My LIS journey

To hell and back (hopefully)

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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My LIS journey

Postby brokenbottom » 21 Apr 2016, 07:24

So here I am, a week and half after taking the plunge and going for the surgery. It wasn't a hard decision to make in the end - months of increasing pain every single day for up to 10 hours after a BM meant it seemed like my only chance of getting back to some sort of normal life.

Generally, I'd say I'm very glad I went for it (I'm so superstitious though that I worry just typing that has cursed me to have the pain come back!). But it's no picnic that's for sure. I can't imagine going through with it if I was just occasionally having the pain or if I'd been able to carry on going to work and stuff. But basically my life had stopped and some days I really felt like I wanted to die.

Anyhoo, there are plenty of descriptions on here of the nitty gritty of the op so I won't dwell on that. Three big fears I had (apart from of course the big incontinence/it not working ones) were having to have an enema before the op (they didn't even mention it - phew!), what would happen with the dressing they stick up there (I left it be and it just worked its way out on the day after the op) and of course the dreaded first post-op BM. That last one certainly wasn't fun and deserves its own heading...

First post-op BM
It came on day two after the op and, because the one after I had botox was so hideous, I went into total panic mode, something I excel at. The pain was bad, but no worse than what we're all accustomed to on here, I just went into total shock mode, feeling so faint that cleaning up was quite a struggle and it took me quite a few hours to calm down. The pain lasted a while but 'only' about four hours. But now, a week on from that, it's better each day. Now I felt relatively calm afterwards and the discomfort had passed in about half an hour.

Pain
There has been pain post-op, but different to before and less each day. The fissure pain felt like some sort of medieval torture; this feels like what it is - a wound healing. My surgeon wrote on my discharge notes that I'd be very sore for two weeks and full recovery would take up to 8 weeks so that's managed my expectations. Measuring my pain by the drugs I've taken, I needed 8 x 500mg paracetamol and 3 x 400mg ibuprofen to get me through the first few days, plus codeine after that first BM. Now on day 9 I've had 2 x paracetamols and 1 x 200mg ibuprofen. I might have some more paracetamols later, but I might not.

Leakage
This is not pleasant, but was better than I expected. Once I took the big outer dressing off the day after the operation (and goodness that thing was stuck firmly in place!), I wore period pads all the time for the first five days or so. I also had a big mat thing they gave me in hospital on the bed for good measure, but didn't need it. There was a bit of blood there most of the time for about a week but it sort of lurked and didn't generally even make it to the pad. I'm still finding a bit of something if I wipe with tissue but it seems to be getting less.
As for the other kind of leakage, I am still passing wind without warning or control. Not too often - maybe once or twice a day - but enough to be concerned about mingling back in with general society. Hopefully this'll improve!

Bathing/showering/cleaning
I couldn't manage to get in the bath for the first three days - getting in there without sitting down is impossible. So I only showered initially and couldn't even face that till day two after the operation. My surgeon said the area is designed to be dirty so not to worry too much about obsessively cleaning it, so I chose to go with a low interference policy. Wet toilet wipes have been an essential and pouring water from a plastic bottle down over my bottom into the loo after a BM has helped make cleaning up easier. My new technique for getting out of the bath is to spin round onto all fours and out from there.

Sitting, or rather not
Part of the reason I haven't written on here during the past week is that it's been so hard to get in a comfortable position to type. Lying in bed sounds great until you have no choice! I didn't sit at all until day 5 and I'm still finding sitting tricky. More than 15 minutes and I feel sore when I get up. So mainly I'm on my side in bed (our sofa is too small unfortunately!) or standing. My surgeon said that sitting cuts off the blood supply to your bottom so stops it healing, so I'm not in a hurry to do too much of it yet.

That's all for now. Thanks again to all the lovely boardies who have been so kind and supportive along the way!
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: My LIS journey

Postby FissureFighter80 » 21 Apr 2016, 13:01

Good to hear your experience. Mine has been very very similar. I have had LIS about 2 weeks ago. The pain is almost gone apart from some discomfort during BM.
The only thing bothering me now is that when I walk around then I get minor incontinence which makes me itchy and uncomfortable. Same as you I keep a plastic bottle handy to wash my bum and/or wet wipes. I am hoping that this incontinence thing will go away soon but even if I am stuck with it forever I dont mind as I went into the surgery with so much pain that I was happy to wear diapers for the rest of my life.
Hope you get well soon and congratulations on your bravery :)
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Re: My LIS journey

Postby dmcff » 21 Apr 2016, 14:03

Thank you so much for this account of your LIS, brokenbottom - it's inspiring to read, and gives me hope for my own journey. You have showed the courage that, in spite of the pain, I haven't yet been able to find - can't even think how I would cope with the surgery and afterwards. All the very best to you for a swift and complete recovery.
2014 Anal fissure
2015 CAT scan, EUA, sigmoidoscopy, 2 MRI scans - 4 hospital stays
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physiotherapy, pain management
2019-20 Just living with it
2021 Better, but AF is still a recurring problem
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Re: My LIS journey

Postby brokenbottom » 22 Apr 2016, 11:56

Thanks Dave and FF for your kind words! I have to say that "bravery" and "courage" and not words I associate with myself during this experience! There have been many, many tears and a lot of despair along the way, but in the end the fear of watching my "real" life drift away from me for ever was greater than the fear of the operation.

