Re-tear 4 months after LIS - want to cry!

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Re-tear 4 months after LIS - want to cry!

Postby becsbum » 29 Apr 2013, 13:01

I had LIS surgery at the beginning of February. According to my CRS, I healed up perfectly! I was still having some discomfort when sitting which she suspected was the nerves and recommended PT. This made sense to me as I have some pelvic floor issues. I decided to wait a bit and sure enough even that discomfort was greatly improving.
Then a week ago - a little ZING when I went to the bathroom. And then that week slightly more discomfort than I'd been having (sitting, walking). I happened to have a follow up with her that friday and she saw a slight purple line where a new fissure was healing and was "either healed or mostly healed." She said not to worry, that is ok - it is healing and the muscle is not in spasm.
Then today another ZING and a little blood.
I'm so worried that I am starting the horrible cycle again! Has anyone had re-tears a few months after LIS and had them heal up and continue on to better things???
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Re: Re-tear 4 months after LIS - want to cry!

Postby becsbum » 09 May 2013, 19:12

Still wondering if anyone has any insight or comments. Monday I started back on Nifedipine. Today most of the day I felt cautiously hopeful that it may have helped...was more comfortable than previous couple weeks...then had BM #3 which caused a burning feeling similar to (but less than) before surgery. Last night I did have roasted garlic cloves - I am hoping I may be just sensitive to that. But at any rate after that last bm I feel sore again and depressed. Appointment with a new CRS scheduled for may 20th to get her opinion on things.
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Re: Re-tear 4 months after LIS - want to cry!

Postby howtobepositive » 09 May 2013, 20:57

Hey I just had my LIS 9 days ago and this comes as a shock and disappointment! I guess at this point what you really need to do is try to stay positive and tell yourself that this new fissure would not get to the "worst" point because you are well versed with managing these things now, you have already started using nifedipine! Plus one CRS already looked at it and another one will so you are in good professional hands.
Dont blame yourself for this - thats the biggest thing.
Before going for surgery, I had been getting AF's and healing on their own for approx. 2 years, there is a very good chance that this will heal on its own and with the ointments and other care like sitz baths. Go see the CRS and keep praying, stay positive, you will be fine!
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Re: Re-tear 4 months after LIS - want to cry!

Postby becsbum » 09 May 2013, 21:17

Thanks Positive! It helps just to hear your support. :) I just wish I could sit down without thinking about it. I have the kind that bugs the most when sitting and driving. Luckily, though, it has never been too terribly dreadful in the bathroom.
How is your recovery going so far?
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Re: Re-tear 4 months after LIS - want to cry!

Postby Lauren12 » 10 May 2013, 08:50

Hi becsbum
I had LIS just over two years ago and I've formed further fissures twice since then, the second time only a week and a half ago.
What happened with me on these occasions was that the fissure was as painful as my fissure pre-LIS for just one day, then it started healing and healed within about two weeks. So, I spent one day laying in bed for hours in pain, as I used to do when I had the chronic fissure pre-LIS, and then the very next day I was able to function normally again. I could feel I had a (healing) fissure for a couple of weeks afterwards (a week and a half in the most recent case as it's still healing up), but it didn't interrupt normal life - I could just ignore the sensation.
I did want to know if this kind of thing would keep happening however, and what the best thing to do about it was, so I went back to see the CRS who'd done the LIS.
He examined me (last Wednesday) and said yes, I had a fissure which was mostly healed up (bear in mind it's become mostly healed up within one and a half weeks and for all of that time except for one day, it hasn't bothered me). He said that the muscle tone in my internal sphincter is still quite high. Apparently the average length for the internal sphincter is one centimetre, whereas mine is longer than average at 2 centimetres, with quite good muscle tone in addition. He said I had the anal sphincter of a 25 year old male, whereas I'm a 59 year old woman! I said that I wished more areas of my body were like they were only 25 years old!
He said that he didn't want to go back to surgery to cut further into the muscle and said that if he was doing the operation again, he still wouldn't cut to a further degree. The fissures post LIS happened both times because of a combination of change of diet/dehydration from hot weather/large stools/constipation. After this second time, I started on Movicol again, not having used a stool softener since I'd recovered from surgery. I take less than the minimum recommended dose each day, just half a sachet which, in conjunction with the rest of my diet, is enough to keep my stools reliably soft throughout. So prevention is one thing. After the LIS, you can't just revert to eating any old thing, but have to keep to a healthy diet - but I'm sure you kow that anyway.
So I asked him that if this occurs again, can he guarantee that it will always heal rapidly and he said "pretty much". He said if it happens again and seems to be taking a bit longer to heal, e.g. a week(!) then to come back and he'd do a shot of botox. But he seemed pretty reassuring that if it does happen again, then again it will heal rapidly and not really cause me any bother in the process.
However after this last time when it happened, I reintroduced a low level of a stool softener (Movicol) to keep my stools soft (I didn't do that the first time it happened). So I asked him whether it would have healed had I not re-introduced Movicol and he said it would still have healed. However the best thing is prevention. I asked him if Movicol was something I could take for the rest of my life, to avoid times when my bowel habit becomes disrupted by stress or whatever and he said yes. He checked his formulary and went through every possible contraindication of long term use of Movicol and discounted them all in my particular case. So I'm going to continue to take it. He said that constipation is an individual thing, like bowel habit, and different people find different measures work for them (or don't) and it's necessary to experiment with different things or combinations of things to get the right bowel habit for you. Bowel habit also is very individual with some people's normal bowel habit being to go several times a day whereas others have days where they don't go - the important thing is that whatever people's bowel habit, they don't feel blocked and of course, the stools are of good quality.
So it seems that the problems I had with fissures in the first place are largely due to my individual anatomy (the 2 cm long internal sphincter and high muscle tone) - and there was I thinking it was all due to stress/lifestyle/diet, etc. - although those things may well have contributed, who knows. However he said on the good side, I'll never develop incontinence in old age, as frequently happens to elderly women!
If you're still developing fissures, I'd ask the CRS why that is. I wanted to know why I was still developing fissures and what the prognosis was for my life span. I see you've got an appointment with a second CRS coming up - or you could ask the first one for an explanation.
All the best, and let us know what the CRS says!
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Re: Re-tear 4 months after LIS - want to cry!

