LIS or no?

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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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LIS or no?

Postby GilmoreGirl » 05 Dec 2016, 11:37

Hi all,
Sorry for the long post, but I need a hand deciding on whether to go ahead with LIS!

As I've posted before, I've had 2 fissures (anterior and posterior) for about two and half months.

Up until last Friday I was having spasms for about a minimum of 6-7 hours after a bm, and for some bad spells the painful spasms never stopped.

I was taking morphine and Tylenol all day. Then I had to have a colonoscopy, with a hellish prep. Colonoscopy was clear. The gastro said one fissure was healed and the other was healing, and superficial, but I was still having debilitating spasms.

Post colonoscopy I didn't go a couple of days. I tried a new combo of Metamucil and miralax that seemed to help bm (I have combination ibs mostly). I was able to wean off the morphine and am now just taking an anti inflammatory twice daily.

I am feeling SO much better since last Thursday, I have been able to go shopping, wrap presents, do chores, sit for a few hours without pain, etc. Bms are not particularly painful and sphincter is NOTICEABLY looser than when spasms were happening. Any spasms post bm are stopped by sitz bath and nifedipine (which did nothing before)!

I don't know HOW this happened but I'm grateful. However I'm scheduled for LIS on Wednesday of this week, with a pre op appointment tomorrow morning!!

I have contacted my surgeon's office and she will be calling me between surgeries today to discuss quickly what to do.

I'm really unsure of what course to take - I am scared of relapse and I still have this "bruised" feeling down there. But also I really don't want to have surgery if not necessary and deal with recovery etc.

Another important factor is that the fissures were likely caused by straining from pelvic floor disorder mixed with frequent bms from ibs. The surgeon suggested I have the surgery to stop the spasms then start physio for pelvic floor as soon as I could...but now I'm wondering if it's possible to see how the physio goes before delving into surgery, since the pain is receeding?

Any advice would be so greatly appreciated.

GG
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Re: LIS or no?

Postby Mypoorbutt » 05 Dec 2016, 11:47

Can't really offer advice but if your fissure is healing and is superficial then surely Botox while you get your pelvic floor addressed would be a better option than LIS.
It's like you say why operate if there is no real need....my surgeon always checked my fissure before both Botox and LIS as he said he wouldn't perform a procedure on a fissure that was nearly healed.
In the end GG it's up to you....could you delay it till after the holidays give yourself more time with the new combo and see how you go...is that a possibility. I'm so glad your doing so much better.
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Re: LIS or no?

Postby GilmoreGirl » 05 Dec 2016, 12:19

Thanks mpb. I don't know how this happened honestly, except that since the colonoscopy and Metamucil I've only had one or two small bms daily. The Metamucil does upset my tummy rather a lot (lots of cramps and burping) but I hope that will die down as it is helping.

A little more sore today but still a 1-2 when taking it easy (not sitting or standing for long periods).

No call yet but I'm waiting by the phone. I feel bad because they worked SO hard to get me in asap, and then a few days ago it was like a coin flipped!
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Re: LIS or no?

Postby Mypoorbutt » 05 Dec 2016, 12:24

That happens sometimes Hun and I'm sure they would rather wait than do an op that wasn't needed, especially as you are a young woman who hasn't had children yet.
Who knows if you sort your pelvic floor out you may never get a fissure again....the doctors are there to look after you and you know your body best.
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Re: LIS or no?

Postby GilmoreGirl » 05 Dec 2016, 15:12

Ok so talked to the surgeon - she says probably better to wait and see how things pan out but she thinks the pain will likely return - and now I think it has, tight as a drum and aching again, I may have to take a morphine.

So now the surgery is cancelled and I feel like I made the wrong decision, I don't know why I'm so stupid giving up this chance.

I phoned the office to get an appointment with the surgeon next week or the week after, and may be able to have surgery on the 23rd if things go back to being miserable

I hate these ups and downs, I was so grateful to have three great days and now I'm back to feeling to feeling so low I can't stop sobbing
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Re: LIS or no?

