LIS surgery - 1st week

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LIS surgery tomorrow

Postby Bumpkin » 13 Sep 2012, 19:12

Hello everyone,
I found this fabulous website last week as I was trying to decide whether or not to have LIS. It's very comforting to hear other's experiences. I have no problem talking to everyone I know about my butt problems, but if someone hasn't had a fissure, they can't really relate.
My fissure nightmare began 10 months ago after I had a skin tag removed. My CRS told me there was a 10% chance that the tag removal could lead to a fissure. I'm an optimist and thought I would most certainly be one of the 90%. Ugh...how wrong I was. One month later I was diagnosed with THE FISSURE.
My treatment thus far has included improved diet, fiber supplements, stool softeners, nitroglycerin cream & one Botox injection. The Botox injection was very promising in the beginning. For about 2 weeks, I felt amazing. No pain and easy BMs. Once the Botox wore off about 4 weeks later, I was back to square one...with pain & bleeding. That's when my CRS suggested LIS. I thought about it for a long time and did all the research I could possibly do. I finally decided last Friday that I really don't have any more options. I can either live with this forever...or get the surgery. So I called the office and asked for the first available appointment.
To complicate matters, I have the complete triad of fissure symptoms...the fissure itself, 2 very large hypertrophied papillae that prolapse with BMs, and a brand new skin tag that is even bigger than the original! The papilla have to be manually reinserted after each BM...which is a horrifying nightmare. I have never been able to bring myself to look at them...but they feel huge. I never leave the house without a supply bag containing finger cots & nitro cream. Sigh. It really has been ruling and wrecking my life for the past 10 months.
So...tomorrow is the big day. My LIS surgery is scheduled for 10:30am. My CRS prescribed Vicodin, Valium, and an antibiotic. She told me to take all three 1 hour before the procedure, which will be done in her office. She'll place me in a jackknife position and then inject a local anesthetic. She'll do the LIS, cut out the papillae, and remove the skin tag. She said the whole thing will take about 30 minutes, and then I can go home.
I'm REALLY nervous. I'm not as nervous about the procedure as I am about the recovery process. I've already had the skin tag removal and then the Botox injection, so I'm used to getting poked at down there. I'm just expecting the recovery may be a little more involved considering all the things she will be doing and removing.
Anyway...I'll try to post an update about my surgery after I get home tomorrow and before the injection wears off. I'm hopeful that tomorrow will be the beginning of a new life...free of pain, bleeding, finger cots, and injections! :D
Last edited by Bumpkin on 13 Sep 2012, 20:16, edited 1 time in total.
Reason: misspelling
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Re: LIS surgery - 1st week

Postby suzyljank » 13 Sep 2012, 21:22

Hi, hope everything goes well. Remember as part of your recovery keep your bms soft. It will make it a lot easier. And the fissure itself will take a little while to heal but once you have LIS the area should relax so it can. All the best Suzy
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Re: LIS surgery - 1st week

Postby ZeeZee » 14 Sep 2012, 09:23

Good luck Bump! It'll be fine! Let us knw how it went!
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Re: LIS surgery - 1st week

Postby richibeno » 14 Sep 2012, 12:21

good luck ,
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1 day post surgery

