Hi again Redcharger – I'm so impressed by how proactive you are! I would have gone home and cried. I haven't tried nitro, but I hear it has had good results for some here. I really hope it works for you. I really hope I didn't contribute to your bad experience at Rudd ... I can imagine after hearing my story it would be very difficult to feel comfortable in that place!
I think it's a great idea to go back to the other surgeon. He might be able to help you now. In case you continue to have difficulty finding a doc and getting treatment, I thought I share some info I dug up a while ago in case things didn’t work out for me at Rudd. I’ve pasted below information about different clinics I found in Toronto and Montreal. The advantage of clinics is, of course, they can take you sooner than a hospital-based specialist. The disadvantages … well, we are pretty familiar with those! It might be worth calling the other clinics up to ask how they perform an LIS. I also pasted a link to the directory for members of the Canadian Society of Colon and Rectal Surgeons. You might be able to use this list to call the surgeons in your area to inquire about who is taking new patients and what their wait times are and then ask your GP to give you a refer to the surgeon you find. Perhaps, as Elphie suggests, your GP can push for an early consult, given what you’re already been through.
Wow – I’m so angry at McKenna - what a jerk!!!
I really hope you’re doing ok.
Maybe some of this information will be useful to you:
Canadian Society of Colon and Rectal Surgeons
Jasmin Lidington
Executive Director
774 Echo Drive
Ottawa, ON K1S 5N8
Tel: (613) 730-6216
Fax: (613) 730-1116
e-mail: [email protected]
Here’s a directory of Canadian surgeons who are members of the Society of Colon and Rectal Surgeons: http://www.cscrs.ca/en/patients/directory.asp#on
Mississauga Colonoscopy Centre
2021 Cliff Road Suite 202B Mississauga,
Ontario L5A 3 N7
Phone 905 270 4446
Fax 905 279 3337
E-mail [email protected]
Web www.coloncentre.com
\\http://www.coloncentre.com/anorectalProblems.html
Provis Endoscopy Mississauga Inc. - PES
3095 Glen Erin Drive, Suite 7-10
Mississauga Ontario
Canada L5L 1J3
ph: 905-607-0022
fax: 905-607-0013
RocklandMD
100, Rockland Road, Suite 110
Mount Royal Montreal Quebec
Canada H3P 2V9
ph: 514-667-3383
fax: 514-667-3834
http://www.rocklandmd.com/CLINIQUE%20MEDICALE/en/B2_MEDECINE_DE_FAMILLE.php

Wow, great info!......thanks hopetoheal
Hope your feeling better from your trip to the hospital

I agree with sidra, we should hunt him down in a pack and give him a little fissure of his own! I hope u get a CRS appt soon and that the nitro works, my gp gave me oxazepam for muscle relaxant and it worked great, maybe that's all you need! Either way, I hope you feel better soon.

I still can't believe this guy sent me away like he did. I mean did he think I was lying about the pain? I was sweating and grabbing the examining table so hard I thought I was going to rip it off. Am I the only one to be unable to take the pain? Had I not had a BM in the morning I probably would not have been as tender. My spasm after a BM usually last 6-8 hours. He was attempting to do this procedure when I was at peak pain.
I still don't understand what causes the spasm. For me the BM isn't painful. It's 10-15min after that the pain starts. I assume this is a result of the spasm. But what causes that to happen. I also wonder why they haven't developed some kind of laser to cauterize the wound and seal it shut. They use lasers in eye surgery and so many other procedures. I would think that this particular situation would be ideal.

I have no idea what he was doing trying to poke around there. He didn't do that to me. He just took a peak at the anal verge, visualized the fissure, and then started taping me. There was no poking, just needles in the ass right away. If he had poked me up there first, I would have gone through the roof right then.
I think the stretching from a BM causes the spasms, as the sphincter "over-shoots" going back to a resting position. Then the pain from that causes more spasms, and on it goes. But I'm not a doctor, so I could be wrong.
I do, however, agree with the others that there is one docotr who should be made an AF patient!

