LIS and anal advancement flap 5 days ago (NHS route advice)

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LIS and anal advancement flap 5 days ago (NHS route advice)

Postby Maciej » 21 Sep 2011, 10:12

Hello to all of you fellow sufferers!
I am 26 years old, and i live in manchester
(I had 2x botox; LIS; Anal advancement flap)
Long story short:
A year and 2 months ago i had a long car journey from the UK to Poland
I was quite stressed as it was the longest ride i have ever had, I remember how constipated i became few days beforehand due to loads of stress and bad diet.
I remember the poo that started it all...
by the time i arrived in poland i was in a lot of pain.
I rented a flat in poland for a month it was a gift for my wife, perfect holidays. I spent most of the time at the flat thinking that it is just a hemoroid or something trivial, how wrong was I.
When i went back to the UK i went straightaway to my farmacist and bought all the most expensive remedies for hemmies. After about a week of using suppositories i decided to go to my GP, as my pain was worst than ever in my life. It took them more than 6 months to diagnose the problem. No one even looked at my bum, even thought i went to three different practicioners at my GP clinic they all just assumed that i have hemoroids...
The worst thing was that they prescribed me with codeine based painkillers which made me so constipated that i could not open my bowels for a week
The big day when i learned it could actually be something different than hommies was when I finally opened my bowels. Codeine based painkillers made it near to impossible, i was in so much pain, I bled extensively, and I felt like loosing consciousness any minute! I called for an ambulance, My first call was ignored! I was told that i should book with my gp asap and take some more painkilers! (Only call for an ambulance when you feel that your life is seriously in danger!)
I was fuming , so i called again and talled them that I will keep calling till they send someone! as I was still bleeding quite badly.
So they did sent an ambulance and when the paramedics came they treated me like an idiot cry-baby. The emergency ward called for a CRS to see me and after about two hours he came to tell me that hemoroids would not cause so much pain, and blood loss, and that I probably have an anal fissure.
(at that point I was in so much pain that they could not examine my bottom, and even thought no one thought about a proper examination under the anesthetic). He prescribed me with movicol, lactulose, diclofenac and paracetamol and send a letter to my GP to pescribe me with rectogesic... I used it sceptically for about a month but it made my head throb like crazy, my gp prescribed me with anoheal instead and referred me to a specialist. Both creams were for me a total waste of time...
I visited my specialist on at least three occasions with 4 weeks interval. Every visit ended in the hospital bed as the visits were in the morning just after the loo when my pain is at it's worst. Emergency admissions are for everyone remember that! On my last emergency admission i had a colonoscopy, and finally i learned that it is not hemoroids but an anal fissure. I was prescribed with anoheal for 8 weeks. It did not worked so my CRS proposed Botox. First few weeks after the botox injection were terrible, but than after the week 8 things started to look a little bit better, i was able to go for a walk with my wife first time in 8-9 months. But then it stopped healing, so i had a follow up botox injection... sorry to say but it was a U-tern all the benefits of the first botox were lost...
another 8 weeks passed, without any improvement so my surgeon decided that it is the time to do the LIS... He reffered me to the hospital in less than 4 weeks.
well when i was in the hospital bed he came and told me that he will carry two procedures instead of one.
He made an anal advancement flap and LIS operations. I was on the table 5 days ago. It is too fast to say if it worked or not...
All I know is that going to the toilet is painful as hell! I even think that it is actually worse than it was before the op. I think that if it will stay like that, and i will not stop bleeding badly after the toillet I will go to the ER, I fear that there was something wrong with my LIS as the spasms, even thought smaller are still there... and as far as i know LIS should kill that completely.
I will keep posting on my progress.
I can give few good advices regarding NHS:
- Do not be afraid to go to the emergency, they can sort you out faster than your GP, and can make refferals and prescriptions for you on the spot, just be firm and persuasive if you are not they will send you home with a bunch of painkillers
- If you have an appointement with a specialist they can arrange for an emergency admission to the hospital the same day if they decide that you are really suffering, so do not hide your pain from them! In that way you can get your examination the next day, and a refferal for a treatment in about 4 weeks! If you are in pain and your stress levels are at the extreme show them that you can not wait! Remember to be polite but firm. It worked perfect for me!
- If you can not walk or drive to the emergency unit call for a comunity ambulance (your GP can help you with that, they can give you a number to call), they are there for you. If you feel that your life is in serious danger (you bleed extensively, much more than normally, feel like loosing consciousness) call the ambulance and if they do not treat you seriously when you call them finish the call and call again there is a big chance that the next operator will take your call seriously! Remember that you will never speak twice with the same operator, so do not worry, if they are bad to you, call again... Still remember to use the ambulance services only when you feel that your life is threatened.
- When you are able to go to the emergency unit remember to tell in the reception that you are unable to stand or sit down for an extended period of time becouse of the pain in your bottom...
(Once I was waiting for an hour before they let me through, i was so uncomfortable that i started to cry... My wife was furious, as they let a violent drug addict before me :( finally i lay down on the floor in the emergency unit as i was unable to sit any longer)
- People do not know what an anal fissure is so when you enter the hospital, your gp clinic, or the emergency tell them you have got it, describe the pain you are experiencing and ask if they have a room where you could make yourself omfortable. Same rule apply: Be Polite but firm.
I will writte to you tommorrow on my progress on day 6
Last edited by Maciej on 22 Sep 2011, 04:28, edited 1 time in total.
Reason: I was too excited with the fact i can share my experience that i gave some bad advice on the use of ambulance services.
Maciej
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Re: LIS and anal advancement flap 5 days ago (NHS route advice)