Postby Bumpkin » 15 Sep 2012, 17:27

Thanks for the well wishes everyone! Image
It's the day after surgery and I wanted to give a quick update. I'm alive! :)
Let me just start by saying that I have a pretty high tolerance for pain...and medications. One hour before my surgery I took one 5mg Valium and one Vicodin (hydrocodone 5mg/acetaminophen 500mg). By the time my husband dropped me off at the doctor's office, I had worked myself into a frenzy of anxiety and was shaking and sweating. My blood pressure (normally 100/70) was 137/89 and my pulse was 94. The Valium & Vicodin were doing nothing for me. My doctor asked me to take another 5mg Valium while she talked to me and waited for me to calm down. By the time she began, my BP was normal and I was breathing normally.
The procedure took about 40 minutes, 15 of which was injecting lidocaine to numb me up. We talked all the way through the procedure, about what she was doing and just about life in general. Then suddenly she was done. I didn't feel a thing after the injections. She showed me what she removed...the skin tag, the papilla...which was about 2cm wide, 3 cm long, and some tissue from the sphincter I assume. She put in a few stitches, bandaged me up, and wrote a prescription for a stronger painkiller (Norco: 10mg hydrocodone/325mg acetaminophen) and a 2nd antibiotic. I actually felt great (I must have been really numbed up). She said the anesthetic would wear off in about 2-3 hours. I was counting on the Vicodin I took earlier to carry me through until I could get my new prescription.
Unfortunately, I had to wait about 45 minutes for my husband to leave work and come pick me up so he could drive me home...and we live about 45 minutes away from the doctor's office. By the time we picked up my prescriptions and got home, I was in intense pain -- aching, spasming, sharp pain. I couldn't even speak. I took 600 mg of Ibuprofen & the Norco, and just laid on the couch until it kicked in about 45 minutes later. It barely took the edge off the pain. I pretty much laid there for the next 3 hours, getting up just to get water and use the bathroom. I felt like I could barely make it until my next dose of pain meds four hours later.
After the next dose of pain meds, I began to feel much better. I was able to get up, walk around, and take a 15-minute sitz bath, which also helped with the pain. Basically, the first 12 hours were all about pain meds, changing gauze, taking sitz baths, and drinking water. I also managed to eat a little so that the pain meds & antibiotics wouldn't make me sick. There has been some blood & drainage, but it's not too bad.
By the time I woke at 6am this morning (18 hours after surgery) I felt MUCH BETTER. In fact, I didn't even need any pain medication, but I took it anyway because I was expecting to have my 1st BM...but that still hasn't happened. So here I am, not in pain, eating & drinking, taking medications (antibiotics, stool softener, ibuprofen), resting (LOTS of tv!), and waiting for the dreaded BM.
I shouldn't have done this, but I looked at the area yesterday and it looked horrible -- bruised, swollen, and pretty much unrecognizable. I just took a shower and looked at it again and the swelling has gone down by about 50%. I was starting to get nervous because I didn't even pass any gas by the time I went to bed last night. When I got up this morning however, I passed A LOT...and it wasn't at all uncomfortable.
That's all there is for now. My plan is to do more of the same...rest, sitz baths, keeping the area clean & dry, eating healthy foods, and drinking lots of fluids. I'd be more than happy to answer any questions at all! Oh, and give an update after the first BM. Yikes. :(
Thanks for listening Image
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First BM after surgery!

Postby Bumpkin » 16 Sep 2012, 14:14

Well...I had the dreaded 1st BM at 6am this morning...almost 48 hours post-surgery. I'm not going to lie...it felt like I was trying to pass giant rocks...extremely painful. I was sweating and forcing myself to breathe normally and relax and just let things come. It usually takes me about 10 seconds to have a BM...this time it took about 15 minutes. I expected to turn around and find super hard stools and lots of blood. Instead, I found lots of soft formed stools...and NO blood. Strange that it was so painful and yet there was no blood. Image
It's been 7 hours and I still have some soreness toward the right side...not sure what from...maybe that's where the incision was made? I certainly hope each day becomes less painful. I've decided to double up on the stool softeners. Anyway...I'm happy the 1st one is done with. Image
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Constipation...or...?

Postby Bumpkin » 18 Sep 2012, 15:48

Image
So, I had my 2nd BM on the 3rd day post surgery. It was...how should I put this...absolutely horrendous? Yeah, pretty much. I'm not relating this story to be a drama queen, but it's something that may happen to someone else, so I think it's important to share.
I felt an urgent need to go to the bathroom, sat down, and it started to come, and then it kind of....got stuck? I thought "Oh man, I'm constipated!" I sat there cursing myself for taking too many pain pills over the past 3 days. I sat there for ONE hour, barely making progress, and getting severely anxious. What was I gonna do? I couldn't leave the toilet because there was already BM on it's way out...but I couldn't sit there for hours either. I wanted to call my CRS but my phone wasn't nearby. After an hour, and out of desperation, I got up, filled my sitz bath with hot water and then sat on it...thinking that maybe the water would soften things up. Ten minutes later, and with a little bit of a push, out came a giant soft & fluffy BM! I was so confused. If it was that soft, why was it so difficult to get out?!? Image
After I took a shower, I called my CRS and said "I'm constipated!" Then I explained to her what happened and she said "You're not constipated, you just have a tremendous amount of swelling down there, making it difficult for things to exit." It actually made perfect sense, but in my angst ridden mind, I couldn't see things so clearly. As I was sitting on the toilet, I imagined having to call an ambulance and being carted away to the ER to be disimpacted!
So, my CRS suggested that I do this right before my next BM: rub some nitro cream inside the anal area, and then sit on the bath for 10-15 minutes. She said it would loosen things up and make things easier. She also said if I do indeed feel constipated, to take some Milk of Magnesia as a last resort. So I woke up this morning, inserted the cream, and sat on the sitz bath, expecting my usual morning BM...but it never came. I simply haven't had the urge. I will tell you that when I inserted the nitro cream, it was unbelievably easy to insert my finger! Pre-LIS, it was always a huge struggle to insert my finger and get the cream in there because things were so tight. Upon inspection, it also seems that the swelling has gone down considerably, so I'm hopeful the next BM won't be so insane. I'll be sure to update the board with my good news (that's positive thinking right there!)
:D
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Lost a stitch!! :(

