Just had 2 fissures removed and sphincterotomy today

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Just had 2 fissures removed and sphincterotomy today

Postby ryanman0 » 04 Oct 2012, 13:57

Hello,
I just had surgery today and I will share my experience. I just had surgery, so I don't know if it will be a good or bad one yet.
2 years ago- first noticed blood with no pain every couple of months
1 year ago- noticed irritation along with the blood.
1 year ago- got scared from the bleeding and went to ER at night
1 year ago- doctors did not know what it was and gave me a CT scan (radiation)
1 year ago- followed up with GI generalist who did a colonoscopy
1 year ago- colonoscopy did not identify the issue
6 months ago- starting having unbelievable pain along with the fissure
6 months ago- pain continued. Each time I healed, fissure would re-rip upon straining
2 months ago- went back to GI generalist who now suggested this might be a fissure
2 months ago- GI put me on rectiv, got headaches, no improvement. Recommended I use laxitives
2 months ago- found this forum
2 months ago- began to understand diet, avoiding straining, 5 sitz baths a day, and began abusing heating pads
1 month ago- worked from home thanks to my boss which made this more manageable
3 weeks ago- found a CRS to see, switched me to NIFEDIPINE. He knew his stuff and his advice matched this forum. He recommended against laxative abuse and only Colace. He suggested surgery if no improvement
2 weeks ago- had a day of no pain. Could tell upon medicine application that muscle was not as tight. Was feeling optimistic
10 days ago- got constipated, blood and a rip followed, wanted to cry. Even though I knew better, I strained (probably because I was feeling better). Funny how its a mental battle as much as physical.
9.5 days ago- called and begged for the next available surgical appointment
1 week ago- made arrangements with work to be out for 10 days and then work from home as needed for 2 weeks
1 week ago- began to get paranoid about the operation, anesthesia, post-op
5 days ago- ate lots of healthy superfoods, drank lots of water & tea. Still drank coffee and followed the same diet (some fiber and soluble fiber, bananas, fish, veggies)
2 days ago- felt like it was healing again, thought about canceling. Ate some junk food (mentally kind of like a chance to enjoy a last good diet cheat meal just in case I am the rare case that does not wake up from the surgery -- I tend to be a bit paranoid even though the odds seem to be in my favor)
1 day ago- decided that I had to try the surgery to get a chance at having my life back
1 day ago- As I mentioned to co-workers about my surgery, I found several others that either had fissures or used to. I then heard a horror story from a coworker who had a bad experience with many complications (not the guy I needed to be talking to before surgery)
Last night- My paranoia drove me to call most of my family say my last goodbyes (just in case of the rare chance that something happened).
Last night- Normal diet all way until night. Ate a small hamburger around 10:30 PM because nothing after midnight. Drank lots of water, could not sleep due to fear until around 2AM
6:00AM, woke up (still scared like a big chicken)
7:45 Today- drove to surgery center which is about an hour away, still paranoid and hoping I would survive this. still no food or water since last night
8:30- prepped for surgery (IV, gown, paperwork, questions)
around 8:45 today- spoke to doctor. Asked him to please proceed with the operation even if it looked like it was healing once I was in surgery. Explained that if he didn't, I would probably just re-rip and be back in. He agreed and explained he would cut out the fissure, remove the scar tissue, and put a small cut in the sphincter.
around 9:00 today- spoke to Anesthesiologist. IV antibiotics started. First drowsy drug started getting sent in the IV. I got wheeled into the room and then I dozed off
9:30 AM today- I woke up. They administered local numbing agent, so I felt no pain at all. Doc came in and told me that I had 2 fissures. He cut them both, removed the scar tissue, and made the cut to the sphincter. He said everything went well. Said I could keep using the Nifedipine. Instructions for discharge say to use ice for swelling and sitz baths for relief. Baby wipes for cleaning
9:45 AM today- I was mostly energetic and awake, urinated with no issue, drank water, still no pain. I was able to beat the phone in little game of chess, send e-mails, and talk. I had some ritz peanut butter crackers, water, and some sprite
12 noon PM today- my ride arrived, still no pain. I was able to climb into the truck without major issues. Sat on a big pillow and tilted the seat back.
1:00PM today, dropped off the pain medicine prescription and got home, still no pain
1:30PM today, drinking tons of water. Had a protein shake with banana, blueberry, coconut oil, a bit of flax, lactose free milk
1:45PM - drank my 4th coffee of the day and some teas and TONs of water (oh yeah- don't take my diet as advice - I am no expert and I'll see how this works out)
2:40 PM today, not as numb. I am aware of the area more. Still no real pain yet. Very slight discomfort. I figure it is surely coming. But I guess I am still enjoying the medication's pain numbing affect for now.
3:00 PM- no bowel movement yet (still scared to death of that). Maybe a little bit of gas from the shake- can't really tell yet. Area is still bandaged. I have not yet looked. There is some drainage. I am walking about every now and then. Have not taken the pain medicine yet. It should be ready soon.
I will try to update this as I progress forward. Wish me the best.
ryanman0
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Re: Just had 2 fissures removed and sphincterotomy today

