Just joined the LIS club

Some info as well as questions on my recent LIS 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 joined the LIS club

Postby BlueFissure » 09 Apr 2016, 05:51

Hi everybody,

This is my 1st post, so let me start by thanking everyone that contributes to this great forum, as so many people have already stated, the information and support is simply invaluable !

Let me also quickly introduce myself: 36yrs old male, have a history of anal fissure(s) since 2007, but I managed to keep it in check with GTN for most of this time. And Calmol 4 suppositories, which I find are by far the best, and I have to order from the U.S. as they are not available here in the UK.
However I could feel that overtime it was getting worse, until Dec 2015 when GTN wasn't working properly any more.
Also tried Diltiazem both a couple of years back and last month, but it didn't do anything.

Long story short, I had a LIS 9 days ago on the 31st of March, in London, privately, with Dr Carapeti (I know many people on this forum from the UK have used Dr Windsor).

So below is my experience, in case it's useful for other people:

BEFORE
- the only "official" requirement was the NIL by mouth from 6 hours prior to admission, due to the general anaesthesia
- however 1 week prior I started being careful what I was eating and using 1/2 (6.9g) Movicol twice a day and a small spoon of Psyllium husks, just to make sure the BMs were soft and regular
- this last week I was off work, and my whole life was directed by this darn fissure: painful BMs every day, then small pain for a couple of hours, then intense pain for another 4-6 hours... nothing new, I'm sure everybody here knows the drill

DURING
- I'm fortunate enough to have private insurance (I also had a NHS appointment, but it was 1 month later and that was just an initial one, don't even want to contemplate how much later the operation itself would have been...)
- checked in the hospital at 12h00 pm, in average pain following that morning BM, saw the consultant, the anaesthetist, the pharmacist (they like to discuss/prepare the medication you take home in advance)
- waited and suffered some more for 2-3 hours ( strangely enough, the peak of my pain was always a few hours after the BM)
- then went to the theatre all stressed shaking and with cold hands :) but the anaesthetist was very nice and in less than 30 seconds I was asleep
- woke up roughly 1hr later, very dizzy but with no pain, had a glass of water and kept drifting back and forth between sleeping and being awake
- was taken to my room 30 mins later and I continued to keep falling asleep on and off for another couple of hours
- had several drinks, no problem going to have a wee (very important apparently, they really want you to do that before leaving the hospital)
- by 6pm when I had dinner, I was feeling ok. Some blood on the sheets but not too much, and some mild pain or general soreness in the bum area, but had no problem walking (like a penguin :) ) to and taking the cab back home
- had 1g Paracetamol and 400mg Ibuprofen before going home, and was sad to have to leave my fishnet knickers and compression stay ups behind :)


AFTER

- Day #1
Feeling a little pain, but not much (2-3 on a scale of 10) and most importantly psychologically very pleased and optimistic. I guess like someone that's happy (or shall I say even somewhat proud ?) that after all these years of problems and being afraid of the operation, I finally did something about it !
Took Paracetamol and Ibuprofen just in case, but determined not to use the morphine sulphate tablets provided unless I really had to (they cause constipation apparently).
Passing wind is slightly strange, always quiet as others have mentioned on the forum, and somehow you don't feel it the same way.

- Day #2
The famous 1st BM arrives like clock work at 7am... I was so scared and quite surprised when I could feel no pain... initially... then 3 minutes later the pain kicked in, quite intense, probably 7-8 / 10, but I would say no more painful than the worst pains I had before the operation.
Jumped into the bath tub and had a warm sitz bath for ~45 mins which did help. After 10-15 mins the pain was down to 4-5, which made me quite happy... and again proud of myself, I had finally conquered the legendary "1st BM" ! :)

- Day #3
Continue to take Movicol and Psyllium husks twice a day + 20ml of Lactulose in the evening.
BM again at 7am, painful again, but less so, sitz bath again.
Then some pain, level 3-5/10 for most of the morning, then little pain in the afternoon.
Apart from passing wind that felt strange, I haven't experience any incontinence.

- Day #4 & #5
More or less same routine, BM in the morning, painful but not too bad, then pain comes and goes for 4-5 hours until mid day and then the afternoon is "ok".
All this with only some Paracetamol + Ibuprofen in the morning, which is really not too bad !
However I'm starting to worry, as the doctor told me that the pain peak should be day 3-4 and then it should slowly calm down by the end of the 1st week.

