Seven Months Post-LIS. Honeymoon over???

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Seven Months Post-LIS. Honeymoon over???

Postby Jojo1 » 20 Jun 2012, 07:52

Let me begin by saying that I refuse to re-tear . . . I just refuse to. I had my LIS on November 15th and had absolutely no bleeding and nothing more than a little tenderness immediately post-op for a couple of weeks. I continued the strict regimen of water, fiber, soft diet, three daily soaks and miralax morning and evening until about April - I wanted to give myself every opportunity to heal this sucker (though I do know complete healing takes a year or two).
I've been doing very well. I will say it was almost May before I began to stop being apprehensive when I had to have a bowel movement and I wondered if I would ever be nonchalant about it as a normal bodily function ever again. I still do a good long soak each morning following my main bowel movement, which insists on taking place between 4-4:30am and I reduced my miralax to a full dose nightly at bedtime. I will never be able to stop taking the miralax because I must take 2,000 mg of calcium daily, which WILL constipate you, and I have to do this for life.
Was terrified to start back with the calcium because it definitely caused my fissure, but I had no choice and through trial and error learned that one full dose of miralax nightly keeps me straight . . . or, it had been . . .
Don't know what happened last week, but on last Wednesday my stool was formed, a little more dense, not hard, but very sluggish. I wasn't concerned about it being formed as I know the muscle must get used to the stretching again. There wasn't any pain, but an uncomfortable stretching. However, by Thursday, it was VERY sensitive and would burn immediately after elimination and last for 3-4 hours at the peak which was this weekend. I became concerned that I had re-torn the fissure because when I read back over my diary immediately prior to the first fissure, I experienced similar feelings for a couple of weeks prior to the fissure actually happening. Had no bleeding whatsoever, but then, I didn't have bleeding with the fissure . . . just blinding, mind-numbing pain and spasms and . . . oh, the HORROR!!!!!
Oh, dear God NOO . . . Image . . . this CANNOT happen again and I've been so careful. I will not survive it (a bit over-dramatic I know, but I was in the moment). The only thing I did was indulge in some cashews - making sure to chew thoroughly and last week, I made a batch of salmon salad (made the same as tuna, but with canned salmon) and I was meticulous in cleaning the salmon of anything remotely resembling a bone.
I tried to take comfort from the many people on this board who have said re-tears can be common during the first months post-LIS, but they also heal very quickly, so . . .Starting on Friday, I cut out the cashews added 1/2 dose of miralax back in the morning and returned to my three daily soaks. WAs still very sensitive during the weekend, but never got to the point of real pain, if I had to give it a number, I'd say 1.5. What mde it so bad was the fear of what it meant.
Had my regular PT/INR check Monday morning one floor down from my CRS, so I stopped in his office to let them know my status, what I was doing and if there was anything else they'd recommend. He said he wanted to see me so I was back in there the afternoon, he checked and said he saw no evidence of a re-tear, but it does sound like something majorly irritated the area. Continue what I'm doing and come back to him if needed.
The last few days brought back horrible memories of my fissure-days, but with each day, I've noticed a definite improvement in how strong the burn is afterward and how long it lasts, etc. Yesterday, things were still sluggish which I couldn't understand with the extra miralax and I really wanted to get that sludge out, so I did a dose of MOM around 6pm and my regular full dose of miralax at bedtime. Not sluggish this morning, but more formed that I would have expected with MOM and miralax in me.
So, this morning, I did a full miralax dose and will try to get it back to very soft stage for the next few weeks, then slowly, carefully balance back out - learning from this little episode I hope. One thing that I did wonder, I usually have large, golden delicious apple for a snack around 10am each day and 2-3 days last week, I neglected to eat my apple. I wonder if that could make a difference - there's some to that "apple a day" saying.
So, while I'm not convinced I didn't re-tear, I'm claiming that I didn't, it's just major irritation and I'm on the upswing now. I did finally experience the "zingers" I heard someone refer to on this board - or, at least, what I think they are. I'm hoping that means there's some healing taking place in those nerve endings.
That's where I am, for the benefit of anyone who may experience a hitch months after LIS. I thought I was home-free at almost 8 months, but there you go. I don't think I was careless, but perhaps not as careful as I still needed to be. Not making that mistake again. I would appreciate any input from others who have had hitches months after LIS. Thanks.
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Re: Seven Months Post-LIS. Honeymoon over???

