Just had LIS and sharing my experience

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Just had LIS and sharing my experience

Postby Happyending » 22 Sep 2016, 18:20

This forum has given so much to me and I think it's time to give back. I will share my story going through LIS and what follows. I posted my background and history in another post titled "Creams, Botox and now looking at LIS". Feel free to read up on me prior to proceed below. I will be happy to answer any questions regarding home remedies and alternative treatment methods that I tried.

One big mistake I made was wait too long before seeing a doctor who diagnosed a fissure, before realizing I did not have hemorrhoids and wasted months treating them, etc. So my acute fissure turned chronic.

Here we go. My LIS journey is about to start.
A little more than 24 hrs before surgery.
Having second thoughts because I currently don't have pain. The BM this morning caused only a little bit of pain, and no burning or anything afterwards. But yesterday was a different story, pain during BM and burning afterwards. But then again, two Advil took care of it. I figured out the burning is probably caused by stool getting into the fissure. The better I clean, the less chance of the burning pain. And it's also related to straining, which is why I increased my fiber intake, and now I have to go to the bathroom twice a day, instead of once. I will reduce that again, because I don't want to go twice on surgery day.

So, being pain free today, it's really hard to settle with surgery! But I will go through with it because I know this fissure will act up again before I know it, and the weeks of healing are always time intensive. The fissure, by now, must be chronic, after about a year or so. I see surgery as an investment of a few weeks (hopefully not more) that will solve this problem for good.

I am not even so much scared of the LIS itself, since the cut will be outside of the anus. I am more afraid of the cleaning up of the fissure inside the anus/rectum. There is currently no bleeding, so the thought of introducing a new wound in there is gruesome.
The other thing I am afraid of is the removal of an older skin tag, not at the current fissure site, but across from it. That will give me a third wound down there.

Currently, after each BM, I use wet toilet paper to carefully wipe the inside of my anus clean. That requires some plucking and pulling on the skin around it. And that for sure won't be possible after surgery. So my concern is also how to keep it clean. A sitz bath can only reach the outside, not inside.

Yet another concern is not being able to pee after surgery, because that can happen to some guys. When my fissure acts up and things are swollen down there I already have a bit of a problem sometimes.

I am sure everybody facing this surgery is having their own set of concerns depending on their specific situation.

My surgery, by the way, will be an office procedure, only with local numming. The doc seems to prefer this, since it's quicker. Booking the surgery room requires much more time, and wouldn't have happened this quickly.

I took care of a few household chores today, which I know I don't want to be doing the next two weeks, such as laundry, cleaning the bath tub, etc.
Happyending
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Re: Just had LIS and sharing my experience

Postby Happyending » 22 Sep 2016, 23:16

So today is the day! I hadn't been sleeping much the past 2 days due to anxiety about my impending surgery. I had been given antibiotics, norco (pain medicine), and valium to be taken one hour before surgery. I had breakfast at home, a good BM, and then was on my way with my wife. We dropped the kids at school, and then took about an hour to get to the doc. I took all pills as instructed, and had another bowel movement upon arrival. It was diarrhea, triggered by mere fear. The Valium then took the edge off, and I really calmed down.

As I had mentioned, this was a procedure in the office, with only local numbing. The CRS told me the needles would hurt a bit more than what I had experienced during Botox. She had her assistant message my calves, to "distract the brain" from the other incoming signal, the poke from the needle. Well, the first needle hurt like a regular shot, nothing special. She said she uses an extra thin needle, a size 31, which is apparently smaller than the regular size 30. My wife, who is a physician, confirmed that. All subsequent shots should have been painless, but I felt them, which surprised her, and lead her to up her dosis. She asked if this what happens when I ge a shot at the dentist, and I told her she was spot on with that. My dentist always has to give me extra numbing.
So overall, the needles did not hurt more than the Botox shots. Surgery started at 11am.
The three ladies in the room ( doc, assistant, and my wife) kept talking throughout the procedure, which was a welcome distraction. I felt nothing down there. I decided to not have my old skin tag removed, which was optional.