Postby Guest » 04 Oct 2012, 14:20

Hi Ryanman,
You were right to go ahead with surgery. I hope you heal well & that your first BM won't be too bad. All the best with your healing. I've not had surgery I hope I won't need too. I'm trying the Botox route first.
Keep us posted good luck 😊
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Re: Just had 2 fissures removed and sphincterotomy today

Postby ryanman0 » 04 Oct 2012, 14:25

3:30 PM today- Feeling it a little, but only when I walk around or move. It really is nothing yet. Maybe just a bit of discomfort down there- they must have drugged me up good because the medication still has me feeling very little pain. Took 2 Hydrocodone/Acetaminophen 5-325 since the doctor instructed me to take it even if the pain had not come yet.
3:30 PM today- Ate 4 oz. sliced roast beef, cup of sugar free pudding, banana, apple, mate tea, 2 more cups of water, big bowl of unsweetened apple sauce, a probiotic, and 1 TBSP of extra virgin olive oil.
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Re: Just had 2 fissures removed and sphincterotomy today

Postby ryanman0 » 04 Oct 2012, 14:58

Baily, Thanks for the reply and thank you for wishing me good luck. Good luck to you as well.
some more notes:
- I had to avoid vitamins due to the blood thinning affect that some of them have for up to 1 week. Also, no alchohol for the most part (I had one small beer 3 days before though)
I went to the grocery the day before surgery to get unsweetened applesauce, pudding, bananas, apples, fish, tea, berries (watch those seeds that some berries have), etc.
I used to eat lots of carrots and broccoli raw. Now, I boil them in water and run them through a Costco Blendtec blender. I also make sure I don't get too much fiber. There seems to be an imperfect art to trying to master the texture and amount of stool.
- supplies I found helpful
* corn bag (heating pad) from amazon. you put it in the microwave. I sat on it on long drives in to work because the car rides were painful. Also, I used it for relief while sitting at work. I also felt safer sleeping with that pad on those nights where I could not fall asleep. It works well when you can't get 110 power or can't use a traditional electric pad. This helped me get at least a few hours of sleep on those nights where there was just enough pain, twitching, and tightness to keep me awake
ice bag- recommended by the doctor to reduce the swelling that I am most likely about to encounter
electric heating pad- They say not to sit on them- however, I got a good one and I didn't listen
full body pillow- useful for getting in some awkward sleeping positions that might just help take the edge off the pain on some nights
Gloves or finger gloves- needed. I got the textured ones from walgreens and just ripped off 1 finger as needed.
Enimas- recommended by the doctor to have on hand. Note that my doc did not ask me to take one before the surgery.
4:00PM surgery day- still no pain. Pain meds seem to be kicking in
ryanman0
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Re: Just had 2 fissures removed and sphincterotomy today

