LIS incision site

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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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Re: LIS incision site

Postby msimon » 20 Apr 2015, 13:15

Thanks Canadabum. As far as I know there aren't any members in my city on here (but I suppose there may be some lurking that may know). I am located in Edmonton, AB. Anyone know of a CRS in my city or nearby? Thanks :)
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: LIS incision site

Postby chachacha » 20 Apr 2015, 13:50

If you're brave enough, you could tell your current CRS that you need a second opinion and that the other one has refused you. If he doesn't mind you doing so, he could actually refer you to the other, and provide notes and history, which could be very helpful. If he's a really decent guy, he may even admit to the new guy that he's at a loss and can't think of anything else to do.
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: LIS incision site

Postby Canadabum » 20 Apr 2015, 21:01

Hey msimon...i tried sending you an email and not sure it worked so i will repeat a bit here.

Why not go on to the College of Physicians and Surgeons of Alberta search function:

http://www.cpsa.ab.ca/PhysicianSearch/A ... earch.aspx

And put in searches using words like "gastro" "surgeon" "general surgeon" "colorectal" etc etc.

You will get a bunch of names both in Edmonton and likely in Calgary. That will give you a great pool of people to call -- even if they are not specialists in the exact area that you need call them and tell them what you are looking for and see if they can recommend anyone in the area...doctors know other doctors and they may lead you to the right people. Also, you may want to expand your scope and include Calgary -- i know it is not that close but I would imagine that Calgary has a lot of great surgeons and docs who specialize in this area given the population size and the wealth of that City.

I hope this idea helps...since you will find many names through your search I would encourage you to enlist your family, partner and friends to help you make the calls.

Good luck and keep us posted on your search.

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Re: LIS incision site

Postby Broncosgirl » 20 Apr 2015, 22:30

Hi Msimon,
I know you're in Canada, but I wanted to pass along the info for the doctor who I had my phone consult with. They charge $200 for a 1 hour phone consult and won't bill insurance for it so it's a hefty fee, but if you wanted to give it a shot I thought I'd pass it along. You can go to his website to see if he seems like a good fit.

Office of David B. Rosenfeld, MD, FACS, FASCRS.
2650 Jones Way
Suite 25
Simi Valley, CA 93065

Office 805 579-8972
Fax 805 579-9784
www.davidrosenfeldmd.com
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Re: LIS incision site

Postby msimon » 21 Apr 2015, 02:16

Thanks for the great suggestions all. You are so sweet. :smilyhug: Hugs to you all!

Chacha, thanks for the suggestion but I definitely don't feel comfortable doing this. My CRS can be a bit unpredictable as far as moods go and a couple of visits ago he actually snapped at me really badly and now I am afraid to say much or ask much of him. It is odd as he seems to have 2 different reputations and I'm still trying to figure him out. I don't want to burn any bridges here. The other CRS wouldn't really offer me much unless I am in for flap surgery down the road. I know my CRS hasn't done many of these while the other has.

Canadabum, thank you as well for the suggestions. I actually did comb the College of Physicians and Surgeons website on the weekend to make sure I wasn't missing anything and if I go by the special interests indicated there there was only my CRS, the one I referred to trying to get back into and a 3rd one. I called the 3rd one today and was told he is not accepting new patients for fissure/hemmie problems. I'll have to get my GP on the task as she would likely have better resources than I but I know I have heard that we have very few CRS Doctors here. I don't know why...

As for travelling to see one and enlisting family etc. Unfortunately my family has become rather unsupportive of things like this after this long struggle. My husband is definitely not on board with the second opinion and is definitely not on board with spending any $ on it. Since I haven't worked in years that leaves me few options there. Hubby seems to think I just need more time. Maybe that is true but I just have a really bad feeling about this as this seems quite rare and seems like exactly what I went through with my fissure before the LIS. This early on though another CRS would probably not want to do anything anyway. I really was just trying to get the ball rolling as it takes so long to get into a new specialist here. I wanted to be prepared for if more time was not going to be enough. It also would help me not feel so much despair as at least I could think that maybe I wasn't at the end of the road yet.

Broncosgirl, thanks for the suggestion but as I was telling Canadabum, my husband does not support this sort of thing and he holds the purse strings rather tight these days. I also don't think I would travel well now and a phone consult would not likely be thorough enough.

