Hi All!
I am scheduled to have my surgery tomorrow (my "slice and dice"), Tuesday, July 24th.
Wish me luck!
A brief history: About a year and a half ago, I decided to start running with my wife since she was starting to look much better than me in a bathing suit. We ran about 6 to 7 miles a day (that's not pertinent to the story, I just like to brag). However, one day (about 10 months ago) we ran way too far for way too long with far too little water and I became dehydrated. The next morning I went to the bathroom to have a bowel movement (BM) and out came a solid brick, a bowling ball, a 1967 Chevy El Camino (paint color? brown, of course) and Jimmy Hoffa. I was sweating and grabbing onto the sides of the toilet for leverage. I said a couple of Hail Marys (which is odd, since I'm not Catholic) and just prayed to God that I would die quickly.
The toilet became permanently clogged and we had to move. I'm sure some of you can relate.
After that BM, my butt immediately started to ache (and not in a good way). I never had any blood, just pain following a BM that lasted for SEVERAL hours. A couple of months later I went to a CRS who found, you guessed it, a fissure. He immediately prescribed Nifedipine. The fissure healed (yeah!), although it healed incorrectly as a superficial fistula (not so yeah!). My CRS discovered the fistula while doing an examination under anesthesia (EUA). He recommended surgery to "deroof" the fistula since it is rare that a fistula goes away on its own. In addition, he also recommended that I have a lateral internal sphincterotomy (LIS) at the same time as he thinks I am prone to having fissures (lucky me) AND he wants to make sure the fistula heals correctly.
So, I am having surgery under general anesthesia - LIS and a fistula repair.
A couple of pre-surgery thoughts that may be helpful to others (in no particular order):
1. Pre-surgery prep:
DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT THE NIGHT BEFORE THE SURGERY.
ON THE DAY OF SURGERY, USE A SALINE ENEMA AT LEAST ONE HOUR PRIOR TO SURGERY.
2. My CRS would like me to be on a "soft" diet for 5 days following surgery. I hope this includes soft drinks, soft-serve ice cream and soft pizza with mounds of extra-soft cheese.
3. For the past several months, I have been taking a daily dose of Miralax (one full dose every morning), which has made my stools nice and soft, like melted ice cream (yum!). My CRS has recommended that I keep taking the Miralax for life, along with a fiber supplement (he recommends Konsyl).
4. I have a follow-up with my CRS at two weeks and six weeks. He expects me to be nearly pain-free at two weeks and he expects a full recovery at six weeks.
5. My CRS said the biggest risk following surgery is infection. He said it is rare, but he does have a patient every couple of years that has an infection following surgery. If I do get an infection, he said it is a "simple" in-office procedure to take care of it. I'm guessing this means simple for him and painful for me. Let's hope I don't have to find out.
The symptoms of an infection: your butt will be red, swollen, you will likely have a fever AND (the key) each day things get progressively worse, not better.
6. My CRS gave me his personal cell phone number in case I have any questions following surgery. How cool is that? For $20, I'll give it to you.
7. The cost of the procedure is as follows (U.S.):
GENERAL ANESTHESIA - $350
LIS - $1,500
FISTULA SURGERY - $1,250
TOTAL COST = $3,100
8. Ironically, since I scheduled the surgery about three weeks ago, I have been 100% (100%!) pain-free. Go figure. Ten looooooooooooooong months of pain, I schedule the surgery and the very next day, NO PAIN. It's the longest amount of time I've gone without pain in ten months. My CRS said this isn't unusual, as for some people the simple act of scheduling surgery immediately relaxes their muscles which relieves their pain.
I asked him if I could just keep scheduling and then canceling the surgery for the next couple of decades, but he said it only works if you REALLY believe you are going to actually have the surgery.
Crap.
9. I feel like I should be nervous, but I'm not (although, at the moment, I am a little gassy). I think it's because I am just ready to get this chapter of my life over with. Of course, that may change tomorrow morning. My CRS did give me some Valium to take (10MG), if I needed it, an hour before the surgery.
10. My CRS has given me the following post-op medication:
CELEBREX 200MG, an anti-inflammatory - 1 CAPSULE 2X A DAY
BACLOFEN 20MG, a muscle relaxer - 1 TABLET 4X A DAY
FLAGYL 500MG, an antibiotic - 1 TABLET 3X A DAY
ULTRAM 50MG, a non-narcotic (i.e., non-constipating) pain reliever - 1-2 TABLETS 4X A DAY
My CRS has recommended taking all of the above medication for 10 days, whether I feel like I need it or not.
11. My CRS has recommended the following post-op clean-up following a BM for the first couple of weeks:
No wiping! No wiping! No wiping!
After no wiping, hop in the shower and use a removable shower head to thoroughly clean the area. Then, hop in the bathtub for a soak. Then, hop back in the shower and use the removable shower head to clean the area again. After all that hopping, use a hairdryer (on the COOL setting) to get everything nice and dry.
If needed, I can gently shove some gauze between my butt checks.
12. The surgery, not including the time to put me to sleep and wake me up, will take less than 30 minutes.
13. My CRS said post-op recovery is like a roller coaster: some days you are up, and some days you are down. He said the key is that you should be improving over time. He said to measure your healing in terms of a week at a time and not a day at a time, and not to be too concerned if you have an occasional bad day or two, as this is to be expected.
14. Since my fistula is superficial, my CRS has assured me that the recovery from fistula surgery and LIS won't be much different from the recovery for just fistula surgery or just LIS.
15. My CRS said I could start having sex again as soon as I felt up to it. Being a guy, I'm guessing I'll be up for it tomorrow night.
I will post post-op comments and observations periodically, for those that are interested.
P.S. A special thanks to Davo (if you are even thinking about having LIS, you MUST read his posts), Ever The Optimist and Sue27uk. I'll see you guys on the other side! Your posts have been VERY helpful in my preparation for surgery! GOD BLESS you guys and everyone else on this forum (especially jr2 - I hope you find a good CRS soon and get some relief)!