Postby ryanman0 » 04 Oct 2012, 18:14

4:20 PM surgery day- Doc said its important to get the bowels working to avoid constipation. I felt like I could go to the bathroom so I Removed bandage. I cut the dangling tape and bandage off with scissors and left a portion hanging. No pain yet; however, I can feel the sensitivity of the area a lot now whenever I sit or the bandage gets moved. I have some blood - nothing concerning.
5:00 - its not numb anymore, no pain yet, coughed and it hurt; however, only a little. ate salmon, 2 servings flax meal, tons of water, green tea, banana, coconut oil, coffee, Colace, probiotic, fiber supplement, small pulp free orange juice. I have a ton of energy. I feel like I need to rest more and eat less. Still no first bowel movement. Some blood on what is left from the bandage. Not a large amount, but enough.
5:40- Sat on toilet. I am, of course, very scared at this point with anticipation of what may lie ahead. Lots of internal bowel movement being felt. It sort of feels like pressure from either gas or all the food, fiber, and water. I pulled on bandage a tiny bit and it actually came off. Fair amount of blood at first. I looked at the cut with a mirror.
6:20, back on toilet for 40 minutes. slight pushing, no strain. some leaked out. Not any pain; however, my back is hurting a bit from sitting so long. This is because I lean to the side during bowel movement. This is a habit since leaning and not spreading seemed to always help me (and I don't want to spread the cut open).
10 more minutes and some more leaked out (soft almost liquid - no pain, just discomfort). Damn, not really a first bowel movement. But it was enough to dirty everything up. I used baby wipes and some toilet paper patting it very gently (no wiping). After, I got in tub of luke-warm water (not the scalding temps that I had to ease into that used to bring me relief before the surgery). I got in very carefully and was mindful of the area. While in the water, I carefully made sure that the entire area was clean.
7:05: Filled up an icebag and am using it now. Took 2 more pain pills. Sensitivity continues to return to the area. Some mild throbbing. Also, feels sort of like mild gas pressure. So far, nothing I have felt is as bad as the pain of the original fissures. However, since the medicines from this morning are wearing off (and since I was moving around too much today), I suspect this might get very bad soon, unless I am lucky. I shall find out soon. Time to lay down and rest.
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Re: Just had 2 fissures removed and sphincterotomy today

Postby cherylk » 04 Oct 2012, 18:54

Ryanman,
Your story is so INTERESTING! I would give you some advice--do not sit for 40 minutes on the toilet. That puts pressure on the rectum. Do not push and do not strain. You might try Miralax (even a small amount) to keep things soft for awhile. Try not to worry. I've not had surgery and healed my fissure with diliatzem. Not on this board very much, but have visited here recently to post about the squattypotty and some other updates. Good luck with your healing! We're all here to help one another (and learn in the process). Image
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Re: Just had 2 fissures removed and sphincterotomy today

Postby ryanman0 » 04 Oct 2012, 20:08

Cherylk,
Thank you so much for the reply. I figured I would share my experience since I enjoyed the ones that I read before the story. My story is probably interesting because I am running my mouth while on painkillers!
Also, thanks for the advice and keep it coming. I'm certainly not the expert on all of this. I'm trying to learn through experimentation (with my diet and treatments) and stuff I have read online. However, Its a best effort attempt by me to understand all of this. So, any helpful advice from any others more experienced is appreciated. In other words, keep telling me what I am doing or thinking that is wrong or probably a bad idea. The more advice the better. Remember, I'm drugged up and not thinking clearly.
8:45 PM (still same day as surgery)- I basically just laid on my side in bed for a long time. I have a bit more pain now. Even on the pain medicine, I now find that I have to move slower and very careful. However, its not yet worse than the pain that would keep me up for 6 hours after I used to have a bad bowel movement from when my fissure was at its worse. In other words, I'm still doing good. I'm just hoping that I can avoid making some stupid mistakes and causing some type of complication.
8:50- Brainstorming as to any mistakes I might be making so far. Let me know your thoughts.
* I'm a bit worried that I might have removed the bandage a bit too soon (but its clean and not really bleeding now)
*Perhaps I have eaten a bit too much and started the bowels up a bit too soon. Stool is soft. Is there such a thing as "too soft stool" right after surgery? Anyone else had a small soft bowel movement on the same day as surgery?
* maybe I got up and walked around too much and should have barely ever gotten out of bed all day.
9:05 (still same day as surgery) - still eating every 3 hours or so... 1/2 an avocado, 1 TSP natural peanut butter, some unsweetened applesauce, unsweetened moringa tea, 3x hard boiled egg, water, salt, Q10
9:25: I'm wondering if I will be able to sleep tonight. I'm still laying in bed now. I guess I'll get off here for a while and watch some TV. Might have another bowel movement urge starting (may be just gas). Nothing new to report.
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Re: Just had 2 fissures removed and sphincterotomy today

