My Fissure Story

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My Fissure Story

Postby James2247 » 25 Dec 2016, 14:51

I have been reading around about this condition most of us here share and I thought it prudent to share my own experience; it might help someone.

I started this nightmare about seven months ago. On consulting Dr. Google, I narrowed my diagnosis to be Hemorrhoids, Anal Fissure or Anal Cancer. Due to the implication, I avoided giving the last option a lot of consideration. In the early days, I visited a clinic with the hope that my problem would be investigated. The ''Doctor'' who saw me didn't even do a physical examination on me but sent me for a stool lab test. The shocking thing was that what he was looking for and did get, like he will in almost 100% of his patients, Helicobacter pylori (H. pylori) was really so irrelevant with my symptoms that I immediately dismissed him as a quack. I didn't have any Ulcers manifestation and I had clearly told him I had anal pain during BM with fresh blood at the tail end of my stool and on the tissue paper.
Anyway, fast forward. Both Hemorrhoids and Fissure as per Dr Google are harmless inconveniences that can be treated by diet, lots of fiber, water and sitting on hot baths after a BM. I also started using suppositories and Lidocain. These efforts seemed to contain my problem and since my BM will be normally once in the morning I did manage to live with the problem without much issues in the first months.


However, after months of my condition not showing any sign of dissipating like Dr Google had advised, the possibility of my problem being a bigger one started getting real and of course fear of doing a proper check set in. I know Cancer from my experience with my own relatives has got such dire consequences that I dilly dallied in seeing a specialist. As time progressed, I started needing to take pain killers to dull the pain after my morning ritual. Initially, one 400mg Ibuprofen was enough to get me through the day until the next morning. Progressively this started being ineffective and had to migrate to stronger over the counter options. Diclofenac 50mg was the next stop which eventually stopped being ineffective as well and had to start using 100mg. I knew I had to seriously address the issue otherwise long term usage of NSAID's would bring other complications sooner or later. But I kept getting excuses not to do it. I would dread my next bowel movement for the anticipated throbbing pain, itching once in a while and generally leading a nightmare for a life.
Last edited by James2247 on 27 Dec 2016, 04:46, edited 5 times in total.
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Re: My fissure story

Postby James2247 » 25 Dec 2016, 15:36

A month ago, my pain got unbearable. In the preceding days, I had started feeling a hitherto nonexistent swelling/growth at my backside. My fear that I had a Cancer there increased tenfold. I went to see a Gastroenterologist with the thinking that a colonoscopy would be necessary. By this time I couldn't even sit and no amount of Diclofenac would dull my pain. Without my knowledge, an anal abscess had developed very close to my anus which was the swelling I had started feeling but due to the pain killers I had been taking, it had grown so much that as this specialist was inspecting me, the abscess burst on its own. The pain I was in necessitated the Doc to first address the abscess issue before looking at my original problem. This development obviously made me very happy because my original fears of the fearful C word seemed unfounded. The Doc sent me home with antibiotics, Panadol [since she felt I had taken NSAID's for too long and therefore my liver/Kidney needed to be protected] and instructions to sit on Salt bath three times a day with the hope that the abscess would fully drain so that we could address the other problem.

However, even after draining continuously for three days the abscess was still there, now with increased risk of serious infections. I decided to self admit myself to a hospital. By this time I couldn't sit and the pain I was experiencing was unbearable. Luckily my Medical insurance would meet the charges but as is their practice here, to manage costs which otherwise escalate greatly when hospitals get a free hand to manage Patients admitted in their facilities, only Doctors in their panels can handle their inpatients. Therefore, on admission at their casualty department, I was told I would have to wait for a Surgeon who the Insurance were sending to come and handle my case. When he eventually came, an elderly Doc, obviously with many hours spent on the Operation table, confidence enhancing of course, on inspecting me, decided I had to go to operating theatre on General Anesthesia. Eight hours after the admission, I was wheeled into the Pre-operative room
Last edited by James2247 on 27 Dec 2016, 11:41, edited 5 times in total.
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My Fissure Story

Postby James2247 » 25 Dec 2016, 16:21

With thanks to God, I have been healthy most of my life. I am 51 and had never been admitted in a hospital before so the fact that on my first admission I would head to an operating theatre obviously had me uncomfortable. At the Pre-operation room, a very quite area where I stayed for an hour or so as we waited for the Surgeon and Anesthetist team, I quietly reflected on my life my successes, my failures. Stories I have heard before of some patients not making it out of operation Theatres kept flashing through my mind. Under these circumstances, I was strangely calm. Of course the thought that what had tormented me for seven months might be finally solved had to be an explanation of this state of mind.

