Should I push for LIS? Please help!

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Should I push for LIS? Please help!

Postby draze1458 » 26 Nov 2017, 10:43

Hi all,

I had my second round of botox twelve days ago. My fissure symptoms had been getting a *bit* better after the botox - the spasms were were much less intense- although there was still pain for 3-4 hours after a BM, and uncomfortable to sit down.

Today, my morning BM was not too painful but afterwards I had very strong burning pain, which has left me bed-ridden all day.

It is all so frustrating.

I drink loads of water (always have done).

I eat lots of fibre. My typical diet is - branflakes for breakfast, an apple/blueberries, beans on toast for lunch, vegetable soup with pitta bread for dinner.

No problem with constipation. I am regular and my stools are soft. I have half a sachet of Movicol and a tablespoon of olive oil just in case.

GTN cream. (I got contact dermatitis with Diltizaem).

Sitz baths at least twice a day.

I've had the fissure for 7 weeks now and have only been able to work about 50% of what I need to, which is not at all sustainable. I have a very stressful City career which involves a lot of sitting down and travel.

I am also expecting my first child in a few months - I cannot only be somewhat "normal" from 5pm.....

I've been suffering on and off from fissures/general discomfort when using the toilet for the past 2.5-3 years. Otherwise fit and health 35 yr old male.

The NHS has been good but quite slow. I have seen two private CRS surgeons - the first was very unsympathetic. He did the first botox injection and afterwards told me "I'm sorry you can't work, but what do you want me do about it?". He didn't appreciate the amount of pain I was in. The second thought I had a yeast infection as the skin was very sore down there (which proved to be wrong, due to the aforementioned dermatitis from the Diltizeam cream).

Should I go to a third surgeon and push for LIS?

Overall I am getting very depressed and frustrated about this.

Thanks
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Re: Should I push for LIS? Please help!

Postby Finally81 » 26 Nov 2017, 11:00

Yes. I am 8 days post op. 32/m - 2 kids. Yes, you need to push for it. If you are missing work and are dealing with that much pain. You have to find a doctor that has a better solution. I dealt with it for 9 years. I am kicking at myself now for not getting it done sooner. At day 8 I am 80% better. I had Lis and 2 fissures removed.

Find a good CRS that has done multiple LIS’s (and she/he is confident in their ability) with success.

The awkwardness from post surgery only lasted about 3-4 days.

Let me know if you have any questions!

All the best!
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Re: Should I push for LIS? Please help!

Postby getmylifeback » 26 Nov 2017, 12:43

Hella Draze,

Absolutely you should get it. I am 9 days post OP and it was one of the best decisions in my life, I wish i did it way sooner instead of suffering on and off for 8 years. I know how it feels to do everything you possibly can to only re-tear, its frustrating and depressing, and I know how crippling this condition is to every aspect of life to the point that I consider this condition a legit handicap.
The procedure was A LOT easier than i expected, and post op pain is actually LESS than fissure pain. Just like what Finally said above, there is an awkwardness feeling for a few days, but feeling more and more normal now after 9 days. I too also feel about 80% by now, and am set to get back to work tomorrow.
Not only will LIS help with the physical pain, but it will ease your mental strain greatly. If you have any questions, let me know ill be glad to answer.
You are not alone, there are plenty of people like you, but take the steps necessary to get your quality of life back. Do your research and find a good CRS, the surgery will be a breeze!
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Re: Should I push for LIS? Please help!

Postby Mypoorbutt » 26 Nov 2017, 14:47

Hi,
Yes go for LIS but you may have to wait until the Botox has worn off a bit as most surgeons here in the UK won’t do LIS while the Botox is in system.
I agree find a great CRS there are lots all over the UK and look online at their reviews. I paid private for my consult but then went on his nhs waiting list as he was so very busy that his private list was longer than his nhs.
Most people are back to pre fissure condition within a month or so and are pain free within the first few weeks after LIS.
You have no underlying issues or even constipation so not sure why you weren’t offered LIS as a first option as a private patient
Also have you tried gabapentin as a painkiller while you wait for LIS, I had tried everything before and nothing came close to touching the spasms but gabapentin worked really well and as it’s not an opioid it doesn’t constipate or make you drowsy
Good luck
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Re: Should I push for LIS? Please help!

Postby draze1458 » 27 Nov 2017, 03:27

Thanks all for your replies, that is very helpful. It is hard to know what to do when different doctors tell you different things, and sometimes you feel as if they don’t appreciate how bad the symptoms can be.

Has anyone else experienced a very short term (=a few days) relief from spasms following Botox only for them to come back? My doctor says she has never heard of that before and the injection should always relieve the pain for a few months at least.
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Re: Should I push for LIS? Please help!

Postby patience_and_healing » 29 Nov 2017, 14:18

Botox may not work the same for everyone, unfortunately. According to my doctor, it affects only voluntary muscle fibers, not involuntary ones, which is what the internal sphincter is made up of.
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Re: Should I push for LIS? Please help!

Postby Mypoorbutt » 29 Nov 2017, 15:49

My Botox seemed to work well the first couple of days then wore off and kicked in properly about week 3 building to max pain reduction at 6/8 weeks and that lasted for about another 8/12 weeks
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