![frusty :~!@:](https://anal-fissure.org/images/smilies/fissure_smiles/560739.gif)
I had an internal lateral sphincterotomy in April of 2021. SOOOOOO GLAD I FINALLY DID IT!!!
I had previously tried an ointment that lowers the blood pressure locally as well as Botox shots (1 on each side, I think), but neither treatment did much. I got to the point that the pain from the AF was preventing me from falling asleep, and woke me up many nights when I did manage to get to sleep.
I got a very expensive memory foam cushion for my work from home office, and I would take five-minute warm baths every hour since I was able to do only that amount of time while working from home. I am grateful that the most painful times occurred during lockdown because I would’ve had to have taken off work or leave work, then drive an hour home, and that would’ve been torture, of course. (We’re 100% back in the office since sometime in 2021 with no remote option.)
I know that I had a skin tag or maybe more than one, and I don’t know if the surgeon removed it. I don’t know if he performed a fissurectomy too, but I think so. I now think I only had one AF, but before surgery, I would’ve sworn I had 2 or 3.
When I woke up after surgery, I was moaning in pain. They gave me something IV that they won’t send home. The surgeon said it all went very well and that for pain, I was to use ice packs (which seemed to relieve the pain for a few moments, then make it even worse), warm baths, and/or acetaminophen. He refused to give me any higher type of pain killer because he said it could constipate me.
My mother and father had me stay at their house after the surgery. I was to take warm baths 4-5 times daily for 1-2 weeks, but I didn’t need them for that long (at least, not for pain). I did the warm baths for several days, but I think I was back at my own house after day 3, maybe even earlier. (I hate sitz baths on the toilet; they don’t seem to work at all for me and make me feel like I’ve gone to the bathroom on myself.) I had the surgery on Thursday and was told I could return to work on Monday. I think I took that Monday off, but if I hadn’t had any full-pay sick days left to use, I could’ve made it through work that day.
After that, I would still occasionally have some pain. The surgeon said that does happen sometimes, that some people still have pain after the ILS. I would just take warm baths and acetaminophen or ibuprofen or both when that would happen. BUT any pain I’ve had since the surgery has been much less than what I had before surgery.
My verdict: it was well worth it. If I acquire incontinence when I’m elderly, I hope that I will be happy that I had thirty or so years without all that pain and deal with it as gracefully as one can.
HOWEVER: In the ensuing time period, I’ve gone from obese to even more obese. Up to 250 pounds at 5’7” (113 kg at 170 cm). I’ve finally found a (different) doctor who is helping me work effectively on losing weight. The diet plan is very extreme: I eat very little. But since stopping eating all the food I used to, I’m also getting basically no fiber. Maybe that is why I’ve been having anal pain again. Maybe it’s the hemorrhoids? My CRS didn’t want to remove them because he said it would inflict ten times as much pain as I was experiencing with the AF. Yes, I would prefer to have the external ones removed, but I didn’t want any more pain, so I followed his advice to leave them alone.
Anyway, my weight loss doctor and I have agreed on 2 tsp Metamucil per day to try to prevent my stool from getting hard.
On this very restrictive diet, I’ve had very small BMs every one or two days. They usually don’t hurt before or while coming out, but a few hours later, or at what seems to be unrelated times, I’ll have anal pain that will make me take NSAIDs, and today, for the fist time in months or maybe even a year, I’m sitting in a warm bath as I write this post.
I’m still glad that I got the ILS surgery because the pain I’m having now is nothing like what I had before. It’s about 50% less or maybe even less than that.
But now I’m wondering if people ever get second ILS surgeries, what’s different from the first surgery, and whether the chances of incontinence increase with a second ILS.
I don’t know where my AF was located.
I feel foolish when I see other posts by people who seem to know every detail of their surgery. I kind of want to go back to my CRS just to ask these questions.
If using 2 tsp Metamucil (psyllium husk) daily doesn’t help the pain, I’m going to have to go back to my CRS.
Again, I’m very glad I got the surgery and wish I hadn’t put myself through a year and a half of pain trying more conservative methods, but you don’t know what you know until you know it.
Anybody had a second LIS a year or more down the road? Why? How did things turn out?
I still don’t understand why my BMs rarely hurt while coming out, even before the ILS, but a few hours later or at seemingly unrelated times, I will get anal pain and throbbing. Does anybody know why it has a delayed onset?