I am finally wheeled to the operating table with hooded people all over. Quickly, two injections through the IV kit on my left hand inserted earlier to inject pain killers, and then someone putting a gas mask on me telling me to breathe in and out which I remember only twice. My recollection in the operation theatre cannot be for more than a minute. I woke up about an hour later back in the pre-operation room. I was groggy and remember asking for some water because my mouth felt very dry. I was given like 10ml of it in a vial like container. I concluded that you are probably not supposed to take water immediately after getting awake from anesthesia.

After another hour I was wheeled back to the ward with the Male nurse doing it telling me that the Surgeon had removed the abscess waste and a fissure which was my problem all through and due to that, I would feel an urge to go but I shouldn't because down there was bandage which would cause that feeling. I was generally very happy that all had gone well and I was on the path to recovery. I was informed that the Surgeon would see me the next day. I had little or no pain which I associated to the pain killers I was getting through the IV tubes. I asked if I could go to the bathroom to urinate but on getting there, try as I could, I did not produce a drop even though I felt like I had urine. I settled down to sleep which I did soundly due the huge relief I felt and also the sleep that had accumulated in the last week of agony.
Last edited by James2247 on 27 Dec 2016, 04:22, edited 2 times in total.
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Re: My Fissure Journey

Postby James2247 » 26 Dec 2016, 10:13

After the Surgery night, I am woken up at 8 am by a Lady dishing Breakfast Trays to patients in my ward. My last meal had been the breakfast I had taken the previous day before I got admitted and due to food and fluid restriction issued by my Surgeon in preparation of the operation, I was certainly feeling hungry but due to the fear that I might need to go, I was hesitant to eat. However my Ward nurse informed me that I needed to go soon before they could change the dressing. Seeing that I had little choice, I cleared the whole tray. At this point all my medicine, Pain killer and Antibiotics is been done intravenous except Duphalac oral, 30ml of Lactulose which I was taking orally. After breakfast, I walked to the bathroom and was able to do my first pee. I realized that my pyjamas and my bed sheets were messed up with blood so had to ask the ward orderlies to clean up.

The Surgeon came in to see me at about 10 am. He was pleased that I looked fine and told me that unless some drastic changes happened, he would discharge me the next day. He however informed me that he had gorged out a big cavity close to my anal opening to clear the abscess which would present some challenge since being so close to fecal waste infection risk was quite high. Therefore I must sit on a salt bath for 20 minutes after every bowel movement. Lunch would come later which I ate. My need to go came at around 4 pm. Of course I was dreading this moment. I asked the ward nurse to remove the dressing so that I could do it. I was surprised that that the poop popped out effortlessly without the pain that I was accustomed to before the Surgery. My first Salt bath was however a bit discomforting due to the fresh surgery wounds. Once I was done, the ward nurse dressed me again and as per the Surgeons instructions, the cavity was to be packed with Bactigras which was going to be a daily ritual.

As promised, I was discharged the next morning with instructions to seek daily dressing in a medical facility. I was sent off with a week’s ration of Olfen 75 and Panadol for pain and Augumentin for Antibiotic
Last edited by James2247 on 27 Dec 2016, 04:32, edited 1 time in total.
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Re: My Fissure Story

Postby James2247 » 26 Dec 2016, 12:09

Yesterday marked exactly four weeks since my operation. I completed my medicine dosages after a week and have generally not been taking any pain killing or Antibiotic medicine since. However, once the Lactulose I was discharged with was over, after reading somewhere else about it being better, I am currently using Lactitol 15ml twice a day to keep my stool soft. Below is the summery of my progress, challenges in the various areas in my healing journey.

