postop 3 weeks more pain

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postop 3 weeks more pain

Postby Karinann » 13 Jul 2013, 19:07

Hello:
I'm new to the forum.  Found it after much searching for info about post op experiences. My name is Karin and live in the Clearwater area of Florida.  
I had LIS surgery for my fissure on June 26.  Now almost 2 and half weeks following surgery I still have intense pain when I have a BM.  The first week following surgery was probably not the greatest with respect to pain level but I managed to bear it with the help of Vicodin (two 500mg every 10 hours).  Ten days after surgery with help of the pain meds I felt good enough to go to the market to go food shopping.  That was on a Saturday.  I had some roasted chicken and mashed potatoes for dinner, went to bed around two in the morning and fell asleep for about four hours.  By the way my ability to get any quality sleep at all has been severely diminished ever since the surgery.  Sunday morning I woke with terrible pain and an immediate to need to go sit on the toilet.  The BM caused the most severe pain I've ever felt in my life.  After the BM I jumped into the tub with warm water which soothed the pain.  I sat in the tub for about a half hour as soon I stood up to get out the tub I felt the need to get back on the toilet.  Another BM started with again more pain.  Back into the tub.  Again as soon as I stood up to get out of the tub I had the urge to have another BM.  This went on for about four more episodes of toilet then tub.  I finally had things quiet down a bit with regards to the pain, and then I laid down in bed.  
The next five days I only was up out of bed for about 1 to 2 hours a day.  It seems that gravity is an enemy for me as every time I stood up the urge to have a BM would return with more pain.  I have to say I blame myself for a lot of this as I did not ask enough questions about the recovery process and what I would be in for during the recovery process.  I've other surgeries about fifteen years ago and remember the informed consent and information presented to me was much, much more detailed.  If I had known that the cure would be much worse than the fissure I think I would never have had this surgery.  
My first experience and diagnosis of anal fissure was about 25 years ago.  At that time it was explained to me that any kind of surgery was not possible, as I recall, it was a long time ago.  I spent 5 days in the hospital at that time on a soft food diet and intravenous pain meds.  The pain from that fissure eventually subsided and probably healed itself.  Since that initial episode 25 years ago I have no pain at all from fissures.  I have had some occasional hard BM over that 25 year period but no pain related to the original fissure.  Lucky me.  Around April of this year (2013) I had another hard BM where I felt I might have passed a stone.  At least that is what it felt like.  Then the pain from the fissure started back.  It would only last about 2 hours or so following a BM, but I noticed that each successive BM would cause the pain to increase.  My primary care doc sent me to see a colorectal surgeon and she had me use a cream ointment.  Don't recall the exact med name but something like Dilatem and Lidocaine.  Also eating yogurt with probiotic every day.  Did that for three weeks and it did not help with healing at all.  
On the follow up visit with the CRS she recommended doing surgery.  So here it is 17 days out from having the surgery and I am still in intense pain during every BM.  I am taking Colace and Metamucil twice a day so my stools should be soft but most of them are what I would call well formed.  Not hard, but not like tooth paste as the CRS told me on the two week follow up after surgery.  I only get about 2 to 3 hours sleep a night.  My CRS suggested taking Benadryl to help with sleep which I did for the first time following the 2 week follow up visit.  I did get 8 hours of sleep that night, and awoke with no pain at all, at least until I had a BM.  It is difficult for me endure the constant pain now, as I am not taking any pain meds, as my CRS will not renew the Vicodin script.  I am taking Ibuprofin (400mg at a time) which doesn't seem to help with the BM pain.  It seems that the pain from the original surgery site is non-existent at this time.  All of the pain I experience now is from the internal fissure sites (my CRS found two of them) when ever I have a BM.  At this point I'm starting to loose my mind and wonder if this was such a good thing to do in the first place.  But now that the surgery is done all I can do live with pain and hope to God that things will get better.
Karinann
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Re: postop 3 weeks more pain

Postby Please go-away! » 13 Jul 2013, 19:52

Hi Karin, All though I'm glad you came to the wright site..I feel for your pain. I know you will get so much help and advice here.
This med is a opiod, which can cause constipation, even if it's a milder drug combo, Please, please drink alot of water and up your Soluble (softer fibre) foods over insoluble. I know through experience when opiods are or have been in your system
They can still cause constipation, even after you have stopped taking them, so keep drinking the water, a lot.
Vicodin contains a combination of acetaminophen and hydrocodone. Hydrocodone is in a group of drugs called opioid pain relievers. An opioid is sometimes called a narcotic.
If you like your mashed potatoes (they can be too binding) try to go half and half, like mashed cauliflower and potato or sweet potato.
I didn't need the surgery, I did have to be intubated in an induced coma for 11 days,due to throat closer, they think it was auto-immune/allergy, they don't really know. Which made an existing fissure worse because of all the opioid's they gave me, and other issues, I'm finally healing, and you will too. Please be patient, call back your Doctor, see a CRS or Gastro, Doctor, what ever it takes,
I just love my heating pad, along with the ointment, it works double.
Another thing is Metamucil, is a insoluble item that compacts you and bloats you with gas,( my Pharmacist told me not to use it) so avoid that, you can try colace, softener with the vitamin magnesium oxide,or Mira-lax, But still speak to your Doctor.
I feel you should re-evaluate your diet again, check out the many post"s on here about the wright fibre for fissure's.
If your compound/ointment doesn't make you dizzy, then apply it twice a day, and don"t forget to purchase a heating pad, it"s been my lifesaver, and has healed me faster.
Please don't give up, stay on board, there is so much help here, People are just amazing on this site, you will get help I promise you that. Image 
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Re: postop 3 weeks more pain

