I still have pain passing a bm as expected but ill suffer it because at least i know progress is being made...she kinda rushed me out of the room!!!! lol i dont know what hypertonic means....no one has ever told me its tight but that kinda runs in my family.....i dont think shes ever made anyone incontinent and she told me men have less chance to be incontinent.....but do you think its worth my while going for botox? or should i just go straight for LIS? i duno if i can wait for botox to work i just had to leave my job because of the pain sitting!!!!

If it's intolerable then I'd say go for LIS. It has much higher success rates than Botox and I would have gone for it myself if the fissure had completely ruined my life.
If the pain is still tolerable though then I would at least give Botox a try. Sure it's not nearly as effective as LIS but the tradeoff is it's also far less invasive. You can have Botox and still get LIS later if it doesn't work. Once you get LIS then the muscle is altered and you can't decide to reverse it. Botox didn't heal my fissure but it provided at least temporary relief. Getting the injection wasn't the most pleasant thing I've ever done but the pain wasn't that bad -- if you've had a fissure for a while, it's going to be a walk in the park by comparison. The whole thing is over within a few minutes and the actual shot is just a few seconds, once on each side. You'll be a bit sore for a while but I think most of us are unfortunately used to that by now :)
Any procedure has risks and side effects, so no matter what you do, it's not going to be risk-free or a guaranteed cure. But it sounds to me like you're apprehensive about jumping straight to LIS, and you don't sound like you're suffering quite as badly as when you first joined the board, so if I were you I wouldn't discount giving Botox a go despite the lower success rates. Look at it this way, when you first joined this board, your doctors didn't even give you the option of either Botox or LIS, and now you have both. So either way you go is an improvement

"Hypertonic" - meant "too tight" , with above normal pressure. It is very important to know that since if your sphincter is not in spasm and you have normal pressure inside than Botox or LIS will make no difference theoretically :roll:
Is your doctor well trained to administer Botox ??? If she misses that internal sphincter than you will have no effect . Ask her for how long is she doing that and what was her success rate with Botox !!! Never let anybody "rush you out" !!!!!!! It is very important for you to be assertive, proactive and very well informed when you deal with doctors or you will have many questions unanswered and than hard time making a right decision : ((.
Remember also that visual observation of a fissure really does not mean a lot !!! It can close on the surface or be hidden and actually still be there in it's full glory .
The only objective measure of your healing is level of the pain and discomfort you have :( .
I was told that my fissure was completely healed and I still had some pain. I went to another CRS and he told me that it still could be there but hidden in the folds inside and he was right !!!! He did a colonoscopy and made a photo of my fissure !!!!!!! So - it was there even though nobody could see it at that point !!!!!!
You have to make that decision for yourself unfortunately- only you know when enough is really enough :( .
And regarding "altering the sphincter forever" - my sphincter completely regenerated after first LIS ! CRS could not even feel a scar tissue - NOTHING !!!! So he used special scalpel for my second LIS that is not just cutting the tissue but "braking strands" so that they can not connect together again!!!! I know that I am exception - just trying to say that if done with great care the "alternation" is really minimal.
Also - if sphincter is too tight than it NEEDS to be altered to become "normal". So LIS is not changing a sphincter for the worse - it is putting it into the spectrum of "normal" sphincters.

hey guys i'm scheduled for LIS on 2nd march really nervous now =/ really hope it helps...and to top it off i think i have a urinary tract infection.....great lol god really does hate me!!!!

Fantastic post Fissy :) Interesting news that I will ask the CRS about. Think my sphincter has also completely regenerated after LIS. You cannot see that I have had LIS either. There is no scar tissure in my anus after it.
Good luck with LIS kyriakos. It will be a life saver for you :)

Fissulyna wrote:"Hypertonic" - meant "too tight" , with above normal pressure. It is very important to know that since if your sphincter is not in spasm and you have normal pressure inside than Botox or LIS will make no difference theoretically :roll:
Is your doctor well trained to administer Botox ??? If she misses that internal sphincter than you will have no effect . Ask her for how long is she doing that and what was her success rate with Botox !!! Never let anybody "rush you out" !!!!!!! It is very important for you to be assertive, proactive and very well informed when you deal with doctors or you will have many questions unanswered and than hard time making a right decision : ((.
Remember also that visual observation of a fissure really does not mean a lot !!! It can close on the surface or be hidden and actually still be there in it's full glory .
The only objective measure of your healing is level of the pain and discomfort you have :( .
I was told that my fissure was completely healed and I still had some pain. I went to another CRS and he told me that it still could be there but hidden in the folds inside and he was right !!!! He did a colonoscopy and made a photo of my fissure !!!!!!! So - it was there even though nobody could see it at that point !!!!!!
You have to make that decision for yourself unfortunately- only you know when enough is really enough :( .
And regarding "altering the sphincter forever" - my sphincter completely regenerated after first LIS ! CRS could not even feel a scar tissue - NOTHING !!!! So he used special scalpel for my second LIS that is not just cutting the tissue but "braking strands" so that they can not connect together again!!!! I know that I am exception - just trying to say that if done with great care the "alternation" is really minimal.
Also - if sphincter is too tight than it NEEDS to be altered to become "normal". So LIS is not changing a sphincter for the worse - it is putting it into the spectrum of "normal" sphincters.

[i][u]
my inept doctor (kaiser, go figure) doesn't seem capable of understanding this. Ever since my AF healed, I've told her that my sphincter is permanently tight, and i have to keep taking miralax or else i just cant pass bm's through it. She just doesn't understand that fact. She wont do botox or LIS, instead she wants to do the crohn's disease cononoscopy :/

Best of luck to you Kyriakos. Here's hoping that you finally get some relief!

thanx guys! nebelwerfer u really need to find a good surgeon....it took me time to find one who understood me (she had a fissure which healed through surgery herself) they're worth looking for...
and guys how long is the recovery time from LIS or botox? i've had a trip booked for the 11th and i'm having the top on the 2nd lol is that too soon?

Hello kyriakos,
I had my LIS on February 5th. The day after surgery I was amazed at the lack of pain. I still had discomfort from the stitches but that is to be expected. Two days after surgery I had my first bm and it did not hurt. Ten days after surgery I was snowmobiling and skiing! Just remember not to try to pick up heavy objects (learned from experience ) . I am staying on the Miralax (Movicol).
Good luck on the 5th!

thanx for all your support guys, it's been a long mess but tommorow is the big day and ive never been so nervous.....lol