Postby 44alegna44 » 20 Jun 2012, 18:35

Hi Jojo,
Just wanted to say that I'm glad you're feeling improvement :D ...and sorry that you had a little scare Image there. I guess when these things happen, we have to consider them a reminder to "stay on our game"...they do say a good year for full healing, so keeping up with the dietary life-style changes is something we need to do our best to commit to. It's not always easy, and we may "get away with a few cheats now and again", but overall I guess staying conscious of "what goes in must come out" is our safest bet. Image
Wishing you smooth sailing going forward Image .
Angel Image
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Re: Seven Months Post-LIS. Honeymoon over???

Postby Jojo1 » 21 Jun 2012, 07:52

Thanks. I'm more than a little frustrated this morning, though. I was sure with the full dose yesterday morning and last night, that this morning would be soft - possibly too soft.
Lo and behold, I could tell it was going to be a doozy. Not quite hard as what tore me in the first place, but definitely quite "firm" and sluggish and I did have to do some pushing to get the first 1/2 of what ended up being quite a bit (sorry if TMI) of elimination. I was literally crying beforehand on the throne because I could tell it was going to be bad and I didn't know why. I cleaned myself, got up and did some walking and put tea in the "wave" to heat hoping something would help. I cried and I prayed and went back. There was no help for it, so I did push moderately, but consistently until I got to the soft part. But I had gotten to softness yesterday morning too, so I don't understand how this happened. I wondered if I didn't have enough water or what.
I'm at a loss, with the exception of my eating last week, I haven't really deviated much from my fissure friendly diet and I didn't think a cashews and salmon salad was that bad, but apparently so. What I can't figure out is, that was last week - it's been a weeks of straight and narrow since then, I should not have had this scare this morning - and now, I'm at a loss because so far, the things I know to do aren't working.
The one bright side is that even after all that, there was only a little burning for a few minutes afterward and a little sensitivity for about 1/2 hour after my soak. Other than that I feel normal . . . my fear is, though, that if I can't get this straightened out, I'm gonna really mess myself up, big-time. Also, even though I eliminated quite a bit in that session, my insides feel like there's more, but it hasn't moved down . . . which is another fear. It's my understanding that once stool gets to the lowest area of the colon, things like miralax can't get to it and even if it was nice and soft when it moved down, the longer it's there, the harder, drier and more dense it will become.
Today, I started with a full dose of miralax and may take another at lunch, I'm pushing fluids and walking as much as possible. My goal is "stew" and then I'll carefully balance things back. I just wish I knew why this was happening. If I don't figure that out, how can I keep it from happening again?
Still frightened a bit, but trying to be productive and not overwhelmed.
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Re: Seven Months Post-LIS. Honeymoon over???

Postby Jojo1 » 21 Jun 2012, 08:52

Figured I'd pop in and give an update . . . not that you're all waiting with baited breath for a play-by-play of my drama. At any rate, had another bathroom session about 15 minutes ago after my 2nd 32oz cup of water and a short walk to help things move - and currently on my third 32oz cup of water.
I'm thankful for the elimination because I knew this morning there was more and I DID NOT want it just sitting in there getting dry all day. Burning a little bit more, but still mild. That's typical as it's usually more sensitive when/if I have more than one solid elimination in a day. Wish I could take a soak now, but after work will have to suffice. Right now, I think I'm out of fear mode and cautiously watching/waiting. We'll see how the next few hours/days go.
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Re: Seven Months Post-LIS. Honeymoon over???