Postby Mypoorbutt » 05 Dec 2016, 15:34

Maybe you need to give yourself time to heal naturally Hun...if the surgeon said it is healing, they wouldn't do the op here on the NHS if you were showing signs of healing.
You haven't been silly but you made a choice and now you are hyper aware of what your butt is doing....I know that as soon as I get stressed I can literally feel my sphincter tightening. You have the 23rd as a date so here's a thought....and please trust me I really do not mean this flippantly and I truly understand how hard it is to do....but could you keep taking your supplements and cream and live your life as you would do if you had no fissure see what happens, I know your really into fitness so going to the gym and being careful might be frustrating but it would show you that you haven't totally lost touch with your old life. We truly do become so sensitised to our butt that what could be a healing sensation is interpreted as pain because our nerves in that area are always on alert.
Worst case scenario you have to have the op on the 23rd....best case you continue to improve and decide the op can be postponed or even cancelled.
It is so typical that the blooming fissures do this but if a dr told me I was healing I would give it more time especially as you have a safety net of the op in 2 weeks.
On a side note is there anything other than morphine if you have transit issues in any form it's not great.
Good luck GG sending big hugs x
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Re: LIS or no?

Postby GilmoreGirl » 05 Dec 2016, 15:46

Thanks mpb,

Your message helps a lot. It scares me that the fissures are healing and I have this tightness again, unexplained. What's weird is it seems mostly anterior...I'm worried that there is nerve damage or something that I will have to live with forever. This is where my mind goes!!! Argh

I have a lot of anxiety about returning to anything tbh...I will try and get out and about tomorrow. I'm confined to sweatpants and that drives me nuts, I am no longer myself and I have no motivation to do anything I used to.

It's hard to be so hopeful and positive one day, making plans etc. And then so low the next.

I have taken a prescription anti inflammatory, a Tylenol, put on more nifedipine and had a bath but not much relief. Will try lying with heating pad yet again.

Will need to call my psychologist this week I think, I can't deal with it anymore I'm a total shadow of how I used to be
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Re: LIS or no?

Postby Mypoorbutt » 05 Dec 2016, 15:58

GG, this awful thing changes us this level of pain would change anyone.
I don't want to worry you but if your fissure looks like it's healing could the spasms have something to do with your pelvic floor issues.
It's so hard to get back as the fear is so strong but I know I felt better after I went swimming and to the gym...was I annoyed I only did 15 lengths instead of 64 heck yes I was. But it made me feel a little bit like me again.
I know people with crohns who go to the loo 40+ times a day but still go out with family and to the gym and I know others who go 15 times and spend their life in bed.
We have to try and fight back and if the only weapon we are left with is a little positivity and a little effort then that is what we have to do.
You sound like a great young woman who is caring and ambitious....you will get better and in the process you have helped me and others at a low point in our lives. You are not a shadow you are changing and becoming stronger. Push through your fissure will heal and hey if it doesn't we can put your name on my colostomy petition (joking) lol xx
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Re: LIS or no?

Postby GilmoreGirl » 05 Dec 2016, 16:08

I will try. Thanks so much for the encouragement. I feel like there's a golf ball up there and have a list of a few things I could ask a physio about. One is pudendal neuralgia, where there is pudendal nerve pain. What I found interesting is that sufferers of ten mention a "golf ball" feeling in the rectum (that's me 100%) and it can be caused by exercise - like lifting

Before this happened, I was having physio to help realign the pelvis and shoulders, and things just felt different in the gym, maybe it's related.

I'm going to try and distract myself somehow. If I need to I will make an appt with family doctor to discuss Ativan prescription or something
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Re: LIS or no?

Postby Mypoorbutt » 05 Dec 2016, 16:15

Oh right can certainly say I have never had that sensation....sounds like it could be something like that perhaps.
Ah maybe not the gym then maybe a walk round a park or xmas shopping or baking.
Could you ask for gabapentin as its prescribed for neuralgia but it has been the only painkiller so far that has touched my fissure pain took it down from a 7 to a 3/4 in about an hour as its a nerve blocker...maybe something to try while you wait for your op. I can't use it a lot as it makes me sleepy but I would really recommend it
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