Anxiety...should I have surgery?

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Anxiety...should I have surgery?

Postby xanderla30 » 03 Oct 2012, 07:03

Hi all. I am so glad I found this board!
First a little about me.
I am a 30 year old male. I live in Houston, TX. I have always dealt with on again off again painful bowel movements and blood on the toilet paper. I just assumed it was normal and the result of passing a hard stool. It was never pain I could not handle and would just happen once and after that I would be normal again.
This past summer I was under extreme stress. My father was passing away, I was away from my home to help take care of him, and was also eating very poorly and had a few bad bouts of terrible constipation.
Last Thursday I noticed excrutiating pain when I would go to the bathroom, but no blood. This happened every time I went to the bathroom and caused me to immediately change my diet and of course I suspected hemorrhoids.
Yesterday I went and saw a CRS. He talked to me for a minute, and then checked out my butt for a few seconds and diagnosed me with "severe anal fissures."
He said in my case the only sure cure is the LIS. He said he has never seen someone with as many fissures as I have (he said there were 2 or 3) heal with just the medication.
I told him I wanted to research some and he gave me a prescription for lidocaine .5% and nifedipine .3% and scheduled a follow up in 2 weeks.
I started the nifedipine last night and again this morning (says to take every 8 hours) and this morning my bm while still painful, did not make me cry out in pain as previously. But I did notice a lot of blood on the toilet paper which I had not seen so far this week. Is it getting worse?
He told me the surgery would be very simple and if I had it on a Thursday I'd be back to work on Monday. Does this sound about right? I am very nervous about the complications (incontinenance) post surgery.
I am thinking about seeing a different CRS just to be sure. I actually had wanted to go to a different one to begin with but he is very popular and did not have an appointment available until later this month, so I chose my second choice who could see me sooner.
Sorry this is so long but it's causing me a lot of anxiety. I am young and active and don't want to be suffering like this the rest of my life. Any advice is appreciated! Thanks! :-)
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Re: Anxiety...should I have surgery?

Postby Bambi » 03 Oct 2012, 07:36

As you are young and active, my advice would be to have the surgery. I had my active fissure for about 2 years and it really impacted me in terms of my already tending to be an anxious person. I used 2 different creams for months, then had 2 rounds of Botox over several months and then finally the surgery several months later. The other things would help but then the fissure always came back or got worse again.
If you could get in to see the other Dr for a second opinion, that might ease your mind. It is important to feel confident in your Dr. I wonder if they would pencil you in on his surgical schedule for a week or so after your appointment, since you have to wait to see him. That way you wouldn't be waiting yet again for a slot in his surgical calendar. I don't know if they would do it, but it never hurts to ask.
Does the first Dr have a pretty good reputation and does he do the LIS a lot? Is he a board certified colon and rectal surgeon? My primary care Dr sent me first to the general surgeon next door and because my insurance allowed it, I then found my own CRS. I wanted someone who did this surgery routinely and not occasionally. Good luck and fetit over with as fast as you can while getting the best Dr for you so you feel comfortable ith your decision.
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Re: Anxiety...should I have surgery?

Postby xanderla30 » 03 Oct 2012, 07:39

Thank you for the response! :)
The first doctor is board certified...he is a certified colon and rectal surgeon. I am not sure how to find out about his reputation. I will say while I was waiting in the waiting room yesterday, an elderly man came out with his wife and he asked me if I was waiting to see that particular doctor. I responded that I was and he told me that he is very good and that he really cares. That made me feel pretty good, but I think I would still like to see a second specialist just to be sure. How can I go about finding out about a reputation of a particular surgeon?
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Re: Anxiety...should I have surgery?

Postby Bambi » 03 Oct 2012, 07:47

Oh and most folks on here will tell you that for some reason the Drs do underestimate recovery time. Others could chime in, but I think a week off would be a good minimum. You just don't want to overdo. And then maybe work from home some if you can or have some possibility of flexibility in the second week. Definitely some on here have gone back sooner, but it is better to lie on your side on the couch and have access to sitz baths.
As far as incontinence goes, I wouldn't think about that very much because I think it is a very small number of people who were already quite elderly who make up the very small percentage . You may go through a period where you need a little extra cleanup a while after a BM, slight leakage, but usually does not seem to be anything but a little extra need for hygiene checks. That seems quite common on here as a discussion and I can reassure you it gets better with time, although I went through a plateau of sorts after a few months that made me think that was the best things would be and then I started to improve again. But otherwise you could still be in this awful time of pain every day, spasms, etc.... And you are too young for that! I'm too young for that at 58!
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Re: Anxiety...should I have surgery?