- Day #6 & #7
Things are getting slightly better, I think the pain is slowly improving.
Even had slightly harder stools one morning (still soft for a "normal" person I shall say, but less so that previous days) and while that increased the initial pain in the 30 mins after the BM, it didn't have any effect on the rest of the day.
By now the general soreness of the area due to the operation (in the first few days the whole area around the sphincter is blue due to bruises) is gone, I can clearly feel that the only pain left is the one from the incision.
And I can also feel this is different than the initial fissure, which was at 6 o'clock, whereas the incision is at 9.
Also, the new pain is different, it starts rapidly after the BM and finishes quicker.
May sound strange but I feel happy about this pain, and the fact that it's different... it means something has changed... the fissure that has had been hurting for the last 3 months appears not to hurt any more.

- Day #8 and #9 / today
Hard to compare exactly but the pain is not improving.
On the contrary, today the BM was more painful than last few days and also the pain throughout the morning. Level 5/10 maybe... in any case clearly worse. Probably the fact that I had a 2nd BM last evening didn't help, as it didn't give it enough time to heal...?



Anyhow, sorry for the long message and thank you if you made it thus far :)
I'm still optimistic and happy that I finally did something about this fissure that was/ still is so debilitating.
However, I start to worry that maybe in my case the surgery will not be as effective as for others.

Are there people out there that had similar experiences ?
I know all healing processes are different, etc. ... but still, there is often some sort of initial period after which, depending on your state up to that point, one can statistically know if it's likely the operation will be a success or not ?

Thanks,
BlueFissure
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Re: Just joined the LIS club

Postby Hopeful1 » 13 Apr 2016, 10:13

Hi BlueFissure!

I'm really glad you've finally had this operation after suffering from a fissure/fissures for so long.

We all need reassurance when we're recovering. That's what brought me back to the forum today. I'm a worrier. Every twinge of pain makes me panic and think the operation failed! I had LIS 4 weeks ago tomorrow. I'm a 29 year old male.

But I think it's perfectly normal to get pain and discomfort - of varying degrees - for several *months* following LIS. Everybody heals differently and at a different rate.

My CRS tells me I can expect to be healed by about the 3 MONTH mark. That sounds about right considering the level of discomfort I'm currently experiencing.

For me, I'm still getting soreness after a BM from the fissure. My incision is pretty much healed up, but there is still one stitch left. Burning from incision stopped a while back. Occasional pangs of discomfort and have to be careful sitting down for long periods. I drive a taxi so have been taking it slow. Overall, slow progress in the right direction but I can't wait to heal up.

Hope some of this helps :)

The important thing is not to give in to doubt and negative thoughts. You WILL heal, but it's going to take months. Just keep your chin up!

Andy
Haemorrhoids: for about 8 years - lived with it
Rubber Band Ligation: Spring 2015
Anal Skin Tag Removal: Summer 2015 (missed sentinel pile)
Fissure diagnosed: Aug/Sep 2015
GTN unsuccessful
LIS: 17 March 2016
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Re: Just joined the LIS club

Postby Jocko » 14 Apr 2016, 03:35

Hi first time user but like others have been following everyone's stories
I elected to have Botox to my fissure.im not keen for the LIS. Due to the point that I want some control over my BM
Like many it took a while to settle down post surgery, probably due to the initial insult from the procedure

I've had mixed success with Botox and wishful thinking that it will work

I must say thou when you think you need to have a BM. Then do it, no time to put it off. I find the squat position better

One thing that I have found helps with pain
I have a back massager that vibrates and pulses onto your muscles
No it's not your sordid vibrator, but that may work too
By lying in bed and placing this massager machine on my fissure helps with pain and relieves a little pressure
I use it externally

It's a temporary relief but relief it is

Obviously it don't look right while your doing it, but my wife has accepted the view she gets

Thanks everyone for your threads and advice. It's pleasing to know we aren't alone
Jocko
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Re: Just joined the LIS club

Postby FissureFighter80 » 15 Apr 2016, 16:21

BlueFissure,

I had my LIS with Dr Carapeti on 5th of April so we are pretty much in the same boat. In the second week I feel like the shaved hair on my bum are causing a lot of itching and even rashes specially when I walk. Did Dr Carapeti say anything about how to deal with this(I am guessing he did this to you as well) ?

Thanks,
FissureFighter80
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Re: Just joined the LIS club

Postby Bst2011 » 23 Apr 2016, 06:33

Dear All,
Is it normal to have a blue bruise by the pinter area after LIS?
I had my LIS 2 days ago and so far no bleeding. But I just saw my left sphincter area is blue/black. Bluefissure you mentioned you had it till day 6 or 7...

Thanks in advance
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Re: Just joined the LIS club

Postby Hopeful1 » 23 Apr 2016, 13:46

I believe bruising is very common. I had bad bruising all over my left bum cheek for some reason!
Haemorrhoids: for about 8 years - lived with it
Rubber Band Ligation: Spring 2015
Anal Skin Tag Removal: Summer 2015 (missed sentinel pile)
Fissure diagnosed: Aug/Sep 2015
GTN unsuccessful
LIS: 17 March 2016
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