RedCharger, I have to be honest here: when I read that you were going to have LIS without being sedated, I thought that was nuts. I really wanted to say something yesterday, but decided not to because I didn't want to risk putting you in a negative mindset before the procedure.
But now that things are where they are, I'm going to come clean here: IMO you absolutely need to be given more than simple local for LIS. Not having either (A) conscious sedation; (B) general or MAC anesthesia; or (C) spinal anesthesia for this procedure is -- in my humble opinion -- TOTALLY F'ING CRAZY. Straight up.
I'm sure it can be done. Heck, in Asia it's not rare to have colonoscopies and upper endoscopies done without sedation. But if there's a better option to save the patient some pain, then why not use it? It makes zero sense to me. Medical science invented painkillers and sedatives for a reason, and that reason isn't to sit idly by while patients suffer unnecessarily. If the doctor doesn't want you conked out during the procedure for whatever reason (and really I can't think of a good one when it comes to LIS aside from the standard risks that come with all surgical anesthetics), an anesthesiologist can give you spinal anesthesia so that you're fully awake and lucid, but just can't feel anything from the point of the nerve block downward. It's still technically local, but like an epidural given during childbirth.
BTW, here's why I'm so against the "local only" approach: after I had LIS, I developed an abscess. It was very close to the anal verge so per my (misguided) request, my surgeon tried to slice and drain it in the office using just local. She insisted that this should not be done using local only, but I wanted a quick fix and asked that she try. Note that this is a less invasive cut compared to LIS. Well, she was right, and I was wrong... As soon as she put considerable pressure on the scalpel, I knew there was no way in hell I'd be able to tolerate it. So I ended up getting it done properly in the operating room under MAC/general again.
I just don't see how anyone can tolerate cutting there with an active fissure without something stronger. It's ridiculous that anesthesia wasn't even an option. Totally, completely bogus. It should be the patient's call. If you asked for local only, then that's a different matter. But if it wasn't even an option, then what this surgeon is practicing is not medicine, it's barbarism. If this jackass has no concern for the patient's preferences, then screw him and find someone else. You'll be better off for it, especially since you'll need to see your surgeon again for follow up care.
Hopetoheal, I didn't get a chance to read up on your post-LIS thread, but saw here that you had LIS with local only. My hat's off to you. Well, my hat, shoes, glasses, socks, ummm shirt, jacket, and might as well include pants too!!! My goodness. I don't know how you did it, but I think you're my new hero for having gone through with it and for managing to maintain your sanity.
P.S. For what it's worth, I've been having some stomach problems and need to have an upper endoscopy done soon. My GI doctor normally does this under conscious sedation (fentanyl + midazolam) only. However, I am a Valium addict (unfortunate collateral damage from my battle with my fissure) and thus have very high tolerance to benzodiazepines, which account for most widely used sedatives. During a colonoscopy back when I was in fissure hell, the doctor gave me 5x more sedatives and painkillers than he typically gives (and I'm a small guy at only 120 lbs on a good day), and I still wound up waking up during the procedure, which resulted in it being aborted midway through. I explained this past experience to my GI doctor and he immediately agreed to have an anesthesiologist put me under MAC/general using propofol for the upper endoscopy. No questions asked, no rebuttals, no "that's not how we do things here." Just a simple "I understand and it's your call." That's the way it should be. You will find a doctor who has his head screwed on straight. Just be patient. I know in Canada it can take a bit more time to get in to see a new doctor than here in the States, but believe me, it will be worth it in the long run. This last guy you had the misfortune to deal with shouldn't be operating on people's asses. In fact he sounds like he needs an operation just to get his head out of his own ass! I'm sorry to hear you had to go through all that crap and look forward to hearing when you find someone else who isn't an arrogant moron.

