LIS surgery scheduled

Finally having LIS surgery this week after 2 years of dealing with fissures.

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 surgery scheduled

Postby NDMK312 » 01 Apr 2015, 11:11

msimon, I can't thank you enough for the recommendation for Ibuprofen. I was thinking it last night as I could feel how swollen the area was down there, then I re-read my packet of information and it said I could take that with the percocet if needed. I called the doc this morning to be sure, and they said of course. Well, this morning was a bit painful no more than yesterday, and still no bleeding and soft…all good signs. I got the stinging pain after at the incision area. I popped the Ibuprofen jumped in the tub, and as of lunch time I'm almost completely out of pain. Amazing! I haven't taken anything since this morning, but may take more to keep the swelling down. I've been sitting and working form home comfortably let's hope this gets better and better! Thank you again for all the advice and recommendations. Yes, I do prefer the tub as well, but the sits is good for a quick 15 minutes here and there.
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Re: LIS surgery scheduled

Postby msimon » 01 Apr 2015, 13:04

You are very welcome :)
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 surgery scheduled

Postby Broncosgirl » 01 Apr 2015, 13:59

It has been nice to "go through this with you". It has been so helpful for my own recovery to read your posts. I am glad you found a combo of meds that seems to work well. I think I will try to ibprofeun as well.

I was wondering, how do you know where the incision site is? Does the incision start outside the anus? I realized that I know little about what actually went on back there other than they made a cut to release pressure
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Re: LIS surgery scheduled

Postby chachacha » 01 Apr 2015, 14:01

My first day extreme pain was due to the fact that I didn't know that the LIS incision was outside the anus. I stupidly was trying to push all swollen tissue back inside the hole (until LIS, I had internal hemmies that needed to be replaced after each BM, and thought that they'd slid out during surgery), not realizing that I was causing damage to the incision site. My incision ran parallel to the anal opening slit, just to my left (facing forward).
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 surgery scheduled

Postby Broncosgirl » 01 Apr 2015, 14:44

Wow, thanks chachacha... I didn't know it was on the outside either. Maybe I will try to take a look
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Re: LIS surgery scheduled

Postby NDMK312 » 01 Apr 2015, 19:36

Okay, I just need to vent a bit, this forum is aggravating me with logging me out after I've written a whole response and not posting it. I will now resort to writing them in Word and cutting and pasting. Enough about that though.

Broncosgirl, I was under the impression that the incision is made internally into the smaller sphincter muscle…at least that is how my surgeon described it. This website (http://emedicine.medscape.com/article/1 ... erview#a15) provides a pretty good description on the procedure, and as I think I noted before, the videos in this forum doesn't seem to be accurate depictions of what actually is done. Maybe in some countries or by some doctors, but definitely not what took place with mine.

I hope you are feeling a little bit better. Don't be afraid of those pain meds though!

Day 5 official update
As I indicated in an earlier post, I had some discomfort this morning going. However, the Ibuprofen has made a world of difference. I was probably at a 1 pain wise by lunch time, and right now I sense a little discomfort there, but I wouldn't necessarily define it as pain. Hopefully turning a corner here at day 5, but we'll see how tomorrow goes. I'm still concerned about pain going, so I connected with the doctor today to ask about how long I should anticipate that happening before being concerned. They said, typically it can go on for one to two weeks, but should definitely subside. The key, the doctor said, just like with fissure healing, is keeping things soft. It's not an easy task, especially on pain killers, but I have been pretty good with that. My issues is I need to stop going two to three times in a morning. Looks like I need to give up my oatmeal and coffee routine as it might be too powerful these days.

Thank you all again for your good thoughts, questions, and recommendations. Keep them coming! Although I hate that we are all going through this, it is nice to have a support group of folks to talk to about this ridiculously, crazy, and torturous thing!
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Re: LIS surgery scheduled

Postby chachacha » 01 Apr 2015, 19:42

NDMK312, the video that I referenced is followed by one that accesses the internal sphincter through the anal opening, but mine, done in Canada, was definitely via a cut to the outside. Are you sure that yours wasn't done in the same fashion. Your surgeon would have been correct by saying that he cut the smaller, internal sphincter, as mine was, and to me, it seems a safer route in, so perhaps you can have your husband take a good look.

I'm just editing to add that the link you provided was for a Fissurectomy. Your post title indicates that you had a LIS though. Are we talking apples and oranges here?

I'm also editing to add that I found this comment very hurtful. "and as I think I noted before, the videos in this forum doesn't seem to be accurate depictions of what actually is done. Maybe in some countries or by some doctors"

I live in Toronto, which is home to some of the top surgeons in the world, and certainly at least as good as any in the U.S.
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 surgery scheduled

Postby NDMK312 » 01 Apr 2015, 20:08

From what I understand, there are two methods for conducting this surgery--open and a closed technique--although I'm still trying to fully understand them. I believe my surgeon used the closed technique. While the article I referenced, says Fissurectomy, it discusses LIS within it and in comparing with other articles I've found the procedure reads the same (http://www.surgicalcore.org/popup/50201). I did have LIS not a Fissurectomy. A fissurectomy is done where the fissure is located and the edges of the fissure are removed and any tags distal to the fissure are removed also and the entire base of the new wound is then cauterized…very different. That doesn't look like what the article I provided describes, but is consistent with other articles on LIS. I could be wrong, and perhaps the incision is closer to the outside, but again, doesn't feel like it. Thanks for calling out the incorrect title in the article though, I didn't realize that at first read. I certainly don't want to misinform anyone here. I'll send the my doctor's office an inquiry tomorrow to see if they have better materials that can be shared.

In addition, I want to apologize, I did not mean for that to come off offensive, but only acknowledge that techniques could vary across countries and doctors. It was not meant to offend anyone, and I certainly was not saying that they are wrong only that it might not be accurate for what others might do.

You have a brave husband. I'm not letting anyone but the doctor look down there!
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Re: LIS surgery scheduled

Postby NDMK312 » 02 Apr 2015, 06:43

Hi all, I'm posting early since I have a full day of work ahead. I'm finding that attempting to get back to some sort of normalcy is helpful, and distractions work well for me too.

Day 6 update - This is starting to feel "Captain's log Star Trek-ish"… I'm hoping that folks are finding it helpful though.

Still some pain this morning (went twice…what's wrong with me?), but did not feel as intense. I did have some bleeding, not a lot, which concerned me a bit since I haven't really been having much. Perhaps has to do with going off percocet and switching to Ibuprofen? I took another Ibuprofen this morning shortly after and the pain seems to be slowly subsiding. I made the mistake of not taking one last night before bed since I was feeling good, and I'm considering changing that tonight. I feel like I may have to go again (make it stop), and we'll see how that goes. I'm not sure how I'm going to physically go back to work next week, but I'm trying to stay hopeful that I will make this miraculous turn over the weekend. Patience is a virtue right?

Anyhow, I sent another message to my doctor to make sure the bleeding is okay. I'm certain they think I'm ridiculous at this point, but it's for my peace of mind and what they are there for. You have to do what helps you get through the days without worrying over everything. This whole experience has turned me into an over thinker. It is exhausting!
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Re: LIS surgery scheduled

Postby NDMK312 » 02 Apr 2015, 08:39

Quick update - heard from the doctor again. Bleeding at this juncture is normal. Also, she confirmed the incision is on the inside and not the outside, but did not send an example. Definitely confirm with your doctor where it is, that was very comforting knowing the pain I was also feeling, which doesn't feel like the fissure pain, is definitely from the incision site. Whew!
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