Postby val » 21 Sep 2011, 11:19

Hi there,
congratulations on having the surgery, hopefully you will soon be putting this awful experience well and truly behind you.
I am sorry, but I really can't agree with calling an ambulance for a fissure. Yes, they are EXCRUCIATINGLY painful - those spasms had me screaming in agony for seven long months.
But, fissures are NOT life threatening, and while an ambulance is sorting you out, just trying to jump the queue, they might not be able to respond to a TRUE emergency, where somebody's life is at risk.
I don't wish to be rude, but your actions are extremely selfish and I don't think you should be advising other people to do the same.
val
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Re: LIS and anal advancement flap 5 days ago (NHS route advice)

Postby Deleted User 579 » 21 Sep 2011, 13:40

Hi! Congratulations on your surgery! You have certainly been through an awful lot and I hope you feel better and get completely healed very soon.
I agree with Val, though, that a fissure is not a sufficient reason to call an ambulance. Believe me, I know how incredibly painful they are; but unless there is an extreme amount of blood and dizziness and other issues, it is possible to get to a hospital some other way. I think calling an ambulance should be reserved for situations where there are no other options and medical attention is required immediately for life-saving purposes.
That said, I agree with the rest of your advice about not letting doctors send you away without taking your condition seriously. That happens to too many of us, and it is important that doctors understand that even though fissures are not life-threatening, they are not trivial either.
Do keep us posted on our progress - I hope you feel better very soon!
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Re: LIS and anal advancement flap 5 days ago (NHS route advice)

Postby Maciej » 22 Sep 2011, 04:10

I can see where i have made a mistake... I will edit my post, the thing is that in my case it always was dizziness, lots of bleeding and feeling like loosing consciousness... I will add those details to cover for the use of ambulance. I was so excited that i can share my experience for the first time that i omitted important details.
I do not know how your fissures acted after the BM but in my case after the toilet i could not move for 6-8 hours and that was happening every day for the last year... I was being paralized with pain, i could not walk or sit, and even laying down was not helping.
Val and hopetoheal you are both absolutely right, if you do not fill that your life is in danger no one should call the ambulance, in my case I thought I was going to die so many times due to malnutrition, superstrong painkillers on max doses every day etc.
I am so glad that i found this forum it is seriously the first time I can speak about those things to anyone.
Once more i am really sorry for a wrong kind of advice i will change the post to include the omitted detail.
Oh and here is a thought I learned yesterday that many GP clinics have got contracts with the community ambulances, their sole purpose is to take patients to their apointements, or to the hospital when needed. You need to book it in advance. The drivers are really friendly and they are driving really cautiously, so here is an alternative :). I tried to use taxis on many occasions to take me to my appointements or to the hospital, even though i always asked them to be really careful as i was in a lot of pain they did not took notice and driven like crazy, when finally i was "delivered" to my destination i could not sit in the waiting room, so I always asked for a bed to wait for my appointement. I do not know about you guys but after my bm I needed many hours to be able to walk again... That being a case traveling after bm was the most dreaded thing :(
I will edit my post now, thank you for pointing it all out for me :)
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Re: LIS and anal advancement flap 5 days ago (NHS route advice)

Postby val » 22 Sep 2011, 07:44

Yes, fissure pain sure is hell on earth! When I had spasms for hours, I couldn't do anything except lay screaming in pain and rolling round the bed - I know how you feel! And I used to want to die too - I was scared to wake up each morning, and got "bathroom phobia" LOL!
I do think doctors should be aware of how much misery fissures cause, and refer people to a CRS very quickly! But then, you could say that about any disease - there are long waits even for very serious conditions.
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Re: LIS and anal advancement flap 5 days ago (NHS route advice)