Hope your recovery goes well FF and Dave I hope you find ways of coping that work for you. I guess we all have slightly different things wrong with us and different fears so it's certainly not one cure fits all. BB x
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: My LIS journey

Postby Canadabum » 27 Apr 2016, 16:21

BB -- thinking of you, how are things progressing? Sending you tons of support and encouragement.

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Re: My LIS journey

Postby Skiponzo » 28 Apr 2016, 11:56

"I have to say that "bravery" and "courage" and not words I associate with myself during this experience! There have been many, many tears and a lot of despair along the way, but in the end the fear of watching my "real" life drift away from me for ever was greater than the fear of the operation."


Exactly how I felt. All else (potential incontinence, pain, fear, etc) took a back seat to losing my real life. I'm almost crying just typing this with the almost unbelievable feeling that my life might really be returning to me (it's 5 weeks post LIS and I'm still scared of falling back into the abyss).
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Re: My LIS journey

Postby brokenbottom » 09 May 2016, 13:26

Well it'll be four weeks tomorrow since my surgery so I guess it's time for a little update.

The improvement has been slower than I would have liked, but at least that's what it has been - improvement. I'm still aware that something is not quite right down there but it is nothing like the desperate, miserable daily pain I had before the operation. I find that I can sit down fine, but it gets uncomfortable if I do so for more than half an hour or so at a stretch.

In terms of general functioning, I'm keeping very regular with the help of Fibogel, a pro-biotic with fibre, a small dose of Lactulose and three Dulcoease. Not sure when I'll stop all these - scared to yet! Don't have an appointment with the surgeon for another four weeks so I might carry on until then. I'm also keeping up with a pretty high-fibre diet. Fruit and veg, brown pasta and bread, carefully chosen cereal and what I appetisingly call "brown fruit" - dates, dried figs and prunes.

One worry I have is that when I need to go (which is always pretty soon after I get up) I really need to go and very quickly. I don't feel I have as much warning as I used to. This means I fret that if this ever happens when I'm not safely at home there will be some sort of a disaster. But that's a bridge to cross if I ever come to it. Another thing is wind - I have had wind that I couldn't control but that has improved over the month. At this point I'd say it happens occasionally still but certainly not every day. As for incontinence that thankfully has not happened. Big phew there!

So I don't feel like a total success just yet but it feels like it might just be possible. I find that I still have good days and bad days, but that's life anyway isn't it?

Hope everyone else is doing OK out there. This board and the support it offers has been a total lifeline. Thanks so much! BB x
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: My LIS journey

Postby dmcff » 10 May 2016, 04:23

Thanks for your progress report, BB. I'm so glad that you have seen some improvement since LIS, even if it's slow improvement.

My own progress is also slow.. I still have a lot of pain, and am waiting to get a date for my consultation with the specialist, whom I asked to see at my local hospital. I was told that the new "batch" has not yet come in, whatever that may mean. If I haven't heard anything by 20 May I am to contact the local GP surgery.
2014 Anal fissure
2015 CAT scan, EUA, sigmoidoscopy, 2 MRI scans - 4 hospital stays
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physiotherapy, pain management
2019-20 Just living with it
2021 Better, but AF is still a recurring problem
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Re: My LIS journey

Postby brokenbottom » 10 May 2016, 04:39

Hi Dave! Sorry to hear you're still in pain, but good that you have a date to see someone when the "batch" comes in! You'll have to update us on that when you find out what it is! Good luck! BB x
Suffered acute AFs since about 2010
2015 Chronic AF diagnosed
18/2/16 Botox (unsuccessful)
12/4/16 Lateral anal sphincterotomy and removal of polyp and two tags
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Re: My LIS journey

Postby ahoos26 » 10 May 2016, 17:06

hi bb and all,
BB, it sounds like you and I are on the same schedule. I'm 4.5 weeks post op. I have been lurking but finally decided to register. I had LIS, fissurecotomy and internal hemi removed on April 8th. A lot of what you have said sounds like what I have experienced. The recovery from the surgery wasn't really bad and now I am waiting for a 6-week post op appt. Although I still see blood every now and then, so I'm not sure what the status of my fissure is. That does stress me out. I want it GONE! You mentioned you have to GO right away when you get up. I do to, but I think that's the Miralax and Konsyl. Maybe that is what you are experiencing. I thought it was incontinence at first, but I don't think it is now. Hope every day is better than the previous!
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