Well Happy Halloween;
I have my follow up with the CRS on Monday (trick or treat?) and I have compiled a list of questions for him. It's everything I've thought of up to this point. It may be overkill and unrealistic to expect him to take the time to answer, but that's how my mind works. I have to know specifics, minute specifics . . . it's how I handle the fear. Plus those pieces of information come back to me when I need them. Plus, plus . . . his reaction will tell me a lot about him. Here are my questions so far:
QUESTIONS ABOUT LIS FOR DR. ROSEN
1. Where exactly is my fissure located (I can feel it, but don’t know
what “position” it’s considered to be in)?
2. Do I have any skin tags? Is it necessary to bother them if they
don’t bother me?
3. Where would you make the cut? Does the position of the cut
matter in healing or aftercare?
4. Will it be an open or closed LIS and what is the difference (want
doc’s words)?
5. Will/can you do a colonoscopy at that time?
6. How long have you been doing this procedure?
7. How many have you done thus far? Approximately how
many per year?
8. How conservative is your cut? What size incision?
9. Percentage of incontinence with your patients?
10. Occurrence of other complications with your patients?
11. What is the bowel prep?
12. What anesthesia type (my preference is GA)?
13. What position, face up or face down.
14. Do you stitch the incision site and, if so, what consideration
should I give this in aftercare?
15. Do you use permanent stitches or do they dissolve (if applicable)?
16. Would you be doing a fissurectomy as well and if so, do you stitch,
glue or cauterize the area?
17. Do you plug or pad with gauze following?
18. Should I expect drainage afterward and for how long is normal?
19. At what point should I be concerned?
20. What is the typical healing time of the incision site?
21. What can delay healing of the incision site?
22. When should I be concerned about the incision site?
23. How will I know if it is infected?
24. What is the typical healing time of the fissure site following LIS?
25. What can delay healing of the fissure?
26. When should I be concerned about the fissure healing?
27. What is the likelihood of bad scar tissue or tags developing
following LIS? Is there anything I can do to prevent this?
28. How common are fistulas after LIS? What can I do to prevent
this, anything?
29. Do you prescribe antibiotics following LIS and, if so, which ones?
30. How soon after procedure should I begin taking? Are they
constipating?
31. Do you prescribe pain meds following LIS and, if so, which ones?
32. How soon after procedure should I start taking? Are they
constipating?
33. How soon after should/could I eat and what types of food?
34. How long should I stay completely off the area? At what point can
I begin to sit a little?
35. What is the recommended time off from work for recovery?
36. If blood accompanies gas (flatulence) should I be concerned?
How do I know if it is something internal or from the incision/cut?
37. What things can I do now to prepare for this procedure?
Treatment while waiting for LIS:
1. What more aggressive treatments can we incorporate until then?
2. Can I get a stronger nitroglycerine ointment (like .4% or .5%)
3. What about Nipedifine (sp?) (coum?)?
4. What about Diltiazem (coum?)?
5. What about Valium (coum?) to help with the spasms?
6. What can I do to soothe the internal tract as the area often feels
raw?
Did I miss anything? Am I crazy?
And of course, I'll ask if I can speak to a few of his patients about their experience and progress.