Postby Karinann » 14 Jul 2013, 19:39

Thank you for the reply. I am taking Metamucil twice a day right now along with 100mg Colace. My doc suggested Metamucil. I'm probably not doing the best I can with regards to diet. After my horrible day on Sunday a week ago I was afraid to eat anything for fear of causing more pain. After the Sunday episode I only had some raisin bran and some apple sauce. I have been drinking lots of water. I have friend who used to work in a VA medical clinic as a physicians assistant, and she emailed a suggested soft diet regimen. My CRS recommended a regular diet. I got some Ensure which I've been taking now for the first time today, and had some pancakes and maple syrup today for breakfast. That made me feel almost human all day today. Although walking is still very painful, most of my time is spent lying down either in bed or out by the pool in the chaise lounge. I did not get very much sleep last night, so was up early today and went out to the family room to watch some TV with my SO. We got into an argument over my whining about my pain. All day today I've been having a lot of gas pass followed by severe cramping for a short time. Around 8 Pm this evening I had a very painful BM with fairly large stools, two of them, plus a lot of blood. Jumped into the tub with warm water immediately and that helped relieve some of the pain. But I still have what I would call a lot of soreness back there around the anal opening. I'm lying bed typing this and can feel the soreness slowly diminishing. I did take two more Vicodin immediately following the painful BM. I'm a wimp when it comes to pain. On the bright side if there is one, I do notice that I'm able to handle the pain associated with the BM's better since the initial surgery. And there is no sharp pain associated with the fissure sites like before I had the LIS surgery. So it appears the LIS did do something to mitigate the searing pain. I think I have a small hemorrhoid that pops out during BM, and most of the pain is associated with something on the hemorrhoid internally to the anal canal. I'm going to try to relax and try to get some sleep tonight. The one night I did sleep for almost 12 hours felt so good after I woke up I wish that could happen again. The diet part of this experience escapes me right now, and I am trying my best eat. I know I have to do that. Since the episode of a few days of not eating has probably caused more cramps not really associated directly with the surgery. As soon as I put some food into my stomach the cramps diminished.
I'm not sure I want to stop taking the Metamucil, as the gas it does produce helps push out the stools. I'm not straining to push anything just trying to let things come out naturally. I'll call my CRS to check that out. Still haven't found my diet regemen yet. What I'll try is in the morning orange juice, bran cereal, a slice of toast. Alternate that with pancakes for the bran cereal for some variety. Haven't had any salads yet so I might try that for late afternoon lunch. I was a very big eater before the surgery so its hard to start eating three meals a day. I think it might be better to eat smaller meals more frequently during the day. Regards for now Karin
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Re: postop 3 weeks more pain

Postby Please go-away! » 14 Jul 2013, 20:40

Wonderful that you have help."and she emailed a suggested soft diet regimen" follow the soft food diet until your healed, Watch the pancakes they can bloat and bind you, raisin bran is OK some of the times, read the ingredients, hydrogenated fats plus fructose can slow down the absorption of nutrients, water and good fats which in turn slows down a BM and in the long run can make us constipated.
I know it's a lot to ask, But it's very important to read the ingredient labels. Careful with that breakfast, " What I'll try is in the morning orange juice, bran cereal, a slice of toast." Careful with that breakfast , its a lot of Insoluble, meaning very heavy (insoluble foods act as a brush, by sweeping out any particles of food,but it has no soluble food to sweep) try to add more soluble
foods.
Like a chopped apple, plum or prunes or better yet make a small fruit bowl, fresh no sugar, If you can only have the cereal for now, don't forget, one large glass of water before and two large glasses of water after your meal.Don't force your self to eat big meals,a lot of us here can't, so don"t worry.
Stick with the Metamucil as long as it doesn't upset your system.
OK Image  take care.
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Re: postop 3 weeks more pain

