Just had LIS, fissurotomy

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, fissurotomy

Postby Ozark English » 13 May 2013, 16:29

Hey all. Just woke up from a long post-op nap, thought I'd post my experience so far in the hopes it helps somebody down the road. I'm a twenty-five year old male living in the US, with a fissure that started back in the beginning of November that gave me quite a bit of hell off and on for the last six months. Diet changes, analpram, and nitroglycerine didn't seem to be making headway, so I got a surgical consult in April and finally decided to schedule surgery that same month.
I had about two weeks to spend getting more and more worried about the surgery. I kept myself busy, since I've been mostly symptom-free for the past few weeks. I went ahead with the LIS because my surgeon and doctor were fairly sure that even if this current fissure had healed up (which it hadn't, turns out), this would most likely become a recurring issue.
I went in today at seven in the morning, very tired because I hadn't slept well at all last night, and was positively terrified once I got settled into the wait room with my partner. The surgeon was backed up with an emergency he had to take care of before me, so we had an extra hour and a half to sit and fret. Since I hadn't slept much the night before and my partner hadn't either (looong overnight shift), we just sort of curled up on the bed and drifted in and out of sleep. Had to take a fleet enema at one point, which wasn't anywhere near as bad as I expected, though every bit as effective. There were about a half-dozen times where I honestly considered trying to bail on the surgery, but with the support of my friends and family coming in on my phone during the wait, I managed to stay put and prepared.
When the nurses finally came, I can't lie. I was scared Image -less. They carted me to the OR, moved me onto the table, and my anesthesia crew immediately went to work talking to me and giving me something to calm me down. Didn't feel drugged or weird from it, just suddenly very relaxed and friendly. If there's a big recommendation I can make for you at this point - tell the staff how you're feeling and make sure they take care of you. After the initial calming dose (valium? not sure. . .), we talked a little more, I got moved into position, and the next thing I knew I was waking up in recovery. Didn't even start a pre-knockout countdown, I was just out. I honestly thought I wasn't done yet, like I had woken up or there had been a delay, because they'd done just that good of a job. My hips were somewhat sore from the position they'd had me in, but so far I haven't felt any pain.
They told me they had performed the LIS, a fissurotomy, and had found a small piece of tissue that they removed to examine further. I've been pretty groggy, and definitely a little dim-witted, but I think that's probably a mercy. Keeps me from overthinking everything I've been through today.
It's now about 5-6 hours after the operation, and I haven't taken the Norco (hydrocodone/acetaminophen) prescribed to me yet. A little nervous about the constipating effects of the hydrocodone on top of everything else they gave me during the surgery, but I think I'll probably take one soon just to keep on top of any pain that might be coming later. Just took some milk of magnesia to try and offset the pain meds. Aside from some pretty mild nausea, I can hardly believe I even had surgery today.
Anybody out there have any tips on when to start taking a look under the gauze, how to clean, etc.? I've read a bit about cleaning with just coconut oil, but different places say different things. And one more thing - a million thanks to all of you, for your experiences and your support to others dealing with this. Finding this board has been a tremendous help for me, as I'm sure it has been lots of folks. Y'all are the best!
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Re: Just had LIS, fissurotomy

Postby Savaici » 13 May 2013, 17:10

Very glad it's over for you, and you are on day one of healing.
This is a link to posts by Davo, one of our moderators, as he healed. Hope it might help you along the way:
http://anal-fissure.org/t4589-my-lis-diary-march-2012-fully-healed-in-4-weeks
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Re: Just had LIS, fissurotomy

Postby Cueball3335 » 14 May 2013, 09:24

Hey Ozark, I just had surgery May 13th and feel too as if nothing happened. It's so minimal I feel the dr must have not cut enough or something as I don feel loose and have trouble passing wind. Anywho cool we are going through it at the same time.
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Re: Just had LIS, fissurotomy

Postby Anne37 » 14 May 2013, 18:00

I'm not sure why, but although I'd used coconut oil before my LIS my doctor told my mom to use a product called Balneol to help with cleaning instead. It's an over the counter cleansing lotion, but the pharmacy had to order it and it took a day to come in. I think it was about $15, but I felt like it was easier to use than the coconut oil so worth it. I know some people use squirt bottles of some sort, but I mostly just used the Balneol and took a bath after every movement for the first two weeks, although sometimes I'd just wet toilet paper with warm water and use that. I switched to hypo-allergenic baby wipes after the two weeks and have yet to just use plain, dry toilet paper. I'm not sure I ever will again! lol.
Last edited by Anne37 on 14 May 2013, 18:04, edited 1 time in total.
Reason: added more information
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Re: Just had LIS, fissurotomy

