Hey gang - I'm in healthcare and so I thought I'd post my recovery in diary format to help folks, a lot of what I see on here is horror stories which can be intimidating. Hopefully my recap provides a bit of helpful hints and a realistic spin on things.

So my fissure noticeably started in March. I am a gay man who is often on the "catching end" - so it's not uncommon to have small tears that heal rather quickly. However, in March I went to use the bathroom one day and had a toilet that was bright red. Then came the telltale spasms - which were breathtaking, and I'm one with a reasonably high pain threshold. So not only did I have the displeasure of torture on the toilet, but I also had the one-two punch of being sexually out of commission. I am 30 years old, single and so you can imagine that puts a damper on things. Prior to opting for LIS I was on several months of both Rectiv, and then Nifedipine compound. I also developed skin tags, and had to have IRC (Infrared Coagulation) performed twice over the summer. My PCP is specialized in colorectal and infectious disease so I'm fortunate that he was able to do it in office - but at $350 out of pocket a pop, they're not procedures I sought to have frequently. He removed the tags because he indicated they would hinder recovery.

I opted to see a CRS in August - the topical ointments had healed me to a point where I could use the restroom without agony but I was still sexually out of commission. Fissures are more than just the pain, I have struggled with some severe self-consciousness, depression and loss of confidence that I'm hoping to regain with healing. The CRS examined me and indicated that the fissures I had were quite evidently healing but then retearing frequently and indicated I would likely need LIS to fully cure them - as I have a high resting pressure. I was initially resistant (I already had a tonsillectomy at the start of this year which was a bear so another surgery and more time away from work did not appeal), but I talked with other friends that have had it done (fissures are more common than we think) and they indicated that it's a reasonable recovery. I opted in on the premise that a. my deductible for the year is paid, so now's the time and b. if I'm going to continue to be "out of commission" I want it to be with high likelihood of a full recovery.

Pre-Op: I did not have to complete any anal "prep" however I was required to essentially fast after midnight Tuesday, so only clear liquids all day on Wednesday. Then full fast after midnight on Wednesday, as surgery was Thursday. This of course made for a rough day Wednesday as I worked, and had a pretty considerable headache by afternoon and evening from the lack of food. By Thursday I was crampy and headache-y and anxious of course.

Day of surgery (Thurs, 10/22): I am fortunate that my mother who lives in NY came down here to GA to help me. I woke up to no hot water so that was problem #1 - my leasing office got several calls to make sure I'd be able to sitz bath once I got home. Then I got to the outpatient surgical center to discover that my originally scheduled 12:30 PM surgery had been scheduled in error and was at 2PM. Not a happy camper but forced to go with the flow. I was taken in for preparation around 11:30 and then had to sit there. The IV was a breeze, this was the first time I was injected with lidocaine prior to insertion of the IV and what a good practice that is! My procedure was done under general anesthesia, which I tolerate well. Surgery itself is very quick, and I was in the recovery room for about an hour. I had to urinate before I left, and I had some considerable bleeding and drainage that when I saw it surprised me - if you're squeamish about that kind of thing.... prepare yourself. I was home at about 4:15PM. Very conscious but a little unsteady on my feet.

1st night Post-Op: I was sent home with prescriptions for Lidocaine ointment (5%), Toradol, and Oxycodone - which I am to alternate every 4-6 hours. I would recommend not resisting pain meds the first 24 hours, give your body a rest from the trauma of surgery and stay ahead of the pain. I had poached eggs on toast and applesauce for dinner, and drank considerably as my mouth and throat were very dry from the breathing tube inserted during procedure. I benefited from the numbing agent used during surgery and spent the first six hours or so with next to no sensation down there. It was floating on pain meds kind of evening. I headed to bed around 9:30PM after my first sitz bath, and immediately noticed that laying down I am more prone to spasm. I had to really focus on relaxing as much as possible to deter spasm, which occurred with just about every move in bed I made. I fell asleep after about 20 mins. I woke up twice, once at about 12:30AM, at which time I urinated, applied some more lidocaine ointment and took a pain med. At 4:00AM I woke up pretty crampy both rectally and abdominally. I took a hot sitz bath, applied lidocaine, took the next pain med and proceeded to apply a warm heating pad (I have a soft sand-like filled bag I can pop in the microwave) to my lower abdomen. This helped considerably and allowed me to fall back to sleep.