Fissure: I have kept two appointment visits to my Surgeon this far. I asked him what he did on the fissure and his story on it was that it was a five months fissure at the 6 o'clock point. Due to the tightness of the sphincter muscle, blood was restricted from flowing to the injury hence limiting healing. He reckoned that a fissure that is more than a month old cannot healed by the conservative measures of diet, fluid and hot baths I had taken when it occurred; surgery was the only solution. He told me that he had removed the fissure and from my reading around this could be Fissurectomy. I am not sure about it, but the tightness of the Sphincter muscle feels like it lessened so probably he did an LIS [Lateral internal sphincterotomy] as well. I will clarify this in my next visit. Generally, I am able to do regular BM without pain other than a slight discomfort at the beginning of the process. However, I am concerned because I am still producing fresh blood visible on the stool and tissue paper. I wonder if this is will disappear once I am healed.

Abscess: This has presented my biggest challenge in my healing process. Due to the size and location of the cavity, it has necessitated daily dressing and Salt bath sitting after every BM. Since on alternate days I am doing two BM while on the other days one, I have had to remain at home during this period because I don't know how I will handle a BM urge in a place I cannot be able to salt bath.
Right from discharge, I was informed that the cavity could only be expected to regenerate naturally which would take time, 6-8 weeks conservatively. However someone told me of an ointment, Regen D which is said to accelerate the healing. I have been applying it for the last three days and will report on its efficacy in due time.

Incontinence and Discharge: So far, I seem like I am in control of my BM and gas passing but when the urge to go comes, it appears like I wouldn't be able to restrain from doing it for long. However, I still have some discharge which I can't exactly pin it to either the abscess or the Fissure surgery but hopefully in due time I shall be able pinpoint the culprit in due time.
That's my story for now. I will keep filling in as I progress in this journey
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Re: My Fissure Story

Postby James2247 » 28 Dec 2016, 10:39

Today the 27th Doc 2016, I went for my 3rd Appointment with the Surgeon after my operation. He started by doing a physical examination of my butt area; more specifically on the operated fissure and the cavity formed after the abscess was drained.
His first reaction was that the cavity is almost healed and reckons that the appointment in the next two weeks might be the last on this matter. He prescribed Sepgard ointment to apply to the filling cavity.
I mentioned to him about the discharge I have been observing. He said he would apply Nitroglycerin on the fissure which he did cautioning that it could pain slightly. He said this would heal the fissure faster and eliminate any discharge from it. I will make observations and see if it indeed does.
After the examination, I asked the Surgeon for details of the operation he had performed on me. He told me that he did a Fissurectomy like he has done on more than 2000 other Fissure cases. On asking him about LIS, he detailed to me the inherent complications for not cutting the right amount of the internal sphincter muscle. Cut a little less, you face a non healing Fissure. Cut slightly more, gas incontinence is experienced and if cut too much, fecal incontinence comes along. He used to do the LIS a while back but after facing these complications, he opted to be doing Fissurectomy only. During the operation, he dilates the Sphincter Muscle when the patient is under anesthesia. This way, the Fissure heals and the social embarrassment of incontinence risked by a failed LIS is avoided. With this, he sent me off until the next appointment two weeks later.
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Re: My Fissure Story

Postby LemonMan » 28 Dec 2016, 15:51

Hi James,
What a fantastic post! I suffered a similar abscess which took around 12 weeks to fully heal up completely after being laid open, so I can relate to what you have been through.
It sounds like your surgeon is a good one.
Hope you continue to heal well.
Cheers, LemonMan
Aug 14: Anal Abscess diagnosed
Dec 15: Anterior Anal Fissure diagnosed
Jan 16: Anoheal - Thought was healed end of Jan
Apr 16: Anoheal - Thought was healed end of May
Sep 16: Fissure back. Started Anoheal again
May 17: Botox and banding - fingers crossed
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Re: My Fissure Story

Postby James2247 » 28 Dec 2016, 21:00

@Lemonman, thanks for the moral support. My Surgeon certainly seems like he knows his stuff. However, his proficiency shall be proved by the end result. Hanging on there
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Re: My Fissure Story

Postby Joy » 30 Nov 2017, 00:34

Just had a LIS done two days a go as I had two chronic fissures at each end . Sitting hurts also there is a bit of discharge and pain but I haven’t experienced any blood during BM. Please can someone advice if this is normal after a LIS.
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Re: My Fissure Story

Postby Eastern Europe guy » 17 Dec 2017, 15:45

test
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