Postby becsbum » 10 May 2013, 15:31

Lauren - thank you so much for sharing your experience! Interesting, I remember after surgery my CRS saying I had a longer than average muscle as well. I do know when she examined me (after the first re-tear was already healing, according to her) she said the muscle was not in spasm and was still nice and loose compared to before. Before she had said it was extremely tight.
My fissure pain/discomfort is not the sharp knives when I have a BM - more a general discomfort/itching/irritation throughout the day when sitting or sometimes walking. This has now been going on for a few weeks. Re-tear #1, then re-tear #2 a week later, and now we are nearly 2 weeks after that.
I am working on the bowel habits thing. I am finding it hard to figure out how much mirilax (I think this is the same as movicol?), metamucil, and fruits/veg to eat to keep things soft but not end up going too many times in a day. Yesterday I went 3 times and that definitely aggravated things.
Yes I am planning to talk to the new CRS about all this. I actually do have an appointment with my first CRS lined up in June, so I'll decide after the second opinion whether to keep that one as well. My original CRS is ridiculously hard to get in to see (6 weeks) whereas the new one is much easier - but an hour and a half away! So both are tricky. Anyway what matters now is who can help, and I felt like the original one kind of dismissed me last time I saw her.
Anyway, I'm glad to hear your re-tears are healing so well. I still am hoping I can get this one to go away, and then get the diet thing straightened out so it doesn't happen again for a loooooong time!
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Re: Re-tear 4 months after LIS - want to cry!

Postby becsbum » 21 May 2013, 17:10

Just wanted to post an update after my appointment with the new crs yesterday. She examined me and said the retear had healed (yeah!) and that the discomfort I was having now sounded like it was muscle related. She agreed with doc #1 that it is not uncommon to retear, but the key is to heal after. Which, technically, I did. She said the sphincter muscle feels good and that physical therapy could really help with the lingering problems. This is all the same thing crs #1 said, actually. She also recommended magnesium. She would rather I use magnesium than mirilax (but I am scared to stop the mirilax!). I'm glad this didn't turn chronic! Now I will continue the diet and attack the discomfort from a physical therapy perspective.
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Re: Re-tear 4 months after LIS - want to cry!

Postby marg6043 » 22 May 2013, 18:30

becsbum, sorry to hear about your ups and downs after surgery, but remember for some it can take up to a year for a full recovery and life back to normal again.
So hang in there and keep a routine that will be easy for you and for your delicate areas.
I been dealing with my fissure for 11 months now and while is under control and I life a normal life with minimum discomfort I know that the fissure is still there.
I hope the best.
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Re: Re-tear 4 months after LIS - want to cry!

Postby becsbum » 25 May 2013, 21:07

Thanks marg! You're right - and I think this last dr visit has reassured me that I need to be patient and that I can and will heal!
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Re: Re-tear 4 months after LIS - want to cry!

Postby ravians » 25 May 2013, 23:32

gud news that ur fissure is healing but take very gud care of it even after it has healed completely. can u please tell me what physical therapy ur Dr recommended.
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