Postby Maciej » 22 Sep 2011, 08:58

You have the point Image
The problem is that Not so many people know how seriously this illness affects one's life.
Pain is not a part of a healthy lifestyle... It is an illness in itself. Only recently doctors started serious and conclusive studies on pain management.
It is like having a cancer without the hope that it will finally end your life :) What is worst than that.
Funny thing is that people do not actually know that the fissure pain is one of the most painful if not the most painful experiences available for a human being to suffer from.
I heard people who passed kidney or bladder stones quoting that it was nothing in comparison with the AF.
While the medical world claims that passing a bladder stone is the most painful experience.
I myself suffered from a serious bacterial infection on my big toes. I had rotting flesh wounds on both of them for 6 years, the final advice from my GP in Poland was to amputate both toes, thankfuly My mom found a doctor who made the final op, He whisked all the rotting flesh and transplanted some fresh skin over the area. Recovery took a year for each toe. I still say that it was nothing in comparison with my AF
That is how bad those things are!!!
The world, especially the medical world should know about it all, and yet GP's are just blaming things on hemmies and tend to send suffering people home with some painkillers and an otc cream, without even looking...
Last year was pure missery!
I can proudly say that i fought for my illness to be recognised as a serious problem. I was so low that I even asked my Gp if she could put me in a crazy house because I was so fed up with my life... :) She did not put me there but instead she helped me with a faster refferal.
I sometimes feel that people are to scared to show their GP's how bad things are!
This illness should be treated seriously, when I had my low back pain problem I was refered for the physio within few days. When I was suffering pain far more greater than my back I waited half a year for it to be investigated...
As you say Val all illnesses should be treated seriously but in my opinion our doctors should know how each illness affects our life so they could decide which illnesses should have a priority.
If an illness produce pain that even death would be a remedy worth looking for, than it should be treated asap.
It makes me angry that so many people here waited 6 or more months before their first proper examination like colonoscopy or sigmondoscopy.
You would not believe how many doctors tried to examine me by the digit insertion method (finger in the bum), I was screaming my throat off, and sobbing like a child afterwards, and even though none of them said "ok my man you need a proper examination" My first colonoscopy came as a surprise as the visit to a CR doctor ended up on bed in the hospital due to the emergency admission. I was stuffed with so much morphine that i lost consciousness... When i reclaimed my senses a practicioner finally said that they need to do something about it...
Well said as it is I hope it will finish soon.
The worst time so far was waiting for a diagnosis when i learned what it is I could finally name my enemy and started to live accordingy...
I will always tell people that they need to be firm to the extreme with doctors as they are working up to the budget rather than wellbeing of their patients :)
As my wife puts it "Be firm but polite"
Bless her she is a saint!
Thank you Val and hope to hear from you soon
Maciej
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Re: LIS and anal advancement flap 5 days ago (NHS route advice)

Postby val » 22 Sep 2011, 09:06

I think if you haven't suffered the pain of a fissure though, you can't possibly understand what all the fuss is about - after all, it is essentially a very small cut! If you had that size cut on any other part of the body and made a huge fuss screaming and yelling in agony, I think we would actually get carted off to a crazy-house LOL!
So, it's not really surprising that doctors don't take it seriously.
But you are completely right, and it's advice I always give to anyone here when they are trying to persuade the GP to refer them - don't leave the doctor's chair until they do what you ask!
val
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Re: LIS and anal advancement flap 5 days ago (NHS route advice)

Postby Maciej » 22 Sep 2011, 09:54

You are wright but this cut is in a place with the intricate nerv system, with all the different chemical profiles and defensive mechanisms which all are agaist healing... In other words no one would poo on their wound, pour acidous substances on it or poke it with a turd :)
Not every doctor had a stomach ulcer which is a bit like a hemmoroid in your higher digestive system and yet they are taking care of it with high priority without questioning the illness...
I want to thank you for your time Val! I feel much better after just few posts... all the negative stuff was brimming till few days ago when i registered with the forum... It is so weird to not be able to speak about all that for a year!
I feel relived...
Once more thanks
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Re: LIS and anal advancement flap 5 days ago (NHS route advice)

Postby Deleted User 579 » 22 Sep 2011, 11:37

Hi Maciej- thanks for the clarification and for the information about transportation services. That will be very helpful to people! It sounds like you went through an incredibly tough time. I also get angry that people have to wait so long and suffer so much with fissures. It really is something that has to be taken much more seriously, given how life-altering some much pain is. Many of us lost a lot of weight and ended up being in very poor health generally by the time we got treated.
I'm really glad you are doing better now! :D
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Re: LIS and anal advancement flap 5 days ago (NHS route advice)

Postby Maciej » 23 Sep 2011, 03:29

thanks for the reply Hopetoheal!
This illness should finally gain reognition!
If I win the lotttery or all of the sadden become rich I will start a fundation, propagating AF recognition...
:)
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