I don't want it to seem like I am shooting down all your ideas. Definitely as time goes by if things don't start improving they will certainly be considerations. Unfortunately, I am stating to think the only way this is going to heal is through a colostomy, which I would do, but am not sure where I would find someone willing to do it and I definitely don't have the families support on that. Oh how nice it would be to not be terrified of my bathroom anymore!
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: LIS incision site

Postby Canadabum » 21 Apr 2015, 16:24

msimon -- i am so sorry that you are not getting the sort of support from your family that you deserve. I do not want to be presumptuous by making suggestions when i do not know your whole situation...but given you are considering a pretty extreme solution - colostomy - i think you should apply all extreme measures to find help...you deserve it.

here is how i would approach it -- forget about the lack of funds right now...the effort should be on finding someone who can give you advice and perspective based on an examination. i would do your best trying to track down someone in Edmonton or Calgary...once you feel you have found someone who could be helpful then you can go about figuring out how much it will cost to either travel to the destination...or if you are lucky you wont have to travel. if funds are the limiting factor then perhaps you can set up a crowd funding fundraiser, sell lemonade this summer...hey, I will set up a stand on my front lawn and do what i can myself....bottom line is that you are suffering and we all know how difficult it can be -- you owe it to yourself to really explore all options.

as for exhausting your avenues in Edmonton -- I would really encourage you to try and get referrals to not only CRS specialists but try and engage general surgeons as well...why, simply because they might add a bit of understanding and they might be your avenue to another doctor. for instance, i found who i considered an incredible CRS here and was told by his staff that the waiting list was a year or more...when i explained to them that this condition was really impacting my quality of life and then asked for some other names...the doctor supplied me with 3 other names that he recommended...one of whom i have been able to get an appointment with. use each conversation with a physician as a gateway to getting one or two more names that you can call.

also -- have you contacted the university medical department and spoken with the professors there -- many of them have deep contacts with practicing physicians and might be able to recommend some names for you.

one more idea -- there is a clinic in Ontario called the Rudd Clinic and they have 3 or 4 locations...they specialize in issues of the underside...you could call the clinics and ask them if any of their physicians has relocated to Alberta because you need their specialty...who knows, they may have physicians that they refer to where you live.

just a few more thoughts...hope it helps a bit

best
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Re: LIS incision site

Postby msimon » 21 Apr 2015, 17:40

Wow! Canadabum you are a wonderful human being. Thank you for caring so much to provide all this information to me. It means so much that you care and really understand this hell we go through with fissures.

I have been very rigid in trying to see a CRS based on the emphasis here for people to see a CRS for the LIS but now that I have had it I suppose there is no reason a general surgeon may not be helpful. I will try calling some tomorrow. Afterall, it was a general surgeon that did my hemorrhoidectomy many years ago and he was quite good.

The university is a very interesting approach. I'll have to check that out. As for the Rudd clinic, I'll give that a try. Thanks again. :Rock:
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: LIS incision site

Postby Scientist2516 » 21 Apr 2015, 20:11

msimon, my heart hurts for you. Not getting the support you need must be unbearably depressing. Your health is worth any amount of money. Keep searching, my dear. It's forumers like you and Canadabum (and so many others) that make this place so great.
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: LIS incision site

Postby owmybum » 22 Apr 2015, 06:17

I'm sending you my biggest hug sweetie. You are having such a tough time healing I would like to agree with others... You need to have someone else look at your unhealing wounds.... A general surgeon would be just fine to take a look if you could get your GP to refer you to one. They may have some advice on healing etc.
I'm not sure if a colostomy would be the answer. You still have pelvic floor dysfunction, and this is the reason I believe is the root of most of your troubles. A pelvic floor specialist would be another person I would be seeking out.
Have you tried the wound honey?
I saw the specialist rhumertologist on Monday, who has confirmed a diagnosis of hypermobility syndrome with EDS type 3 . This is a genetic condition, so I can't really do anything about it, but what it does mean is now that I have a written diagnosis I need to be operated on and stitched up differently to others. My skin has very poor collagen and connective tissue, so healing is super slow. Do google it and see if you recognise any of the signs in yourself.
Any questions just ask.

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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: LIS incision site

Postby msimon » 22 Apr 2015, 18:23

Thanks OMB. You are so sweet. It means so much to me that you have stuck around on here, especially given your current struggles. I have seen so many come and go... :Rock:

I am glad you at least have a diagnosis now. Hopefully with a diagnosis comes knowledge that can be helpful for you. I don't think I have the symptoms of any of the connective tissue/collagen disorders, at least anything I could find to read on the net. My skin issue is strictly related to the incision site as even my fissure healed (it was slow but did heal) and the wound from my sentinel tag removal healed up quite quickly. I heal very fast elsewhere. I do have chronic pain in my muscles throughout my body but had that long before my fissure and it seems to be made worse mainly by the stress of all this.

I do have a pelvic floor specialist that is a wonderful lady but often I seem to just flare up from the treatments so I am not sure what to do about that. I really think my problem is too many years of botox down there that has left my muscles weak and dysfunctional. There are a few that weren't injected with botox regularly and go crazy while the rest feel super weak. I also have IBS which doesn't help with frequent BMs. If the BMS weren't so traumatic I'm sure it would still heal but the daily repeated trauma has me stuck. That is why I would like a colostomy (a temporary one of course). Sometimes I think it is either death or a bag...so in that sense the bag doesn't seem so extreme to me anymore.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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