Postby Bumpkin » 20 Sep 2012, 19:01

My last post was my 4th day post LIS. It passed by uneventfully, without a BM and without pain. When I took my final sitz bath of the night before going to bed, instead of feeling relief, I noticed a burning/stinging sensation coming from the surgery site. I didn't think much of it, stopped the bath and went to bed.
DAY 5
I woke up at 6am to take my antibiotics and immediately had the BM urge. I was so scared given the previous BM. Well, as soon as I sat down, it pretty much all came right out. I felt some discomfort and stinging at the surgical site, but it was nowhere as horrible as the previous time...and no bleeding. I guess the swelling had a lot to do with my prior BMs. But as I was taking my post-BM shower, I began to feel increasing pain. By the time I finished my shower, I was feeling 10/10 pain radiating from the surgical site, out toward my butt cheek and up by back...aching and spasms. It felt like day #1 of surgery before my pain meds kicked in. I immediately popped a Norco and laid on the couch. I was in so much pain that I couldn't move or speak. The Norco barely took the edge off...I'd say the pain came down to 6/10...and I felt that way for a total of 6 hours. As the Norco wore off, I wanted to call my CRS to see if I could come in, but then the pain began to subside. Because I began to feel better, I rationalized that it couldn't be an infection or anything horrible. So what was that insane pain all about?
DAY 6
I woke up this morning and immediately had a BM. It came out quickly with a little discomfort/stinging at the surgical site, but I had remarkably little aching afterwards and no bleeding. I was feeling pretty good and did 3 loads of laundry, washed the dishes, and responded to a bunch of emails. After all this activity I started to feel a little sore and the incision site was stinging, so I did my 15-minute butt bath. Before I emptied the water, I noticed something in the basin. I fished it out with tweezers and it was one of my stitches...complete with the loop and everything! What I noticed immediately was that all sensations of pain, discomfort, and stinging were GONE. That was about an hour ago, and I'm actually sitting upright with barely a twinge of anything. Now I'm wondering if all that suffering / burning / stinging / aching / spasm-y pain was from that stitch???
Now I'm scared to death that the stitch was PULLED out prematurely during one of my horrendous BMs in the past few days. Looking back it certainly felt that way. I'm also wondering if I injured the surgical site...and that's where all the previous day's pain derived from. I have my first post-op visit tomorrow...so I'll find out for sure then.
I'm curious...has this happened to anyone else? I didn't expect to lose a stitch so soon...I thought it would dissolve over a period of weeks...not come out completely intact. I don't know whether to be scared about it or happy that I'm not in pain. Does anyone have any insight on LIS stitches and what role they play in the healing process? Are they simply to keep bleeding in check...or do they serve some crucial purpose of not letting the muscle get ripped apart??? I think I need a Valium.
:roll:
Last edited by Bumpkin on 20 Sep 2012, 19:09, edited 1 time in total.
Reason: misspelling...again
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First post-op visit

Postby Bumpkin » 21 Sep 2012, 18:11

DAY 7
Image
Today was my 1st post-op visit with my CRS. I gave her a summarization of the entire week, and ended by telling her I lost a stitch last night. To my relief, she said she only puts the stitch in because it seems to facilitate quicker healing, and that I'll be fine without it.
She then examined me (finger & anoscope) and said the LIS site looks good, and that everything looks and feels like it should. She also said my fissure is healing nicely and barely visible. To be honest, I haven't even thought about the fissure since the surgery. I haven't have any pain or bleeding from the fissure site at all. All of my discomfort comes from the LIS site. She said the level of pain/discomfort I'm experiencing is completely normal and should continue to improve.
She said to continue with the diet, stool softeners, antibiotics, water, sitz baths, and to return in 1 week for a check-up. I feel sooooo relieved that popping the stitch didn't cause any damage!
Image
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Re: LIS surgery - 1st week

Postby Grateful Al » 22 Sep 2012, 04:32

Hi Bumpkin, its great to hear that things are progressing nicely. :) I too had my stitch pop out today. Image For some reason, it was red which automatically gets me into panic mode. But upon closer observation (ick) Image it was a string...just an fyi, my poop went smoothly and with minimal burn igf any Yay! ..Clean up took less than 5 minutes. I have my follow up this coming Tuesday. Still have some pinching from time to where the cut site so I assume that a sign of healing. But over all, feeling cautiously amazing..I also forgot what it is like to not plan a day around a perfectly timed and prepared BM...Well keep in touch and heres to more healing...Cheers Image
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