Postby cherylk » 04 Oct 2012, 21:08

Ryan,
I would try to relax a bit. Sounds like your diet is good. Some protein (fish, turkey, chicken, tuna) might help the healing process. Squash and sweet potatoes (lots of vitA) I think would be good also. Maybe even some cooked spinach if you like that and yogurt. My guess is that you live alone and are fairly young. Being young should help you heal quicker. Try not to fret. Having 2 fissures removed and an LIS is quite a big deal. I'm sure that you will do just fine. Good luck!! Image
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Re: Just had 2 fissures removed and sphincterotomy today

Postby ryanman0 » 04 Oct 2012, 22:02

10:05 PM (about 13 hours after surgery)- Had my first bowel movement. Discharge instructions state pushing was ok. Hmm... I sat for 10 minutes with no activity. I really felt like I had to go. I tried relaxing and some tiny amount passed. Then, I pushed a little (very carefully) just to get things started. And I had to back off a couple of times b/c I was not willing to push harder (which would probably be straining). Fine line of judgment here. Anyway, it worked. I would say I only pushed about as hard as I would normally have to push to pass gas at some times when things were really tight before. It definitely wasn't any straining. After it started, things flowed pretty easy. I helped it along as needed, but mostly, it was easy, soft, and painless. The movement was very soft (but not liquid). Is far as quantity, it was about 1/2 of what I had hoped for. There was some blood; it was not even as much as before. Definitely not as much as the toilet filling episodes caused by my fissures at times.
Anyway, this bowel movement was followed by gentle pat with Toilet paper followed by minor wipe/pat with unscented baby wipes. After this, I got in the lukewarm water for 10 minutes. While in the tub, it burned a bit. Another note is that I clean the tub before each sitz bath with scrubbing bubbles and a sponge. Then I rinse it a lot to make sure no chemicals are left to irritate it.
Last edited by ryanman0 on 04 Oct 2012, 23:16, edited 1 time in total.
ryanman0
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Re: Just had 2 fissures removed and sphincterotomy today

Postby ryanman0 » 04 Oct 2012, 22:35

10:50 - I had barely gotten out the tub when I realized that I was now in some real pain. When I walked or moved it hurt. But now also when sitting. Then I had some gas sounds and felt pressure. I decided to try to pass gas in case that was causing pressure that might be amplifying the pain.
I figured that I had better stand over the toilet just in case I had an accident. I sort of bent over and pushed a little bit. Good thing I was over the toilet. It wasn't gas that came out. I had a bowel movement. It kept coming, so I stayed in the same position (not worrying about the splashing mess that would need to be cleaned up). It was more than last time. Between the two of the movements, I had really moved a lot of stuff. Since it was soft, no real pain during the act. Cleaned and into the tub again-- this time, not as much pain. Hard to say if there was a bit of blood. If so, it wasn't a significant amount.
11:10 PM -Now, I'm back in the bed and I have filled up the old style ice bag again (screw top, flower pattern, ice from the freezer) and have ice on the area. I'm laying mostly on my back with my legs tilted to the left which takes the pressure off the center. This sort of presses the buttocks together instead of apart. It also allows for the ice to be sort of propped up using a pillow to where it rests around the area.
11:31 - I am about to take another dose of the 2 pain meds. Pain level is tolerable (no regrets so far). But there is pain. As such, I will continue to take the max dose that the doc prescribed. Since I read that this can constipate you, I'll continue to drink tons of water and all the other stuff (mentioned above) that I have found might help.
I'll ramble on a little more about the pain. There is a consistent pain when resting that is not too bad. Also, when moving or walking, I have to go real slow. Sharp pains do occur if I move the wrong way or cough. Additionally, this is to be expected as pointed out above.
However, I think it is important to clarify this pain. So far, I have not experienced any agonizing pain like I did with the fissure. I'm talking about pain where you are about to go, so you grasp your hand against something and squeeze while making sure your tongue is clear of your teeth so you don't bite it off if you happen to bear down your teeth with force from the pain. The kind of pain where you want to scream, but you are at work so you somehow manage to mute it to a few grunts. Nor have I (yet) experienced anything like the 7 hours of sphincter contractions and pulsations that sometimes follow fissure related bowel movements that involve straining and lots of blood.
So far, I am doing good. I'm not having much blood or drainage. I have not had any pain that makes me regret having the surgery. Even if I was in extreme pain (which may unfortunately happen), I feel this was something I had to do. As such, I would need to suck it up and drive on (as my old drill sergeant would say). <-- just my way of self-motivating myself as the pain meds kick in again.
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