Postby 44alegna44 » 21 Jun 2012, 20:03

Jojo,
Could your period be an issue here? I guess you'd know, but just throwin it out there anyway. Pms and the week of my period would always mess with my normal bm routine.
Also, have you tried prune juice? Maybe try half a glass before bedtime...if this issue arises again...it might offer you some relief from straining.
Hope everything gets back on track.
Angel Image
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Re: Seven Months Post-LIS. Honeymoon over???

Postby rubius » 22 Jun 2012, 01:13

i guess things do happen.
i had my LIS pretty recently 16 may precisely.
after reading ur cautious daily routine ... id say iv been if not careless.... liberal. just manage 2 soaks a day but yes have kept my diet adequate to keep the stool soft.
iv even skipped the softener in the last week afew times.
things were okay till today morning..... when i had like u said it wasnt hard but not so soft BM .
ihave v mild pain.... just an inkling which we have learnt to percieve after all this time.and there is some leftovers after cleaning the area. that is after i v cleaned up..if i press with a tissue over the anal opening there is sum(2-3mm) of fecal debris.
so i am living in the worst fear so far of a retear.
can anyone tell me whats the problem now? plz dont say its a re tear.... :(
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Re: Seven Months Post-LIS. Honeymoon over???

Postby Jojo1 » 22 Jun 2012, 06:41

Thanks, Angel. My period is due to start, in fact it should have started yesterday or today. And it does mess with my normal routine, but mainly it makes things more soft and really changes the odor.
I seem to be getting things back to normal, but I'm still taking it slow and cautiously. This morning was good in that it went from medium soft to very soft, so I'm glad to know that I've at least gotten through the sludge. Did my full dose of miralax this morning and pushing fluids again.
I did use prune juice occasionally, but stopped because I was advised to stay away from prunes and prune juice since I am on coumadin. One thing I did do yesterday was pick up a small package of Raisinettes and snacked on them through the day. They used to be a sweet snack I only indulged in occasionally because they had a tendency to run right through me, so I thought they'd help under the circumstances. Feels kind of wicked to have a reason to indulge in them.
Rubius;
Not sure what to tell you, only your CRS can really confirm for sure. It is possible you have a re-tear, but being so soon out, if you do, get back on track and it'll recover pretty quickly. Your muscle is still pretty loose and will be for quite a while. Whether it's a full re-tear or not, you know you need to step up the treatment . . . water, fiber, stool softening, soaks and ointment if you have it. I didn't use my nitro stuff, just Boudreaux's butt paste which is a diaper rash cream for babies. I didn't think I had re-tear yet, but the stage was set. I depending on the water, fiber, diet, stool softeners and soaks to ensure that it didn't progress to an actual re-tear and the ointment to relieve the burning after elimination. You kind of have to use your judgement sometimes.
I would advise that you stick to your pre-op, fissure friendly routine and diet for at least 6 months and even then don't stray far from it for the next 6 months. It's my understanding that the initial healing takes place in about 4-6 weeks, but it takes a year or more for truly complete healing - which makes sense when you think of all that area has been through . . . the initial tear, constant spasms, trauma and contamination of the torn area with each subsequent bowel movement . . . then there's the ointments, etc. that we use. That's a lot to recover from even after the initial tear has healed. I'm going for complete healing and as you can see, even being relatively careful, things can happen.
I honestly don't think I could survive a repeat of what I went through for months prior to my LIS. Don't be in a hurry to get back to normal. Good luck.
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Re: Seven Months Post-LIS. Honeymoon over???

Postby Baba » 23 Jun 2012, 22:21

Jojo1, when I think the stool is going to be hard and cause problems I use the small water enema, wait about 20 min and things are softened up to pass easily.
I know what you mean about the calcium - I don't know your medical reason for having to take so much but I have osteoporosis and am supposed to take lot of calcium also. The calcium's what caused a lot of my misery in the past.
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Re: Seven Months Post-LIS. Honeymoon over???

Postby wecc » 02 Jul 2012, 05:41

I did not go the LIS route, rather I had a SAD. Been 7 months and no problems at all. One thing I would suggest that has really helped me is Magnesium pills
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