Postby Just 'Pain' Tired » 14 Jul 2013, 22:40

I have a short attention span at night and your posts are really long!  You are trying to figure out that good regimen for your stools and body and it is a little different from person to person.  A friend I spoke to swears by Metamucil every morning (for life!).  A lot of people here like Miralax (which made me too loose). So you do have to find what works for you.  Those narcotic pain medications are known to be constipating.  I have avoided them at all costs (though I haven't had surgery!!) and used local ointment like lidocaine and of course warm/hot sitz baths and lying on my heating pad (my best friend).  The pain can sure be incredible...keep finding those ways to soothe it!   My particular regimen includes a teaspoon of Metamucil in the morning before anything else and an easy to digest breakast (thinking ahead to plug/no-plub the next day).  I take magnesium every other day.  Watch your mix of soluble to insoluble fiber and don't consume too much insoluble fiber!!! At first I had lots of water but also lots of insoluble fiber and passed bricks.  Who needs that!!??  Hoping for healing and pain relief for you!  A fellow sufferer.....:(
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Re: postop 3 weeks more pain

Postby Karinann » 15 Jul 2013, 10:08

Thank you for the kind thoughts. Yesterday was particularly difficult day for me. After enduring gas bubbles passing every five minutes, followed by cramping during the day, I had a very painful BM passing two stools Bristol 2-2.5, plus a lot of blood. I was very, very concerned about what was happening to me. On the verge of outright scared. I sat in the warm tub for almost an hour which helped relieve the pain. I had to take two Vicodin to help relieve the pain. After an hour in the tub I was feeling quite a bit better as the cramping disappeared. I went back to bed and had a good sleep. This morning when I awoke I was very sore down there but no cramping and no passing gas. I took my morning Colace plus two Ibuprofin. For breakfast I had some oatmeal plus a glass of orange juice with a tablespoon full of Miralax (about half recommended dose). It's now about an hour since I had the oatmeal and am going to drink some Ensure. My sister is supposed to visit me this afternoon and do a bit of food shopping for me. What I have found so far that eating a good diet (still haven't found that yet) at least keeps me a bit more focused in not obsessing on the pain. The first two weeks following surgery I had the mind set of not wanting to eat anything for fear of causing hurtful bowel movements. Now I know better and what I still need to find is the correct diet for me to get my stools into the right softness.
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Re: postop 3 weeks more pain

Postby Please go-away! » 15 Jul 2013, 15:03

I know I sound like a broken record, but from experience with opiods, using that Vicodin is creating a vicious circle for you. I think you stated earlier that your doctor won't give you another script, good.
Try to slow down on taking them, trust me from experience.
I'm so glad your sister is helping you.see if you can pick up a heating pad, The one I have turns off in a couple of hours, if I fall asleep.
OK. Take care.Image 
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Re: postop 3 weeks more pain

Postby Karinann » 16 Jul 2013, 12:27

Thank you for the support "Pleasegoaway". Yesterday was a pretty good day for considering everything going on. My BMs are still very painful and am having them once or twice day now. Still bothers me why taking three Colace a day plus two Metamucils haven't turned my poop into toothpaste consistency. Drinking four 16 ounce bottles of water each day. Also having one Ensure protein drink a day. Had breakfast this morning. Orange juice scrambled eggs, ham bits, potato. Felt a bit bloated and nausea after finishing eating breakfast. Not getting much sleep, in fits two hours sleep wake up, the back to sleep two more hours. About only 4 to 5 hours a night. My biologic clock is all screwed up not falling asleep until 3Am to 4 Am in the morning. Waking around 11Am in morning. Had a very painful poop this morning.
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Re: postop 3 weeks more pain

Postby Please go-away! » 16 Jul 2013, 19:42

I know I sound like a broken record..but we care and want to see you get better and heal fast..this is not the way to do it,(Orange juice scrambled eggs, ham bits, and potato.) Not to mention potatoes are binding.
I promise you, that you can go back to some of those food's,when your healed, but for now ..Please, Please try to stick to more fissure friendly foods. You will see that a lot of the post's will help you with that.
Your doing great with the water and everything else, we just got to tweak your diet still, OK.
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Re: postop 3 weeks more pain

Postby hunter/jumpergirl » 17 Jul 2013, 12:25

Hi Karinann,
I had LIS on July 5th, along with a sentinal pile removal. I am 12 days post-op. I do have some pain after I poo, but it is getting better each time, goes away with a tub soak in under 5 min.The key to helping my healing are these. Maybe they will help you. STOP THE VICODAN. Take a generic motrin, 800 mg every 8 hrs for pain. It will not constipate you. Take mineral oil, 2 tsps before bed in a glas of prune juice. Eat 5-10 prunes each day. Lots of fruit - get nice big bowl of chopped fruit from Publix. Lots of soups, water, Fiber-one cereal in am along with 2 hard boiled eggs. i am telling you, keeping the stool soft is going to be your key. It really speeds healing. I also cleanse the area inside with a q-tip, smeared with vaseline. Discovered Dr. Wheatgrass superbalm which I put up there after cleaning with vaseline. IT has really helped. You will get better. It may not seem like it, but this surgery makes all the difference. People care and I know what you are going through!
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