Postby Ozark English » 14 May 2013, 23:04

Anne, I just looked into Balneol and I think I'll give it a go. I'm ready to try anything to keep this clean and healthy.
Savaici, thanks for the heads-up on Davo's report. That is absolutely A+ writing right there, it's really helping me keep my head up.
Cueball, it's funny, it seems like there's a handful of people on here who all got their LIS at the same time. I hope yours is treating you as well as mine is me.
I just took my new hardware out for its first spin, and wow. I'd say the pain was probably a 3 or 4 out of 10. I took half of a Norco tablet as soon as I got off the pot, didn't feel like letting that get out of hand. A quick bath helped calm things down almost immediately, though, and now I'm lying on the floor just feeling pretty OK. I hope that's the worst of it, because I'm a bit of a wuss, but I'm just gonna keep going one day at a time. As for right now, I think I'm going to watch some TV and let my mind shut down for the night.
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Re: Just had LIS, fissurotomy

Postby owmybum » 15 May 2013, 02:28

Glad to hear you are having minimal pain.
I would also like to recommend the balneol... It is very soothing, and when you use it to wipe, it just glides... No pulling. It is fairly expensive, but you don't need to use that much, so it lasts quite a while.
OMB x
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: Just had LIS, fissurotomy

Postby BootyMcOuchersons » 16 May 2013, 10:52

Hey Ozark (and Cueball),
I'm wondering how my fellow 5-13 LIS patients are doing? How's your pain, BMs, etc?
Image
My nurse told me not to use anything on the incision, and clarified that I shouldn't even use wipes (even if rinsed out w water) because they remove natural oils necessary for wound healing. She also said not to use anything that would coat the wound (neosporin, coconut oil, etc) as it needs to breathe. I know different docs recommend different things, and they aren't always right. Just wanted to share in case using cleaning products is prohibitive to healing. She told me to take a Sitz bath after BMs, and only use wet TP otherwise. That's what I've done and it seems I'm healing well.
I hope you are doing as well as I am... I'm not 100% comfortable, but not bad. For it only being day 4 after our LIS, I can't complain.
Let me know how you are. Thinking about you and Cueball.
-B.M.Ouch
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Re: Just had LIS, fissurotomy

Postby Ozark English » 16 May 2013, 18:19

A little bad but mostly good. Last night I had some pretty unpleasant nausea and woozy-headed action going on, that I think might be from the pain medication. I haven't taken any of the Norco today, just hot bath after going to the bathroom and that seems to be an ok replacement. Even went for a short car ride today with my partner, which I wouldn't have expected to be doing this soon after. I do have this occasional issue where the muscle down there clenches up and it hurts a good bit, between 2-10 times an hour maybe? Sometimes it seems triggered by gas or stress (not a good time in my life to be reading horror stories) - are these the spasms that other folks talk about? They hurt like hell!
It's a shame, but I'm so bad at cautious optimism. Aside from some momentary pain I seem to be recovering pretty well, but I'm a little worried that if anything takes a downward turn I'm going to be completely blind-sided by it. Like you said, though, not 100% but better than I expected this soon after surgery.
How about you guys, y'all doing alright out there?
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Re: Just had LIS, fissurotomy

Postby suzyljank » 16 May 2013, 18:40

Hi, I have norco too but only take it at bedtime, once in a while I did take it during the day. The doctor gave me zofran for nausea, this is a wonderful medicine. I take it when I have to use the norco. Wouldn't be able to take it otherwise. All opiate medicines make me nauseous. If you're having spasms try sitting on a warm, not hot heating pad and ask your doctor for Valium, it can help. Spasms can be very painful and last a long time. Sometime the Valium can break the pattern of spasming. Hope you have a speedy recovery. All the best Suzy.
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Re: Just had LIS, fissurotomy

Postby Jessjess » 19 May 2013, 00:11

Hi Ozark,
I had the same procedure a few months ago. I am doing well, still itching on a daily basis. I used Prep H and it works well to help with itching. I don't know if the itching will be lifelong due to just hemmoroids or not. I will inquire as it can be pretty annoying!
My second day of recovery was the most painful and I was taking high doses of painkillers. I offset it with plenty of water, fruits, salad, and a few prunes at night. Each day after surgery the pain diminished bit by bit and I was back to normal with no pain after about 16 days. I used gauze in between my cheeks and took a sitz bath after every bm to make sure the area stayed clean and dry. I also used a blow dryer to dry after bathing.
I'm unsure why you are still having spasms. I didn't have the painful spasms after the surgery.
Anyway, I hope my comments might help you!
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