After years dealing with this fissure, and following Botox and skin tag removal in December that actually seemed to make the fissure WORSE, I underwent a sphincterotomy yesterday.

The pain following the procedure when I woke up in the recovery room was intolerable. Even repeated shots of Fentanyl had no effect on my pain levels. After reaching the Fentanyl limit they escalated to what they called a "Ketamine protocol" which involved shots of Ketamine every 15mins. During this time I experienced no pain, as I was moving at lightspeed through fractal geometry in another dimension that felt like it was constructed of pure love. Sadly, as my pain was now under control they ceased the "Ketamine protocol", moved me back to the ward where my wife had been waiting for my return to this dimension, and soon discharged me.

About half way through the 40min uber ride home, the short acting analgesia began to wear off and my pain returned at an incredibly high level. Now quite cognisant and no longer completely off my face on Ketamine, I was now aware that none of this pain was eminating from the all-too familiar site of my fissure, but rather from the surgical incision. So despite struggling to hold it together, not start screaming and writhing around in agony and completely freak out my uber driver Les, I actually felt quite positive and relieved.

Upon returning home, I had a sandwich and some jelly, dropped 10mg of oxy, doubled down on Movicol and attempted to sleep on the couch whilst watching trash on television. It was a rough night, with my sleep regularly interrupted by throbbing, stabbing pain in and around my asshole.

Which brings me to today.

I awoke at 5am, immediately downing 10mg of oxy with a can of red bull along with some breakfast and another movicol. I struggled to urinate, with the muscles required to do so difficult to isolate with all the neighbouring pain going on down there. But tenacity prevailed and it was incredibly satisfying.

Needing to take my first sitz bath of the day, and eager to get a look at this thing, I removed the large gauze pad that had been enthusiastically taped to my ass with at least 2 metres worth of surgical tape, grabbed my phone, flipped to the selfie camera and positioned myself to get a good angle.

It's a mangled mess down there. The left side has swollen up to the size of a quarter of a small stonefruit, with the incision point and sutures at around 9oclock creating a visible choke point leaving my butthole looking like some kind of nightmarish half deflated balloon animal. There is a significant amount of discharge, mostly red, and the swelling so severe that I was unable to get a finger in to apply the prescribed nitro.

The following hours have been uncomfortable, but not overtly painful. Despite fasting for 2 days pre-surgery and the bowel prep, I've felt like I needed to go to the bathroom for most of today, but the swelling combined with some spasm are not cooperative to this process. Without any feeling of real urgency, I don't want to force it. I have been passing gas pretty regularly though - it's been largely controllable and uneventful, which is comforting.

All in all, it's been a rough couple of days, with a few small and encouraging signs of what may be ahead. The first post-op bowel movement will surely arrive soon, and whilst I am not looking forward to it, it will be an important milestone. Maybe I'll post a commemorative photo on Instagram.

To be continued

Fabulous narrative! I had excruciating pain about 15 hours after my LIS and I realized shortly afterward that it was my own fault for pushing at and poking the swollen tissues around the incision site in the mistaken ASSumption that my internal hemmies had prolapsed and needed to be returned to the anal canal. I can't guess what caused your extreme post-op pain, but am thrilled that things have started to improve. My first bowel movement just slid out (when it was ready), so you're right not to force it before it's ready. My CRS said that I should take Milk of Magnesia if nothing happened by the end of day three though, but hopefully yours has already met the toilet bowl.

Please keep us posted and I hope that the rest of your recovery is quick and as pain-free as possible.