Next Day (Fri, 10/23): I opted for one oxycodone instead of two this morning. I am sore but it's not unbearable. I spasm mostly with movements like getting in and out of chairs, and using the toilet. I have not had a BM yet but have taken a laxative and put benefiber in my morning coffee to promote a healthy movement when it does happen. Scrambled eggs and ham with toast and some fruit this morning.

Will keep everyone posted about every 24 hours. My plan is to rest this weekend and return to work on Monday - which my CRS indicated was a pretty reasonable plan. I am quite swollen and bruised this morning, and sore - but it's not a throbbing soreness and nothing worse than the post-fissure spasms. I am hydrating heavily. Do yourself a favor and stock with thick pads or gauze - the pantyliner style does not work and for men with body hair down there... the adhesive adds insult to injury! My drainage is decreasing steadily.

Well folks - here's a report on Days 2 & 3 (Sat & Sun, 10/24-10/25). I would say that the difference in soreness between the first and second day of recovery was significant, in my favor. That's not to say I'm out of the woods but much of Day 1 was spent struggling with uncontrollable spasms that were really quite painful. I had two small BMs the day after surgery, and then nothing Day 2, with a good movement with effort on Day 3. I find placing my feet on some folded towels to prop my legs up a bit toward a squat makes it easier and more comfortable to go. I feel very tight down under and so I am sitting in sitz baths and on a heating pad as much as I can to keep things relaxed. Using stool softeners and laxatives to keep things moving. As far as bleeding and draining - it remains at a steady pace and I am swapping out gauze about every four hours, which I really look forward to not having to tuck away - particularly as I have to go back to work tomorrow. The pain is not extreme and I'm hydrating as much as I possibly can and eating more fruit and fiber than I traditionally would. I am not prone to constipation so difficulty with BM is new and uncomfortable. I am sticking to Toradol during the day and then I take the narcotic at night, which I will likely discontinue soon, as I'm no longer spasming during the night. Lidocaine remains my closest friend. :)

Day 4 (Mon, 10/26): Today I had to head back to work - I purposely scheduled surgery to recover over a long weekend. My CRS had indicated she thought that was a reasonable time table based on my age and health (I'm 30 and fortunate where health is concerned). Yesterday was a rough day because of bowel movements that upped the bleeding and pain, so I didn't feel like I rested that much, up and down, in and out of the tub. It's a regiment. Today I woke up in a pretty low amount of pain which was exciting - but I was hesitant about getting up and going. I packed my supplies for work which included: gauze pads, tucks medicated wipes, heating pad, water, lidocaine ointment, Aleve.

I did pretty well this morning, and work close enough to home that I usually head home for lunch. Came home and had a BLT for lunch, and as I was preparing to leave and head back, felt the urge to have a BM. Yesterday's were soft and almost like mud, todays were formed... and plentiful. I was in pretty intense spasm afterward and jumped into a hot bath. I envy people who report their BMs are easy. Mine have SUCKED. I headed back to the office after catching my breath and relaxing my anus somewhat. Sat on the heating pad at my desk, and as soon as I got home tonight hopped back in the bath. I feel like things are improving, the stitches seem to have dissolved, but with each BM I find I am set back. It's frustrating. The discharge and some bleeding continue - I applied some coconut oil to the area to ease it as the gauze pads get uncomfortable in my opinion.

Day 5 (Tues, 10/27): Evidently no one else has any LIS or Fissure related issues and I'm the only poor soul on here. ;) That being said - I'll keep posting.

Today was victorious in a way - as I learned a new trick that was helpful. As previously reported - the pain I have with BMs is pretty strong and stinging, and caught me by surprise frankly. I really wait until my body is telling me I have to go - and I am on an internal schedule that I go typically 3x per day, thankfully I'm typically at home when this occurs. As you have more bowel movements, you are more conscious of the coming pain and I think it makes me do a better job of attempting to fully void before spasming. In going through this process and washing up afterward, I identified the pain is really more waste on the incision that is causing burning - which then leads to the spasm as a response to the pain. So I brainstormed, a portable sitz bath will allow you to do this without the tip, but if you don't have one or wish to get one:

Today when I was ready to have a movement I began filling the tub with hot water beforehand. I placed a bulb syringe nearby in the tub. I had my bowel movement - still a fair bit of blood and the burning and pain sunk in quickly. I got into the tub, and took the bulb syringe and began filling it with water and expelling the water onto my anal area, at a medium pressure. I did this repeatedly to clean any leftover waste from the area, and I stopped the burning/spasming MUCH faster. The jets onto my bum felt soothing helped relax it fairly quickly. NOTE: the water you are using is the same temp as the tub so you're not burning anything you're just using the syringe as a tool to expel water directly onto your anus. I then clean with Tucks wipes - which are a godsend.

I am shocked with how copious my BMs are and how little I feel DURING. I can tell the sphincterotomy loosened things up. Bleeding and discharge are down. I'm looking forward to when the pain dissipates with BMs but am hopeful I'm looking good for the CRS during my follow-up next Wednesday, and fortunate as it's only been five days.

Day 6 (Wed, 10/28): Felt like a human being this morning. Yesterday was pretty rough as far as days go because of having four bowel movements with significant pain after each. I was in bed by 9PM last night. Gets tiring.

Today I had to go very early this morning. I braced for the usual pain and found that while I had pain, it was not nearly as intense - in fact I was fully able to control when I constricted the muscles, as opposed to the involuntary spasms. This is great as it helps with hygiene and getting a full "void." My morning breakfast of a bowl of raisin bran and a cup of coffee with benefiber in it is a great option for mornings. Lunch these days is usually some kind of sandwich with fruit, maybe some chips, sometimes half a fiber one bar. Dinners vary but I definitely make sure to get some roughage in there. For those that don't like the taste of water (me), no-sodium carbonated water mixed with some cranberry or other juice has kept me on the up and up with hydration.

I have tried to keep optimistic throughout but today was the first day I felt like things are really feeling better. Three BMs in and they've all been managable. Get your rest!!! The healing that goes on overnight is significant.

Day 8 (Fri, 10/30): It's officially been over a week since the procedure. The incision site is still the only element that is sore - drainage and bleeding are WAY down, almost to nothing and I think that letting the area "air out" will help with healing as opposed to covering it with gauze constantly. BM's are still stinging and require sitz bath after - which is a bit all-consuming in that I have to time my life around having them, since I need to be home to sitz bathe. I have found that applying a layer of Vaseline to the incision site just prior to having the BM helps take the edge off the sting and delay it such that I fully void. As far as pain meds go - still taking NSAIDs during the day, take a small dose of oxycodone at bedtime. I'm waking up in the morning painless, can't wait to stay that way. :)

Day 9 (Fri, 10/31): Happy Halloween, this year my costume is the man with the rebellious arse. :)

The incision site has tightened and I think the area appears to be less swollen and certainly drainage and blood are WAY DOWN. I wouldn't be surprised if no more gauze tucks by Monday. Which I won't miss. Still experiencing burning & stinging during BMs, but at this stage I've got my regiment down. I draw the hot bath while using the john, hit the bum with a tucks pad, then hop in. In retrospect - I'd probably get a sitz bath for over the toilet. If you're using the tub, rather than sitting in it - try squatting in it. Lay your lower legs and knees flat, slight over from the hip to "sit" your arse in the water. You are in the ideal position with the warm water to gently expel any "leftover" - which is the source of the burning and stinging. After that - I am nearly pain free. BMs are taking about 10 mins all around, but I still have to be HOME for them - which can be a hindrance.

Day 11 (Mon, 11/2): Today's AM BM was the first I was able to have where a sitz bath was not required afterward. There's a bit of itch and discomfort but nothing near as painful as a week ago. The incision site looks good - I can't say enough for Tucks wipes and then a bit of vaseline, coconut oil or other skin conditioner to help with comfort (the wipes are astringent). The first week to ten days you look down there and think "what was the point nothing looks like it's healing" then when the swelling goes down it's all the sudden very encouraging.

Day 12 (Tues, 11/3): Tomorrow is my post-op follow-up. I'm psyched because I had my first bowel movement without any more than some pulling and a little itching sensation. Beyond that... no stinging, no sitz bath. I have to search to find the original fissure.

GREAT NEWS!!! Good luck with the check-up.