Hey Redcharger - how're you doing today? I hope you're feeling a bit better.
I think I read somewhere that they don't laser fissures because that wouldn't fix the underlying problem, which is a too tight/spasming sphincter. But I'm not 100% sure about that.
Man, I'm still soooooo angry at McKenna!
NG - maybe you can advise us. Elphie suggested creating a new thread/forum, whatchacallit where boardies can discuss experiences with doctors and share information about how and where to find good specialists. But I don't think any of us know how to create it (you know, like on the home page, "introduce yourself", "considering surgery", we could have "Discuss Doctors" or some such). Do you think that would be a good idea? And, do you have any idea how we could set such a thing up?
(BTW - thanks for taking all your clothes off for me ... next time I'll just buy ya dinner instead of having my ass tortured!)
I'm really not surprised that the fissure gave you an addiction to valium. I lived on muscle relaxants and would have happly shot heroin if it had been offered. I know valium is hard to kick - I really hope you're doing ok with that now. I also really hope your endoscopy goes well and that you are able to resolve your stomach issues soon too. I've been struggling with some serious digestive issues lately myself, so I feel for you! Let us know how it goes, k?
RC - I'm going to keep my eyes open for options. I called the Reimer Clinic in Kitchener today, but they don't do LISs there. If I find anything, I will pass along the information. I hope you are not in too much pain today.

When I was at my GP yesterday he gave me a Rx for a muscle relaxer but when I asked if it was Valium he said no, he didn't like prescribing that because it is hard to get off once you have taken it regularly. He gave me Cyclobenzaprine.
I called a couple of the place you listed for me too Hopetoheal. The Mississauga Colonoscapy Centre and the Provis do Sphincterotomies but neither do so under sedation and only under local.
I called the other local surgeon here to me but the soonest I can get into see him is June 16 and I bet it will be at least another month to 3 before he will be able to do the surgery. A friend of mine who is a Chiropractor and who I have been keeping informed told me i should schedule the procedure with one of the clinics that do it under local and just take 2 or 3 pain killers before I go in and maybe I'll be able to tuff it out........he was being sarcastic but it may actually be something I consider.
I got my Rx for the Nitro filled and when i got talking to the Pharmacist and told her the Dilt didn't work she was pessimistic the Nitro would , especially since the dosage is so low at only .2%
Does anyone in the Toronto area do Botox procedure for this problem?
Thanks again everyone for your input and support to keep me from letting this get me down.

Oh no RC - that sucks. I'm sure the no sedation policy is a cost-saving measure. There is no sound medical reason for it. Unfortunately, it also sounds like you got a pretty quick appointment with your surgeon, by Canadian standards. Perhaps if you impressed upon the surgeon the pain level and how AFs affect health generally (weight loss, digestive disorders, etc.), maybe he can speed things up for you. I really hope so! Hang in there - one way or another, you will beat this!

"For me the BM isn't painful. It's 10-15min after that the pain starts. I assume this is a result of the spasm. But what causes that to happen."
Same here. 10-15 min after, peaking about 3-4 hrs later, and gone in 6-7hrs. Weird.
"I also wonder why they haven't developed some kind of laser to cauterize the wound and seal it shut".
Actually there is a laser, but it's used for refreshing the wound, burning away dead and hardened tissue, so it can start healing again. I will have this "laser fissurectomy" in a few weeks, I'll let you know how it goes. Tbh I haven't found a lot of info on the internet on this laser, only that it's very expensive (maybe why it's not widely used) and it should provide less pain and quicker healing afterwards.
Reg. sedation for colonoscopy: i've had two so far, no sedation. They were not painful at all. Uncomfortable, yes. Painful, no. In fact, at some points when they would "wash" some areas to better see what's there (which I could see on the monitor) it felt quite good. Anyway, the part I'll always remember ('cause i thought it quite funny) was the beginning: you know, looking at the monitor you see yourself from the camera's point of view, then it starts to approach...comes even closer...and whooooosh, it's in! Kind of like the star wars planet monster sequence...in reverse :D