I did the whole super-food, rest, water, light exercise thing.
- Then I got out my list of updates. I explained to him that I had the urination issues that freed up with a BM. I told him about the pain and how I irritated the area at the gym. I told him how it was ups and downs as I healed slowly. I also said that there was no way I could have worked after 5 days. But, that now I was working from home and even in the office sometimes. He said it was good that I was getting around. He seemed interested.
Then, I got out my list of questions. I explained that I was curious how the procedure was performed and that I had watched some videos on the procedures. He kind of laughed for a second. Then I started with my list of questions. I was trying to hurry up as I was the last patient of the day and I didn't want to make his visit take 2 hours.
Here are the questions with the answers (hopefully I recall what he said correctly from my notes) (Yes, I took notes!)
* how the healing appears to be progressing? = much faster than normal
• Do you recall any details about the 2 fissures (near each other, thickness, scar tissue, length). They were not together. One was around 6 O' clock and the other off to the left side
• When you cut the 2 fissures, did you cut them both out at the same time in one big cut or individually? There were 2 fissures that were worked on separately.
• Was the LIS procedure open or closed? Blade or electrical? There was no cut external to the anus. In other words, they worked from the inside of the anus. I think he said this was closed. Everything was Blade, no electrical was used.
• What areas have stitches? Do they dissolve or have to be removed? No stitches were used. What they do is cut off all of the area around the fissure that has the scar tissue built up and the edges of the cut. If I understood correctly, they cut the ends of the fissure off on both sides. This leaves it open again without the scar tissue and he didn't cut it all the way off. In other words, just some of the tissue is removed. So, there are no stiches at all anywhere. I explained that I watched the video where they cut the whole area out with scissors. He said in my case, they didn't have to cut/stitch like that. It seems like they just cut the ends of this big cut off, but not too deep (as opposed to in the video, it appears they cut the skin completely and then stitch it up). So, hopefully, from my brief conversation with him, I got the right idea of what was done.

• Any heat used? Any graphing of tissue over the area? No. He said that they only does that occasionally depending on what the patient needs. Its a more advanced procedure that is not done in all patients. Basically, it seems like what they do depends on what they find when they take a look up there.
• Any experience with other people working out with weights or aerobics. Any recommendations about returning to those activities. Any comments on the exercising I have done. How long before I can go back to very hard and heavy weights? Yes, he said that I can go back in about a week, just not as hard as I did before. He said there is no magic amount of time. Everyone is different and it depends on what they had done and how fast they heal. However, he was very pleased with how fast it was healing and was recommending that I go back to moderate load next week based on how fast I was healing. He said to ease into it. In other words, do a little and see if it bothers the area. If so, ease back. Like, when the step class bothered the area, back off that for a while. However, based on how well it was healing, he did not think I did significant damage in the workout. Pain and discomfort will be normal at this stage. I can start to ease back into somewhat heavy weights, based on how well it is healing.
• Was the sphincter extremely tight? He said it was pretty tight. It didn't sound like the "tightest he had seen" like some people reported here. But yes, he felt it was pretty tight.
• Was the sphincter cut on the left side? Darn. I forgot to ask him this. Here is my answer --> Well, it sure feels like it. This makes me wonder if they just go through the fissure to get to the sphincter??? I'm not sure.
• You mentioned that I could start using the NIFEDIPINE again. When? In other words, do I wait until the sphincter starts to regain strength? He said that I should only use it if I need it. In other words, as the sphincter starts to heal and I find it getting tight again (If I do find that), then I can use the medicine. Right now, I should not be using it because the sphincter is still damaged, weak, and applying it might hurt the area.
• Based on what you found in there, do you think surgery was the correct path? Were either of them healing? Definitely! This question here seemed to catch his attention a lot. He seemed very certain that things were bad in there. Based on what he saw, I would have continued to have issues over and over again. He felt that I was going to have a tough time. He is very sure that, in my case, surgery was the right decision.
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So, Yes. I got good news today. When he took a look and was surprised to see how well it healed, I confirmed with him that he can see the whole area and everything looked very, very good.
Regarding a follow-up visit. He said that I do not need to return unless I have issues. He said that normally a follow-up visit might be required. But, since I am healing so well, he doesn't think I'll need it. So, I'll just keep doing what I am doing and he was confident that it would continue to get better and better. He was happy that I was up and about again, able to sit down now pretty well, exercise some, etc.
So, I am no expert; however, I feel like the doc was great. He sat there and answered all my questions. I am glad he was recommended to me. If your in North Texas and need a good CRS, I would be glad to give you his name if you PM me. He was recommended to me by another person who also sang his praises. I also left him some good feedback on the Dr. Rating sites.