I am not 100% certain of the sequence of events, but I think she felt the fissure first with her finger, then performed the LIS, then went in to cauterize the fissure. The one disturbing thing that happened was her saying she had to take into account that a little bit of Botox might still be present "from August". But my last Botox was end of June. I didn't say anything as my brain processed that info and what it could mean. Afterwards I though she might have cut more during LIS, assuming my spincter would be normally even tighter. But my Botox is completely worn off. Hoping she didn't make a mistake here and cut too much!
The other weird thing is that she said she had to put a stitch on the inside where I spontaneously started bleeding. I have no clue why that would be. Did she cut too deep and puncture the mucosa? I sure hope not. When everything was over, after about 20 min, I was in a good mood, and forgot to get a full explanation for that spontaneous bleeding.... I thanked the doc, and we left. In hindsight, the local numbing was so much preferable over full a full blown anestisia. I could just get up and leave.
On the way to the car one area began feeling a light itch, which I found weird. Turns out it was the numbing beginning to wear off. That seemed really soon. Then in the car a burning feeling crept in and got worse. The ride home was one hour, and the pain went up to a 5-6. I really wanted more pain med, but had to wait till we got home.
I was also scared since the pain level kept increasing. At home I took 600mg of ibuprofen, which didn't do anything, so I added another norco. That brought the pain level down to a 3. Bearable, but I was wondering how I would fall asleep with that. The whole time I am lying on my belly. I talked to my mom on the phone, who only found out today about this. I didn't want to have her worried leading up to this. I then dosed off and took a nap.
It's 9 pm now, my norco should have worn off, some ibuprofen might still be in the system, and my pain level, when I don't move, is about 2-3. Totally bearable. My fear is, of course, the first BM, which hopefully doesn't happen before tomorrow.
I took two colace, one with each norco. I took 8grams of fiber. The doc told me to take 25grams. But I already feels my bowls working and think I passed some gas. I do NOT want to have a BM tonigh. Hoping for tomorrow.
I was told to take frequent but short sitz baths, 2-3 minutes at a time, just to get water to the wound. And there is a gauze I should change. Wondering if I should do that already tonight, or maybe tomorrow morning. My preference would be tomorrow...
So far, folks. I hope this wasn't too long and too much boring information. I will post another update in due time.
Last edited by Happyending on 23 Sep 2016, 23:31, edited 2 times in total.
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Re: Just had LIS and sharing my experience

Postby Mypoorbutt » 23 Sep 2016, 06:23

Thanks for posting it's really interesting and reassuring to ready others journeys.
I'm having my LIS around November and it helps to read others experiences.
Can't believe they let you have it without being put under....wish they would here.
Good luck with your first BM here's hoping it's as painless as possible
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Re: Just had LIS and sharing my experience

Postby Buttpalsteven » 23 Sep 2016, 09:12

Nice post Happyending. Hope your pain is less today than yesterday and that you were able to sleep! My doc stitched me up too and I am healing well so I wouldn't be to worried about that! Let us know how the first BM goes!

Hope all is well,
Steven
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Re: Just had LIS and sharing my experience

Postby Happyending » 23 Sep 2016, 13:28

Ok friends, here is my update from day 2.
Last night I ended up removing all the gauze. The hardest part was getting that gorilla tape off my butt cheeks. Happy to report that my behind is smoothly waxed now! Then i took a short sitz bath and even dared to take a look with a mirror. My incision is on the lower right side, the fissure center/posterior. It doesn't look too bad, I can see some thread form the stitches. But the left side, which supposedly was left intact, is swollen beyond recognition. The size of a baby fist and rock hard. I wonder why that is.
So I fell asleep, slept six hours and woke up completely pain free this morning. The only feeling I had was like somebody had shoved something big between my cheeks and butt. It's the swelling from the left side. I decided to place some ice on it, but that somehow stimulated my bowels and I got scared. I have been incontinent to gas since yesterday, I was afraid I wouldn't be able to hold the BM long enough. Plus I didn't want to have a BM yet and ruin my nice pain free morning. I took ibuprofen and norco, preventatively, so it wouldn't hurt so much when I eventually had to go. I still had some Valium left and took one of those as well. I also managed to get some Vaseline onto that super swollen left side. Then it was time to face the toilet bowl.
Then came the surprise. No pain at all. Granted, everything was super soft, there was no straining, it basically just fell out. I wiped with wet TP, took a sitz bath, then washed it out in the shower. No pain at all either.
I took the narco 4 hrs ago, by now it's worn off. I have zero pain. I tried to ice the swollen left side of the asshole again, and it seems to trigger another BM. I immediately stopped the icing, so I wouldn't have to go again.
Let's see how the rest of the day goes. I will report on important developments if there are any.
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Re: Just had LIS and sharing my experience

Postby Happyending » 23 Sep 2016, 20:00

Second BM of the day in the afternoon, again no pain at all. So far so good.
The only worry is the immense swelling on the left side. Must be hemorrhoids. Worst is actually the skin tag that i did not have removed, it's hard like a pebble and the size of a small grape or large garbonza bean.
Question to those who have been through it: Is this swelling normal and how long until it reduces? Again, it's on the site opposite of the LIS incision.
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Re: Just had LIS and sharing my experience

Postby chachacha » 23 Sep 2016, 22:56

I had one sentinel tag before LIS and about 5 afterward. All were extremely swollen after the surgery and took a few weeks to become smaller.

It sounds like you're doing really well. Keep up the good work!
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: Just had LIS and sharing my experience

Postby Happyending » 23 Sep 2016, 23:37

Thanks Chachacha for the info. I sure hope these huge things will get smaller soon. Otherwise no complaints at all!
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Re: Just had LIS and sharing my experience

Postby Happyending » 24 Sep 2016, 00:34

Third bowel movement of the day. Not sure what's triggered that. I didn't eat much yesterday or today, but I think the swelling down there might be sending signals to my bowels. But honestly, I got no idea. I am just happy and thankful that they have all been pain free.
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Re: Just had LIS and sharing my experience

Postby Mypoorbutt » 24 Sep 2016, 01:28

Hi happy,
Really glad it all seems to be going well for you and it must be so good to go to the toilet and not be in pain....did you have spasms before if so have they stopped, also are you still getting the burning aching pain after your BM?
Again hope you have a pain free weekend
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