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.