My LIS surgery

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My LIS surgery

Postby EndlessSummer » 16 Jan 2017, 11:51

Hi. I got a lot of benefit from reading about other people's experiences, so I thought I would post mine.

I'm a 38 year old female. I had a bad case of diarrhea in spring of 2016 that resulted in hemorrhoids and then what I think was the fissure. I was too uncomfortable to let the doctor examine me - a mistake I will never make again! I went travelling in Europe for a month and when I was there something burst and I was draining pus. As soon as I got back to Canada I saw the doctor. I saw a general surgeon at the end of August 2016 who diagnosed a fistula. I asked it if could possibly be a fissure as well, since the symptoms fit, but he said no.

Before he would do a fistulotomy he wanted to rule out Crohn's, so a colonoscopy was scheduled for mid October. From mid-September to mid-October was some of the worst pain I've ever experienced in my life. I would have a bowel movement and then lie flat on my side for hours. I could usually be up and around for a few hours in the evening, before going to bed and starting the whole thing again in the morning. Fortunately I had a really good sick leave plan at work, and I also used all of my extended benefits for massage, acupuncture, counselling etc so I didn't become depressed. I made sure I left the house every day, even if only for a 15 minute walk.

I had the colonoscopy and Crohn's was ruled out. The prep wasn't as bad as my normal bowel movements, so after that I made sure to keep everything really soft. I had one or two bm's a day, but I always felt constipated - I think it was too soft to really empty properly.

I had to wait until mid-November to have the follow up appointment with the general surgeon, at which point he signed me up for a fistulotomy without re-examining me. The fistulotomy would be scheduled for "sometime in the new year". I didn't want to wait that long, I really wanted to get back to work, so I contacted a private surgery clinic and paid to consult with one of their surgeons (not a CRS but I think he had more experience in this area). When he was examine me he asked me a few times where the fistula was and I kept thinking - you're the doctor, shouldn't you be able to see it?! When he finished he said that he could possibly see where a fistula used to be, but that I definitely had a fissure.

We reviewed treatment options. I decided to try nifedipine first before surgery, although he said because I'd had it so long I would probably still need surgery. The nifedipine did help and I was able to return to work, but it was still bothersome, especially after bm's in the morning. I sit all day for my job, and one thing that really helped me was sitting on a donut cushion, with a heating pad on top of it. That really soothed the pain.

After 6 weeks of nifedipine, it still wasn't healed so i decided to go ahead with the LIS. I had it on Jan 14. I wasn't particularly nervous, although this was my first surgery and my first time under general anaesthetic, so I wasn't sure what to expect. Also, I'd read that recovery can be fairly painful, although I was sure that it wouldn't be as painful as the fissure at it's worst and that it would be worth it for the healing.

I had the surgery in a private clinic. There was no prep except no eating after midnight and no drinking two hours before arrival time. It was really calm there, all of the staff including the surgeon were very kind and comforting. I walked into the OR, breathed some stuff in through a mask, and woke up in recovery. I had no problems coming out, the only thing I didn't like was that I couldn't take full deep breaths at first because the tube had slightly irritated my airway, but that quickly passed. I left a little more than an hour after waking up. I had my appetite back before I even left the clinic.

I live a little more than an hour from the clinic. I had a couple minor tweak feelings on the way home, and I was a bit nauseous from being hungry and from the anaesthetic wearing off, but otherwise no problems. I just laid around and watched tv the whole day. I took the painkillers, tramacet, at 5:30 but didn't feel any need to take them before bed. The next morning I woke up with only mild discomfort. I took two tramacet right away in case it was going to get painful, but I probably didn't need to. I didn't take any other painkillers all day. I went for a long leisurely walk, ran errands (after the anesthetic was all out) and even did some housecleaning! There was a tiny bit of blood on the toilet paper when I would pee, but otherwise nothing. I had no dressing. I changed out of the mesh underwear with the pad into my regular underwear with a menstrual pad, but no blood or discharge was on it, so I stopped wearing it.

This morning (day 2) I had my first bowel movement. I've been taking metamucil (surgeon says it is now my friend for life). It was totally fine. It maybe stung a little, but I was squeezing a stress ball to distract me so I'm not even sure :-) I took one tramacet after I got out of the bath because I have them so why not, but I'm not sure I would have needed it. It feels even less irritated then when I just had the partially healed fissure (this may also be the tramacet talking). There was no bleeding. I've had a few farts escape on their own (usually I have to intentionally let them out) but mostly only when I'm already on the toilet to pee. No problems with poop incontinence.

So far recovery has gone far better than I expected, and I wasn't expecting it to be too bad. I am so glad I had this surgery and for me it was worth it to pay for it. I still haven't gotten a date for the fistulotmy that I don't need from the public system :-)
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Re: My LIS surgery

Postby chachacha » 16 Jan 2017, 14:20

Thank you so much for sharing your experience. It's great to add positive stories to the success column, so that others trying to decide what to do can make a more informed choice (having both good and bad reports to read).
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: My LIS surgery

Postby Ms.HurtBooty » 23 Jan 2017, 03:34

I had my LIS Jan. 9th. I had hemorrhoid for two years and in the third year I developed a anal fissure that wouldn't heal. This began from a minor surgery that required pain killers. I didn't know they would constipate me (the painkillers) and ended up with three years of misery. After seeing my primary care physician after two and half years she finally recommended me to a CR surgeon. BEST THING EVER!!
So I had my surgery on the 9th (today is officially my 2 week mark since surgery); I was afraid.... I worried and thought about postponing my surgery (glad I didn't). When I arrived they handed me 2 Valium to relax me as I was nervous, ran IV in my hand, talked to me about general anesthesia then put a mask over my face I was out in what seemed like a half a second (good stuff in that mask) woke up in recovery. Immediately after waking I had to pee which was great because I didn't want the catheter in my VaJJ. I had complained many if times about the pain on my way home (3 hour drive from surgeon) so I was given a On-Q anesthesia catheter that was connected to my butt and went all through my lower region which kept me numbed up for 5 days. The most I felt was uncomfortable but really no pain. Before leaving they gave more pain meds. don't know what that was because I was disorientated at that time. Got home sent my husband to go get my meds. My doctor gave me a 100 Norcos, 15 morphine, promethazine, and colace. He MADE sure I was comfortable while I was home. I didn't have a bowel movement until Wednesday (had surgery on a Monday) I glad it came two days later because I was afraid. I was also afraid that I haven't went since Monday morning so I took two shots of magnesium citrate which made me go with ease NO PAIN. My bowels have been pretty regular since then. I stayed ahead of my pain (which was minimal with On-Q catheter) taking my meds. (Minus the morphine, I was afraid of pain but more afraid to take that pill) when my On-Q ran out the first day without it was painful about 7/10 I took 2 Norcos every four hours which helped ease my pain. Made my pain 2/10. Each day is better. I just reached my two week mark. Today I'm painkiller free the only thing is extreme itching that don't know how to ease. But I would have done this a long time ago had my regular doctor had any sense to just send me to a specialist a long time ago and would recommend this surgery to others. I too read ALL the horror stories but my experience was definitely different than described by the many post I've read for the past year. I also think my body heals pretty fast. My doctor explained to me the best two weeks of pain or years of pain.... I picked two weeks because I wanted my life back. Go get it done! I'll be glad to recommend my surgeon to anyone in the state of Kentucky. He is a bit of a smart ass and jokester BUT he knows his stuff and is genuinely concerned for his patients.
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