Postby Bambi » 03 Oct 2012, 07:58

It isn't always easy to find these things out. Have any friends who are nurses? Sometimes I think they know a lot!
I live near Denver and our city magazine does an issue each year on"Top Docs" and my guy was listed with 2 others in that. He had been on their list 3 or 4 times and that was determined by asking drs who they would take a family member to. I then got online and googled his name and it pulled up a couple of review sites. One was called Health Grades I think and the other I can't recall right now. One of those was better than the other in that you could read comments from people. I have occasionally seen a Dr reviewed on Yelp. My daughter reviewed anDr after a very uncomfortable situation developed.
None of this is perfect and I actually would put weight in the elderly gentleman's unsolicited comments to you I the waiting room. I think these things happen for a reason sometimes.
My CRS was great in his surgical skills, but had a rather odd bedside manner. Sometimes I thought he cared and sometimes he was a little off putting. He did call me at home after several weeks a following my second Botox, when I was struggling with what to do cause I was a little better but had still 3 or so bad days a week. He said on the phone that we should move on to surgery and got me in fairly quickly. One thing I did not like was that he did not have a nurse to call with questions, but then he seemed a little annoyed by my question. I would rather have to go through a nurse, who might be able to answer a lot of questions after surgery. You might ask about how it is handled I'd you have questions afterward.
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Re: Anxiety...should I have surgery?

Postby xanderla30 » 03 Oct 2012, 08:19

I did a websearch and found out that both doctors I am considering are board certified in colon and rectal surgery and have both been practicing about 10 years. Tough decision!
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Re: Anxiety...should I have surgery?

Postby xanderla30 » 03 Oct 2012, 09:00

I am now scheduled for a second opinion on october 24th...three weeks from now. I hope I am feeling some relief by then.
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Re: Anxiety...should I have surgery?

Postby Bambi » 03 Oct 2012, 10:55

The one site I couldn't remember was called vitals.com. You could read comments from patients. I hope you are able to get some relief as well.
I see you are in Houston. I thought that being at the beach helped me a lot when my fissure was acting up . We met my sister and family at Port Aransas for several days Oct. 2010 over Columbus Day weekend. I grew up in Victoria.
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Re: Anxiety...should I have surgery?

Postby xanderla30 » 03 Oct 2012, 10:57

Yes, I am in Houston. No shortage of doctors here.
I found the Top Docs thing you were talking about, and the CRS I scheduled my second opinion with is listed on Top Docs as being in the top 10 in the nation...so that has put me at ease a bit. I just wish I could be seen sooner than three weeks from now but I'll survive somehow!
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Re: Anxiety...should I have surgery?

Postby Katrina915 » 04 Oct 2012, 13:22

Xanderla30,
I am 4 weeks post LIS and fissurectomy. Fissure was gone at 1.5 week point, but I am still healing from LIS suture according to CRS yesterday(seems like same symptoms). You are 20 years younger than me and I am main caregiver for 90 year old father so you may have no problems.
I was given the same line "surgery on Friday, back to work on Monday". Hopefully, this works for you but based on my experience and others on this board, it may not.
Suggestions to you:
1)can you get post op instructions ahead of time so that you can ask questions/plan (did not work for me), but I was already doing sitz baths and miralax.
2) While you are on pain meds, docs will advise you not to drive. and pain meds may constipate you which is against your objective of soft stools. I mixed up with Advil and Aleve.
3) I went back to work the following Thursday (surg on Friday). I have a computer job and I was in excurciating pain. Other doc told me ok to drive with pain meds but make sure they did not make me groggy.
4) post op indicated not to do heavy lifting-now I know that doc meant really any lifting if possible and be careful bending, squatting, exercising etc.
5) lay on side as much as possible
6) do sitz baths 3-5/ per day
7) Consider donut hole pillow for sitting/driving
Image Try to stay relaxed and call CRS with questions.
9) If in pain and sitting, try low setting on heating pad.
I have no incontinence problems and am better than I was pre surgery. Just was hoping I would be further along than this. Good luck!
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