Lateral Internal Sphincterotomy Surgery on Jun 18th

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Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby Tryingtorelax » 19 Jun 2019, 20:55

Thank you chachacha! I appreciate your encouragement!
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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby woeisme » 21 Jun 2019, 04:13

Thank you so much for these updates! Praying for super smooth BM for you! I’ve read it can take up to 4 days to have a BM post surgery-if you get worried you can always try prunes or prune juice. Some people swear by it for providing a BM that requires no pushing.
I just had a modified LIS and fistulotomy (my fissure got infected and caused a fistula to form) on the 20th of June. So I am 2 days behind you.
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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby Tryingtorelax » 21 Jun 2019, 07:26

Woeisme, how is your recovery going?
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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby Tryingtorelax » 21 Jun 2019, 07:28

Post Op Day 2 (for reals day 2)
I woke up around 3:30 am and took an ibuprofen. Went back to sleep. I should tell everyone, because I was curious before the surgery, that mobility wise I’m getting around okay. I’ve been walking around the house in small steps, not long strides. I know that once this Experal wears off that I will probably be in more pain but for now the walking feels good in a short amount of time. Getting in and out of the bed or couch where I’m laying is tricky. I have to use a lot of arm and leg strength or get someone to help me because I am not using my tush to push myself up. The swelling is about the same, looks like I have a giant grape or prune down there. I’m also very bruised around the area and on my cheeks. That’s to be expected I know. I’ve been rotating ice packs and heating pad about every 20 minutes. This morning at 8:30 I ate oatmeal, had a dose of miralax, a stool softener, and ibuprofen. I walked around the house and massaged my lower belly. At about 9:45 I ate a cutie and by 10:05 I was on the toilet with my first bowel movement!!!!!! (Yes, this is what my life has become, excitement for a bowel movement. I know you fellow sufferers understand completely though). It was not bad, probably a little too watery and loose but that might be best for my first. Gotta ease into it. The pain was at a 2-3 level. There was some stinging afterwards. I used baby wipes to clean. I did a sitz bath then used the shower head and antibacterial soap. Then a towel and hair dryer to dry off. The rest of the day was uneventful. I ate an apple and zucchini and squash for lunch. Applesauce for a snack. Dinner was mashed potatoes with the skin, cooked carrots, and a cutie. I drank over 70 ounces of water. I did not have another BM but I hope to tomorrow. I took ibuprofen throughout the day. The longest time between doses was 5 hours. I rotated ice and heat today. I am more sore and tired today but I think I overdid it walking around.
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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby Tryingtorelax » 21 Jun 2019, 07:29

Forgot to say that I did 3 stool softeners and 2 miralax spaced throughout the day.
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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby TubDweller » 21 Jun 2019, 08:56

You are doing fantastic! Sounds like you're doing a great job of managing your pain and taking meds when appropriate. My circumstance was similar to yours (active lifestyle while suffering with fissure + external hemorrhoids). One recommendation though; try not to anticipate the pain too much. One thing I've learned is that pain has a very strong mental component. The more you anticipate it, the worse it seems. It's kind of like when you're running, it doesn't help to think about how far the finish line is :) In the first couple of weeks, it's kind of a lost cause, but as you get past that point, look for ways to distract yourself. I listened to podcasts, which really relax me as well.

There's no such thing as TMI on this forum. I'm sure that most of us here look at our anatomy in an entirely different way than non-sufferers. I know that as far as I'm concerned, my anus might as well be my big toe, haha :) When you've got to deal with the stuff we do, you don't have time for taboo. I don't know if you've seen the Marcia Cross interview where she talks about her anal cancer, but I'd highly recommend it. There's a point where she says, "anal, anal, anal" and then laughs, as she tries to get the point across that it's a body part. We can talk about it. It's OK :)

Not sure if you've hit this point yet, but next up will be the mucus discharge. It's a real fun time, always feeling like you have soggy britches. It's normal though. You've got this.

Side note: If your BMs are soft and happening daily, don't take too much laxitive. Talk to your doctor, but mine warned me of something called stenosis. Your anal canal actually needs some work while you're recovering, even though it's painful. Stenosis is a narrowing of the anal canal that can result from scar tissue formed during healing. The skin needs to stretch to prevent that, and loose stools won't do the trick. The target is natural peanut butter consistency, but believe me, I know how hard that can be to achieve. Once you're off the opioids and moving your bowels daily, ease off the miralax. The stool softeners are much more gentle.
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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby Tryingtorelax » 21 Jun 2019, 09:28

Great advice Tubdweller!! All of it! Thank you! You are so right about the anticipation of pain. I’ve been praying for it to not be as painful as what I’m imagining. I don’t mind pain but I want it to be manageable. Good to know about the stools and stenosis. I’m trying to add more food day by day, more fiber foods. I want it to be loose right now until I can get in a good routine. Before the surgery it was a good bulk and soft but maybe a little too big. It’s a tricky balance for sure.
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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby Cez » 21 Jun 2019, 11:21

Hope you are recovering well
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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby Tryingtorelax » 21 Jun 2019, 20:45

Post Op Day 3
Today’s the day the Exparel is supposed to wear off and I’m scared of how bad my pain level will be. I feel like I’ve been super spoiled so far because my pain has not been above a 3 or 4. I really, really hate to use the hydrocodone but I will if I have to. I’m hoping to get by with just ibuprofen so that I don’t get constipated. Breakfast is a stool softener and miralax (ugh) 2 bran muffins and red grapes. Lunch was a small piece of turkey breast, mashed potatoes with skin, green beans, broccoli, carrots and stool softener. Dinner was an apple, peanut butter, ritz crackers, pineapple and a stool softener. Had 4 BMs today. All loose and watery. I know this is not good so no miralax tomorrow, only stool softener and I’ll determine how many as the day goes by. We’ll see how that goes. If I have to take hydrocodone then I’ll do miralax. So far I’ve been fine with just ibuprofen.
I wrote the first part this morning and now it’s evening. I really can’t tell if that Exparel is wearing off or not. I have some pain but it’s not unbearable. I’d say at its highest it’s been a 4. I’m wondering when I get my stool back to normal if it’ll hurt more. Or if within the next few days when the shot wears off completely if my pain will spike. Not looking forward to bigger stool but it’s got to be done at some point. Not looking forward to pain either. So far I haven’t had too much trouble going to the bathroom. It has hurt waaaayyyy less than before the surgery. Is it the Exparel? I don’t know. Only time will tell if less pain continues to be the case. The only real issue I’m having is that it is difficult for me to tell if I need to go so I have many false alarms throughout the day. Still doing my sitz baths and showers after. Once or twice a day I wash with antibacterial soap as requested by my doctor. I’m also still rotating heat and ice packs. The redness of my LIS side is better but the swelling is not. The pain I feel is like muscle soreness and stitches pulling and a bit of stinging. I walked just a bit outside today, not even a quarter of a mile. I don’t think I laid on my side enough today so I’ll try to focus on that tomorrow. I’m afraid I’m laying on my back and rump too much. I did not sleep well last night. I am drinking a lot of water which means a lot of bathroom breaks and every time I wake up I’m in panic about registering my pain level. I hope I can sleep better tonight.
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Re: Lateral Internal Sphincterotomy Surgery on Jun 18th

Postby Tryingtorelax » 21 Jun 2019, 22:16

Any of you that have had the surgery (LIS)....how long did it take for the swelling to go down?
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